Home

  About us

  Depression

  Trauma / PTSD

  Military trauma / PTSD

  OCD

  Weight

  Alcohol & Smoking
  Relaxation
  Training

  Contact
  Links
  Media

  

rewinding trauma


Do not let anyone tell you that PTSD is for life, or that recovery is a painful and slow process, or that 'you can learn to walk again but the PTSD will always walk beside you' This is, generally, not the case: most people can recover reasonably quickly and without unnecessary pain.

But why are tramatic memories so powerful, so different from the everyday bad memories that most people have?  In brief, there are two kinds of unpleasant memories:

One - a bad thing happens, it feels awful at the time but gets slowly better. A year later you are coming to terms wiith it, five years later it's history. It may not be pleasant history, but it's history.

Two - a bad thing happens and it stays stuck at the back of your mind. Every time something reminds you of it you feel bad, perhaps as bad as you did when the event was really happening. Perhaps you think it really is happening again. Perhaps you dream about it, in terrible dark dreams that wake you in a sweat, maybe several times a night. Ten years later it may be even worse.

This second kind is trauma, post-traumatic stress disorder, PTSD. Even if you don't qualify for a diagnosis of PTSD (and if you're in the UK military you probably won't), any memory which creates effects that are unpleasant for you fits into this second category.

The difference between the two kinds of memory appears to be in the way they are stored. It seems that traumatic memories are strongly recorded in the amygdala, a part of the brain that looks after the fight-or-flight reflex. When the amygdala sees something that matches the original trauma, it sets off the alarm bells just as it did when the event was really happening. Sometimes these pattern-matches are so strong the whole brain is commandeered into re-enacting the original events. The problem in treating these memories is that you can't just talk over the original events, as this also sets off a post-traumatic reaction.  This is unpleasant for patient (and unnecessary) and prevents any useful work being done to re-process the memory.  It can be counterproductive, re-embedding the trauamtic response.

One solution, originally proposed by Milton Erickson in the 1960's, is to allow the whole brain and body to re-experience the trauma in a partially dissociated way while staying very calm, so that the amygdala can learn that this memory is not really life-threatening. The idea was picked up by the NLP school in the '70s and developed further by David Muss in the early '90s; Muss's book 'The Trauma Trap' contains a self-help protocol for sufferers to use his version of the technique, which he named the Rewind. Further developments of the idea have been proposed by a number of therapeutic schools, and the latest and most elegant version, developed by Joe Griffin and Ivan Tyrrell, is the human givens rewind technique.

This is simple, safe and very effective for most people, and crucially it is a very humane way of treating trauma. It does not involve talking over the traumatic events - in fact the patient does not have to describe them at all, just give them a name and watch them on an imagined television screen while in a highly relaxed state.

This makes it a highly suitable way to treat victims of sexual abuse, bullying or other events which would be hard to talk about.  Treatment is conducted with the patient in a highly relaxed state, which makes it a safer way to treat people who might otherwise be prone to acting-out their trauma.

In single-incident cases the nightmares, panic attacks and flashbacks of PTSD usually resolve straight away. However, there may still be other things to be done to relieve depression that often accompanies PTSD, and in some cases the main traumatic pattern is relieved but other memories then surface which are not related to the pattern that has beeen detraumatised. These memories are treated in the same way as the original trauma. In multiple or complex trauma the process is the same in essence, though it may take longer to reach a point where the post-traumatic symptoms are no longer intruding in someone's life.  As a guide, we would want to see anyone, even with a simple problem, at least twice.  Reaching a satisfactory conclusion in a complex case will depend on many factors, but can happen in a handful of sessions.

So what actually happens in a session?
 
Briefly, the patient is relaxed by whatever method works for him or her; usually a combination of extended out-breath, progressive muscle relaxation and visualisation techniques, all of which come from Yoga.  The aim is to achieve a calm, slightly disconnected state in which the patient can imagine resting in a pleasant place. This step can usually be omitted in children, who seem to have much easier access to their imagination.  Then the patient is invited to imagine that she/he has a portable TV and video, a laptop, a games console or any other kind of screen, with a remote control, and a tape, film, DVD or whatever of the traumatic event(s).  If there are two or three discrete traumatic events there would be one tape of each; if it were a repeating pattern of abuse over several years one would suggest picking three significant examples and having a tape of each; with an unremittingly awful life history (as often emerges in someone who is seriously depressed) a single tape of the whole life is usually best.  The patient is invited to float out of himself, press the remote control and watch him/herself watching the tape, without looking at the screen.  The therapist suggests that the patient will, somehow, ‘know’ when the tape has finished playing, and that  this could happen quite quickly, and that the patient can indicate, perhaps with a nod, when that has happened.  Even though the patient is not looking at the memory, there is usually some rapid eye movement activity visible during this phase.  When the signal comes, the patient is invited to float back into his body, press the rewind button and watch the events going rapidly backwards on the screen.  It is thought that the cognitive effort involved in reconstructing the history backwards keeps the thinking brain active and prevents it surrendering to the emotion connected to the memory; in any case, the body remains reasonably calm even though the mind is visualising the trauma. If a high degree of arousal has been experienced the patient is calmed down and taken back a step. When ready, he/she is invited to press the forward button and watch the events through, fast-forward, on the screen, then the process is repeated backwards, forwards, backwards, etc, always keeping the patient reasonably calm.  After two or three passes the view, on the backwards passes only, can be switched to a first-person view, going backwards through the memories as the patient remembers them instead of watching them on the screen.  It is useful to ground the start and finish of the film in a calm place, so the therapist may suggest, for example, that a reverse pass should end ‘back at a time when you feel ok, back before anything went wrong’; or that a forward pass could end ‘right here in the present, with you feeling calm and relaxed in that chair, knowing that all of those events are in the past now and that those particular events can never happen again’.  When the patient reaches the point where she/he can view the events forwards with no visible signs of physiological arousal, that is no obvious muscle twitching or facial distress, the process is done.  This would normally be achieved in six to twelve passes.  It is unusual for any one event to need this doing more than once, though people with long and complex histories of overlapping traumatic memories may take several rounds of this process.
 
 
It is not at all unusual for someone to have nightmares every night for 25 years and for those nightmares to stop, and the sleep pattern normalise, after a single session.  However, it is also not unusual to release someone from this degree of trauma and still have a patient who is burning with anger or grief, and who now has more energy with which to express these emotions. This is where the whole context of the HG model is so important.  The guided imagery of the Rewind leaves the patient in a calm, mildly dissociated state in which it is easy to step into more guided imagery, constructing further reframes of the past and then encouraging the patient's focus of attention into the other direction, towards the future.  The history-taking now comes to the fore as the therapist takes the patient through imaginative rehearsal of new patterns of thought and feeling, rehearsing kinds of behaviour that will yield benefits in emotional terms, tapping into old motivations that have been ignored during the traumatised time and re-connecting with the satisfaction of doing those activities again, re-framing the negative events of the traumatised time as 'things that happened when you were not quite yourself', and so on.  All of this work, plus the core trauma work itself, are aimed at helping the patient build a life that meets his or her own emotional needs in a realistic, sustainable and balanced way, as a life in which this happens should be self-sustaining and independent.