What Are PTSD Symptoms in Women?

What Are PTSD Symptoms in Women?

Post-Traumatic Stress Disorder (PTSD) affects individuals differently, with women being two to three times more likely to develop PTSD compared to men. The symptoms of PTSD in women can manifest uniquely, leading to differences in how they experience and cope with the condition. Here is an overview of PTSD symptoms in women based on the provided search results.

Symptoms of PTSD in Women

1. Re-experiencing Symptoms:
- Recurrent distressing memories of the traumatic event.
- Flashbacks where the individual relives the traumatic event.

2. Arousal and Reactivity:
- Being easily startled or frightened.
- Always being on guard for danger.
- Trouble sleeping and concentrating.

3. Avoidance:
- Avoiding places, activities, or people that remind them of the traumatic event.
- Trying to avoid thinking or talking about the traumatic event.

4. Cognition and Mood:
- Negative thoughts about oneself, others, or the world.
- Hopelessness about the future.
- Difficulty maintaining close relationships.
- Feeling irritable, having angry outbursts, or engaging in self-destructive behavior.

Causes of PTSD in Women

- Women are more likely to experience high-impact trauma such as sexual assault, abuse, bullying, harassment, and violence.
- Traumatic events like sexual violence, physical assault, accidents, natural disasters, traumatic childbirth, and loss of a loved one can trigger PTSD in women.

Treatment and Diagnosis
- To receive a diagnosis of PTSD, a person must exhibit specific symptoms across different categories like avoidance, re-experiencing, cognition, and arousal.
- Treatment for PTSD often involves cognitive behavioral therapy (CBT), prolonged exposure therapy, eye movement desensitization and reprocessing (EMDR), group therapy, and medication such as antidepressants or anxiety medications. The most effective way to cure PTSD without drugs is the use of a step-by-step protocol (RTM) that works by taking the emotional charge out of the trauma memories.

Long-Term Impact
- PTSD can disrupt various aspects of life including work, relationships, health, and daily activities.
- Individuals with PTSD may be at a higher risk of developing other mental health issues like depression, anxiety disorders, substance abuse problems, eating disorders, and suicidal thoughts.

Understanding the unique symptoms and causes of PTSD in women is crucial for effective diagnosis and treatment. Seeking professional help is essential for managing PTSD symptoms and improving overall well-being.

What Are the Risk Factors for Developing PTSD in Women?

Post-Traumatic Stress Disorder (PTSD) can affect individuals differently, with women being more susceptible to developing PTSD compared to men. Several risk factors contribute to the likelihood of developing PTSD in women:

1. Experiencing Traumatic Events:
- Living through dangerous events and traumas.
- Witnessing another person being hurt or seeing a dead body.
- Childhood trauma.

2. Emotional Responses:
- Feeling horror, helplessness, or extreme fear during the traumatic event.
- Having little or no social support after the event.
- Dealing with additional stressors post-event like loss of a loved one, pain and injury, or loss of a job or home.

3. Pre-existing Conditions:
- Having pre-existing mental health problems such as depression or anxiety disorders.
- Family history of mental health problems.
- Experiencing additional life stressors.

4. Biological Factors:
- Genetic predisposition that may make some individuals more likely to develop PTSD.

5. Vulnerability to Specific Traumas:
- Women are more likely to experience high-impact trauma like sexual assault, abuse, bullying, harassment, and violence.
- Experiencing traumatic events at a younger age.

6. Social Roles and Interpersonal Violence:
- Gendered social roles like wife, mother, or caretaker may compound the negative impact of trauma exposure in women.
- Ongoing interpersonal violence within relationships can increase susceptibility to mental health consequences.

7. Lack of Treatment Seeking:
- Females may experience symptoms for longer before seeking diagnosis and treatment compared to males.

8. Complex PTSD:
- Exposure to chronic multiple traumas can lead to Complex PTSD, which includes a complex of symptoms associated with early interpersonal trauma like alterations in affective impulses, attention and consciousness, self-perception, and relationships with others.

Seeking professional help and support is essential for managing PTSD symptoms effectively and improving overall well-being.

Which Careers Put Women Most at Risk for PTSD?

Certain careers have a higher percentage of women with PTSD due to the nature of the work and exposure to traumatic events. Here are some careers that are known to have a higher prevalence of PTSD among women:

1. Military Personnel:
- Military service involves exposure to combat situations, violence, and high-stress environments, leading to a higher risk of developing PTSD. A study was done to help women overcome PTSD using a non-drug intervention and & around 72% were symptom free in 6 weeks using the Reconsolidation of Traumatic Memories protocol.

2. Police Officers:
- Law enforcement personnel often face dangerous and traumatic situations, witnessing violence and dealing with high-pressure scenarios that can contribute to the development of PTSD.

3. Firefighters:
- Firefighters frequently encounter distressing situations such as rescuing people from fires, witnessing loss of life, and experiencing the emotional toll of their work, which can lead to PTSD.

4. First Responders/Ambulance Personnel:
- Individuals in these professions are exposed to traumatic events like accidents, shootings, and disasters, which can result in the development of PTSD due to repeated exposure to distressing situations.

5. Healthcare Workers:
- Healthcare professionals working in high-stress environments such as intensive care units may be at a higher risk of developing PTSD due to the emotional strain of dealing with critical situations and patient care.

6. Journalists:
- Photojournalists and war correspondents witness emotionally distressing events regularly, which can lead to PTSD symptoms due to exposure to traumatic content and experiences.

7. Other Healthcare Professionals:
- Mental health professionals are particularly at risk due to potential threats or violence from patients, contributing to a higher prevalence of PTSD among this group.

These professions involve exposure to trauma, violence, life-threatening situations, and high-stress environments, increasing the likelihood of developing PTSD among individuals working in these fields. It is essential for employers in these sectors to provide adequate support, counseling, and resources for employees who may be experiencing work-related PTSD symptoms.

To learn how to overcome PTSD using the reconsolidation of traumatic memories protocol you might want to take a look at our notion template called how to erase trauma memories in 5 hours which highlights successful intervention done on military men and women that suffered from PTSD.

How to Cure PTSD Four Times in 5 Hours with Memory Reconsolidation Therapy

How to Cure PTSD Four Times in 5 Hours with Memory Reconsolidation Therapy

This case study shows how a non-drug intervention can be successfully used to cure PTSD in a Vietnam veteran in under 5 hours.

Here is the PDF of The Reconsolidation of Traumatic Memories Protocol Case Study marked with my notes.

Below is a copy of the relevant text.

'Carl, our pseudonymous client, met criteria for at least one Diagnostic and Statistical Manual of Mental Disorders (DSM IV) Criterion A traumatic event and a current PTSD diagnosis. In addition, he asserted the presence of one or more flashbacks or nightmares during the preceding month. At the initial assessment, and at 2- and 6-weeks post-treatment, Carl completed assessments for PTSD.'

