Don’t let your past dictate who you are, but let it be part of who you will become.
—NICK to TULA, My Big Fat Greek Wedding (2002)
It is always a good idea to learn from the past, but not always to dwell on it. Processing trauma memories is a common practice in trauma therapy and is often advised in self-help books. However, there is a growing debate in the field of traumatic stress: How useful is the revisiting of trauma memories? The jury is still out. As common sense would predict, it seems to be an individual matter—helpful for some but not for others. A good many benefit from going over their traumas, sometimes repeatedly. On the other hand, some become further disabled by the practice. Actually, most people recover from trauma without any formalized reviewing of the past at all. It is a viable option, though not necessary nor even always advisable.
This chapter is not concerned with whether or not you remember your trauma(s); safe recovery is possible in either instance. The subject matter of these next pages involves illuminating commonsense options for deciding if, when, and how much to work with trauma memory. At the time I was pursuing my own trauma recovery, there was only one acceptable option. The only philosophy at the time assumed that traumatic memories must be recovered and processed. I remember sometimes wishing there were other choices. Since then, I am happy to say, the field of traumatic stress has matured and more options have emerged.
Dr. Pierre Janet’s Key
The clearest, most commonsense framework for managing trauma memory actually evolved in the late 1800s. I am hoping that eventually it will be the standard for all systems and methods of trauma recovery. In the latter part of the 19th century, Dr. Pierre Janet laid a firm foundation for the future of trauma recovery. He defined a three-pronged system for healing from past trauma. His phase-oriented approach can be applied across the full spectrum of available philosophies, methods, and models. However, to my knowledge, the only previous discussion of Janet’s concepts in the self-help genre appears in Judith Herman’s seminal classic, Trauma and Recovery.
According to Janet, it is not advisable to move to Phase II, working with past trauma, until the goals of Phase I are achieved, that is, until the traumatized individual is safe, stable, and able to function on a daily basis. I could not agree with Janet’s philosophy more and have never encountered a trauma client, professional, or author who disagreed with Janet in principle. However, there are few who actually follow his framework. Most clients as well as authors and practitioners seem to become too impatient to get at the trauma memories, sometimes with disastrous results. Waiting to ensure stability seems much too difficult for many.
Janet’s model is full of common sense. You may have noticed by now, dealing with your own issues, that recalling trauma—even under the best of circumstances—throws you off balance. For anyone, recalling a traumatic past in an already wobbly state only increases the wobble. Of course, many people can manage moderate levels of unsteadiness. But for those who live with emotional instability on a daily basis due to their trauma, increasing that instability can land them in deeper trouble. The concern here involves the necessity of maintaining an adequate level of functioning on a daily basis. This is quite different from becoming upset, which is a normal part of life in general, and trauma recovery in particular. However, if you are not able to continue to function—to think clearly and care for yourself, in spite of being upset—that is cause for concern. Janet’s model, which requires stability (able to function, but not without feelings) before approaching potentially destabilizing memories, ensures safety and makes infinite sense. However, for some there is this risk: If you prioritize stabilization before dealing with the past, you may find that you must put off moving on to focusing on your trauma memories—which is not necessarily a bad thing. For some of you that would be a relief. For others, postponing or even skipping delving into your memories will be a scary idea, perhaps even seeming intolerable.
Take a minute or two to consider your actual goal: Is it to process and reprocess your past, or is it to better your future? For many of you, the surest route to the latter will be via memory processing. However, for others, the better future will be found via a memory bypass. When remembering trauma interferes with your quality of life, then consider if avoiding memory might serve you better—at least for a while.
The first goal of trauma recovery should and must be to improve your quality of life on a daily basis. Contrary to common sense, however, processing trauma memory is and always has been the primary goal of trauma self-help books and therapies. While some individuals definitely do benefit from revisiting their traumatic situations, all too many do not. In fact, a significant portion of individuals either do not want to remember (see Stuart in the next section), cannot remember (like Martha, mentioned in Key 1), or become decidedly worse when they do remember (like Stephanie in the previous chapter). In any of these instances, remembering should never be required by you or anyone else.
