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Why There’s No Need to Relive the Trauma All Over Again

Which PTSD treatments can make things worse, and why

Women in Trauma

“My father murdered my mother. Right in front of me and my brother. The police came and took my dad away and eventually he was put in a secure psychiatric hospital. After that, me and John went to live with our grandparents. That’s when the real trouble started.”

June related these awful memories from her remote past without any noticeable sign of being upset by them. Her voice was calm. She was just telling me facts.

“Do you get flashbacks to the murder?” I asked her. “Do you get nightmares which seem to relate to that time?”

“No,” she said. “I know it seems weird, but I really feel like I came to terms with all that a long time ago.”

June was 48 years old when we met. She had never talked about her past, and had never had any therapy, except for some “psychoanalytical stuff” that had been “worse than useless”.

“What did you mean, June, when you said that the real trouble started when you went to live with your grandparents?”

“They used to beat us,” she said. “They beat me and John for anything really. I think they enjoyed it. But that wasn’t the worst of it.”

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When talking makes things worse

I was watching June’s face as she was talking. And I saw it happen. An invisible sharp wind whipped across (for the merest moment) the otherwise placid surface of a glass-calm lake. The burning flicker of pure fear, brief but unmistakable.It reached her eyes, her mouth, and each and every muscle of her face.

“When I was twelve my uncle also came to live with us. That’s when…”

She paused, and now she seemed to be struggling to find words. I felt it was important she didn’t tell me too much. But gradually she revealed the bare facts.

Her uncle was a car mechanic and worked on cars in a field at the back of the house. He would wake her up at night, drag her down into his makeshift mechanic garage and brutally rape her. He did this hundreds of times. This went on till she was eighteen, when at last she fled this twisted travesty of a family, never to return.

The uncle had never been arrested. June told me she didn’t care what had happened to him, she just wanted to feel safe again. Now, thirty years later, she was working two jobs, in a relationship she didn’t feel was right for her, running for two hours a day to ‘get rid of the anxiety’, and waking up every few hours through the night, often with a scream on her lips. On top of all that, even just the smell of engine oil would bring on a terrifying flashback of being raped.

“I don’t drive or go anywhere near cars if I can avoid it.”

June needed help, clearly. I knew how to help her. And I fully intended to help her.

But suppose June had not come to see me. Suppose she had gone elsewhere. What kind of ‘help’ could she have expected to get…?

Back into hell

It has long been recognized that people who have been through very traumatic experiences often need help if they are to recover fully. A long-established approach is to get victims to ‘relive’ their trauma, either by ‘talking it through’ or even, most cruelly, by hypnotically reliving it as it happened.

And what’s wrong with this? Everything.

Talking about the trauma, even just trying to put what happened into words, can actually worsen a victim’s trauma by re-activating it in the brain, and embedding it deeper.

Dr Noreen Tehrani, an occupational health and counselling psychologist specializing in post traumatic stress, explains what happens:

“If a trauma victim is debriefed in a state of high emotion, the process can increase the arousal to the point of overload, trapping the sensory impressions in the amygdala.” (1)

This is why so called ‘critical incident debriefing’, where disaster survivors are encouraged to ‘talk it out’, can itself be a disaster (2) for the 25% of people (3) who remain severely traumatized after an event.

Getting people to ‘relive’ their trauma is not therapy.

If ‘reliving’ a trauma could heal PTSD, the first real flashback would do the trick (4).

If 'reliving' a trauma could heal PTSD, the first real flashback would do the trick

Talking it out may be fine for the 75% of people who would anyway not have gone on to develop persistent PTSD after their traumatic experience. But for the remaining 25% (that’s 1 in 4 people) it is an irresponsible and dangerous approach.

So how can the 25% of people who are likely to develop long lasting PTSD get over their trauma?

Exorcising haunted minds

“Even the smells come flooding back… it just needs the smallest reminder…”

June’s experiences of reliving the nightmarish assaults from her uncle in flashback are typical of people suffering long-term effects of trauma.

