Trauma Therapy in Lisbon
English-speaking trauma therapy for PTSD and complex trauma (C-PTSD) — in person in Lisbon, Avenidas Novas, and online. Emotion-focused, psychodynamic work at a pace your nervous system can tolerate.
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What is trauma therapy?
Trauma therapy is psychotherapy focused on the lasting effects of overwhelming experiences — a single frightening event, or years of neglect, abuse, or emotional deprivation. The problem is rarely the memory itself. It is what your mind and body still do, automatically, to protect you from what that memory carries: the fear, grief, rage, and guilt that were too much to feel at the time.
Those protections made sense once. Years later, they often become the symptoms that bring people to therapy: anxiety that seems to come from nowhere, emotional numbness, relationships that never feel quite safe (see our piece on betrayal trauma or trauma bonding for two specific patterns), a harsh inner critic that never rests. Trauma therapy works to change this — not by forcing you to relive the past, but by gradually restoring your capacity to feel what was once unbearable, in the presence of another person, safely.
How trauma can show up
Many people who seek trauma therapy have never called their experience "trauma." They come because something in daily life stopped working. Common signs include:
PTSD and complex trauma (C-PTSD)
Not all trauma is the same, and the distinction matters for how therapy is planned. The WHO's ICD-11 classification recognises complex PTSD as a separate diagnosis from PTSD.1
Single-incident trauma
Typically follows a distinct, identifiable event — an accident, assault, medical emergency, or loss. Core symptoms are:
- Re-experiencing (flashbacks, intrusive memories)
- Avoidance of reminders
- A persistent sense of current threat
Complex, developmental trauma
Usually arises from prolonged or repeated trauma, often beginning in childhood — abuse, neglect, or chronic emotional invalidation. Alongside PTSD symptoms, it includes:1
- Difficulty regulating emotions
- A deeply negative self-concept, with shame and guilt
- Persistent difficulties in relationships and closeness
Our approach to trauma therapy
International treatment guidelines consistently recommend trauma-focused psychotherapy as the first-line treatment for PTSD.2 Within that broad category, our work is emotion-focused and psychodynamic. Rather than only managing symptoms, we help you identify the defenses that keep painful feelings out of awareness, regulate the anxiety that rises when those feelings approach, and then actually experience and process what has been avoided — in session, with support.
Piotr Szmyt works with ISTDP (Intensive Short-Term Dynamic Psychotherapy), an intensive 90-minute format built precisely around this process. ISTDP has a growing evidence base, including effectiveness research in routine clinical services.4 How the method works — including the Triangle of Conflict it is built on — is explained in detail on our ISTDP page, so we won't repeat it here.
Sylwia Latacz, licensed psychologist in Lisbon, works integratively with trauma, combining a psychodynamic understanding with tools from TFP and CBT, adjusted to what each person can use at a given stage of therapy.
For complex trauma in particular, pacing is not a detail — it is the treatment. Guidelines for C-PTSD recommend a phase-based approach in which safety and emotional capacity are built before traumatic material is processed.3 This is how we structure the work described below.
What to expect
Initial consultation
An extended first session in which we clarify the problem you want help with, look at how it shows up in your current life, and decide together whether and how to work. You are not expected to tell your full story in the first meeting.
Safety and capacity
Before processing anything, we build the foundations: recognising your anxiety and learning to regulate it, noticing your habitual ways of avoiding feelings, and establishing enough trust in the therapeutic relationship for deeper work to be possible.3
Processing
At a pace matched to your capacity, we turn toward what has been avoided — the feelings attached to what happened. This is active, sometimes intense work, and it is always dosed: close enough to be real, never so much that you are simply overwhelmed again.
Integration
As old feelings lose their charge, attention shifts to the present: relationships, self-image, and the life decisions that become possible when energy is no longer spent on keeping the past at bay.
Trauma and life abroad
A large part of our practice is English-speaking internationals living in Portugal, and relocation has a particular relationship with trauma. Moving abroad removes the routines, roles, and relationships that quietly held old wounds in place. Many people are surprised to find that difficulties they thought were long behind them — anxiety, old relational patterns, a dormant sense of not belonging — resurface months after an otherwise successful move.
This is not a setback; it is often the first time those patterns have become visible enough to work with. When relocation strains a relationship rather than an individual, our couples therapy practice may be the better fit — we've also written about online couples therapy for expat and long-distance relationships on the blog.
Questions about trauma therapy
Do I have to retell every detail of what happened?
No. Trauma therapy does not begin with re-telling everything, and detailed narration is never forced. We first build safety and the capacity to regulate anxiety; processing follows at a pace you can tolerate.
What if I don't remember much, or I'm not sure it "counts" as trauma?
That's common, especially with developmental trauma. We work with what is present now — your feelings, anxiety, and patterns in relationships — rather than requiring a complete narrative of the past. Whether an experience "counts" matters far less than whether its effects are limiting your life today.
Do you work with both PTSD and complex trauma?
Yes. We work with single-incident trauma and with complex, developmental trauma (C-PTSD). The structure and pacing of therapy differ between the two, which is why the initial consultation matters.
Is trauma therapy possible online?
Yes. We offer secure online sessions in English — see our online therapy page for how it works. For some clients we combine in-person sessions in Lisbon with online sessions.
Who do you work with?
We work with adults (18+), in English, in person at our Lisbon office in Avenidas Novas (R. Pinheiro Chagas 32, near Saldanha / São Sebastião metro) and online. Session formats and fees are listed on our contact page.
Related reading & tools
References
- Maercker A, et al. Complex post-traumatic stress disorder: a new diagnosis in ICD-11. BJPsych Advances, 2019. World Health Organization, ICD-11 classification of PTSD and complex PTSD.
- International treatment guidelines uniformly recommend trauma-focused psychotherapy as the first-line treatment for PTSD. See e.g. Hoppen TH, et al. Augmentation of trauma-focused psychotherapy for PTSD: systematic review protocol. BMJ Open, 2025.
- International Society for Traumatic Stress Studies (ISTSS) Guidelines Committee. Position paper on complex PTSD: phase-based treatment recommendations. 2019.
- Johansson R, Town JM, Abbass A. Davanloo's Intensive Short-Term Dynamic Psychotherapy in a tertiary psychotherapy service: overall effectiveness. PeerJ, 2014.
Ready to take the first step?
An initial consultation is where we clarify your problem and decide together how to work with it — nothing more is expected of the first meeting.
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