Of course, working with your trauma memories might be an important part of bettering your daily life. In such a case, moving on to that task after you are sure you can manage it (when you are stable) will be logical for you. However, you may already know the opposite is true for you: remembering trauma makes it more difficult for you to function, including accomplishing simple tasks, or enjoying the company of others. In that circumstance, reviewing your trauma will not be a good idea in the short or perhaps even the long term.
The theory and exercises associated with Key 3 will help you to identify your unique needs and capacities for remembering trauma. By the chapter’s end, you will be better able to judge for yourself whether you should, now or later, or at all:
Please remember: They are your memories and you have a choice whether or not you want to spend time on them. Being able to predict if you are someone who could benefit from processing the memory of your trauma or if you would be better off—at least for now—leaving your memories alone could help you to make an informed choice. In a few pages I will outline criteria for that purpose. However, first I would like to show you an example of what recovery from trauma without processing memories of the event might look like.
An Example of Recovery in Phase I: Stuart
Stuart began having periodic flashbacks and frequent panic attacks following his survival of a terrorist bombing. I first met him several years following the incident, after he had tried medication and psychotherapy to no avail.
In discussion of his goals, Stuart was clear: He wanted to be free of the panic. However, remembering the details of the bombing was still so upsetting that he feared to go there at all. Respectful of his wishes, I suggested we could possibly tackle his panic attacks by investigating their course. If we could identify a pattern, we might, I proposed, be able to find a way to interrupt it. For that to have a chance, though, Stuart would have to be willing to take on regular homework assignments. He was agreeable to that.
At our second meeting, I proposed to Stuart that he take the role of a scientist. I suggest this often, as it is a great way to get people fully engaged in their recovery process. Moreover, the information they gather can be invaluable for helping themselves. The first step involved mindfulness (per Key 1). Stuart learned to pay attention to his body sensations, emotions, thoughts, and feelings. I suggested that he get in the habit of observing the shifts in those states as much as possible for a week or two. As he became more adept, I added the next step: keeping track of what he ate and drank, what he read or watched on television, the topic of conversations with friends and family, and so on, and how each affected his body sensations, emotions, thoughts, and feelings. Of particular interest would be his state immediately before the onset of panic, and anything he could identify that was different on the days he had a panic attack from the days he did not.
Soon, we could identify several patterns from Stuart’s research. Certain types of music helped him to feel calmer, while other ones made him more agitated. He found that eating chicken and steak made him feel more present and stable but desserts, except for ice cream, had the opposite effect. Most important, Stuart eventually identified that every panic attack he had was preceded by one or more cups of coffee within 30–60 minutes before the onset of the attack. As he paid more attention, he observed that during the first half hour after drinking coffee, his heart rate would climb. He would notice he was nervous, then anxious. Finally, if his heart rate did not quickly decrease, he would break out in a cold sweat, feel faint, and begin to panic in earnest. The attack would last around an hour and subside in sync with a reduction in heart rate as the caffeine worked its way through (and out of) his system.
Because of the cold sweat and fainting feeling, I asked Stuart to get a physical examination and a stress test. I wanted to make sure there was no biological cause, complication, or connection, and no heart irregularity. However, all exams and tests were negative. His doctor confirmed Stuart’s symptoms were provoked by caffeine.
That was a tough realization for Stuart. He loved coffee and the social aspects of drinking it with his colleagues and friends. He had always been skeptical of “the herbal tea crowd” and was loath to join them. However, after trying a single coffee-free (and other caffeinated beverage-free) week he felt so much better that he was willing to make the switch permanently. When he held to caffeine abstinence, he was entirely free of panic attacks.
Stuart recalled that he had been drinking espresso at a café at the time of the bombing. It is likely his heart rate was already high and the fright of the bombing spiked it higher. Thereafter, the coffee taste combined with the increased heart rate became associated with the bombing and mortal danger, triggering his subsequent panic attacks.
Many would not consider Stuart’s increased control over his symptoms to be a cure. And Stuart knew that the actual bomb attack still played a big role in his (much reduced) anxiety. But the quality of his life improved a great deal. Moreover, he was very happy to feel mastery over his body and appreciated that he had not been forced to delve into recollections that he feared would be overwhelming. We parted company with the understanding that my door would remain open to him should he be interested in or require further help.
