How do you move forward when your past feels like it’s always right there, just behind you, holding you back? For someone with PTSD, it can feel like joy is something from the past, like a memory they can barely reach anymore.

According to the National Mental Health Survey (NMHS) 2015-16, approximately 10.6% of adults in India suffer from mental disorders. There’s also a significant treatment gap in a country with just 0.75 psychiatrists per 100,000 people. (WHO)

For many Indians, it’s not just a matter of not knowing where to turn; it’s also the shame, the lack of awareness, and the stigma that prevents them from speaking up or reaching out for support. The emotional weight of PTSD is a silent struggle that leaves many feeling isolated and stuck, with little access to the support they need to heal. 

We had a conversation with Dr. Seema Girija Lal, the founder of Together We Can and a seasoned mental health consultant with over 20 years of experience in India and the UAE. Dr. Seema specializes in mental health, education, and disability, working to empower individuals, families, and organizations through training, consultancy, and advocacy. A pioneer in inclusive education, she has helped drive policy changes and legal reforms for marginalized communities and neurodiverse individuals.

In this interview, Dr. Seema shares her insights on how trauma survivors can begin to reclaim joy, even after the most harrowing of experiences, and why healing, although challenging, is never out of reach.

Let’s start. How do you typically approach therapy with PTSD survivors in the early stages of treatment?

The early stages of therapy are usually all about meeting survivors where they are and providing them with a safe space where they feel heard and in control of their healing. 

The first session isn’t about rushing into solutions, it’s about understanding what the survivor hopes to achieve from therapy and ensuring our approaches are aligned. Most importantly, I want them to feel they have choices in their healing journey.

I use a framework called NAVIGATES, which combines structure with flexibility, allowing survivors to feel empowered in their recovery:

• Narrate: A space to share and vent without judgment.
• Acknowledge: Naming and understanding emotions.
• Validate: Unpacking thinking patterns and emotional responses.
• Implement: Setting goals and focusing on solutions.
• Grow: Delving into childhood coping mechanisms and understanding their impact.
• Authenticity: Embracing your true self in relationships and life.
• Transform: Breaking free from obsessive thought patterns.
• Embodiment: Grounding the body and emotions.
• Self-Worth: Building resilience and inner strength.

NAVIGATE sounds like a wonderful tool, indeed. But what are some common fears that hold PTSD survivors back from beginning their healing journey?

One of the biggest fears is whether they will ever “get better.” For many, “better” means “feeling better”—a place of relief and comfort. However, the paradox of healing is that it requires learning to feel all emotions, even the painful and messy ones. The journey isn’t about reaching comfort but about developing the ability to navigate discomfort with resilience.

A common misconception is that therapy should always feel comforting, but in reality, therapy can be uncomfortable.

It’s about sitting with pain rather than rushing to “fix” it. One of the first challenges trauma survivors face is creating safety within their own bodies. As emotions surface, bodily triggers often pull them back into seeking safety. This is natural—we work from the bottom-up, addressing bodily responses before engaging the mind. But for some, this body-focused approach is tough, especially when they’re desperate to “get rid of” their pain.

How does this impact their progress?

The challenge is slowing down and befriending discomfort rather than escaping it. Many survivors want to rush through the process, but healing isn’t linear. The first step—awareness without rushing into action—is empowering and triggering.

Another major hurdle is self-blame and shame. Survivors often blame themselves for what happened while resenting those they hold responsible. For those with event-based trauma, the blame is tied to specific incidents, while for those with complex trauma, it stems from ongoing patterns of harm. When old patterns resurface, survivors feel like failures instead of recognizing these moments as part of the process. They may feel anger toward those they blame, only to later experience shame for struggling to forgive.

How do you help clients navigate this stage?

This is where self-compassion and self-forgiveness become crucial. I help clients replace self-judgment with self-kindness. Many survivors are tempted to quit, thinking, “Nothing works.” The non-linear nature of healing can be discouraging, especially when relief isn’t immediate.

Emotions stored in the body for so long hurt as they surface. The release is messy, unpredictable, and often frightening. The key is not pushing too hard or too little but finding a balance that allows progress without overwhelming the survivor.

The key is staying present, trusting the process, and continuing even when relief doesn’t come immediately. Healing is about moving through pain—step by step—until it no longer holds power over us. Every small step forward is progress, even when it feels messy. With patience, self-compassion, and gentle guidance, survivors can move toward true emotional freedom.

Is emotional freedom also hope? How do you define ‘hope’ in the context of PTSD recovery? 

