When people think about Post-Traumatic Stress Disorder (PTSD), they often imagine a single, catastrophic event or a moment so overwhelming that it forever changes someone. And while that can certainly be true, PTSD is often more layered, quieter, and cumulative than we tend to acknowledge.

From a trauma-informed perspective, PTSD isn’t best understood as what happened to you, but rather what happened inside you as a result of what happened to you (Maté, 2022). This framing, deeply aligned with the work of Dr. Gabor Maté, shifts the focus away from pathology and toward compassion. Trauma, at its core, is not a disorder, it is an adaptive response to experience that exceeds the nervous system’s capacity to cope at the time. 

PTSD as a Survival Response, Not a Defect

When Dr. Gabor Maté often emphasizes that trauma is less about the external event and more about the internal disconnection that occurs when a person must suppress emotions, needs, or responses in order to survive. (Maté, 2022) In moments of threat, whether acute or chronic, the nervous system prioritizes safety over integration. Fight, flight, freeze, or fawn responses emerge not as choices, but as reflexes.

PTSD develops when these survival responses remain active long after the danger has passed. The body continues to scan for a threat. Memories remain unprocessed. The present moment is repeatedly interrupted by sensations, images, or emotional states that belong in the past.

This is why triggers can feel so confusing and intense. A sound, smell, relational dynamics, or internal sensation can activate the nervous system as if the original trauma is happening again, even when the person knows, cognitively, that they are safe. PTSD lives not just in thoughts, but in the body, memory, and nervous system.

Why Safety and Pacing Matter in Trauma Therapy

Effective trauma therapy does not rush healing or force disclosure. In fact, moving too quickly can reinforce the very sense of overwhelm that created the trauma response in the first place. Trauma-informed therapy prioritizes safety, consent, and choice, allowing the nervous system to gradually learn that it no longer has to stay on high alert.

There are many evidence-based modalities that support this work, including Eye Movement Desensitization and Reprocessing (EMDR), Accelerated Resolution Therapy (ART), Somatic and body-based therapies, Trauma-focused Cognitive Behavioral Therapy (TF-CBT), and parts-based approaches from Internal Family Systems (IFS), Each works differently, and the “best” approach is always the one that aligns with the individual’s needs, readiness, and the nervous system.

One modality that is particularly effective for individuals with complex, cumulative trauma is Narrative Exposure Therapy (NET).

What is Narrative Exposure Therapy (NET) and What to Expect?

Narrative Exposure Therapy (NET) is a trauma-focused treatment with a clear and intentional structure that helps make sense of fragmented memories. Unlike approaches that focus only on isolated events, NET understands trauma as part of a person’s life story and not something separate from who they are. In NET, the goal is to transform the fragmented pieces of painful memory into a coherent narrative that you can own rather than be controlled by (Narrative Exposure Therapy Institute [NET Institute], n.d.).

Early in NET, your therapist will introduce the idea of a lifeline, or a visual, chronological representation of your life from birth to the present. You and your therapist may use imagery, timelines, or symbolic markers (such as “stones” for painful experiences, “flowers” for positive moments, or other personal symbols) to literally map your experiences in a way that feels tangible and grounded (NET Institute, n.d.).

Once the lifeline is laid out, the therapeutic work begins by walking through it together, calmly and collaboratively. You’ll revisit each significant event in sequence, paying attention not only to the memories themselves, but to how your body reacted at the time: the emotions you felt, the sensations in your body, the thoughts you had, and the context surrounding the experience. Your therapist will help keep you anchored in the present moment so your nervous system does not become overwhelmed, reminding you that these are memories you are now safe to revisit.

As you narrate these life events, the fragmented “hot” memories (sensory and emotional pieces of trauma that feel raw and disjointed) are gradually linked with the “cold” contextual elements (time, place, sequence), which helps the memory become organized and meaningful within the larger story of your life (NET Institute, n.d.). Over time, this structured narrative work helps your nervous system recognize that these memories are not current threats and they are part of your past.

One of the distinctive features of NET is that it does not require you to choose only a single event or to engage in prolonged emotional flooding. Instead, it relies on a lifespan approach, meaning the therapy attends to the full arc of your experiences, both the painful and the positive, so that traumatic memories can be integrated within the broader context of your identity and life history.

At the end of therapy, people can receive a written narrative of their life story that they helped construct in session. This document can serve as a powerful tool, not just for internal consolidation and self-understanding, but also as testimony to a life lived fully, with dignity, resilience, and meaning. 

How NET Supports Healing

Through NET, individuals often experience a reduction in intrusive memories, hypervigilance, and emotional reactivity. Just as importantly, they often report a stronger sense of identity and coherence. When trauma no longer dominates the narrative, there is more room for agency, self-compassion, and integration. 

NET aligns closely with Dr. Maté’s emphasis on reconnection to the self, to one’s emotions, and to one’s story. Healing doesn’t come from erasing the past, but from allowing it to be held in a way that no longer overwhelms the present.

Healing is Not Linear and That’s Okay

PTSD healing does not follow a straight line. There are moments of relief and moments of activation, periods of clarity and periods of fatigue. A trauma-informed approach honors this ebb and flow, recognizing that healing happens at the pace the nervous system can tolerate.

If you’re considering trauma therapy, it’s important to know that you don’t have to retell everything all at once. You don’t have to push yourself beyond your limits. And you don’t have to do it alone.

Trauma was something that happened to you. Healing is something you get to participate in with support, choice, and care.

If you’re ready to explore your story in a way that feels contained, respectful, and grounded, Narrative Exposure Therapy may be one path toward helping your nervous system remember that the danger has passed and that safety is now possible.

Maté, G. (2022). The Myth of Normal: Trauma, Illness & Healing in a Toxic Culture. Random House Canada.

Narrative Exposure Therapy (NET) Institute. (n.d.). What is Narrative Exposure Therapy. Retrieved from https://www.net-institute.org/whatisnet