June could talk about all kinds of other horrors quite calmly. But as soon as she tried to talk about the rapes she became acutely upset and struggled to speak. The memories were lodged in a part of the brain beyond language.

I told her that there was no need for her to give me details. It was bad enough that she had had to live through these experiences the first time around.

The beauty of the Rewind Technique, the approach I used to help her, is that it is completely ‘non-voyeuristic’. The therapist doesn’t need to know in detail what the trauma was like.

But what is ‘trauma’ anyway?

How your memories are made

In the normal course of events, memories are laid down as immediate impressions in the brain, and then organized in a coherent way in the hippocampus, and finally stored in the neocortex in ‘long term memory’. This process makes a remembered event a ‘narrative memory’ – something you can talk about, something that feels past, and eventually fades with time.

However, when people are traumatized this process can get blocked, and the traumatic memory may never get turned into narrative.

Imagine all your worst memories feeling ‘live’ – feeling as if they are happening now – even if they are of things that happened half a lifetime ago.

PTSD – the memories that won’t fade

This is what happens to PTSD sufferers – the memory doesn’t fade with time. It feels absolutely current and impossible to talk about. I once worked with a man who had been traumatized in World War II. Nearly 60 years later, he told me his horrendous experiences felt like they happened only a week ago!

During a traumatic event a person’s emotional response can be so extreme that the memory becomes encoded in the ‘fight or flight’ part of the brain, the amygdala, instead of the hippocampus. It stays ‘locked’ in this part of the brain as a survival pattern, ready to reactivate if a similar emergency should arise again.

Useful though it obviously is, this is quite a sloppy process, and the fear pattern can be reactivated by quite incidental elements from the original trauma.

For example, a man who was mugged by someone in a red jacket feels awful fear at the sight of red clothing; a war vet reacts with terror to the sound of fireworks. For June, the mere smell of engine oil would reactivate the memory of being raped by her mechanic uncle, setting off terrifying flashbacks.

As I said, most people who go through a trauma, around 75%, will eventually re-processes the memory though the hippocampus, to finally be stored in the neocortex as a past event. They know it was horrendous at the time, but it no longer makes them feel terrified to recall it. The memory fades.

For the other 25%, recalling the memory is itself a horrendous experience – they feel they are right ‘back there’, in that awful time. Talking about it, for these people, will make things worse, because the pattern just gets reactivated.

So what does help?

Healing haunted minds

An effective trauma relief treatment must be able to generate both sufficient dissociation and sufficient calm in the sufferer to allow the painful memory to be reprocessed safely, so that it can be moved, so to speak, from the ‘now-focused’ fight or flight amygdala to the neocortex, where it will be tagged as a past, no longer threatening event.

Unless this happens the trauma victim could have a whole lifetime of living in the past. And when the past is terrifying, their whole life is affected.

Some therapeutic methods are quite effective, though.

Resurrected hypnosis and tapping

A couple of techniques have had some success in treating PTSD.

Eye Movement Desensitization Reprocessing (EMDR) has people recalling a traumatic event while following with their eyes the side to side hand movements of the therapist. Sometimes the process is automated with a moving light.

This is clearly a resurrected version of the old watch-swinging hypnotic induction. Its practitioners seem to be at a loss to explain why it can be effective. (5) But we can see that by keeping part of the client’s attention in the present time (by giving them the task of following with their eyes something that is happening now) while recalling the traumatic memory, their brain has a chance to log the terrifying memory as ‘past’, releasing it from the amygdala.

Another popular approach is Emotional Freedom Technique (EFT) or ‘tapping’. Therapists using this technique have come up with all kinds of esoteric explanations as to why it works, including ‘ blocked energy channels’ and the like.

But if we look to recent brain research (rather than ancient Eastern philosophies) we can see that ‘tapping’ someone while they are recalling a traumatic event will also keep ‘jogging’ them back to the here and now, giving their brain a chance to re-tag the terrifying event as distinct from the now, and therefore as past.

When people have uncontrolled flashbacks they tend to lose contact with the present moment and become totally immersed in the past event. Tapping, or getting them to look from side to side, stops that happening. So the amygdala gets a chance to ‘give up’ the memory to the neocortex where it can finally be tagged as properly past and so no longer a threat.

