Nat'l Institute of Mental Health, NIH Medical Arts
Did you know that you don’t have to use EMDR or painful exposure techniques to clear the emotional charge of a traumatic memory? All that is required is keeping the client “emotionally present” as they are describing the details of the event.
This concept was introduced to me many years ago by Dr. Jon Connelly. Now, neuroscience discoveries, and trauma researchers like Bessel van der Kolk, MD and Dan Siegel, MD are coming to similar conclusions.
Why does this work? I believe it works because when we keep the client emotionally present, we are helping to prevent the amygdala from activating the fight/flight response. The amygdala is the little almond shaped structure in the mid-brain that is triggered if the deeper mind senses danger. (See the Amygdaloids video on this blog for more info about this.)
The problem is, when the amygdala and fight/flight response go into high gear, the brain inhibits the function of the hippocampus and parts of the pre-frontal cortex. The hippocampus and certain aspects of the pre-frontal cortex are responsible for integrating memory and tempering emotional responses. If these parts of the brain are “off-line,” then the memory stays seared into the deeper brain as a non-verbal, implicit, felt memory.
When a memory stays in this implicit form, associated sensory details like smells, times of year, sounds, and visual images can trigger the same feelings of terror as the original event. However, these triggers are often “unconscious” to the client.
One goal of any trauma therapy is to integrate the traumatic memory over into conscious, explicit memory. To do this, we have to keep the hippocampus and pre-frontal cortex open and on-line. If you have the client emotionally re-live the event, guess what? You inadvertently activate the fight/flight response right there in the session and cause the hippocampus and pre-frontal cortex to go offline again.
“Recollecting’s not forgetting, it’s vivid rehearsal of pain. It keeps fear in my thoughts. It reminds me of that day. It keeps fear in my brain.” The Amygdaloids, from their song Fearing.
For a client to recall a traumatic event without “vivid rehearsal of pain,” you have to use tools that keep them emotionally responding to the present situation. This seems to allow the deeper brain/amygdala to realize the event is over so that it no longer fires off the fight/flight response at the mere recollection of the event’s details.
This has huge implications for how we practice psychotherapy and I am actively staying on top of research related to this phenomena.
Courtney Armstrong is a Licensed Professional Counselor who specializes in treating trauma, anxiety, and grief. She has a private practice in Chattanooga, TN and trains mental health professionals in an approach called Rapid Resolution Therapy. To contact Courtney, visit www.courtneyarmstronglpc.com.