What works varies widely as individuals are so different from each other. But the Phase I (stability) principles applied in Stuart’s case, along with others discussed in this book and elsewhere, can be used by most anyone. The success of concentrated work on stabilization demonstrates that processing trauma memories is not necessary for improving quality of life. It is an option you can choose or not based on what you decide is most likely to benefit you. For many survivors of trauma, the successful self-control achieved by Stuart would be welcomed as a huge step. For some it would even be considered a cure. However, there is one more step to add before calling Stuart’s improvement a successful recovery.
Oft-Neglected Phase III
A common pitfall of trauma recovery is neglecting Phase III, integration. Most of the time people get so involved in stabilization (Phase I) or the intrigue or destabilization of remembering trauma (Phase II) that integration (Phase III) becomes all but forgotten. While Janet advised that integration should be the endnote to trauma recovery, I propose an alternative view. It is my recommendation that integration is best woven throughout the recovery process. Whether emphasizing stabilization or trauma memories, integration should always be alongside. That way any result or change along the way can be relevantly integrated into daily life. For example, Stuart had to learn how to take his new knowledge about caffeine and the change in his behavior (no longer being a coffee drinker), and apply it on a daily basis. This involved not only a dietary concern, but also dealing with his family, colleagues, and friends who would be surprised or remark about his change of taste or habit. We took time to discuss how he was adjusting and where it was easy or difficult. For example, he sometimes rehearsed how to respond to a confrontation or smart remark. Integration for you might mean talking with your partner or best friend about the changes you are making or keeping a log or diary to help you make sense of your changing reactions, view, or situation.
Which Phase Is for Me?
How do you know if you would be best off focusing on Phase I stabilization or the memory processing of Phase II? First and foremost, you need to make an honest evaluation of your current level of stability and safety. Below is a list of general considerations. Please feel free to add any points that are missing which apply to your unique situation. Some of the essentials necessary for stability:
Basic safety implies that you are not continuing to live under threat of trauma. For example:
Of course the examples above do not cover all possibilities but should give you an idea of what is meant by safety. If you are not currently safe, that must be your first priority.
Before Moving on to Memories (Phase II)
If you meet the stabilization criteria for Phase I, there are still several things to consider before moving on to Phase II.
Do You Want to Revisit Your Traumatic Memories?
This may seem an absurd question, but actually it is very, very important. There is no reason to revisit your past if you do not want to or if you do not see a value in doing so. Do not let any doctor, author, therapist, family member, or friend push or force you into reviewing the past. Giving in to another’s pressure in this regard could land you in a much worse condition. However, this is probably easier said than done for many. I was coming unglued before I could convince my therapist to change direction or back off. So I do understand it is not a simple matter to tell a close relation or an authority figure—especially a doctor or therapist—no. You might need support to assert your right to choose. If possible, discussing and rehearsing with a friend who is not pressuring you might prove very helpful. Ultimately, it would be best for you to find your own way to phrase what you want to say. However, below I include a sampling of ways to phrase a refusal, listed here for inspiration and just to get you started.
You are also welcome to share this chapter (or entire book) with anyone who is insistent.
When You Pay Attention to the Past, Do You Lose Connection With Your Present Life?
Some trauma victims become so absorbed by focusing on the past that they miss their life now. Trauma memory processing should be a sideline, like using physical therapy or exercise to heal a physical injury. It should never be the main preoccupation. If you find you cannot live your daily life while focusing on the past, then consider putting your memories aside, at least until you are able to manage a better balance. For some of you this advice will come as a blessed relief. Others may be rolling your eyes and saying, “Yeah, right!” because it seems impossible to do. Remember, though, that a major part of trauma recovery is increasing your self-control, your mastery over your trauma. That includes taking control of the intrusions of memory that may be plaguing you or provoking obsessive thoughts. Many of the keys in this book will help you feel more in control. In addition, there are some tricks you can try also.
Often when trauma survivors are overly preoccupied with trauma, they need activities to occupy their time and their mind. You may notice that it is in the spaces where you have nothing structured that you are most vulnerable. Activities that people use to fill this kind of space include singing, computer games, puzzles, beading, car repair, baking, volunteer work, learning a musical instrument, drawing, or painting. Anything that occupies both your hands and your mind can be great for this purpose. During a particularly difficult time, I bought a book on solitaire games and learned to play about 20 different ones. It was like an oasis for me. I would get so absorbed in the games that I would be surprised to discover time had actually passed without my thinking about my trauma (at first minutes, then later hours). Once I realized it was possible to create spaces without trauma thoughts, I was able to expand on that idea, finding other things to do—some more constructive—to preoccupy my thoughts.
