How to stop post traumatic stress symptoms: a psychotherapist explains

I’m assessing the Fusion Diploma at the moment. 

It’s something I really enjoy. The Diploma course is a very intensive training programme for therapists and wellbeing coaches of all kinds. It’s full of professional interventions and practical strategies that can help our clients feel better fast. For me, it’s so rewarding to read the case studies submitted in the portfolios and see how learners are using their new ‘toolbox of skills’. 

One powerful skill included in the programme has the potential to de-traumatise a client in just one session. It’s called the Rewind technique. A Fusion coach contacted me this week after I sent her some guidance on working with a new client. I suggested trying the Rewind, which she had never done before. 

'Hi Frances, 

I did the re-wind on the person who was being bullied by her boss. she scored 62 on the impact of events scale before and I checked again this week and the score has come down to 9 – amazing!   

I attach the impact of events scale….After the rewind I did a guided visualisation to embed it using a therapeutic story whilst getting her to imagine her boss shrinking in size. We also discussed this when she had finished and suggested a mantra too.  

Thank you for sending the info through, it made it so easy to explain.' 

Dr David Muss 

I came across the Rewind technique many years ago when I did some training with the Human Givens Institute. Later, I learned a faster method from Dr David Muss who was the first to use it specifically for Post Traumatic Stress Disorder. He wrote the book ‘The Trauma Trap’ giving instructions about how to use Rewind as self help. He has a produced an app which is freely available on his website. 

The key to fast resolution is dissociation, or the unique human ability to step back into the observing self. It’s also to do with how memory is stored. 

For instance, if I asked you what you had for dinner two weeks ago, you would be unlikely to remember. However if you consulted a diary or thought about it for some time, you may be able to retrieve the memory. Alternatively, if I asked you what you did on your last birthday, you are more likely to remember the details as this event is tagged with emotion which makes it easier to retrieve. 

Imagine an area in your brain that's a bit like passport control; ordinary and every day memories are waved through and put into a filing cabinet and this is where they stay unless you decide to look around in the filing cabinet and retrieve the document. 

However, if an incident occurs which is perceived as a possible life or death situation or is a significant traumatic event, the memory is not waved through by passport control and is kept in a kind of holding bay. 

The amygdala, an almond shaped organ within the limbic system, or emotional centre of the brain, has the job of protecting the human organism. If something occurs which is perceived as threatening to the body, sufficient emotion is tagged onto the memory by the amygdala to ensure it stays in the holding bay. 

The brain will then scan the environment for anything similar to that event and will press the panic button if it perceives a similar threat is present. This is your amygdala's way of trying to protect you. It feels it has information which must not be filed away if it is to continue to stay fully alert to similar danger on your behalf. 

Patterns 

The human brain is also a pattern matching organism and has to be so to safely navigate the world. 

If you walk into a room and see a chair, although you have not seen that specific chair before, you know it is a chair because it loosely matches the pattern of a chair, with a back, seat, and four legs. This pattern matching mechanism has to be quite loose otherwise every time you saw a new chair you would have to work out what it was all over again. 

The loose pattern matching mechanism means that anything in the future which is similar enough to an original trauma may produce the fight, flight or freeze response. 

In this way, a traumatised soldier may be re-traumatised by the sound of fireworks as the sound is similar enough to a bomb blast for the amygdala to loosely connect it to a previous life threatening event. Many veterans of war do not look forward to bonfire night as they are aware they are likely to feel stressed or distressed by the sound of fireworks.

Getting outside of the memory 

In setting up the Rewind technique, it is important for the client to understand the difference between being on the inside of a memory or the outside of a memory. 

For instance, imagine being on a rollercoaster and you are experiencing all the ups and downs. You are likely to feel some of the emotion attached to that experience, whether that is either elation or terror or a combination of feelings. However, if you imagine you are in cinema and watching a film of yourself on the rollercoaster, you are unlikely to experience the emotional reaction as you are detached from the experience.

