The characteristics of trauma and memory have implications for therapy with individuals who continue to be plagued by memories of distressing/traumatic events. Because trauma memories are encoded primarily in images, and the affective disturbance is embedded in the traumatic imagery, it follows that the utilization of imagery is essential as a healing agent in the processing of traumatic memories. Numerous studies have indeed found that while simply talking about traumatic events on a rational level may give some insight into why individuals continue to relive and re-experience negative images, it does not change the images per se. In order for the alleviation of these recurring, upsetting images to occur, it is necessary to visually re-activate and re-process them together with all of the associated thoughts and feelings. As such there are three critical elements that characterize the use of imagery as a healing agent with traumatic memories:
- imagery is actively employed during cognitive recall, reprocessing, and restructuring;
- the recurring traumatic imagery is a primary target for intervention;
- the level of affective arousal during visual reliving is similar to what was experienced at the time of the traumatic event.
There is considerable agreement among researchers and clinicians that post-traumatic stress symptoms develop as a result of inadequate emotional processing of a traumatic event and that these PTSD symptoms are alleviated once a degree of adequate cognitive and emotional processing has occurred. However, consensus has not yet been reached on exactly what constitutes adequate emotional processing of traumatic material or on what specific interventions can best facilitate such processing. Several different views on this topic are summarized here:
- Rachman (1980), in his theory of emotional processing of fear, proposed that successful emotional processing can „be gauged from the person’s ability to talk about, see, listen to or be reminded of the emotional events without experiencing distress or disruptions“ (pp. 51-52).
- Horowitz (1986) contends that the processing of traumatic material is complete once the cognitive schemata have been altered to successfully incorporate and integrate the new information. Until such processing occur, a „completion tendency“ causes unintegrated material (e.g. flashbacks and nightmares) to emerge repetitively. Successful processing of traumatic material is thus frequently delayed or prevented by means of denial or numbing which, according to Horowitz, are defense maneuvers designed to protect the victim from „information overload“.
- Lang (1986) developed a theory of emotional processing in which traumatic, fear-inducing memories are thought to be encoded in a neural „network“ consisting of stimuli, responses, and the subjective meaning assigned to the stimulus and response data. Lang contended that vivid response imagery and affective involvement must be present both in accessing and altering a fear memory.
- Foa & Kozak (1986) expanded Lang’s theory by placing greater emphasis on the cognitive meaning of the trauma and define emotional processing as „the modification of memory structure that underlie emotions.“ They concluded that recovery from PTSD requires activation of the entire „fear network“ – along with the associated affect – and incorporation of corrective information that is incompatible with traumatic elements of the fear structure.
Imagery Rescripting: A New Treatment for Survivors of Childhood Sexual Abuse Suffering From Posttraumatic Stress
Some theoretical foundations for you: Here is an article published in the Journal of Cognitive Psychotherapy: An International Quarterly, Volume 9, Number 1,1995 by Constance Dancu, Edna B. Foa, Jan L. Niederee and yours truly, Mervin Smucker PhD.
Mervin Smucker on the IRRT method
Link to Mervin Smucker’s german homepage.
A factor analysis conducted with a large nonclinical sample of pre-adolescent children yielded the following five depressive constructs (factors) related to the syndrome of children depression, as measured by the Children’s Depression Inventory and reported in Psychological Assessment (1998, 10, 156-165):
Externalizing – is characterized by high loadings on items typically associated with externalizing, acting-out behaviors, such as misbehavior, disobedience, and aggression (boys scored significantly higher on this factor than girls).
Dysphoria – items that loaded highly on this factor were associated with sadness, crying spells, irritability, and loneliness (girls scored significantly higher on this factor than boys).
Self-Deprecation – is characterized by high loadings for items relating to self-hate, negative body image, and feeling unloved (girls scored significantly higher on this factor than boys).
School Problems – items that loaded highly on this factor related to difficulties in school work and performance in addition to low self-esteem and sleep disturbance (boys scored significantly higher on this factor than girls).
Social Problems – is characterized by high loadings on items that include social withdrawal, lack of friendships, and aggression as well as school dislike and anhedonia (boys scored significantly higher on this factor than girls).
Pessimistic thoughts and negative predictions about upcoming activities or events (e.g., „I would not enjoy myself“, „No one would talk to me“, „I would look like a social misfit“, „I’m too tired to do anything“) can result in a loss of interest in activities, low energy, chronic fatigue, and social isolation. The deeper one sinks into a state of lethargy and inactivity, the more depressed one feels, the less one feels like doing anything from which one could derive pleasure or a sense of accomplishment. This vicious cycle is propelled by negative thoughts that arise whenever one thinks about engaging in an activity.
One method for reversing this cycle of inactivity is to plan activities for each day and then to push onself to engage in these activities, regardless of how difficult this may be. The goal is not necessarily to accomplish everything on one’s activity schedule, but to become more externally-focused (and less internally-focused!) by increasing one’s level of physical activity. Clinical research on depression and activity clearly indicates that increasing one’s level of physical activity by itself is a significant mood elevator, a kind of behavioural anti-depressant. In short, the more active one is, the better one feels, and the better one feels, the more active one is likely to be.
Mervin Smucker on strategies to deal with depressions (German)