4 PTSD Memories targeted.

  • Rocket Attack, 1971
  • Viet Cong Sapper
  • Claymore Mine, 1971
  • Ditch Rat Bites, 1971

For the full step by step intervention and resources:
Reconsolidation of Traumatic Memories-Bourke-Gray-Potts

'Carl, completed semi-structured clinical interviews at baseline to assess their current status and eligibility for participation. The PTSD Checklist-Military version (PCL-M) was administered to all participants at intake, two weeks, six-weeks, 6-months post and one-year post.'

Participants were admitted to the program with a PCL-M ≥ 50. Participants also completed the Posttraumatic Stress Scale-Interview (PSS-I) version at intake (PSS-I > 20) and two-weeks post. Observations of autonomic reactivity were recorded using an in-house instrument, the Behavioral Screening Instrument (BSI), whose results are not reported here. Subjective Units of Distress (SUDs) were elicited during treatment sessions at each elicitation of the trauma narrative using the standard ten-point Subjective Units of Distress Scale (SUDS).

Post treatment assessments relied upon the PSS-I and PCL-M at two-weeks post, the PCL-M and clinical observations at six-week, six-month, and one-year follow-ups. Clinical observations included the cessation of nightmares and flashbacks, the ability to re-tell the trauma narrative with a SUDS rating of 0, a fluid, fully detailed recall of the index trauma, and personal and family reports of positive adjustment.'

Carl was a talkative, thoughtful, reflective Vietnam vet who reached out for psychological assistance in 1984 for anger and “doing dangerous things that weren’t me”. He was diagnosed with PTSD, major depression, and was prescribed Prozac, which he had been taking for the past 34 years, along with sleep medications. Carl was an experimental subject, which meant that after qualifying to participate in the study he would immediately receive three individualized treatment sessions with the RTM protocol, with no waiting period. Follow-up interviews and measurements happened again at 2 week, 6 week, 6 month and 1 year intervals.'

'Pre-screen. At the Pre-screen, four different trauma events were reported. Carl easily qualified for the study due to three factors. First, Carl showed fast rising autonomic arousal when speaking of each event. Second, Carl was experiencing weekly trauma related nightmares and flashbacks. Third, his pre-treatment scores on the PCL-M and PSS-I were high, scoring 73 (of a possible 85 points) on PCL-M and 42 (of a possible 51 points) on PSSI. He endorsed PTS symptoms in all DSM IV clusters: re-living, avoidant, mood/hyper-vigilance. Based on the 75 minute pre-screen interview one trauma event was identified by the clinician as most physiologically reactive. This agreed with the client’s assessment that this was the most troubling. This event was linked to intrusive thoughts, nightmares and flashbacks 4 times a month.'

Carl reported that the flashbacks happened in the stillness of the night and he would flash back to the sky, red with incoming rockets and mortars. Additionally, he said he ruminated daily on his partner’s death. During a 1 ½ minute re-telling, the client’s hands immediately began trembling and his leg began bouncing up and down. Then, Carl’s voice broke and he physically froze. The clinician promptly interrupted the narrative and he was told, “that’s enough for now.” The topic was changed to the client’s favorite hobby.

The target event took place in Da Nang, 1971. In a 3 minute timeframe, Carl related the following:

“My worst experience was losing my service dog, Rex. I was part of the canine program at Da Nang and we became very close partners (voice warbles)… We developed a very close relationship. It wasn’t like any of the other units. We worked alone. This particular Christmas morning where Rex was killed (leg and hand trembling, pauses, freezes, head tilted down and right, pauses)… I’ve lived so many years of guilt (posture shifts, voice shifts, head lifts), because I should have died with my dog (voice trembling) … That dog was my partner and I’m alive and that dog died saving my life. When one of the rockets was coming down, Rex could hear the whistling of the fins. And he lunged, which brought me to the ground. The minute I hit the ground that rocket went off (leg shaking). What I re-live is the Medivac out of the area. I always remember I was laying on the floor of the helicopter and I had a loose leash. I still have (notice shift to present tense) the leash on my hand (voice shaking) and my dog (clinician attempted to interrupt telling, yet client kept talking)… I remember I moved my hand. I never felt it without my dog.” Clinician stood and interrupted saying,

“Thanks, count backwards 5-4-3-2-1, please.” Carl counts backwards. Carl shifted to talk of fishing and the recent purchase of a new rod for fishing. Event was given the name “Rocket Attack, 1971”.

Treatment One began two days later.

1.  Rocket Attack, 1971 (8 SUDS)

Treatment 1. Treatment 1 commenced with the first phase of the RTM protocol. Carl learned the visual formats characteristic of the RTM process using practice movies. He chose an activity he experienced recently which was ‘going fishing’ and the bookends (beginning and end points) for the movie were determined. The client was guided through three different versions of the practice movie. Carl was able to see himself dissociated, doing the activity on an imaginary movie screen. Additionally, he was able to take the color out of the movie and watch himself do the activity from beginning to end as a black and white movie. Associating into the end of the fishing event, in first person, through his own eyes, and going in reverse, backwards through the event, to the beginning, was practiced until it could be executed with ease.

'Client was asked to tune in to the event “Rocket Attack, 1971”. Carl responded by saying it was an “8 SUDs” and “it draws a lot of emotion.” Once the trauma intensity was calibrated, the clinician quickly moved on, changing the client’s focus of attention and physical position in order to ensure a relaxed re-structuring experience for Carl. The clinician directed the client to find a resourceful moment before the event happened, where he was safe. He chose “Ski patrol” at Mt. Green, where he worked stateside immediately before leaving for Vietnam. The end of the event, where he felt that he was safe, the event was over, and he survived, was the “Family gathering”, when he returned home. After doing the set-up from theatre to projection booth, Carl was lead through 11 iterations of the black and white movie watching himself in the theatre as he watched his 21-year-old self go through the rocket attack event. He was specifically directed to stay in the booth and watch the self in the theatre as he watched a black and white movie beginning at the safe image at Mt. Green - a black and white still image of himself on ski patrol. The procedure continued through the rocket attack, the death of Rex, and ended with a still black and white image, Carl, back home at the “Family gathering”.

This movie was run in 45 seconds or less. Carl had little difficulty doing the dissociated black and white movie. Only one time was he observed to associate into the movie, seeing it through his own eyes and in color.'

The variations included: extending the distance of the screen, the speed of the movie, watching only the bottom half and then only the top half, and temporal variations.

The Associated Color Reversal step followed and involved 8 repeated experiences of the event as imaginal, associated, multisensory reversals of the rocket attack ‘undoing itself’ beginning at the end of the event (Family gathering), and in 1-2 seconds moving backwards through the rocket attack to the beginning (Ski patrol). Carl experienced the associated kinesthetics of holding the empty leash and falling to the ground in reverse, undoing themselves. The sound of the incoming rocket was reversed, and events associated with guilt feelings were made a specific element of the undoing experience. After completing these two essential restructuring steps, the client looked visibly relaxed and was directed.