You are now on the outside looking in. 

Encouraged to view the trauma in a safe environment, further away and from the outside looking in, the client is moved into their observing self and the amygdala receives the message that this incident is not current and they are now safely out of that situation. 

The client’s 'internal soldiers' who have been scanning the environment for danger are given permission to stand down. Emotion is unhooked from the memory and it can now be processed, contextualised and integrated into normal memory. It is waved through passport control and filed away with other memories. The traumatic memory will not be forgotten and can be retrieved much as other memories can be retrieved at will, but will not now produce the high emotion of the original memory. 

Resolving PTSD  

Wives, friends, and colleagues can all suffer the fallout from Post Traumatic Stress Disorder. 

It often goes undiagnosed because people don’t like to talk about trauma, so they talk about headaches, insomnia, panic attacks, depression or the drug and alcohol issues which are often just symptoms of the real underlying problem. 

My book ‘PTSD Resolution’ demystifies the Rewind technique for professionals and normalises the treatment for anyone experiencing the distressing effects of trauma. For those who have lost hope of recovery, knowledge is power, and clear information will hopefully encourage sufferers to finally seek out help. It is now on the recommended reading list for the Diploma. 

PTSD Resolution is a very unusual book of two halves. It begins by telling a story through the eyes of Rob; a war veteran plagued by PTSD symptoms whose marriage is close to breaking down. He arranges to see a therapist. His first session, based on my interactions with a a real client, is fully scripted word by word and provides a ‘fly on the wall’ account. 

The same session is then described by the therapist, and gives a clear explanation of how she is working. What feels like a helpful conversation to Rob is actually a therapeutic process underpinned by years of experience and layers of technical theory. 

Here’s an extract from both views:

Extract 1: The client 

''As Rob sat outside the cottage, his hands on the steering wheel, glancing from house to road to house, he debated the idea of simply driving away. 

‘How the hell did it get to this? How did I get to a point where my life is so out of control that I need to crawl to someone else for help? I've always been a strong one, the tough guy, the soldier. I look after everyone else. That's my role, not the other way round.’ 

Mary's voice on the phone had seemed calm and confident. ’Nightmares and flashbacks? Yes, I believe I can help’ and the appointment was made. 

His partner, Jane, was relieved. This finally felt like a step in the right direction. She had reached breaking point herself. She wasn't sure if the marriage could survive another year of the nightmares, the anger and the drinking. It was like the old Rob had been stolen, his happy-go-lucky personality taken by aliens and replaced by a restless, jumpy and distant stranger. 

Finally, with a heavy sigh, Rob pulled his key out of the ignition, the decision made. He put his hand on the gate and looked up at the red door ahead, wondering what lay beyond and whether he dared to hope for some peace at last. It seemed unlikely but, he had nothing to lose. 

Mary's smile was warm and welcoming as she took Rob along a little side path to her study.

‘So you found me alright then Rob?’ 

‘Yes‘  

‘And you managed to park up okay? 

‘Yes, just outside the pub.’  

‘That’s great. At least the sun has finally decided to break through.’ 

‘Yes, we could certainly do with some sun.’ 

And before he knew it, Rob was seated on a comfortable old sofa, sinking into its feather filled cushions as Mary handed him a piece of paper. ‘Just a little tick box thing for you to fill in Rob. It'll only take a minute to complete and it means I won't have to fire loads of questions at you. Is that okay? ‘While you're doing that, can I get you a tea or coffee? ‘ 

‘Yes, coffee thanks Mary.' Rob felt more comfortable than he'd anticipated. 

This seemed strange, not like he had imagined it at all. No clinical surroundings. No white coated expert; the most normal and natural thing in the world. Rob looked more closely at the form Mary had left him. An ‘emotional needs audit’; that was puzzling. The first question made him think hard. 

‘Do you feel safe and secure in the major areas of your life…..’ 

