You're not broken—your mind is trying to make sense of what happened, and CPT can help you process it differently
Maybe you tell yourself it was your fault. That you should have done something different. That you can't trust anyone anymore. That the world is completely dangerous. That you're damaged beyond repair. These thoughts feel absolutely true—they're not just ideas, they're beliefs that have become part of how you see yourself, others, and the world.
Since the trauma, you might be replaying it constantly, unable to move forward because you're stuck trying to understand why it happened or what you could have done differently. Or perhaps you avoid thinking about it entirely, but the beliefs that formed during and after the trauma still control your life—keeping you isolated, hypervigilant, unable to trust, or convinced you're fundamentally changed in terrible ways.
You've survived something devastating, but you're still living as if the danger is present. Your mind is stuck in patterns of thinking that made sense immediately after trauma but now keep you trapped in suffering. You don't have to stay stuck. Cognitive Processing Therapy can help you process what happened and challenge the beliefs that maintain your PTSD.
Cognitive Processing Therapy for PTSD in Washington state
Are you carrying guilt or shame for something that wasn’t your fault?
Do you blame yourself for what happened?
You might carry intense guilt about the trauma. Thoughts loop endlessly: "I should have fought back." "I shouldn't have been there." "If only I had done something different, it wouldn't have happened." "It's my fault for not seeing it coming." These thoughts feel true, and you've replayed the trauma countless times, analyzing every decision you made, every moment where you think you could have changed the outcome.
Self-blame serves a psychological purpose—if it was your fault, that means you had control, which feels safer than accepting that terrible things can happen randomly. If you could have prevented it, that means you can prevent future harm by being more vigilant, more careful, more perfect. But this belief traps you in shame, self-criticism, and an impossible standard where you blame yourself for not having information or abilities you didn't have in that moment.
You might also feel guilt about how you responded during the trauma. Maybe you froze instead of fighting. Maybe your body responded in ways that feel like betrayal. Maybe you survived when others didn't. These normal trauma responses have become evidence in your mind that you're weak, bad, or complicit. The shame is crushing, and you can't forgive yourself for being human in an impossible situation.
The self-blame extends beyond the trauma itself. You might blame yourself for still struggling, for not being "over it," for how the trauma has affected your life and relationships. You judge yourself harshly for having PTSD symptoms, as if you should be able to control your nervous system's response to overwhelming threat. This additional layer of self-criticism maintains your suffering and prevents healing.
Has trauma shattered your sense of safety and trust?
Since the trauma, nowhere feels safe. You're hypervigilant constantly—scanning for threats, unable to relax, always expecting danger. You avoid places that remind you of what happened, but the fear has generalized. Crowded places feel dangerous. Being alone feels dangerous. Trusting anyone feels impossible because someone hurt you, betrayed you, or failed to protect you.
You might have concluded that the world is completely dangerous, that bad things always happen, or that you can never let your guard down. These beliefs feel like they're protecting you, but they're stealing your life. You can't be present with people you love because you're watching for threats. You can't sleep because your nervous system won't believe it's safe to rest. You've organized your entire life around avoiding danger that might not even exist.
Trust has been destroyed—not just trust in the person who hurt you, but trust in your own judgment, in other people's intentions, in the basic safety of existence. You might isolate yourself because people feel unpredictable and dangerous. Or you might cling desperately to certain people, terrified of abandonment, unable to trust they'll stay but unable to function without them.
You know intellectually that not everyone is dangerous, that not every situation will end in trauma, but your nervous system and your beliefs tell you otherwise. The trauma has become proof that terrible things happen, that you can't trust your judgment, and that safety is an illusion. These beliefs keep you trapped in a state of perpetual threat, unable to move forward because the fear feels like wisdom.
Do you feel permanently damaged or changed by what happened?
You might believe that the trauma has fundamentally altered who you are—that you're broken, damaged, or ruined. You look at yourself before the trauma and can't imagine getting back to that person. The trauma feels like a line dividing your life into "before" and "after," and the "after" version feels irreparably changed in terrible ways.
You might feel worthless, unlovable, or tainted. If the trauma involved violation, abuse, or assault, you might feel dirty or contaminated in ways that can't be washed away. You believe others can see the damage, that you're marked by what happened, that you're less than you were before. These beliefs create profound shame and hopelessness about the possibility of healing or having a normal life.
You might believe you don't deserve good things, happiness, or recovery because of what happened or what you did during the trauma. The trauma has become your identity—you're defined by it, and you can't imagine who you'd be without it.
These beliefs about being permanently damaged maintain depression, isolation, and hopelessness. They prevent you from engaging in activities that could challenge the belief, from building relationships that could show you you're still worthy of love, or from pursuing goals that could demonstrate you're more than what happened to you. You're stuck believing the trauma's impact is permanent and total, when neither is true.
We understand that trauma creates beliefs that feel absolutely true but actually keep you trapped in suffering. At our clinic, we specialize in Cognitive Processing Therapy (CPT), an evidence-based treatment specifically designed to help you process traumatic experiences and challenge the stuck points that maintain PTSD. CPT can help you see your trauma, yourself, and your future more accurately, reducing PTSD symptoms and allowing you to move forward with your life.
How Cognitive Processing Therapy helps you process trauma
CPT is based on the understanding that PTSD persists not just because of the traumatic event itself, but because of the beliefs—the "stuck points"—that developed from the trauma. These stuck points conflict with your pre-trauma beliefs or prevent you from processing what happened, keeping you stuck in fear, shame, guilt, or hopelessness. CPT helps you identify these stuck points and evaluate whether they're accurate, allowing you to process the trauma and develop more balanced, helpful beliefs.
