According to the U.S. Department of Veteran’s Affairs, Post-Traumatic Stress Disorder (PTSD) impacts 11-20% of Iraq and Afghanistan War veterans, approximately 12% of Gulf War veterans, and 15% of Vietnam veterans.

A 2021 study by the American Homefront Project found that one-in-four (26%) Americans believes most people with PTSD are violent or dangerous, and a similar number (23%) believe PTSD is untreatable.


In 1980, the American Psychiatric Association first recognized post-traumatic stress disorder (PTSD) following research on post-combat symptoms experienced by Vietnam veterans. Today, in the U.S. alone, PTSD affects nine million people, and more than a third report having severe symptoms (NIMH). 

In terms of treatment, studies have shown Cognitive Processing Therapy (CPT) and Cognitive Behavior Therapy (CBT) to be effective, and a little over a decade ago, a new promising therapy emerged: Time Perspective Therapy (TPT). 

TPT was co-created in 2008 by Philip Zimbardo, Ph.D., and therapist Rosemary Sword, both of whom have collaborated with Twill in developing digital resources to help those living with trauma and trauma disorders like PTSD. 

Zimbardo and Sword co-wrote a piece for Psychology Today about post-traumatic stress and the TPT methodology, which we republished with their permission on The Upside

Here are some of the key insights:

  • Individuals with post-traumatic stress have difficulties leaving past trauma behind them, often reliving the event over and over in disturbing dreams and flashbacks. This leaves them “stuck in the muck of time.”

  • PTSD is not isolated to those who have served in the military. Surviving a life-threatening event like a car accident, terrorist attack or a natural disaster are common causes, as well as physical and/or sexual abuse.

  • Symptoms include depression, anxiety, flashbacks, avoidance, isolation, difficulty falling and/or staying asleep, difficulty concentrating, irritability, an exaggerated startle response, and hypervigilance. If these persist for more than a month after the traumatic incident, it may be PTSD.

  • The more severe the trauma, the more likely it will become a deeply embedded memory in the subconscious and trigger obsessive ruminations on other possible outcomes/”what ifs.” Over time, this can negatively color the person’s overall outlook on life and impact their relationships and ability to function.

    As Zimbardo and Sword explain, “simple things both at work and at home that would never have bothered you before the trauma—finding a parking place in a crowded parking lot, riding the elevator to the office, the mounting pile of laundry—are now monolithic obstructions that must be dealt with before you can mentally revert to focusing on the bad thing that happened and how it changed your life.”

  • TPT is a type of cognitive behavioral therapy developed specifically to address the unique challenges caused by post-traumatic stress. Because PTSD patients have a tendency to dwell on the past and feel hopeless about the future, the goal of TPT is to guide them toward a balanced time perspective, reframing their disorder as an injury from which they can heal. It may sound simplistic, but this “forward-leaning framework” provides a scaffolding to understand and work through their issues.

  • Digital therapies are becoming increasingly accepted in the medical community, especially for those who have no access to in-person therapy. There are now a number of apps specifically for PTSD (like PTSD Coach, created by the VA), based on mindfulness/meditation, CBT, and TPT.

No one’s potential should be limited by their past trauma, and TPT can be a powerful tool to help those with PTSD look to the future with hope. 

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