Healing Through Writing, Reflecting, and Understanding: How CPT and WET Treat PTSD and Complex PTSD
Post-Traumatic Stress Disorder (PTSD) and Complex PTSD (CPTSD) can profoundly shape how a person views themselves and experiences the world. The hypervigilance to triggers, intrusive memories, emotional numbing and deep self-blame that often accompany trauma lead people to think traumatic disorders are permanent. However, over the past few decades, trauma therapy has evolved, offering research tested treatments that genuinely help people heal.
Two of the most effective and accessible approaches are Cognitive Processing Therapy (CPT) and Written Exposure Therapy (WET). Both focus on the power of language – writing and reflecting on trauma and its impacts – to process and ultimately transform our relationship with the past.
Understanding PTSD and CPTSD
Before exploring the treatments, it’s important to recognize the difference between PTSD and CPTSD.
- PTSD often develops after a single traumatic event – such as an accident, assault, or natural disaster.
- CPTSD, or Complex PTSD, usually arises from prolonged or repeated trauma – like childhood abuse, domestic violence or captivity – where escape wasn’t possible.
While both share symptoms like hypervigilance, nightmares, and avoidance, CPTSD often involved deeper struggles with self-concept, relationships, and emotional regulation.
Despite these complexities, therapies like CPT and WET can offer structured, research-backed ways to regain control and rebuild a sense of safety and security.
Cognitive Processing Therapy (CPT)
Cognitive Processing Therapy is one of the most established treatments for PTSD and CPTSD. Developed by Dr. Patricia Resick and colleagues, CPT helps people identify and challenge unhelpful thoughts related to their trauma – known as stuck points.
How CPT Works
CPT is usually delivered over 12-18 sessions and involves:
- Education about trauma and its effects. Clients learn how trauma affects thoughts, emotions, and behaviors and how trauma comes to be from a neurobiological standpoint.
- Writing assignments. Clients write about the impact of the traum to clarify emotions and patterns of thinking related to 5 key areas:
- Safety
- Trust
- Power/control
- Self-esteem
- Intimacy
- Identifying stuck points. These are beliefs that are negative and extreme such as “It was all my fault” or “I can’t trust anyone.”
- Cognitive restructuring. Through guided questioning and tools learned step-by-step through worksheets, clients learn to re-evaluate these beliefs, replacing them with more balanced and compassionate perspectives.
Why CPT Helps
CPT raises awareness into negative self-talk. When a person has negative thoughts peppered throughout the day or week, they may not appreciate just how commonly they’re engaging in negative and fear inducing self-talk. Observing a list of negative self-talk statements in their own handwriting can itself be a powerful wake-up call about how cognitions are impacting daily functioning. Through writing out and learning how to effectively challenge negative thought patterns, individuals learn to temper these responses with a more realistic view thus improving their view of themselves and their relationships with others. Research consistently shows CPT reduces PTSD Symptoms, depression, and guilt.
Written Exposure Therapy (WET)
Written Exposure Therapy (WET) is a newer, streamlined approach to trauma treatment. Developed by Dr. Denise Sloan and Dr. Brian Marx, WET focuses on processing traumatic memories through structured writing exercises in session rather than in-depth verbal discussion.
How WET Works
WET typically involves five sessions, each lasting about 45-60 minutes:
- The therapist provides psychoeducation about trauma and the writing process.
- Clients spend each session writing continuously about the traumatic event – what happened, how it felt, their thoughts about the trauma and how it has affected their life.
- The therapist does not interpret the writing but does check to see that the target instructions were followed; instead, the act of writing itself facilitates emotional processing.
Why WET Helps
Writing about trauma in safe, structured way helps the brain integrate the experience – reducing avoidance and emotional distress over time. WET’s brevity makes it accessible and cost-effective adn studies have shown it to be as effective as longer treatments for many people with PTSD. Additionally, WET has low drop-out rates, meaning, individuals generally find the treatment tolerable and something they can see through to the end of treatment.
For individuals with CPTSD, WET may serve as a gentle first step – allowing processing of traumatic memories while maintaining control and emotional distance.
Choosing the Right Approach
Both CPT and WET offer powerful, evidence-based ways to heal from trauma, but they fit different needs:
Cognitive Processing Therapy (CPT)
- Duration: ~ 12 sessions
- Focus: Challenging and reshaping trauma-related beliefs
- Best for: Those ready to engage in structured cognitive work and reflection who are open to homework; rehashing the trauma is not necessary
Written Exposure Therapy (WET)
- Duration: 5 sessions
- Focus: Writing-based emotional processing
- Best for: Those who prefer a brief and targeted therapy without homework and who want to tell the story of their trauma
The Power of Words and Self-Compassion
Whether through rewriting our thoughts or writing out trauma on paper, both CPT and WET remind us of an essential truth: healing happens when we reclaim our story. Beyond ownership and insight, these strategies are also effective from a neuropsychological perspective – writing shifts people out of their primitive brain (where the fight, flight, fawn, and freeze responses of PTSD are housed) to the frontal cortex (where higher order thinking takes place). Emotional and physiological reactivity are replaced with calm reason and understanding. People can then shift from reactivity to reaction.
Recovery from PTSD and CPTSD is not about forgetting or minimizing what happened – it’s about learning to hold those memories with compassion, understanding, and emotional neutrality rather than fear. Through structured therapy, support, and self-kindness, the past no longer defines the present.
Final Thoughts
If you’re considering CPT or WET, it’s best to seek a licensed trauma-informed therapist trained in these approaches. Healing is deeply personal, but you don’t have to do it alone – and both of these therapies offer clear, research-backed paths toward relief and renewed self-trust.
Resources:
Guest Author, Dr. Alicia Rozycki
Dr. Rozycki is a licensed psychologist, military spouse, and the founder of AROSE eTherapy®. She is a trauma-informed psychologist with over 18 years’ experience and offers empirically validated treatments, including CPT and WET. Focusing exclusively on online therapy for women professionals and military affiliates, Dr. Rozycki offers virtual sessions in Colorado, Delaware, Florida, Maryland, and Pennsylvania. Learn more about Dr. Rozycki.
Reviewed by: Judy Wang, LCPC, CPC, EMDR Certified
Clinical review for accuracy, clarity, and best practices in therapy.