When you're ready to get started, CPT is a structured treatment typically delivered over 12 sessions. You'll learn about PTSD and how stuck points maintain it, write about your trauma to organize the memory and identify stuck points, and systematically challenge beliefs about yourself, others, and the world that keep you trapped. This isn't just talking about trauma—it's actively processing and changing how you think about what happened.
How Cognitive Processing Therapy works
We begin by teaching you about PTSD and identifying your stuck points. In the first sessions, you'll learn why traumatic events cause PTSD, how avoidance maintains symptoms, and how stuck points—beliefs that developed from trauma—keep you from processing what happened. You'll identify your specific stuck points by writing an impact statement describing how the trauma has affected your beliefs about yourself, others, and the world in five key areas: safety, trust, power/control, esteem, and intimacy. Common stuck points include "It was my fault," "I should have done something different," "I can't trust anyone," "The world is completely dangerous," or "I'm permanently damaged." Identifying these beliefs is the first step toward changing them.
Next, you'll write a detailed account of your traumatic experience. This is often the component people fear most, but it's crucial for processing. You'll write about what happened in detail—what you saw, heard, smelled, felt physically and emotionally, and what the experience meant to you. You'll read this account aloud to your therapist and to yourself at home. This serves several purposes: it helps you organize a memory that might be fragmented, allows you to process the full experience rather than avoiding it, helps you identify stuck points embedded in your trauma narrative, and gradually reduces the emotional intensity of the memory. Over time, the trauma becomes something that happened to you in the past rather than something that feels like it's still happening.
We teach you to challenge stuck points using Socratic questioning and worksheets. CPT uses structured worksheets to help you examine your stuck points critically. You'll ask questions like: What's the evidence for and against this belief? Am I confusing thoughts with facts? Am I using extreme words like "always," "never," or "completely"? What would I tell a friend who had this thought? Am I blaming myself for things outside my control? Through this process, you learn to distinguish between thoughts and facts, recognize cognitive distortions that maintain stuck points, and develop more balanced, accurate beliefs. For example, "It was completely my fault" might become "I made the best decisions I could with the information I had in that moment, and the person who hurt me is responsible for their actions."
We systematically address stuck points in five trauma-related themes. CPT focuses on how trauma affects beliefs about safety (Do I feel safe? Is the world dangerous?), trust (Can I trust others? Can I trust my own judgment?), power and control (Do I have control over my life? Could I have prevented the trauma?), esteem (Am I worthless? Am I damaged? Do I deserve good things?), and intimacy (Can I be close to others? Am I lovable?). We dedicate specific sessions to each theme, helping you identify stuck points in that area and develop more balanced beliefs. This systematic approach ensures we address all the ways trauma has impacted your worldview and sense of self.
We help you consolidate your learning and plan for the future. In later sessions, you'll write a new impact statement reflecting how your beliefs have changed through CPT. You'll compare this to your initial impact statement, which helps you see concretely how far you've come. We'll identify any remaining stuck points to continue working on, discuss strategies for managing PTSD symptoms that might arise in the future, and help you apply the skills you've learned to new situations. The goal is for you to leave CPT with both symptom reduction and skills you can continue using independently to challenge stuck points as they arise.
Frequently Asked Questions
How is CPT different from other trauma therapies like Prolonged Exposure or EMDR?
While all three are effective for PTSD, they use different approaches. Prolonged Exposure (PE) focuses primarily on repeated revisiting of trauma memories to reduce emotional intensity through habituation. EMDR uses bilateral stimulation while processing traumatic memories. CPT emphasizes the cognitive component—identifying and challenging the beliefs that maintain PTSD. In CPT, you do write about your trauma, but the focus is less on emotional processing through repetition and more on understanding how the trauma has impacted your beliefs about safety, trust, control, self-worth, and intimacy, then systematically challenging unhelpful or inaccurate beliefs. Some people prefer CPT's more structured, cognitive approach. We can help you determine which approach best fits your needs.
What if I can't remember parts of my trauma clearly?
This is very common. Traumatic memories are often fragmented, with some parts vivid and other parts missing or unclear. You don't need perfect memory to do CPT effectively. You'll work with what you do remember, and it's completely acceptable to include statements like "I don't remember what happened next" in your written account. CPT can still be highly effective even when your memory has gaps. The focus is on processing what you do remember and addressing the beliefs that developed, not on recovering every detail.
Can I do CPT if I've experienced multiple traumas?
Yes. We typically focus on one trauma at a time, usually starting with whichever traumatic event is causing the most current distress. Many people find that processing one trauma helps with symptoms related to other traumas as well, since the skills you learn (like identifying and challenging stuck points) apply across traumatic experiences. If needed, you can process additional traumas sequentially. For complex or chronic trauma, treatment might be longer than the standard 12 sessions, but CPT can still be very effective.
How long does CPT take and how will I know if it's working?
Standard CPT is 12 sessions, typically meeting weekly. We track your PTSD symptoms throughout treatment using standardized measures, so you'll be able to see objectively whether symptoms are improving. Many people notice changes within the first few weeks—intrusive memories becoming less frequent or intense, reduced avoidance, improvements in mood, or better sleep. By the end of 12 sessions, most people experience significant reduction in PTSD symptoms. Some people benefit from extending treatment beyond 12 sessions, particularly if they have complex trauma or significant co-occurring conditions.