At the end of Round 1, Carl offered the following narrative with added information: “It was Christmas morning. We were advised there would be activity. We were three hours into patrol. Rex heard the high-pitched sound [of the incoming rockets]. He jumped and pulled me to the ground. At the moment the rocket hit the ground Rex was killed. At that point it turned into a Medivac. I now remember I did not leave Rex there alone. Rex was on the helicopter and not left behind. They put him on the helicopter with me. He was off leash. The leash was empty, yet he was there. He was covered in a poncho. I got a letter from the Squadron leader explaining how they had a nice burial for Rex.” When asked by the clinician, “how was this re-telling different?”, Carl responded that “I was comfortable. I did not see myself leaving my dog behind. I did not see the horrific things that I thought I saw. My dog was dead, but my dog was with me. I don’t feel painful. It was a terrible thing, but I understand it. I know what happened. I can’t well up in tears and cry like I normally want to do. I don’t know what is going on or what is happening, but I have a sense of pride in what I am talking about.”

Carl reported the event at a 3 SUDs. Client and clinician then moved on to the revised movies with a better, safer different outcome.

The first version of the revised movie involved Carl acting as a movie director on a movie set with cameras and stunt actors standing in for himself and Rex. In this revised version the rockets overshoot, everyone is down on the ground and OK; the rocket fire stops and they all jump on the helicopter, including Rex, and take off. Then, as Director, Carl yells cut and Carl’s substitute and Rex take off for their dressing rooms. A second revision involved Carl and Rex safely finishing their shift and going to China Beach, so Rex could wash his paws. In a third revised movie, the patrol is finished, Carl and Rex are re-assigned stateside and they fly home.

After running these multiple revised movies several times, Carl is directed to tune into the original event, “Rocket Attack, 1971,” and it is a 2 SUDs. He reflects voluntarily, “I don’t feel that whatever it was… that would take over. I don’t feel I’m leaving him behind. Wow, that’s pretty strong. I feel good, I do. (Here client exhales a deep sigh and takes a Kleenex to dab his eyes. The clinician is calibrating tears of relief.) He’s OK.” Client went on to further comment on the process, “I have no idea what is going on here. I feel in a much better place.” For Carl, the shift in focus to recognizing that he did not leave the dog behind represented an important pivot point in rewriting the trauma event. Since the event was not yet a 0 SUDS, Carl was instructed to do another round of five black and white dissociated movies and four associated color reversals for the same event. The same bookends are used. When directed to re-tell in detail, Carl related the event in a matter of fact tone. He said the re-telling was different this time in that, “I’m proud to tell the story. The dog gave his life for me. I’m honored to do that for him. I’m not torn up emotionally. I’m not thinking horrifically bad things. It was war. It is now a 1 SUDS.” Another revised movie was completed with Carl and Rex safely missing the rocket and Rex receiving accolades for his bravery. Revised version was run several times. Carl offered the following comment at this point, “In 40-plus years, I have never been able to discuss something in such a manner, that is, putting it into real perspective. I had to do what I had to do. My dog did what he was trained to do. It was war and we were the casualties of war, but we did the best we could. This is remarkable. This is wonderful.” The event was reported as a 0.

The treatment of “Rocket Attack, 1971” took 78 minutes in total to reach a 0 SUDs rating. 

2.  Viet Cong Sapper (8 SUDS)

Next the clinician moved on to an earlier Vietnam event, Hand to Hand Combat “Sappers”, that was replicated in a recurring nightmare. A Viet Cong ‘sapper’ was akin to a combat engineer. The task of VC ‘sappers’ was to penetrate American defense perimeters.
At pre-screen, Carl reported experiencing this recurring nightmare at least 4-8 times a month.

The nightmare content was described as follows:

“I am in a battle with no end to it.  My dog, Rex, is in the dream and he is aggressively fighting and biting one sapper. I have a knife and am involved in hand to hand combat with a second sapper.”

Carl indicates that he’d wake up in the morning and feel exhausted because it seemed like it never ended. His wife reported that he recently kicked a sliding door off its runner after jumping out of bed during a nightmare. She commented further saying that he frequently talks in his sleep saying repeatedly: “Be careful.”

Carl’s daughter disclosed that many times when she would walk up behind her dad, he would startle, spin around and raise his fists. As treatment one continues, Carl reports the “Viet Cong Sapper” event as follows:

“Rex and I were on night patrol. I went out on patrol anxious every night. Rex and I were always at least one-half mile away from help. It was very lonely on patrol. Drain ditches had outlets around the base. Sappers would come through the ditches giving them access to planes and weapons dumps. I completed 1st quarter of the patrol then started the 2nd quarter where I went down a tunnel. Rex was alerted to action as his ears went up. It happened so quickly. We were there engaged in a fight. Rex took one sapper and lunged at him. I had a rifle but no way to get in position to do damage. The sapper was on me and I pulled my ka-bar [combat knife]. I stabbed him in the stomach and cut the side of his throat (facial muscles tighten, voice quickens, breathing gets shallower). I cut his jugular vein and he was bleeding. He went to the ground and I just kept stabbing and stabbing (throat tightens, voice tone changes). I don’t want him to get up and move. Sappers taped their chests with duct tape so that if they got injured they could keep going and get to their target. They are like terrorists. The most troubling part was blood and things have a terrible odor. I remember the whole picture (looks at the ground) of chaos that I painted. It’s never going to come to an end. That was the first time in my life fighting like that… fighting for my life. It felt in slow motion and ‘please stop, please stop’, I was saying to myself. I did not want to be there at the base of this tunnel with the Viet Cong sapper.” Client reflects that with that re-telling he felt the emotion in his chest and re-experienced stabbing and stabbing and seeing the guy bleeding from his neck. During that telling the clinician observed shifts in breathing, voice tone and tempo, facial muscles tightening and skin color draining. The client described the event at an 8 SUDS with feelings of fear and terror linked to it.

The client and clinician decided to use the same bookends as used in the event “Rocket Attack, 1971”. The client was then returned to the movie theatre, was seated, then guided to put the first still black and white image on the screen. Next, he was directed to float up to the projection booth leaving his body in the theatre. From the booth he was instructed to watch the self in the theatre as he watched the sapper movie of the younger self. The client was guided through 11 iterations of the black and white sapper movie at a distance and dissociated, with each lasting 15-20 seconds or less. The accelerated speed of the dissociated reviews was designed to counteract the client’s description of the event as perceived ‘in slow motion with no end’. Once the self in the theatre was comfortable watching the event in black and white, Carl was directed to come down from the projection booth, re-enter his body in the theatre, walk down to the screen, and step into the end bookmark, “Family gathering”. Seven iterations of the associated color reversal followed. The client completed all steps successfully.

When directed to re-tell the event in as much detail as possible, Carl described it more briefly indicating that when the sapper came upon him and Rex, he slashed him, fell on top of him and stabbed him several times. From there, a SWAT team came. He points out that there was no equipment in 1971 like they have today. He was out on patrol with no radio turned on. He says that this re-telling was different in that he no longer felt tension in his chest and hands. “I was comfortable with it. I did what I was trained to do. My dog did what he was trained to do. If I did not respond the way I did, I would not be here talking to you. It was war.”

Carl’s pre-treatment narrative, Carl reported that he only stabbed the sapper three times, and no longer described the event as “slow motion over and over again”. The event was rated with a SUDs level of 2. Two different revised movies were created and run with multiple revisions. The first revision involved a movie director version on a movie set with stunt actors and Carl as director. All equipment was fake, non-crippling gear and actors got up from the ground after the fight and went to a staff party. This version was run several times.