Some People Become Decidedly Worse From Attention to Their Past.
It is not uncommon for coping mechanisms to weaken or even fail as individuals focus on past trauma. As mentioned before, any focus on trauma memories is destabilizing. Some people can better afford that risk than others. That is, the greater one’s stability prior to dipping into the past, the better one will likely manage. However, when already unstable, or when memory focus causes extreme instability, the cost of spending time in memory may outweigh the benefit. In the next section, I suggest a model you can use to predict if you fall into this category.
Apply a Little Theory
For some of you, the idea that you may not benefit from revisiting your past may come as a hard blow. I know that there are many who become convinced that finding out what happened in the past is the one and only way to a better life. As I said before, for some of you that will be true. For others, though, it will be the opposite—poking around the past could make your life worse. Hopefully the following paragraphs will help you identify which category you might fall into:
Trauma Resolved
If you have suffered trauma in your past but it does not intrude on or affect your daily life, you might consider leaving your memories alone. You have probably heard the phrase, “If it ain’t broke, don’t fix it.” It is apt for this situation. Sometimes a well-meaning friend or helping professional will assume that past trauma always means issues to resolve, but that is not the case. Probing the past is only of value when there is something to be gained for the present or future. And, difficult as it is to believe for many, trauma can and does sometimes resolve on its own. So you may be one of the lucky ones who has managed to recover without obvious intervention. Move on and enjoy your life.
Single Trauma
Have you experienced a single trauma that continues to affect you? That might be one incidence of assault, a lone car accident, a molestation, and so on. If there are no other traumas in your history and assuming you are or become stable first (Phase I), processing memory of that trauma could be of use for you. However, that is only if you want to and see a benefit to be gained. Stuart and Stephanie (Key 3) fall into this category.
Multiple Trauma, Stable
For those of you with multiple traumatic events in your past, there are two likely possibilities. The first one involves people who remain resilient despite their experiences. When they reflect on their past, their thought processes are organized and they can address one issue at a time without confusion or intrusion of the other issues. You will know if this is your situation when you can tell someone, or think about, one of your traumas while your attention stays only on that one. If this applies to you, you may also benefit from processing past events once you are stable and safe—if you want to. Liam, in the next chapter, is an example of someone in this category.
Multiple Trauma, Unstable
If you have multiple traumas in your background and they are in a jumble, and thinking or talking about one causes you to be flooded by memories of other events, you might not do so well attending to memories. In this situation, attempting to process and resolve a single memory is impossible. The confusion and overwhelming stress that usually ensue in such cases leave the individual in worse condition. Those who continue to attempt processing, hoping they will get through it, often end up in truly difficult circumstances. Stability is what is lacking in these situations, so Phase I work must be the focus. See below for a further discussion of this category with regard to Janice, who you met in the first chapter. For a portion of individuals of this type, successful stabilization may actually result in a change in their status, shifting them into the multiple trauma, stable group. When that happens, the other criteria will then apply.
Discovering the Key: Janice, Part 2
Janice is an example of the multiple trauma, unstable survivor mentioned above. Her father’s incest went on for many years, countless episodes. In addition, her history included being beaten up and bullied at school, as well as three auto accidents.
At the start of our work together, Janice was chaotic. She was often late or forgot sessions altogether. Whenever she delved into her past, she would become completely overwhelmed, often followed by dissociation. The work we did together on managing touch, illustrated in Key 1, was a part of Phase I stabilization. Janice also worked to further control her body and symptoms. She began a program of strength training and took an assertiveness training class. Janice was able to translate what she learned in our relationship to better her relationships with her friends and family. Within 15 months, Janice had developed a network of reliable friends, she was consistent at her job, and she was able to use many tools to control her other symptoms. As a result, her thinking and memory process also stabilized. She was eventually able to focus on one incident at a time without being overwhelmed. At that point she became a better candidate for memory work (Phase II), though she did not choose it. Most people with this kind of overwhelming, multiple trauma history can achieve Janice’s level of stability when the focus is on stability and then choose if they want to seek out the past. But many are, like Janice, pleased with the changes in their daily life and have little interest in looking backward.