Both these methods can be effective, but both run the risk of severe client distress, and neither is as thorough, comfortable or effective as the Rewind Technique.

Further, if you don’t fully understand the principles of what you are doing, and are relying on a ‘formula’, you will tend to be less adaptive and responsive to the unique needs of your client.

So what is this famous Rewind Technique, and why do I think all therapists need to know how to use it?

Be kind, rewind

The origins of ‘rewind’ lie in Dr Milton Erickson’s ‘Crystal Ball’ technique. Erickson would hypnotize traumatized clients and have them review their traumatic time ‘in a crystal ball’, while feeling calm. If the memory is recalled in a state of calm even once, this can be enough to decondition the trauma.

The principle was further developed by Richard Bandler and John Grinder of NLP fame, and clumsily titled the Visual Kinaesthetic Disassociation Technique (VKD). Dr David Muss developed the technique so that it could be effectively used in the treatment of Post Traumatic Stress Disorder, and called it ‘the Rewind technique’ (6).

Further refined and promoted widely in recent years by The Human Givens Institute (7), the Rewind Technique is now a highly effective method of giving a traumatized client an opportunity to review their memories from an entirely disassociated relaxed perspective.

The traumatic event is experienced ‘in reverse’. This is such an unusual way of processing the memory that it has the effect of taking out the fear element. Nobody has a fear of things that happen in reverse.

Using this method should be almost entirely comfortable for clients. I myself have used it for survivors of torture, car and train crashes, attempted murder and, of course, rape. It’s also effective for the treatment of many phobias (8) – I used the Rewind on myself years ago to overcome a fear of public speaking.

And what about June?

The upshot for June

It’s easy to think, when you hear June’s story, “Oh, how awful for her!” but try to imagine for a moment the reality of being terrorized day and night by your own mind… for years.

Picture trying to ‘act normal’ day after day, while feeling your life could be ripped from you any second. That is the reality of PTSD. There is nothing ‘theoretical’ or ‘abstract’ about PTSD when you’re the one living the nightmare.

Typically, people who’ve had Rewind therapy say things afterwards like: “That memory feels quite distant now” or “It’s like it doesn’t matter any more.”

I worked with June using the Rewind for her worst memories of rape. Although she’d been raped hundreds of times, we found that, once the worst dozen or so memories had been de-traumatized, there was a kind of snowball effect, and her brain learned the new pattern and all the trauma went.

And then something weird happened. Weird for June, anyway!

A new life

As June recovered, she started regularly sleeping through the night – something she could not ever remember doing. She went on a training course and got a new, more rewarding job. She ended the relationship she was in and found a man she could love and be loved by. The flashbacks stopped completely.

As her body started to free itself of the excess stress, she started to look younger.

“I’m here to be alive, not just survive,” she said.

She is such a decent, brave, kind person. It was an honour to help her.

Near the end of our sessions, she made an announcement.

Confronting demons

“There’s going to be a family wedding,” she told me. My uncle will be there. I want to go. But even though he’s nearly 80 now, I still feel that somehow he might have power over me, that it could all happen again.”

This would be a real test. She hadn’t seen this man in over thirty years!

We hypnotically rehearsed her feeling relaxed and calm during the upcoming wedding. The next (and last) time I saw her, she told me that the wedding had gone really well. Her uncle had been there, as expected, but his presence had no effect on her.

“He was just so small and insignificant. Just nothing to me. Just part of a forgotten life I lived centuries ago. It’s time for me to live properly now and not in the past.”

And she is doing just that.

So if you treat trauma (and if not, why not?), I urge you to avoid any method that relies on just getting your client to ‘relive’ past horrors as they occurred.

Your traumatized client has had enough pain in their life, they don’t need to pay you to have more.

It’s appalling to me that there are still therapists, counsellors and doctors out there who don’t know how to use the Rewind Technique, or how to effectively treat trauma.

Millions of people are suffering needlessly. That needs to stop.