The next safer outcome involved Carl and Rex on patrol, sighting the Sappers from a distance, exchanging gunfire, and taking the Sappers out. Carl liked this version, commenting: “There was no rolling around in sewer water. Engaging at a distance is much better.”

He ran this revised version multiple times. The client then re-told the actual event and indicated that his revised perspective was that “It was a night in the jungle. A night doing my job. It had to be done. I feel it’s a 0 SUDs now.” For this trauma, the client’s entire experience took 36 minutes. As the clinician drew the session to a close, the client was asked how he was feeling. His response was: “I’m not sure. Wow. I’ve sat for a couple of hours and I’ve done some things here that I’ve tried to do with others in a different way and never have come close to having this type of ending with a session. I love it. I want to build upon that.”

Treatment 2. Carl returned for RTM session 3 days later. He described his experience over the past few days as follows:

“A lot of processes inside myself have changed. Since the last session my thought process has changed when it comes to Vietnam. I’ve been talking with my wife and daughter. I remember it as a process. I go to Vietnam, did what I had to do, but came home to a good process. I wasn’t stopping off and dwelling (on past events). I wasn’t getting these charged up feelings. I feel more rested and comfortable than I have in a long time. We talk about the process (RTM). It’s absolutely phenomenal. It’s hard to imagine how somebody can be dealing with something like this for so many years and having psychiatric care and getting medication for umpteen years. I’m off the sleep meds and blood pressure pills and I cut back on the Prozac. I want to take this good feeling and expand on it. I’ve been talking with the neighbors and getting out for a morning walk. My front door is not a blockade for me anymore. I go to bed after the late evening news and am sleeping with a clear head. No more checking doors and windows. Before, I know I’d lock the doors and windows and then go back and check them again. I’m calm now.”
0 SUDS. 36 minutes of RTM Treatment.

3. Claymore Wire, 1971

The clinician directed the client’s attention to a third Vietnam traumatic event, “Claymore Wire, 1971.” At pre-screen, the event was described as follows: “I was assigned at the Da Nang airport to patrol the perimeter. Incoming Rockets were going off. When rockets were going up, there would be infiltration happening somewhere on the base. I was in charge of the machine gun on the vehicle. As we were moving, a claymore wire was set between the trees. (Pause and deep breathe.) The wire wrapped around my neck. (Swallows and color drains from face.) I got pulled out of the turret. Fortunately, the wire broke.” The shift in voice tone and tempo are audible as he expressed with a horrified look on his face: “I would have been decapitated if that wire did not break.”


Because this event was identified at Pre-screen by Carl as significant, and sympathetic arousal was observed, the clinician decided to check and see how he represented the event in the present time. Carl started the description by saying, “It was the 1st event that set a precedent in my mind that this is dangerous. I had only been in country for a week and it was the beginning of events that would weigh on me for years and years and years.” He went on to relate the event with the same details described at Pre-screen, yet was observed to tell it smoothly, with even voice tone and tempo and no autonomic arousal. Client indicated that: “I did not feel choked up and, to be honest, I talked about this with my family since that the last meeting. It’s done. There is no component of it that is troubling.”

4. Ditch Rat Bites, 1971

The Clinician moved on to a 4th Vietnam event, “Ditch, Rat Bites, 1971,” that related to a long term rat phobia.

This traumatic memory is somewhat reminiscent of a scene from First Blood, starring Sylvester Stallone where Rambo walks through muddy water while bitten by rats.


At pre-screen, Carl reported this event with a terse, rapid voice tempo, saying: “Rockets and mortars were incoming. I jumped into a sewage ditch. (Facial muscles tighten, posture shifts.) Rats were biting all over my body and holding onto my skin. (Vocal pitch raises.) I get medevacked to Saigon for rabies shots.” In an interview with client’s adult daughter she reported that when she was younger their family physician wanted her to get a pet. She chose a pet hamster. She said that anytime she brought it in the room, her father would flinch and start sweating.

At the 2nd treatment client and clinician were 25 minutes into the session and Carl’s re-counting of the event sounded as follows: “It was 3 am in the morning. Rex and I were on patrol. Around the base were many sewage ditches. This was how they transported waste. Trenches were a critical point for securing our property. VC sappers would crawl through them. This morning there was rocket, and mortar fire, and they would land close. I literally jumped into the ditch. Within seconds the rats were all over me; it was like a biting frenzy. Rex stayed on the bank. After 15 seconds I jumped out of there. It took 2-3 days before I got help. Rats were noted for their rabies. If you were bit by a rat, you could assume you were rabid. I got back to the base in Da Nang and cleared up the wounds on my hands. I decided to go through a course of injections. I had a terrible reaction to the duck embryo and they medevacked me to Saigon.”

The clinician asked about the most troubling part of the event and the client indicated: “The smell and noise. I smell the sewage (note shift to present tense) and feel them biting (rubs his fingers together).” Clinician calibrated as Carl associated into his worst second in the ditch and re-experienced the smells and sounds. The client then shifted to a dissociated perspective and commented further: “You could not see anything. They were big, black and making a noise. I couldn’t get out of the ditch fast enough. I was confined and did not have control. If I saw a mouse or rat today, I would get pretty tense. (Client looks down and imagines rodent and tightens throat.) I want it removed.”

Carl evaluated: “Telling it now was definitely less intense than before. I go to my happy place, Mt. Green ski patrol.” Carl reported event at a 4 SUDS level. RTM protocol treatment proceeded. RTM process for Carl involved the same bookends, “Mt. Green ski patrol” (beginning) and “Family gathering” (end point). Client returned to the movie theatre, floated to the projection booth, and watched self in theatre watch the younger self go through the event in black and white. Black and white movie variations were repeated 9 times, including lightening the movie to shades of gray due to the night time context of the event. Brightening the movie to shades of gray and running it very quickly so that the self in theatre could see the younger self in the ditch and then jumping out quickly, was reported as comfortable to watch by the self in the theatre. The associated color reversal step was repeated six times. The client was able to do this step handily and each iteration involved undoing a sensory component. The sounds of biting rats were experienced as receding, the smells fading and the felt sensations reversing. Each iteration ended at the start point (Mt. Green, skiing), where the younger self was safe and away from the rats. The narrative followed: “Rex and I were on patrol. There were heavy rockets and mortar. My number 1 instinct was to get down to the ground as low as I could. I jumped into a ditch that was full of rats and sewage. I was bitten numerous times. I finally jumped out of the ditch. I notified the medical folks what happened. It was 1 ½ days before I could get to a place for medical attention. I went to Saigon for 10 weeks of treatment.”

The clinician then asked: “How was that re-telling different this time?”