Applications for You
At this point you might be wondering why, when stable enough, anyone would decide to remember past trauma and process his or her recollections. It is not usually pleasant to do, so what could motivate a person to remember something so awful? It is not a particularly good reason to take on such a challenge just because it is there. The only reason to risk the pain and upset involved is if there is something useful to be gained. The importance may lie in clarifying what actually happened or recognizing the meaning of the events. It may have more to do with identifying what went wrong with the hope of preventing anything similar happening to oneself or loved ones in the future. Additional possible benefits, depending on the methodology, include:
The following exercises will help you decide if it is a good idea for you to spend time on your trauma memories. Do not forget that this is your choice; this chapter and these exercises are for guidance. For those who already know—for whatever reason—that you will or will not be processing trauma memories, these exercises will be unnecessary. If, however, you are in doubt or unsure, they may help you to figure out what is best for you. Before attempting the exercises, remember to check each with your mindful gauge that you developed from the first key. You may discover you would rather skip over one or more of them. Until you have decided one way or the other, stick with stabilizing tasks, many examples of which are outlined in future keys.
Exercise 1: Evaluate Your Stability (Phase I)
Exercise 2: Finding Tools to Increase Stability
List specifics of what you need to stabilize and have a better life. Emphasize things you can do in the here and now such as get more exercise, make a new friend, structure your day, and so on. Would it help you to have more activities such as volunteer work or taking an art class? Also consider what you are doing inside yourself. Do you need better control over your thought processes? Maybe you need more knowledge about or skills in dealing with upset or arousal in your nervous system. There could also be very practical things that would improve your stability and quality of life. You might be one who would benefit from a pet, or joining a religious or spiritual group, or perhaps a sports team or book club would be useful for you. The point here is to consider all options. Do not be limited by my examples or the opinions of others. And be alert for anything you might want but do not think possible. It just might be worth looking into as you or someone else might find a way you did not realize was there before.
Exercise 3: Chart Pros and Cons for Revisiting Your Memories
Take a fresh sheet of paper and draw a line down the middle. At the top, label one column “Pro” and one “Con.” List your thoughts or arguments for processing trauma memories in the “Pro” column and those against in the “Con” column. You may want to do this all at once or over the course of a few days or weeks and then review your points again. You might also make your lists and then put the paper away for a while. If possible, it could be beneficial for you to talk over these points with a supportive friend, family member, or professional. Be sure it is someone who will respect your decision but will also give you honest feedback on anything you might be missing or overlooking.
Exercise 4: Identify Your Type
Based on the information in the theory section above, assess which trauma type applies to you (trauma resolved; single trauma; multiple trauma, stable; multiple trauma, unstable). Be as honest as you can with yourself, particularly when evaluating your stability and if you can stay focused on one issue at a time. It is important that you acknowledge your limitations, particularly if, when you think about one trauma, others come crashing in and you become easily overwhelmed or debilitated.
Evaluate This Key
Use your mindful gauge and common sense to appraise the value of this key for you. Is making a decision about focusing on the past or present useful for you? Will it be a good idea for you to spend more time on this material or exercises? Imagine scenarios and pay attention to the answer of your gauge. Do not be worried if your gauge tells you that this—or any chapter in this or any other book—is not for you. Finding out what is right for you includes identifying what is not.
Plan How to (or Not to) Use This Key
How will you put to use what you have learned in this chapter? Have you made a decision about your trauma memories? If so, is it a firm decision for always or will you want to revisit your decision in the near or distant future?
Endnote
For those without actual memories, but who have a suspicion of past trauma, some of the most definitive research we have in the trauma field indicates that false memories are relatively simple to create. Trying to unearth memory of trauma to account for daily life difficulties is one of the easiest and surest ways to false memory creation. On the other hand, we have many examples of trauma survivors who have or had periods of amnesia for past events, particularly ones of terror or horror. However, attempting to unearth memories for which there is no evidence usually causes more havoc than healing. If you feel as though you have been traumatized, but have no memory or information to account for your impressions, stick like glue to the here and now. Emphasize taking control of and easing your symptoms to better your daily life. Avoid delving into an uncertain or unknown past. For too many, that direction has led to severe consequences.