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Traumatic Memory


Folded different coloured cloths

I've posted this for everyone who, like me is interested in the way the brain works and how trauma memories affect us. There are several analogies for illustrating this; I just prefer this one as I find it simple to understand.


Imagine your brain contains a huge memory bank that looks something like a linen cupboard, in which all your ordinary (non-traumatic) memories are a bit like sheets that have been ironed, folded and stored neatly on the shelves.


Whenever you want to recall a memory, you open the door to the cupboard, take out the relevant 'sheet' and open it up properly so you may peruse the contents of the memory again, enjoy re-experiencing the pleasure of it, or just remind yourself about something the memory contains. After that it's folded again and replaced neatly on the shelf, back into storage, and the door is closed. You know you can take it out any time you want, but until then it's safely stored away, out of your immediate consciousness.


Now consider the memory of a traumatic incident, let's use the simple example of a road traffic accident. This sort of memory is different, because it's often not linear, not chronological, not neat or easily retrievable. When we experience trauma we go into a shock response, so the way the information enters our memory bank is much more disjointed, and it doesn't get stored in the same way. Our recall of it is thus often fragmented and piecemeal, and comprises elements of emotional, physical, and frequently, sensory memory. It tends to be jumbled and muddled and can even be completely incoherent.


This is because when we are experiencing a trauma we cannot absorb or process all the information being sent to our brains. So to continue with our analogy, the trauma memory is a bit like a sheet that you've whipped off an unmade bed, screwed up into a very messy ball and shoved roughly onto the shelf in the linen cupboard. Because it isn't folded, it can't fit neatly, but bunches up and hangs out of the shelf, and as it's not in the cupboard properly, the doors to the cupboard cannot close correctly.


After we've had a trauma happen to us, anything that sounds or looks or feels or even smells like the way we experienced the trauma can trick our minds and bodies into believing we are back in the traumatic event. So in my example of a road traffic accident, we might be triggered by things such as ambulance sirens, or loud noises, or the smell of a hospital, or the feeling of being trapped, or the sight of blood.


Going back to our linen cupboard, every time our trauma memory is triggered by something in this way, the doors to the cupboard fly open and we are confronted with our very messy screwed up 'sheet' of memory. At this point, because it often feels as though we have been plunged back inside the events of that memory, our minds and bodies respond as though this is exactly what has happened. We experience all the emotions associated with the event, such as fear, terror and horror, alongside the corresponding physical symptoms: shaking, feeling sick, heart racing, sweating, dry mouth, etc. Our brains are mistakenly detecting a current threat where none exists, because it is in the past.


Its important to say that most people recover naturally over time, especially from one-off events like these, though some individuals do still have problems related to the trauma many months or years later. This is known as Post-Traumatic Stress. Psychological Therapists treat this by helping us to revisit the trauma memory in a safe and supported way, so that our brains can process it properly. To do this, drawing again on our analogy, we remove the 'sheet' from the cupboard, open it up completely, then flatten or smooth the creases, refold it neatly, and firmly close the cupboard door, so that it sits on the shelf just like any other memory; always accessible, but no longer intrusive. There are several methods by which we can do this in therapy. NICE The National Institute for Clinical Excellence, recommends evidence-based treatments such as Prolonged Exposure Therapy or Narrative Exposure Therapy or EMDR. This is because there is a research base that proves these treatments are effective and safe when provided by therapists trained in the relevant techniques.


With a one-off event such as the road traffic accident example, there might be multiple triggers, but they are all specifically related to the accident itself. After a suicide or other traumatic death our triggers may be everywhere and omnipresent.


Your trauma memory may be like mine, of being told your loved one has died, or you may have found the body of your loved one, or even witnessed their death. Whatever the actual circumstances, the shock and the trauma can be extremely severe, and we are dealing not just with the symptoms of the trauma memory itself, but the grief of losing someone we loved very much. Traumatic Loss can therefore be very complex and layered. Furthermore, research has shown that until the trauma itself has been processed, it may obstruct our ability to absorb the loss into our autobiographical memory, our own life story. Sometimes this will require specialist help from a trauma therapist. We are all unique in the way we grieve and how we absorb loss. I really felt I needed therapy to help me with the trauma, but Alek has never needed any kind of therapy and continues to work through his loss in a very different way. If you are still experiencing symptoms related to the trauma of losing your loved one many months or years later, it might be helpful to find a therapist trained in the methods mentioned above, preferably experienced in working with Traumatic loss.


See also my posts Traumatic Loss and A Therapist's Search for a Therapist, and look out for my forthcoming post on the treatment I received for Traumatic Loss.


References:

Duffy, M & Wild, J (2017). A cognitive approach to persistent complex bereavement disorder (PCBD) The Cognitive Behaviour Therapist vol. 10, 1-19

Dr Michael Duffy, Queen's University Belfast. One Day Workshop (February 2022). New approaches to trauma and traumatic grief. Responding to unexpected and traumatic grief: A cognitive approach to traumatic and complex grief.



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