For me, hope starts with validation. It’s important to recognize that what happened to the person wasn’t okay, but that they are okay. Their pain is real, and acknowledging it is a powerful first step toward healing. Hope is a slow process, and it’s about finding ways to move forward at your own pace, while showing yourself kindness along the way.

It’s also about reminding survivors that their experience is valid, regardless of how others perceive it. Their truth doesn’t need to be questioned by anyone else. Healing can be lonely at times, but it’s important to remember that their journey is theirs alone and is not up for debate.

Hope also means finding a safe space, where people respect and honor your truth. Healing is easier when you’re supported by people who understand and care and are there to help you carry the weight of your journey. Through all of this, hope becomes not just a belief in recovery, but a tangible, living part of the survivor’s journey, gradually building as they learn to trust themselves and the healing process, one small step at a time.

But reclaiming joy after trauma often can feel impossible. How do survivors start to find it again, even in small ways? 

It often starts with being kind to yourself, especially when things don’t go as planned. Many people think that if old patterns resurface, they’ve failed. But that’s not true. Every time you recognize what’s happening and choose to start again, even in the smallest way, you’re making progress. Healing isn’t about fixing everything at once but taking one step at a time. With each step, hope grows, even if it’s just a flicker at first.

The first glimmers of hope can be incredibly subtle. It might be a moment of peace during a chaotic day or a genuine smile that feels real for the first time in a long while. It’s easy to overlook these tiny moments, but they’re crucial because they remind you that joy is still possible, even in the smallest form.

So it’s about progress, not perfection?

Exactly. Healing isn’t about becoming someone you think you should be—it’s about reconnecting with the real you. And sometimes, hope comes in recognizing the process itself. For example, when a client comes back and tells me, “I noticed my trigger today,” that’s a huge step. Even if they still reacted the same way, just recognizing what’s happening in their body means they’re becoming more aware. That’s hope.

Can you give an example of this kind of awareness?

Absolutely. Imagine a mother who consistently yells at her child and then falls into a cycle of shame and self-blame. This time, she realizes she’s about to yell and, though she still does, she catches herself mid-way. The intensity is less. That’s progress. It’s not about saying, “Oh no, I yelled again.” Instead, it’s recognizing, “Yes, I yelled, but I noticed it much earlier this time.” The next level of hope is when she comes back with humor, not as much pain, saying, “I saw it happening, and I just let it be.” That’s when healing deepens.

It sounds like hope is in recognizing the patterns, not just in stopping them.

Exactly. Another example: a young adult struggling with binge eating might say, “I noticed I was getting the urge to binge. I knew I shouldn’t, but this time, I laughed about it. I made a choice, and I didn’t feel the same shame for eating that extra ice cream.” That’s hope—it’s awareness without self-punishment.

Hope is when they recognize the pattern, go through it, but then ask, “How do I come back? How do I repair and reconnect?” For example, someone who repeatedly misses deadlines might say, “I did it again, but now I need to own it and tell my boss or my partner.” When they show up and accept their flawed parts instead of hiding in shame, that’s growth.

So healing is really about learning, awareness, and choice?

Exactly. It’s about the ARCH of healing—Awareness, Reflection, Clarity, and then Health, Hope, or Healing. First, you become aware of your patterns. Then, you reflect on what happened. That leads to clarity, where you start making intentional choices. And finally, you communicate, repair, and release what’s been weighing you down. That’s where true healing begins.

Lastly, what do you believe is the key to long-term healing for PTSD survivors?

The key to long-term healing is accepting that relapses and old patterns are part of the journey. It’s easy to beat yourself up when you slip, but those setbacks aren’t failures but opportunities to grow. 

The truth is, we don’t learn without the bumps along the way.

Healing is about creating new pathways in the brain and body, but we can’t expect the old patterns to just disappear. They’ve been there for years and they’re stubborn. 

Patience is key here. I like to think of it like a river: when there’s a flood, the water instinctively follows its old path. Our bodies do the same thing, they remember the old routes of trauma and survival.

Our job is to slowly create new pathways. Right now, the flow might be blocked by a dam, the shield of trauma that keeps things stuck. But trying to break that dam all at once could overwhelm the system, like a flood. 

So, we work on releasing it bit by bit, allowing the flow to come back in a safe, controlled way. And as we do that, we’re building new, healthier patterns.

It takes time, patience, and a lot of self-compassion. It’s not about forcing change, but gently guiding the body and mind to trust this new path, little by little, until it starts to feel more natural. It’s a slow process, but each step makes the flow stronger and more aligned with who you really are.