Post Traumatic Stress Disorder (PTSD) is a particularly disturbing and disabling illness which can be caused by exposure to any event which is (or is perceived to be) life threatening. Military personnel working in combat situations are particularly at risk. Official US estimates suggest that 15% of those who have seen combat service will suffer from PTSD over the long term. The symptoms typically include the following:
- Intrusive memories
- Sleep disturbance
- Hyper arousal / avoidance behaviour
- Emotional shutdown
Traditionally this has been a difficult illness to cure. Various approaches to helping people with PTSD have been tried, and many of them have failed to help. It used to be thought that talking about the experience would help. We now know that this is quite often counter-productive. It sometimes makes things very much worse. It is significant that critical incident debriefing following violent incidents is no longer seen as a universally helpful approach. It should not surprise us that many sufferers feel intuitively that they do not want to seek help because they expect to have to relive the painful experiences by talking about them. Their gut instinct that it might make them feel worse rather than better is often correct.
Some people recover from the symptoms of PTSD over a period of time. Others remain traumatised for the rest of their life.
The Underlying Mechanism
What is written here is a simplistic approximation which is based on the in8 approach and our experience. It is intended to give a basic understanding rather than a scientifically rigorous explanation.
When a frightening experience causes trauma, it has the effect of programming our “security centre” (which is located within the amygdala – a small almond shaped part of the brain). This particular set of circumstances is stored as one which represents severe danger. From that moment on any situation which resembles the traumatic event can trigger the same fear response. What is important to realise here is that the emotions which are triggered occur before we get any chance to think about the situation. Also note that when the emotions are very strong (such as intense fear) this can have the effect of completely overriding our ability to think rationally. It does not, however stop us from acting on impulse. Imagine a young mother who automatically rescues their child from a life-threatening situation; when asked “how did you find the courage to do it?”, they will often reply “I didn’t even think”. Our pre-programmed response to help our children survive usually evokes very strong emotions. And if you find it hard to imagine doing anything without conscious thought, consider how it is possible to drive a car along a familiar route and arrive at the destination without being able to remember a single event of the journey because we were “lost in a daydream”. Mastering a new skill such as driving a car means that we can now do it without conscious thought.
Imagine that you hear a sudden bang from the street outside the room you are in. Your attention is drawn to the sudden noise and before you get a chance to think about it, you exhibit a startle response. Usually it is nothing worse than a car engine backfiring and after the initial shock, you can explain it rationally and return to whatever you were doing. However, if you have previously experienced a car bomb or being under enemy fire, you may find yourself under the nearest table or out of the door before conscious thought gets to override the initial fear response. You are likely to feel the same emotions as were present in the traumatising event. When these are obviously inconsistent with your immediate surroundings you may also experience feelings of inconsistency, confusion and even unreality. Since we dream about the things which we worry about but cannot act upon, it is likely that these experiences will feature in your dreams.
Relevance to Phobias
We have explained how you can be programmed with a new fear response by a single traumatic event – as in PTSD. But it is also possible to achieve similar results by prolonged and repeated exposure to a number of smaller and less scary events. This is often the mechanism at work when a phobia is developed. Just thinking about the thing which frightens us on a regular basis over a period of time can cause a pattern to become firmly embedded in our unconsciousness. Although there may be an initial frightening event, it is often the repeated exposure in the imagination which embeds the pattern and does the damage. Once this has happened, the slightest reminder is all that is required to cause an automatic fear response. No amount of rational thinking can help since thinking happens after the emotion is evoked. Remember, the brain does not distinguish between a “real” and a “remembered” situation when it comes to emotions.
This explains why the same technique (whether called the “fast phobia cure”, VKD, HGTT, Rewind Technique) works both for trauma and for curing phobias.
The in8 Trauma Technique
The in8 trauma technique is a very quick, safe and effective technique for detraumatising events. It is common for people to come to us for between two and six sessions and typically the second or third session will include use of this technique whenever it seems appropriate.
Treatment does not require the patient to talk about the events that may have caused the traumatic memory. Any referencing of the incidents during treatment that may be necessary is undertaken as sympathetically as possible, with the patient in a highly relaxed state, to avoid further distress. The patient’s calm state during treatment, and the absence of any verbal recounting of the traumatic episode, ensure that this version of trauma-focused CBT is as compassionate and supportive as possible.
If you need help, but want to know a little more before picking up the phone, you might find the video on this next page useful: What Happens Next. Please call us if you have any questions. We can help you.