Extract 2: The Therapist 

I had seen Rob sitting in the car outside for several minutes and wondered if he would come in or simply drive away. I was pleased he came to the door and greeted him with a smile. 

Establishing early rapport with a new client is essential. I am a brief therapist and aim at early changes and improvements. There is much talk about what constitutes a good therapeutic alliance: the kind of working relationship that will allow for someone to trust in the process and have hope of change. 

You are perceived as eight times more approachable if you smile, so this is an early intervention I hope will allow for Rob to have a positive first impression. You don't have a second chance at a first impression and human beings are hard wired to make a judgement about a new face within milliseconds of the first encounter. There is a very good reason for this. 

In the days of the caveman, visual clues about whether a stranger is friend or foe, a possible danger to the group, someone of my tribe or another tribe, could mean the difference between life and death; in other words, a major survival mechanism. 

I live in a long narrow house and usually greet my clients at the front door. By the time they reach the door to my study, I will have tried to elicit a ‘yes’ response three times. This is known as a 'yes set' and is something which the marketing industry has been using for a very long time. By agreeing, there is already a feeling of common ground; an affinity, so that by the time I have embedded the suggestion, 'where would you like to sit and relax', my hope is that Rob is already feeling more confident about our work together. 

In fact, I sometimes set 'smiling' as homework and ask clients to notice what changes it makes. One client had a very balanced outlook on life; a chip on both shoulders! 

Sheila 

Sheila had many difficulties with her family while she was growing up and had developed a very negative outlook on life. She did not really trust anyone and reported that people seemed to shut her out, often looking strangely at her. 

She described herself as 'a fierce maggot', and her facial expression certainly supported the label she had given herself. She looked very stern and had deep furrows between her eyes from frowning even though she was only twenty nine. I explained to her how human beings mirror body language quite naturally so that, if she frowned or glared at people, they would unconsciously reflect back that look, and she would have a feeling that people were looking at her in a negative way. 

I wrote a saying down for her 

'A man with a hammer sees many nails!' and set her the homework task of smiling at people, family, work colleagues, neighbours and writing down any changes she observed as a result of doing that. The following week, she returned with the news that life had changed. She did not feel excluded any longer. A neighbour had invited her in for coffee, the tension at work had evaporated and relations with her family felt more comfortable. 

Questions, questions 

My first impression of Rob was that he was a worried man. His eyes looked heavy and I could hear his low energy in his voice. From our brief telephone conversation, I thought Rob was showing some of the classic symptoms of PTSD with accompanying panic attacks; an area where I have had good success in the past using the Rewind technique. I feel confident I can help him, but need him to have confidence too, and the hope and expectation of change. It is all part of the process. 

I handed Rob a form which contained two questionnaires. Sometimes, clients dislike form filling and I bypass resistance by suggesting that completing the forms will mean I do not have to fire a lot of questions at them. Most people will see a brief form filling exercise as preferable to answering a barrage of questions. 

These two forms will provide me with a huge amount of information and start to provide clues to the underlying issue, the essence of the problem and the essence of the solution..….''

PTSD Resolution, Mindfulness Based Mind Management, epigenetics, mapping the connectome, polyvagal theory, the reticular activating system (RAS)secondary gain, rewind for trauma resolution, coaching for kids, treating depression, worrying well, working smart, therapeutic stories, insight, psycho education, suicide prevention, affirmations, positive mental rehearsal, imagery, dissociation, goal setting, mindfulness, new paradigms, reframes, fast track learning, perception shifting, self actualisation, positive psychology, reframing, metaphor, personal empowerment, motivational thinking, lifting depression, the happiness principle, resilience and resourcefulness, human flourishing, anchoring, rewiring your brain, the STOP System, the SAFE SPACE happiness recipe, holistic coaching and working on the continuum of wellbeing plus many other professional theories, tools and techniques underpin the content of the fast paced, fast track, Fusion training programmes.