When the street is quiet but your mind is not
Ho-Ho-Kus is a small Bergen County borough where neighbors recognize each other at the train station and at school events. That closeness is a gift, and it can also make it harder to admit that something from your past still runs your days. Many people with complex PTSD look composed from the outside while feeling constantly on guard inside.
Complex trauma usually grows out of repeated or prolonged experiences rather than one event: an unpredictable parent, years of emotional neglect, a controlling relationship, bullying that never let up, or domestic violence. The result is less about flashbacks and more about how you see yourself, how safe you feel with other people and how quickly your body reacts to stress.
If you recognize yourself in that description, you do not need a diagnosis before reaching out. You only need a sense that the old ways of coping are costing you too much.
What does complex PTSD look like in everyday life?
People often expect trauma to look dramatic. In practice, complex PTSD tends to show up in quieter, persistent ways:
- A harsh inner critic that never seems to rest, or a deep sense of being defective.
- Emotions that swing from numb to overwhelming with little warning.
- Trouble trusting partners or friends, or repeatedly ending up in relationships that feel familiar in a painful way.
- Hypervigilance: scanning rooms, rehearsing conversations, startling easily.
- Exhaustion, irritability, or physical tension that does not match how much you slept.
- Pulling away from family gatherings because they leave you drained or on edge.
The American Psychiatric Association describes trauma-related conditions as treatable, and organizations such as NAMI offer plain-language education that many clients find helpful between sessions. Reading about trauma can validate what you feel. Therapy is where you begin to change how your nervous system responds.
How Dr. Audrey approaches complex trauma
Dr. Audrey's work is paced and collaborative. Early sessions focus on stability: understanding your symptoms, building practical skills for calming your body and mind, and making sure you feel safe enough to go further. Nobody is rushed into retelling the hardest parts of their history.
Skills first, then deeper work
Because she is C-DBT certified, many clients learn tools drawn from Dialectical Behavior Therapy: emotion regulation, distress tolerance and ways to stay present when a reminder hits. These skills give you something concrete to use on a hard Tuesday, not only in session.
Looking at the family system
Her doctoral training is in Family Studies, so she pays close attention to the patterns you grew up with and the roles you learned to play. Seeing how those patterns formed often loosens shame. When it would help, a partner, parent or adult sibling can join a session, even from a different home.
Rebuilding a sense of self
Later work turns toward identity, boundaries and relationships. The goal is not to erase what happened, but to help you respond to the present instead of the past. Current research in journals such as the New England Journal of Medicine continues to shape how clinicians understand trauma treatment, and Dr. Audrey keeps her methods grounded in evidence.
What progress can look like
Change with complex PTSD is usually gradual and practical. Clients often notice first that they recover faster after a trigger, or that they can name a feeling before it takes over. Later, they may set a boundary with a relative without spending three days replaying it, or sleep through a night that used to be restless.
Dr. Audrey checks in about goals along the way, so you always know what you are working on and why. Some people come weekly for a stretch and then space sessions out as skills take hold. Others return for a few sessions during a hard season, such as a parent's illness or a divorce, when old reactions resurface. There is no fixed number of sessions, and you stay in charge of the pace.
How online sessions work for people in Ho-Ho-Kus
Dr. Audrey's practice is entirely online. There is no New Jersey office to visit, which means no squeezing an appointment around a Route 17 commute or a Manhattan train schedule. You join a secure, HIPAA-compliant video session from a private space, and the link opens directly in your web browser with nothing to download.
She holds an active New Jersey Licensed Professional Counselor license, so she can work with you whenever you are physically in New Jersey during the session. Sessions are scheduled in Eastern Time. For a step-by-step look at scheduling and technology, see how online therapy works for New Jersey clients.
Privacy matters in a borough of about four thousand people. Online therapy means no one sees your car outside a counselor's building, and you choose where you sit. Some clients use a home office with the door closed; others take a session from a parked car when the house is full.
Who this kind of therapy helps
Complex PTSD affects people at every stage of life, and Dr. Audrey works with each of them:
- Adults who have functioned well for years and now notice that burnout, anxiety or relationship conflict keeps circling back to the same old wounds.
- Teens ages 12 to 18 who carry trauma from bullying, loss, family conflict or assault, often alongside anxiety, depression or self-harm.
- Young adults home from college or starting careers who realize that leaving home did not leave the past behind.
- Parents who want to stop repeating the patterns they grew up with and parent from a calmer place.
- Couples and families where one person's trauma has quietly reshaped how everyone communicates.
She also offers an LGBTQ+-affirming space. She is LGBTQ+-owned and aligned with GLSEN and the Human Rights Campaign, which matters for clients whose trauma includes rejection or harassment tied to identity.
Dr. Audrey's training and credentials
Dr. Audrey Kteily earned her PhD in Family Studies and her bachelor's degree in Psychology at Texas Woman's University, and her master's in Counseling at Dallas Baptist University. She is a Licensed Professional Counselor in New Jersey, a Licensed Mental Health Counselor in New York, and a Licensed Professional Counselor-Supervisor in Texas, where she has been licensed since 2001.
She is a Certified Family Life Educator through the National Council on Family Relations, holds C-DBT certification through Evergreen Certifications, and is a published author on family dynamics. With more than two decades of clinical work behind her, she brings both structure and warmth to trauma care. The American Counseling Association sets ethical standards for professional counselors, and her practice follows them. You can read more on her full biography.
If you are in crisis, call or text 988 (Suicide & Crisis Lifeline) or 911. Dr. Audrey's practice is not a crisis service.
Fees, insurance and the superbill
Dr. Audrey is an out-of-network provider. After sessions, you can receive a superbill to submit to your insurance company for possible out-of-network reimbursement. Before your first appointment, it is worth calling your plan to ask about out-of-network mental health benefits. More detail is on the FAQ and fees page.
How to get started from Ho-Ho-Kus
Starting is simpler than most people expect. Fill out the secure appointment request form with a few basics, and Dr. Audrey will reply within one business day to talk about fit and timing. You can also explore her other services from the Dr. Audrey home page or the New Jersey online therapy page.
Ready now? Request your first session, or text or call (917) 905-3183. Texting is the easiest way to reach her; please keep health details out of texts.