Carl responded: “It feels like part of a process I went through. I don’t have that horrible, choked up panicky… it’s over. I can think of the memory, yet the good outweighs the bad. I go to my safe place, Mt. Green. This event is just a memory. As I close my eyes this event is back from me.” Client rates event at 1 SUDs. Clinician decides to do some revised movies even though the event is at a suitable SUDs rating. For a revised movie, Carl indicated that he wanted the smells of popcorn and cotton candy wafting through the event, bunny rabbits in the ditch and landing on green grass. This revised movie was run disassociated, then run associated 8 times. Carl then re-told the actual event and said: “It’s a 0 SUDs. It’s like I go from combat to a Disney movie. It’s amazing. I feel no panic.” The clinician tested further and asked him to imagine a rat in his garage at home. He indicates, “I see it. It’s not going to hurt me. I shoo him out.”

Treatment of this event took 30 minutes in total.

Treatment 3. Carl arrived at treatment 3 saying he was sleeping well and had no flashbacks or nightmares related to the treated events. He was asked to re-tell each of the 3 events. With each telling no reactive indices were reported or observed. Carl indicated there were no other events in need of RTM treatment. The clinician and Carl met for 15 minutes and Carl left.

Treatment Outcomes. The two-week follow-up consisted of repeating the PCL-M and PSSI, the client was also directed to re-tell the target trauma. In Carl’s case “Rocket Attack, 1971” was the event specified. Family members, if present, were interviewed. At the 2 week follow-up, Carl’s wife and daughter volunteered their observations as to differences they were noticing post-treatment. For the three other follow-ups (6 week, 6 month and 1 year), only the PCL-M was administered. The Post Treatment Behavioral Assessment (not reported here) was conducted at all three follow-ups, in order to assess flashbacks, nightmares, and maintenance of behavioral changes. The 6 month and 1 year follow-ups were conducted over the phone.
After two weeks Carl met with the psychometrist. At that time, his score on the PCL-M had gone down from 73 (intake) to 17 (2 weeks), a 56-point decrease. None of the DSM IV symptom clusters were endorsed. His score on the PSSI diminished to 0, a 42-point difference. He reported no flashbacks or nightmares in the past 2 weeks. Specifically, the combat nightmare with the sapper, which had been happening 1-2 times weekly, had not returned. Carl went from sleeping 5-6 hours nightly to a full 8 hours sleep. Carl commented that, “It’s amazing to wake up feeling good. Sleep is half the battle. Since night patrol in Vietnam, I’ve been a night person.” No physiological arousal was observed or reported in relation to the narrative.

Carl was clearly reporting absence of re-living/intrusive symptoms, specifically no disturbing image of Rex’s death, feeling upset when reminded of death and killing, or spontaneously having physical reactions like breaking out in sweats when reminded of Vietnam events. His post-treatment behavioral reports further testified to the shift in re-experiencing symptoms. First, he verbalized: “When I look at Rex’s picture on the wall, it’s more of a positive for me.” Second, he offers, “I am not wearing Rex’s dog tags anymore. They are with my other dog tags. I have never gone without them. I took them off after treatment 2. I put that part of Rex I always felt had to be here (pointing to his heart) aside, in another place.”

Changes in avoidant symptoms were marked by significant shifts in Carl’s thinking and behavior. Rather than having to work to push trauma related thoughts and feelings aside, Carl reported, as early as the beginning of treatment two, that he comfortably talked to his wife and daughter about the treated events, Rocket Attack, 1971 and Sappers, as well as the Claymore wire event. The breakthrough for him was that he felt comfortable doing so with no tearing or other sympathetic arousal. Carl indicated he had reconnected with his fishing partner with whom he had not spoken in 8 years. He said that during the call: “There was no loss of words; no feeling of having to explain. It was like we just got out of the boat together. Now I want to socialize and communicate. I feel no need to be back in a suffering position. Before I would do anything not to put myself in a position to socialize. Now there is no discomfort talking to people.” So, rather than avoiding activities and situations, and having no interest in free time activities, Carl was talking with neighbors and engaging with family members rather than detached. His wife and daughter echoed these changes. His ‘zest for life,’ as he described it, contrasted sharply with past thinking that, “I thought tomorrow would bring nothing but pain and anguish.” Rather than no future plans or hopes, Carl described planning ahead: “I try to make every day an active day. I have been walking and gardening. I plan ahead for short fishing jaunts.” Carl was affirming his future and most definitely conveying a future orientation. Carl says of a difficult family situation that arose recently that, “Unlike in the past, I did not feel myself getting dragged down.”

Carl reported handling this situation decisively, without the tangle of emotions he would have in the past. His emotional palette involved a wider range of emotions, and greater clarity in thinking was his report and the clinician’s observation.

Carl displayed and reported a significant reduction in his level of arousal. The client’s wife and daughter were interviewed and echoed this shift in behavior. The wife reported that when she and Carl would watch TV crime or history shows involving loud banging noises, she was observing that he was no longer startling and jumping out of his seat as he had for years. She offered that he is “so much calmer.” Both wife and daughter echoed their pleasure in Carl’s calmer demeanor indicating, “If dad was in a mood and on edge the whole family would be on edge.” The earlier report at treatment two of no longer being obsessed with a house break-in and compulsively checking on doors and windows, further verified Carl’s decreased need to be on guard and super-watchful. Carl summed up the two-week follow-up by saying: “I’m getting off the Prozac. I’ve been taking 60 mg for as long as I can remember. I’m doing a gradual cutback using a Harvard medical process. When we meet for the 6 week follow-up it will be my last day. Now I want to socialize and communicate.” Carl summed up the follow-up by reflecting: “A significant change was made which impacted how I thought of each event. I have lived with this for 40 years and half of that trying to hide the emotion and pain and then to the point where it comes out. Now there’s an opportunity. I am a changed person after 40 plus years.”

At the six week, in-person follow-up (4 weeks later) scores on the PCL-M were recorded at 17, retaining the 56 point decrease seen at the 2 week follow-up. Carl reported no flashbacks or trauma-related nightmares. He reported socializing, exercising, feeling safe, calm and energized. Carl indicated he had just taken his last 10 mg dose of Prozac earlier that day. Carl had been on that medication for 30 years and was glad he no longer had to depend on it to feel good throughout the day.

At the six month follow-up, Carl’s score on the PCL-M remained stable at 17. He reported no flashbacks or nightmares. The six month follow up happened in February. Carl reported enjoying Christmas Eve and Christmas day, and the anniversary of Rex’s death, for the first time in years. This was in marked contrast to the report of his daughter, 4 months earlier, who had indicated that previously, for every Christmas Eve, for as long as she could remember, “Dad would toast Rex and then sit in silence, alone, for hours. On Christmas day he would seem melancholy all day.” Carl also indicated that this Christmas went smoothly. He reported feeling joy and a deep appreciation for life as he talked with family and visitors and his toasts were a celebration. At the one-year follow-up, Carl again scored 17 on the PCL-M. No flashbacks or nightmares. He reported sleeping comfortably, enjoying his wife and family, socializing, walking, and continuing to experience a “zest for life”.

Once the central trauma (Rocket Attack, 1971) and an important second trauma (Sappers) had been successfully treated, the process streamlined in a significant manner and its effects generalized to other events that might previously have needed treatment, or more treatment.

