As a trauma therapist, I’m often asked this question. PTSD doesn’t always show up the way people expect. Here are some of the most common signs:

• Intrusive memories — Flashbacks, nightmares, or unwanted thoughts about something traumatic from your past.

• Emotional disconnection — Feeling numb, spaced out, or like you’re not fully in your body.

• Strong reactions to small triggers — Feeling anxious, irritable, jumpy, or constantly “on edge.”

• Avoidance — Staying away from people, places, or emotions that remind you of what happened.

• People-pleasing — Putting others’ needs ahead of your own to feel safe or avoid conflict.

• Procrastination — Struggling to start tasks or follow through, especially when overwhelmed.

• Body and sleep changes — Trouble sleeping, fatigue, or feeling stuck in fight, flight, freeze, fawn, or shut-down mode.

As a trauma therapist, I’ve worked with many patients who developed eating disorders in the aftermath of childhood trauma. I want to share some of what I’ve learned about how trauma, dissociation, and disordered eating often intertwine.

When children can’t physically escape trauma, behaviors like purging, bingeing, or restricting may offer a way to disconnect from overwhelming and painful emotions. Food is often the first “substance” available to soothe distress—long before drugs or alcohol enter the picture. Research also shows that dissociation predicts overeating and can intensify binge episodes.

We don’t talk enough about the sexual abuse of boys and men. According to a 2025 article, an estimated 6.2%–18.8% of boys and at least 3.8% of men report experiencing sexual trauma in adulthood. But the real numbers are likely much higher—because many men never tell.

Let’s talk about dissociation and trauma. First, dissociation is normal and all people have varying degrees of it from daydreaming in class, getting absorbed in a book or binge watching a show to Dissociative Identity Disorder (DID) where there are periods of amnesia where you lose track of time like finding yourself in a place you don’t remember getting to or wearing clothes you don’t remember putting on.

Many of the people who are calling me for the first time have been in talk therapy for many years, but their PTSD symptoms continue to get worse – hypervigilance, avoidance, lack of safety in the body, difficulties regulating emotions especially when triggered, and being triggered into fight, flight, freeze, fawn, and shut down.

The root of some people’s adult problems may lie in something they have forgotten in childhood. Our brain spares us what we can’t handle knowing. I have noticed that memory is about attachment.