Dr. Shannon was a psychiatrist with her own issue, which turned out to be nearly debilitating. Her fellow psychiatrists had not been successful in helping her treat it. She had already diagnosed herself with posttraumatic stress (PTSD). Her days and nights had, for months, been shattered by sickening flashbacks and paralyzing nightmares. She had developed a bizarre phobia.
She cried as she painted a picture of increasing despair. The merest hint of similarity between her horrific memory and innocent daily happenings was enough to spin her into pulsating, gasping panic. She felt useless professionally and was starting to wonder whether she could ever go back to work.
So, of what was Dr. Shannon so afraid?
Bizarre Phobias Are Not So Weird
It might surprise you to know that this woman had developed a sickening terror of the elderly. For her, the sight of a grey head or stooped posture was enough to set off flashbacks and panic attacks so severe she believed she might die.
Dr. Shannon’s life was unbearable.
She had read about the famous ‘rewind technique’ and knew I used it for the treatment of PTSD and phobias. She knew exactly why she had the problem and understood its source. But knowing why you suffer and being able to stop the suffering are two different things.
Dr. Shannon knew that her trauma stemmed from a shocking incident. Something that happened one rainy afternoon in the psychiatric unit in which she worked. She didn’t want to tell me. I didn’t want her to tell me. She told me anyway.
Fear of Death
“He’s an old man. But he nearly killed me,” she told me.
An elderly man, a patient, without warning, had attacked Dr. Shannon. Lacing his arthritic, but strong-as-iron, fingers around her throat that day, he had come within a whisker of ending everything for her.
He had smiled toothlessly while choking her. It was all the more nightmarish for her, because he had never been considered dangerous. He was a frail old man. But this seemingly frail and harmless man in his 70s was murderously strong.
“It was sheer luck that he didn’t kill me.”
Why, even now, months later, was she still having flashbacks?
The Trance of Fear
Dr. Shannon was saved by a young co-worker and another doctor. Even they had trouble releasing the man’s deadly grip.
Other than angry turquoise bruises, she was not physically damaged. But in those few vivid moments, Dr. Shannon experienced the type of trance we all experience at the outer edges of fear. It felt unreal and hyper-real at the same time. Fear focuses and narrows attention. During such states you are wide open to learning, a kind of unconscious programming.
My client had been programmed with the template of that experience. Even as her life was leaking away, her mind had been busy at work identifying and storing the patterns that would alert her to such a dangerous threat in future. That template could encode any aspect of the experience, including the pattern of elderliness.
I’ve seen this kind of caution before in PTSD clients: the war vet who would panic whenever he saw individuals back in England of even faint Middle Eastern appearance, or the woman mugged by a man with a beard who would then fear any man with facial hair.
Nature is concerned with keeping you alive, but sometimes it is too thorough. When this happens we need to change things so that whole lives are not ruined by the brain’s overeagerness to tag harmless things as threatening. The part of the brain that can both save lives and lay waste to them is so small.
How a Tiny Part of the Brain Causes Big Problems
A tiny structure deep within her brain called the amygdala caused a massive fear response for Dr. Shannon. It encoded memories of the near death assault. In future, anything at all that reminded her amygdala of the initial trauma would produce strong feelings of fear, and drive her to take avoiding action. Whenever she was confronted with anything that even vaguely reminded her of the initial trauma, such as seeing any old person, there would be a kind of posthypnotic trigger, and she would be reliving her experience again.
She knew what was happening, but she didn’t know how to stop it.
It’s a common assumption that your thoughts determine your feelings, but actually your amygdala produces emotion before your thinking brain gets a look in. Strong feelings need to be quicker than thought for basic survival. A colleague had tried to help her with cognitive therapy. But the 25% of people who have persistent PTSD [1] are not able to be helped by changing their thoughts, because their troublesome reactions happen quicker than thought. This is the basis of triggering reactions as part of PTSD.
Any cure would need to work with Dr. Shannon’s preverbal unconscious responses.
Taking Out Trauma
About three quarters of people who experience trauma won’t need any treatment – just love and support as they recover. They’ll dream it out (the brain’s clever way of releasing any kind of emotional arousal) or eventually be able to reflect on it and talk about it. Their memory banks will relocate the traumatic memory into ‘narrative memory’ and, although they’ll know it was bad at the time, they’ll be able to think and talk about the event fairly easily.
The remaining 25% have persistent trauma. Weeks, months, or even years later, it will still feel recent, or even current. The sufferer won’t be recalling it as much as re-experiencing it. The very same people who have persistent flashbacks (which work like post hypnotic suggestions) have been the very same people who respond best to hypnotic suggestion [2]. Trying to get someone who is deeply traumatized to talk things out may only make it worse, as this may recreate the trauma [3, 4].
When Talking Hurts
Dr. Shannon couldn’t talk about the initial attack without shaking and becoming tearful. I got the gist of what had happened that day then told her that was it. She need never speak of it again, or she need not speak of it until it felt fine to do so, which would be soon.
I was going to use the Rewind technique on her, a natural and painless way of lifting trauma. It uses relaxation and dissociation powerfully and comfortably, to allow the brain to reprocess memories from being contained within the ‘fight or flight’ part to the higher cortical centres where it can be reviewed without strong emotion and where, like many other memories, it will start to fade in time.
Twenty minutes after she’d arrived, we set to work lifting her trauma.
New Life for Old
Dr. Shannon looked a different woman. After Rewind treatment she was — to use a very nonpsychiatric term — blissed out. She was calm and appeared younger, as the creases of tension had melted from her face.
She described with wonder how the memory seemed distant now, bad at the time but no longer bad to think about. She was liberated from that particular prison of memory. She had hoped this was the case, but hadn’t really dared believe it. Some of her colleagues had scoffed. How could such a condition be treated without Dr.ugs? How could something so serious be treated in one session by a man who didn’t own a white coat? But Dr. Shannon was so desperate she didn’t listen to them. And as I said to her: “The PTSD was learned in a matter of a few seconds. Why should it take that much longer to unlearn it?”
Three days later she was back at work. Many co-workers could barely conceal their surprise. Some still doubted her cure would last.
She texted me the following weekend to tell me she was having tea with her 80 year old aunt, surrounded by elderly faces. It was the best text I got all week.
References:
- Wilson, J.P. and Keane, T.M. (1997). Assessing Psychological Trauma and PTSD. The Guidford Press.
- Spiegel, D., Detrick, D., and Frischholz, E.J. (1982). Hypnotizability and psychopathology, The American Journal of Psychiatry, 139, 431-437
- Wison, J.P., and Keane (1997.) Assessing psychological trauma and PTSD. The Guildford Press.
- Rose, S., Bisson, J., Churchill, R., Wessely, S. (2002). Psychological debriefing for preventing post traumatic stress disorder (PTSD). Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/12076399.
The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.
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