Streamlining was apparent in the lessened temporal investment in the treatment of later traumas. The first event took 70 minutes, the second and third took about half of that (36 and 30 minutes, respectively). This suggests that practice effects after the first treatment were a significant contributor to later treatments. Not only had the basic cognitive elements been practiced multiple times before (practice sessions) and during treatment (11 or more black and white movies and multiple associated reversals and rescriptings), but their subsequent negative reinforcement through the lessening of negative affects (fear, anxiety, sympathetic arousal, loss of control) may be presumed to have increased their availability and utility (behavioral salience) across treatments and sessions.

We may also suspect that the new behaviors, through the same mechanism of reconsolidation that we use as a major explanatory element, became incorporated in the meta-experience of the class of negative and intruding psychological states. So that now, when he thinks of rats, the phobic response is gone, and they are imagined, spontaneously, as bunnies. This process may be related to Gregory Bateson’s (1972) concept of second level learning (Learning II), in which the organism learns how to learn and learns to apply the learned behavior in similar contexts (Bateson, 1972; Kaiser, 2016; Tosey, Visser, &Saunders, 2012).
It is interesting to note that Carl so embraced what he called his ‘happy place’ that the bookends at the beginning and end of the “Rocket Attack, 1971” were used as bookends for the second (Sappers) and third (Rats in the Ditch) treated events. This suggests that these were effective for him in delimiting the traumatic space. That is, they really were safe places in which the trauma had either not yet happened or was truly over as an existential reality. Moreover, they, or their feeling tones, appear to have been integrated into his perception of the traumatic memories.

At one point, Carl refers to accessing the Mt. Green ski patrol scene as his happy place. The bookends apparently provide emotional contexts that he now, consciously or unconsciously, uses to reframe the meaning of potentially traumatic events. This may reflect that these “bookends” were in fact incorporated in the larger context of the fear memories as suggested below:
In previous reports (Gray & Bourke, 2015; Gray & Teall, 2016; Gray, Budden-Potts, & Bourke, 2017; Tylee et al., 2017), we have emphasized our belief and intent that the rescripting exercise in the second part of the intervention does not change the original memory, but provides a weakening of its salience and its meaning as an enduring threat in the present time. Here we note that Carl’s restructuring of the rat attack as a Disneyesque fantasy of soft grass, the odor of popcorn, and fuzzy bunnies may have been carried forward into everyday life as an alternate interpretive context for responding to rodents in his every-day life. In an imaginal test following the revised movie we noted above:

Carl wanted the smells of popcorn and cotton candy wafting through the event, bunny rabbits in the ditch and landing on green grass. This revised movie was run disassociated then associated 8 times.

Carl then re-told the actual event and said:

“It’s a 0 SUDs. It’s like I go from combat to a Disney movie. It’s amazing. I feel no panic.”

Clinician tests further and asks him to imagine a rat in his garage at home.

He indicates: “I see it. It’s not going to hurt me. I shoo him out.”
Here we see an imaginal, metaphorical extension (Skinner, 1957) of the revised event to similar contexts. This also reflects our discussion of Batesonian Level II learning (Bateson, 1972), above.
We note that there were several traumas that either were mentioned in intake or arose only after treatment of the other traumas, that Carl felt no longer needed treatment. He felt that they had become just part of his process. Specifically, his near decapitation by the tripwire of a booby trap connected to a claymore mine, was regarded as no longer traumatizing.

Generalization of the behaviors learned in the context of the treatment also appears in his interpersonal relations, his self control, and a general loss of hypervigilance. This supports our previous claims that insofar as other personal issues and comorbidities are directly related to the index trauma(s), they will often be resolved (Gray & Bourke, 2015; Gray & Teall, 2016; Gray et al., 2017; Gray & Liotta, 2012; Tylee et al., 2017). So, Christmas is redeemed, obsessive checking of home security disappears, self-control is manifested in difficult interpersonal relations, etc.
We again point to the persistence of Carl’s positive adjustment at one year post. At the one-year follow-up, Carl’s PCL-M remained stable at 17. He reported neither flashbacks nor nightmares. He was sleeping comfortably through the night, enjoying his wife and family, socializing, walking, and continuing to experience a “zest for life”.

At the beginning of treatment, Carl, like all clients in the study, met diagnostic criteria for current PTSD using PCL-M. The PSS-I was also captured at intake and two-weeks post. Carl scored far above the intake criterion of 20. His two week score was 0. Carl’s SUDs ratings began at 8 for the most intense trauma and decreased to 0 for all traumas at the end of treatment.

When trauma narratives were elicited at follow-up sessions, SUDS levels remained at 0.

At baseline, Carl had shown clear signs of autonomic reactivity, including tearing, freezing, color changes, breathing changes, loss of detail and the inability to coherently relate the entire narrative. At follow-up, his capacity to recall the events fully, as coherent narratives, without the observable indicia of autonomic arousal (tears, flushing, pausing, freezing, changing color and vocal tone, etc.) attested to his changed comfort level with the material. He also indicated that they were now comfortable with the trauma memories and that they were viewed as distant, relatively dissociated memories.

Several significant observations may be made regarding RTM, PTSD and the nature of the observed changes:
a) Here (and in the larger study), the client spontaneously reassessed and reintegrated the trauma memory into a fuller, more self-affirming vision of their own past. This suggests that, rather than being the path to recovery as hypothesized by some (Brewin, Dalgleish, & Joseph, 1996; Resick, Monson, & Chard, 2006), these changes may be the fruit of the transformed perceptions created by the RTM process.

b) With Carl, as with all of the treatment completers, reduction of the felt impact of the trauma, as evidenced by reduction in SUDs, was associated with more complete memory retrieval, more coherent narratives and a larger perspective on the event itself. Moreover, as the negative affect surrounding the index trauma decreased, this suggests that the narration is less the curative agent, as expected in CPT (Brewin, Dalgleish, & Joseph, 1996; Resick, Monson, & Chard, 2006), as it is evidence of trauma resolution. This is supported by a growing body of evidence to the effect that stress and strong emotion impair various memory functions (Diamond, Campbell, Park, Halonen, & Zoladz, 2007; Samuelson, 2011).

c) For Carl and other cases in the study, comorbid diagnoses including depression and guilt were eliminated or at least ameliorated with the resolution of the intrusive symptoms. This has been reported in other studies of RTM (Gray & Bourke, 2015; Gray & Liotta, 2012; Tylee, et al.2016) and have included the cessation of substance abuse/dependence and marital discord. The same effect has been observed by Resick, Monson and Chard with CPT (2006). This suggests that, in some cases, co-morbidities are maintained as responses to the intrusive symptoms of PTSD and not as self-maintaining syndromes.
d) Despite the listing of the age of the memory as a boundary condition of the reconsolidation phenomenon, such that older memories tend to resist labilization (Agren, 2014; Fernández, Bavassi, Forcato, & Pedreira, 2016; Forcato, 2007; Kindt et al., 2009; Lee, 2009; Schiller & Phelps, 2011; Schiller et al., 2013), these results, treating traumas with a life span of 46 years, suggest that some other interpretation is needed. We lead to the belief, with Lee, Nader, and Schiller (2017), that the replay of traumatic memories as flashbacks and nightmares maintains them as current memories. That is, each time the memory is evoked and labilized through the expression of intrusive symptoms, it is reconsolidated as a present-time threat, making it more susceptible to labilization and reconsolidation than older memories not renewed in this manner.

