This episode focuses on different types of distress that may appear in trauma work and explores the types of distress that are most productive to metabolize.

Transformational trauma therapies typically involve transforming traumatic memories into more “normal” memories.  Out of all the prison cells of the limbic brain, we select one memory and change how this memory is experienced by the client from that point on.  Transforming a single memory changes at least slightly how the right now selves experience themselves and how the selves experience the world.  Transforming trauma transforms to some degree… everything.

In many transformational trauma therapies, at least part of what we are doing is transforming the distress encoded in the memory.  There is distress in almost any individual traumatic memory. However, that’s not the only distress that may be present.  One question that the therapist may want to ask is: what distress is productive to try to metabolize and what might be a goose chase.  Cleary, we want to metabolize the distress that is in the memory, but if too much memory comes into awareness or if memory comes with too much intensity, the system—which is designed for protection and containment—may have strong defenses against that much memory content showing up.

Prisoner scenario #1

  • Warden goes to a specific jail cell, unlocks it, and slowly walks that prisoner down the corridor
  • They walk one step at a time
  • As long as no one panics everything is fine
  • The warden, if desired, can wall the prisoner straight out of the prison

Prisoner scenario #2

  • Warden goes to a specific jail cell, unlocks it, and they start walking down the hallway
  • The prisoner starts running
  • The system is designed to protect against that
  • Now, the prisoner has to deal with everything that stinks about his current situation AND now has to deal with the defenses that resulted from moving too quickly

How this looks in Flash Therapy

  • Overactivation or opening too many adjacent memories causes problems with containment
  • Problems with body activation
  • Problems experiencing the calm scene as a disconfirming experience

How this looks in EMDR Therapy

  • When we are working with clients with complex trauma, we are often working with clients with a very narrow window of tolerance… even after extensive resource development
  • Clients with complex trauma have well-developed and automatic survival strategies that kick in when too much distress is activated in too short of a time
  • Noticing the distress or shut down from the defenses against the trauma is not as productive as noticing the content in the actual memory.
  • We need that content to come at a digestible rate.  If it doesn’t we have a goose chase.  And you client is the goose and the chaser.
  • Other forms of distress that don’t tend to be productive in either EMDR of Flash: existential questions or agendas.  Example: divorce memory turns into “Why do all my relationships not work out?”  “Why does everyone I have ever loved hurt me?”  “Will I every find love?”

Strategies to more effectively “walk a memory out” with clients with complex trauma

In EMDR:

  • Work at the intersection of what is productive and tolerable
  • Use the Shapiro-endorsed Video Tape Approach instead of going into the memory at the worst part
  • Don’t lose track of the fact that we have selected the starting memory for a reason.  Anticipate that with clients with complex trauma, when the body feels a certain way, adjacent memories will want to come.  It’s not a good idea to open your little tea party to a whole part of town, just because everything there has the same body-feel.

In the Four Blinks Version of Flash:

  • Be careful not to overactive. Most problems come from overactivation.  If the video of the memory is playing when you open the door on the memory, the prisoner is running.  If you are trying to make sense of the memory, the prisoner is running.  If you have distress in your body from the activation, the prisoner is running.  If multiple memories are connecting, the prisoner is running.

In summary, I wanted to introduce the idea that not all forms of distress are equally productive and that it’s the distress in the memory that we want to metabolize and not the distress generated by protective responses against the memory content.

The Folger’s Coffee Can Full of Black Powder metaphor.

Many times, the most efficient ways to process memories is to take a single step/spoon full at a time.  Complete that step/bite.  Take the next.