How I resolve PTSD: A psychotherapist explains
We all suffer traumas as we go through life. We all pick up scars along the way.
The longer we live, the more likely we are to experience shock and distress as a normal and natural response to some of life’s events which are actually both shocking and distressing; things like accidents, burglaries, bereavements, relationship break ups, physical assault, bullying, the list goes on…
Often, after the negative experience, we are able to put it into context, pick up the pieces of our life and move on. But what happens if we get ‘stuck’ in the memory? What if the event won’t go away and we continue to have intrusive thoughts, regrets or even nightmares?
There are a range of recognised PTSD symptoms such as:
- Difficulty falling or staying asleep
- Irritability or outbursts of anger
- Difficulty concentrating
- Hyper vigilance or being on constant “red alert”
- Feeling jumpy and easily startled
There are also other, vaguer signs and symptoms which people often do not connect with post trauma distress
- Physical aches and pains
- Anger and irritability
- Guilt, shame, or self-blame
- Substance abuse
- Feelings of mistrust and betrayal
- Depression and hopelessness
- Suicidal thoughts and feelings
- Feeling alienated and alone
We understand so much more now about how our brains and minds function. As a result, there are new psychological techniques that can resolve PTSD quickly and easily.
The silent right hemisphere
Recent research has indicated that insight happens in the right temporal lobe of the brain in an area situated just above the ear.
This hemisphere is generally connected with emotion and is an older part of the evolved brain. This ‘silent’ hemisphere has no language and perceives the world in a completely different way to the lateral, logical, linear, left hemisphere. It interprets the world through instinct, concept, shape, colour, dimension, image and metaphor.
In recognition of the emerging significance of the workings of this hemisphere, I have increasingly used guided visualisation in my work and noticed much improved clinical outcomes as a result. For many years I have been using a particular guided imagery technique called ‘Rewind’ to resolve PTSD quickly. The process involves engaging parasympathetic breathing and relaxation before guiding my client to visualize the traumatic episode on an imagined screen.
The client is encouraged to fast forward and rewind the traumatic episode until they are calm whilst recalling the event. This intervention has become a welcome addition to my therapeutic tool box and something I wrote about in detail in my book ‘PTSD Resolution.’
Memory is malleable
To understand why Rewind and other techniques like Eye Movement Desensitization and Reprocessing (EMDR) work, we need to appreciate the implications of both neuro-plasticity and the malleability of memory.
False memory syndrome, is a clear example of how memory is encoded within the neural networks of the brain and, in recollection, can become re-encoded. Although perceived as a negative manifestation of the phenomenon, false memory syndrome actually gives positive hope and reassurance to both clients and practitioners that the nightmares and flashbacks of PTSD can be resolved by the re-encoding of a traumatic memory with the creation of a new and calm narrative around the trigger event.
The roots of the Rewind and the Freudian link
The restructuring of memory was actually something first referred to by Freud as Nachtraglichkeit or the ability to re-conceptualize childhood memory from the maturity of the adult self.
But the technique now known as ‘Rewind’ can trace its real roots to the work of Milton Erickson, an American psychiatrist specializing in medical hypnosis and family therapy, who was noted for his creative approach to mental health. After studying Erickson’s therapeutic work, Richard Bandler, originator of Neuro Linguistic Programming, wrote about the technique in his book ‘Using your Brain for a Change’ and named it, the ‘fast phobia cure’.
He said: ‘I discovered that the human mind does not learn slowly. It learns quickly. Teaching someone how, and when, to associate or dissociate from thoughts or emotions is one of the most profound and pervasive ways to change the quality of a person’s experience, and the behaviour that results from it.
The technique, also referred to as visual kinaesthetic dissociation (VKD), was developed further as a treatment for PTSD by Dr David Muss who described it in his book ‘The Trauma Trap’ and was later adapted by Joe Griffen and Ivan Tyrell who added an imagined TV and remote control rather than the original cinema screen.
What is the Rewind technique?
Whichever version you use, the key to fast resolution seems to be in how memory is stored in the brain and the unique human ability to step back into its observing self.
If you imagine an area like passport control in your brain, ordinary and every day memories are waved through and put into a filing cabinet. This is where they stay unless you decide to look in the filing cabinet and retrieve the document. Memories with emotional significance, like birthdays for instance, are easier to retrieve. However, if an incident occurs which is perceived as a life or death situation, it is not waved through and is kept in a kind of holding bay.
The amygdala, an almond shaped organ within the emotional centre of the human brain, has the job of protecting the human body. If something occurs which is perceived as threatening, it attaches sufficient emotion to the memory to ensure it stays in the holding bay.
The brain then continues to scan the environment for anything similar to that event and presses the panic button if it perceives a threat. Our amygdala is always trying to protect us. If it feels it has information which must not be filed away, it keeps the file open and stays alert on our behalf until the memory is re encoded as past, not present.
Describing the technique
Clients are guided to imagine either watching a TV or being in a cinema watching a film of the traumatic incident from before there was a problem until the memory fades. In some circumstances, the client may be encouraged to end the film in a relaxed place, for instance on a beach if that is appropriate for that client.
Having watched the film the client is then encouraged to move into the film screen and experience the incident in reverse, very fast as they rewind back to the moment before the event occurred.
Case study: A car accident
Jack had developed problems whilst learning to drive. Aged 17, he had been enjoying his driving lessons until an incident occurred when he mounted the pavement.
Although the incident itself had been minor, in his imagination he had played a film of the possible consequences of losing control of the car. He had imagined a major accident in which he had been the cause. ‘If a car had been coming the other way or had been travelling close behind, there could have been injuries or death’, he told me.
Although this incident did not meet the full criteria for post traumatic stress disorder, it had been tagged as significant by the amygdala. Pattern matching was now occurring every time he got into the car for a driving lesson. He was edgy nervous and upset and was at the point of giving up learning to drive altogether.
I explained to my young client how memory is stored and encoded and also how pattern matching occurs before guiding him through the Rewind technique.
The client’s mother happily reported afterwards that the session had been successful and there were no further negative reactions in driving lessons.
Whole brain therapy
Imagination can be used as a powerful psychological tool.
Our growing understanding through neuroscience and research is providing the rationale for ever more creative interventions which access this uniquely human resource; one which can be both the source of our distress yet also, thankfully, the source of resolution and healing too.