The client presented in this case study illustrated successful PTSD treatment using a novel, brief intervention requiring fewer than 5 hours of treatment. Using diagnostic criteria for Military trauma (PCL-M ≥ 50) his intake score was 73 and no longer met criteria for PTSD diagnosis following RTM. These gains were maintained, as reported above, at one-year posttreatment. These results are noteworthy in that Carl suffered from multiple, treatment resistant traumas, a complex trauma history, and had suffered from PTSD, for 46 years. Carl had previously been treated to little or no avail by the Veterans Administration and various veteran outreach agencies.
These results support RTM’s presentation as a brief, effective treatment for PTSD in those cases whose symptoms focus upon intense, automatic, phobic-type responses to intrusive symptoms.


To learn more about the clinical use of memory reconsolidation, this PDF by Bruce Ecker is over 90 pages and a good start. https://www.coherencetherapy.org/files/Ecker_2018_Clinical_Translation_of_Memory_Reconsolidation_Research.pdf

The study for this article is from the RTM-Bourke-Gray-Potts study.  



Learn the mental training strategies used by the military to clear veterans of PTSD.  This is the strategy mentioned in the Washington Post that is considered the most effective and least known protocol for changing problem memories.

Get Over a Breakup and Learn to Change problem memories so you can move forward without the baggage of a past relationship.

Learn how to get over a breakup fast and change the memories of your ex, for good!




How PTSD Can Impact Women

How PTSD Can Impact Women

Post-traumatic stress disorder (PTSD) is a complex mental health condition that can have profound effects on individuals, particularly women. While PTSD is often associated with male combat veterans, the reality is that women are twice as likely to develop PTSD compared to men. This disparity in prevalence raises important questions about how PTSD manifests in women, the unique challenges they face in diagnosis and treatment, and the impact of gender differences on the course of the disorder.

Research indicates that women are more susceptible to developing PTSD due to a higher likelihood of experiencing certain types of trauma, such as sexual assault and abuse. These traumatic events can have lasting psychological effects and increase the risk of developing PTSD.

Furthermore, studies have shown that women with PTSD often face delays in diagnosis and treatment compared to men. On average, women wait four years before receiving a diagnosis, while men typically wait only one year. This delay in diagnosis can have significant consequences for women's mental health and well-being, underscoring the need for improved awareness and understanding of PTSD in women.

In addition to differences in prevalence and diagnosis, there are also unique challenges that women with PTSD may encounter in terms of co-occurring mental health conditions. Research suggests that women with PTSD are more likely to report co-occurring internalizing disorders such as anxiety and substance abuse. These comorbid conditions can complicate treatment approaches and highlight the importance of addressing the full spectrum of mental health needs in individuals with PTSD.

When it comes to treatment for PTSD in women, there are effective interventions available, including cognitive behavioral therapy (CBT) and pharmacotherapy.  The greatest beneficial results for women with PTSD is from a study on military women that had experienced PTSD from battle and military sexual trauma.

What worked for them is a non-drug intervention that is effective by using a mental training strategy that focuses on erasing the emotional content of the memory. The conclusion of that study had impressive results - 'RTM (Reconsolidation of Traumatic Memories) eliminated intrusive symptoms and significantly decreased symptom scale ratings in 90%'. What is additionally impressive is that this RTM protocol is done in under 5 hours. To learn more, I have made a notion template that includes the step-by-step intervention along with additional studies indicating how it works.

In light of these complexities surrounding PTSD in women, it is clear that a comprehensive approach is needed to address the unique challenges they face. Creating a supportive environment that fosters open conversations about mental health, increasing awareness among healthcare providers about gender differences in PTSD presentation, and advocating for gender-sensitive treatment approaches are all critical steps towards improving outcomes for women with PTSD.

By shedding light on the impact of PTSD on women and exploring the multifaceted nature of this condition through a gender lens, we can work towards better understanding, diagnosing, and treating PTSD in women. Through continued research, education, and advocacy efforts, we can strive towards a future where all individuals affected by PTSD receive timely and effective care tailored to their specific needs and experiences.

How Your Memories Affect Your Decision Making – Dr. Jordan Peterson

How Your Memories Affect Your Decision Making – Dr. Jordan Peterson

The purpose of memory is to provide you with a map of what to do so that you can be secure Where You Are and maybe more than that so that you can be secure and and gain Advantage.

You know you can get what you need and want from the circumstance that would be even better but you know lots of times you'll just settle for nothing terrible happening. if you can add some additional gain to that so much the better. I know maybe you learn that nothing happens to you in the playground that's upsetting or maybe you learn that it's a great place to make friends and that's even better and then part of exploring the playground would be going out to make friends and hopefully your mother in some sense is somewhat hands off about that so that you can bang yourself up against the world a bit and learn what you need to learn about how to negotiate friendships.

Now let's go back to this guy who's having the murderous fantasies. Now he's humiliated in high school so you ask yourself why well there's a pretty good literature on Bully's bullying and generally bullies poke at all sorts of people and they start with little pokes and if they can get a response that's gratifying to their desire to shame then they'll keep attacking but they start off small and not everybody gets bullied.

Most people get bullied. Some when they're kids but some people are targeted fairly frequently and they're people who tend to react in the manner of the bully wants and perhaps they're also people who don't defend themselves very well when the first pokes occur.  They don't have a quick word in response they won't stand up for themselves, they retreat, they get over emotional.

Then you might ask yourself well why would that be?

Well if your mother is operating properly in the playground she's there when you run back and you need her.  She's not there behind you when you don't need her making sure nothing bad happens to you and well why?

Because bad things are going to happen to you and what you need to learn is how to deal with that on your own.

That's the best protection your mother can provide in the final analysis is to allow you to be challenged to build competence and that takes a fair bit of forbearance on her part and she has to be willing to let you go out there and make mistakes.

I remember when my daughter was learning. I bought her this monkey bars climb up a ladder cross the ladder down a ladder it was pretty high it was about eight feet I think and she was about three she was out in the backyard learning to climb up these monkey bars it was really interesting to watch her she lift her foot up and lift it up a little higher lift it up a little higher and then she put her foot on the first rung and put a little weight on it and then repeat that then she'd go up to the first rung and then she did that with the second rung I just trial and error right a little foray a little foray a little foray Mastery and then a little higher and a little higher she was it was a fairly High monkey bar for such a little kid but we were watching her and she was doing a good job.

We just let her be and maybe she falls off the monkey bars when she gets to the top and breaks her arm and then aren't you a terrible parent and and the answer to that is Maybe and maybe not too because getting that line between protection and over protection right that's tough.

