"I was looking for a therapist to do trauma work, and I am glad I found Dr. Chacko. He is an honest, compassionate clinician who provided the exact therapy I needed to process painful memories and progress. He has gone the extra mile on numerous occasions."
"I was in bad shape and was about to be swallowed by it all. But here I am. It's been about 8 years since that time — I enjoy the blessing of grandchildren, and much more. Dr. Chacko's help has been a most fundamental part of my story."
Andrew treats trauma and PTSD at his San Francisco practice, serves clients throughout the Bay Area, and offers telehealth across California. Trauma doesn't live in the event. It lives in the nervous system — in how your body responds long after the danger has passed. Andrew has spent his career working with the full spectrum of trauma, from combat veterans to survivors of childhood abuse, and brings both the clinical expertise and the human presence to meet you where you are. About half of all U.S. adults will experience at least one traumatic event in their lives, and approximately 6% will develop PTSD at some point — with women affected at roughly twice the rate of men (National Institute of Mental Health; VA National Center for PTSD).
Request a ConsultationIntrusive memories or flashbacks to the traumatic event
Nightmares or disturbed sleep that leaves you exhausted
Hypervigilance — always scanning for danger, even in safe situations
Emotional numbing or feeling detached from your own life
Avoiding people, places, or situations that remind you of the trauma
Exaggerated startle response to sounds or unexpected touch
Difficulty concentrating or feeling present in the moment
Persistent feelings of shame, guilt, or self-blame
Irritability, anger, or emotional outbursts that feel out of proportion
Most mental health conditions involve patterns of thought, mood, or behavior that have gone awry. Trauma is different: it's a wound. Something happened that the nervous system wasn't equipped to fully process, and the unprocessed residue gets stored — not as a memory in the conventional sense, but as a physiological state the body keeps returning to.
This is why people with PTSD don't simply "think about" the trauma — they re-experience it. A smell, a sound, a certain quality of light triggers a full-body response that bypasses rational thought entirely. Understanding this distinction changes how treatment is approached. Among adults with PTSD, more than a third experience serious functional impairment — difficulty maintaining work, relationships, and daily life — underscoring why specialized, evidence-based treatment is essential (National Institute of Mental Health).
Andrew was the only civilian selected for a military psychiatric residency at Tripler Army Medical Center, where he specialized in trauma and traumatic brain injury. Working alongside active-duty service members gave him an intensive, specialized education in the most complex presentations of PTSD — an education that has shaped how he treats trauma in every patient since.
He has trained extensively in two evidence-based trauma treatments that don't require detailed verbal retelling of the traumatic event:
Both modalities can produce significant results without requiring you to narrate the trauma in detail. The work happens at the level of the nervous system, not just the story.
Andrew doesn't separate the therapeutic work from the medication management. If medication is appropriate — and for trauma, that sometimes means addressing the hyperarousal and sleep disruption that make deeper processing impossible — he handles both himself, within the same ongoing relationship.
The first step is always understanding the whole picture: when the trauma occurred, how it has shaped your patterns and relationships, what has and hasn't helped in the past. From there, he builds a treatment plan that matches your specific situation — not a protocol applied uniformly to everyone with a PTSD diagnosis.
His approach is fundamentally optimistic. The brain retains neuroplasticity throughout life, and there is now compelling evidence that trauma — even severe, longstanding trauma — can be meaningfully processed and resolved. Andrew has seen this in patients who had lived with PTSD for decades. Recovery is not guaranteed, but it is genuinely possible.
Andrew's practice is well-suited for adults dealing with a range of traumatic experiences: combat or military service, sexual assault or abuse, childhood developmental trauma, accidents, medical trauma, sudden loss, or chronic interpersonal trauma. His practice is less suited for individuals in acute crisis requiring inpatient stabilization — if that's where you are, he can help you find the right level of care.
Andrew sees patients for trauma and PTSD in person at his Pacific Heights office — conveniently located for those coming from Presidio Heights, Cow Hollow, the Marina, and Nob Hill — and via telehealth throughout California.
Andrew is accepting new patients in San Francisco. A complimentary phone call — no paperwork, no commitment — is where it starts.
Request a ConsultationDon't see yours? The complimentary phone call is the right place to ask.