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Mark Tyrrell

About Mark Tyrrell

Psychology is my passion. I've been a psychotherapist trainer since 1998, specializing in brief, solution focused approaches. I now teach practitioners all over the world via our online courses.

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Notes:

  1. Noreen Tehrani.
  2. Rose S, Bisson J, Churchill R, Wessely S. Psychological debriefing for preventing post traumatic stress disorder (PTSD). Cochrane Database Syst Rev. 2002;(2):CD000560.
  3. Wilson, J.P and Keane, T.M (1997) Assessing Psychological Trauma and PTSD. The Guilford Press.
  4. Joe Griffin and Ivan Tyrrell (2003) Human Givens: A new approach to emotional health and clear thinking. HG Publishing. (p282)
  5. Shapiro, F. and Forrest, M.S. (1997) EMDR. Basic Books.
  6. Dr D C Muss (1991) “A new technique for treating Posttraumatic Stress Disorder“.  British Journal of Clinical Psychology,1991, 30, 91-92.
  7. The ‘rewind’ technique.
  8. Phobias.

Search for more therapy techniques:

  • Good article on PTSD but Mark, you don’t understand energy psychology. The tapping isn’t a distraction technique in EFT it is one way of activating meridian points. There are other methods like AIT which use holding and can be very effective. I use Rewind but also energy psychology methods

    • Hi Martin. thanks. I think it’s good for those who use ‘energy psychology’ to be open minded to the possibility that what they think the reason is for the effectiveness of their approach may be due to more straightforward reasons. I don’t wish to tread on anyones sacred cows but there are straight forward reasons for much of how the brain works. This isn’t a discussion on the question of whether universal energy, chi, prana or so forth exist or not. This is about helping people and an understanding of how to best do that. All I’m saying is we don’t need to complicate or become abstract in our theory until we have exhausted more everyday explanations, as unpopular/ unexciting as that might be.
      All best wishes,
      Mark.

      • Phil Lee

        As a famous therapist once remarked.. it matters not what therapy is used as long as it works.. or words to that effect, plus.. the same therapy won’t always work with different clients for a whole raft of reasons including rapport, trust etc… Great post, great replies many thanks ..PL

  • “This is clearly a resurrected version of the old watch-swinging hypnotic induction. Its practitioners seem to be at a loss to explain why it can be effective. (5) But we can see that by keeping part of the client’s attention in the present time (by giving them the task of following with their eyes something that is happening now) while recalling the traumatic memory, their brain has a chance to log the terrifying memory as ‘past’, releasing it from the amygdala.”

    It has been proven long time ago, that memory changes every time based on emotional state it is perceived. Concentrating on the watch occupies conscious mind, which can track only so many objects at the same time. This will change persons emotion, which will change perception of experience, and because conscious mind is being occupied it can’t also reinforce experience with its metathinking.

    “The traumatic event is experienced ‘in reverse’. This is such an unusual way of processing the memory that it has the effect of taking out the fear element. Nobody has a fear of things that happen in reverse.”

    In my personal opinion, far better way to do this is lead person into “cinema”, watch experience in disassociated state, and tell him it will instantly stop before anything bad happens. Person can then re-interpret experience like he wants, or get support from hypnotist who can empower with suggestions if solution isn’t found.

    Reversal will definitely purge emotional content, but it is not really that good therapy technique, because it doesn’t give room to create solution and re-interpretation that could prevent similar experience happening in the future. Depending on experience, person could still be bound to do same mistake in the future, because he didn’t learn what he needs to avoid it in the future. And while nobody us cares to hear about traumatic events, there are cases where you need to know what happens to be actually help subject.

    Just my 2 cents.

  • Eliza Lindsay

    I have been abandoned by my husband I believe strongly in staying with whom u love not leaving when feelings happen I am with him again and I was the cause of the abandonment he’s so loving but I still have bad trauma from the abandonment that happened five times in my past by this loving man I want to stay with him but my trauma comes all the time I am pregnant with his child and I see how he need me in his life and don’t wanna harm him what should I do can I last with him and how can Get rid of trauma and be with the one caused it without leaving please