I'll tell you a little story.  Most of you have seen the Disney film Sleeping Beauty and it's a very interesting film very interesting story so the way this story sets itself up at the beginning is there's a king and a queen father and a mother let's say and they're older they haven't had any kids so they're older parents and they really want a child because they're older parents and they haven't had been able to have any kids and so finally they have a daughter they call her Aurora and uh they're pretty thrilled about it and the whole Kingdom has a celebration and it's christening day and they invite everyone in the Kingdom to come except Maleficent which is an interesting word because she's an evil queen but Maleficent means malevolent right it's she's not only that she's  it's not only that she's uh she's mother nature in the negative guys she's the tragedy of life that's another way of thinking about it but she's also malevolent so she's also betrayal and catastrophe and cruelty and the king and queen don't invite her to the christening and you think well no wonder do you really want something like that at your child's birthday party are your the christening let's say and the answer is if you don't want that there then you're that and that's a hell of a thing to realize you know because if you don't allow your child to encounter what's negative about the world in measured Doses and even what's malevolent about the world then they don't learn how to weave their way around that or to cope with it.

Both of those are important and then they're laid open to it and then that's on you and you're doing it because you don't want any of that in your child's life you don't want any tragedy, you don't want any malevolence which is why they don't invite her to the evil queen to the wedding and then what happens later in the story well Maleficent says she's going to either kill Sleeping Beauty and that's because people who aren't prepared are more likely to die and or it's modified in the story so that she'll only become unconscious and what does that mean well that's what happens you know to people who can't cope with the catastrophe of the world is that they are tempted by unconsciousness, maybe they want to sleep all the time they want to avoid.

They're afraid to confront anything. they want to shrink back instead of advancing forward and to advance forward in some senses to advance forward with full Consciousness and courage and to shrink back is to wish for unconsciousness and maybe even death and so when Sleeping Beauty hits puberty she falls in love instantly with some guy she meets in the forest which is not really something to be recommended and and uh she falls too hard and too fast for anyone who's sensible and then finds out that that's a love that's not meant to be and she's so catastrophically destroyed by that that Maleficent is able to entice her into unconsciousness and so then she's asleep and she's asleep because the world's too much for her.

She wants to be asleep you know the rest of this story is about I think it's Prince Philip the hero who confronts Maleficent who transforms herself into a dragon and attempts to destroy him and he confronts her successfully and hacks his way through all the Thorns that she's put around the castle and wakes Sleeping Beauty up and you can think about that in a sort of cynical way that this poor unconscious girl needs the hero who's a man to save her from the catastrophe of Nature and malevolence and tragedy but you can also read it psychologically and you can say that it's the Awakening of the spirit of the hero and the conscious willingness to advance in the face of tragedy and malevolence.

That's the proper antidote to the desire for unconsciousness in the face of the vicissitudes of life and you can also read it as a romance because to some degree women who have to take care of infants do depend on men to confront the world and protect them, but it's very nicely read as a psychological story as well and it's accurate.

Now back to the man who wrote me about his fantasies -the parts of his brain that are bringing those memories of being humiliated back are part of an alarm system.

It's the same alarm system that tells you when something unexplored is dangerous and if you're in a social situation and the consequence of being in this situation is that you're being humiliated and undermined, then obviously you haven't mapped out that situation very well.

There might be all sorts of reasons and some of them might not be your fault, but doesn't really matter as far as these alarm systems are concerned because all they're concerned about is the fact that you don't know what to do when you're in that situation and that's not good for you and you can't forget it.

The reason you can't forget it is - what if you're in that situation again?

So the alarm system says:

What if you're in that situation again?

What if you're in that situation again?

What if you're in that situation again?

Often traumatic memories are repetitive for people.

They can't get them out of their minds and then they try to avoid them and that just makes it worse because what you tell the alarm system when it rings the alarm if you try to ignore it is that the alarm is about something so terrifying that you won't even admit to the fact that there's an alarm and so that just makes the alarm go off more and so you try to avoid and well that doesn't work not something sort of akin to Freudian repression.

What I recommended to this gentleman was that he write down all the times he was humiliated.  ii's like so you've got these memories that won't let you go.  these people who took advantage of you what happened exactly that's hard to figure out right and maybe now he's a little smarter than he was in high school because maybe he's four years older it's like what exactly happened because the memory will have the memory will be emotion Laden but there's a lot of detail around it that's really relevant.

One of the things you can do when you confront a memory like that which is to confront the terrible things that happened to you in the past which is the same as confronting Terrible Things per se is you can ask yourself exactly what happened what exactly what part did I play perhaps and are there things that I could have done earlier or different or is there some manner in which I set myself up for this you know and so I've had clients who are pretty seriously bullied at work and we would go into it and you know as I said it starts with a few pushes and they don't respond and then the bushes get a little harder and they don't respond.

The pushes they'll get a little harder and and then it turns into something.

I had one client who was bullied into psychosis in in high school she was completely fractured by this person who decided to really do her in in a seriously malevolent way because she wouldn't go on a date with him and she had no idea that that kind of malevolence existed and so had been badly prepared in some sense to encounter someone like him.

If you're allowed to bump up against the rough edges of the world the natural world and the social world and if you have someone that you can communicate with this the probability is pretty high that you can learn incrementally how to map the world and your actions in it so that the probability that you're going to be pathologically prone to catastrophe and betrayal is much reduced.

I'll tell you a story about my mother. This one day I was out playing baseball in a abandoned lot empty lot near my house and my wife was there we were only about eight or nine ten something like that, was there with some of my friends one of them was a tough little guy I was little too but not as tough and we're having an argument about something and we're going to have a fight and my mother walked by and my mother is a pretty nice person you know and she had to learn late in life to some degree to stand up for herself when she went back into the workplace and had to confront some relatively intimidating and pushy men and it was hard on her to do that but she was no pushover my mother and she's a good person and she walked by just as this fight was about to emerge and I was not particularly confident of the probability of my uninjured victory in this fight but I was a hell of a lot more afraid that my mother was going to come over and interfere and she didn't but she knew what was happening.

She looked I saw her look I knew she knew she knew I knew and she walked on and it's like more power to her you know and because I was fortunate to have mother like that let's say I got into enough of the sorts of scrapes that teach you how to avoid a certain amount of scrapes and that worked out quite nicely and that's meant my mother was willing to invite malevolence invite the evil queen into my life at least to some degree you know because she knew better than to assume that that could be just dispensed with this program that so this guy that was having these fantasies so he said he's very afraid of the fantasies because they were murderous and I think murderous fantasies when do they emerge well they definitely emerge.

When you've been pushed a hundred times and now you're past anything that vaguely resembles reason and then the fantasy comes up as a manifestation of Rage so I asked him to write down what had happened and also to write down the fantasies you know what is it that you're what reaction is it that you're having now you'd hope that it wasn't like he leapt from happy to murderous in one leap he went through mildly irritated extremely irritated extremely humiliated continually humiliated repeatedly continually humiliated and then well even a few years later into murderous rage and the problem with that is is that you should intervened a lot earlier and so part of what he needed to learn by going back into that memory which was now associated with those murderous fantasies is that the aggression that was manifesting itself in the fantasies hadn't been manifested early enough in the process that led to his humiliation and so then you can imagine well why didn't he react to being bullied in a way that would have stopped it and that's where that might be well he didn't have the skill he didn't have the physical prowess or perhaps he was overprotected I don't know because I didn't know the story but doesn't make any difference because what he needed to figure out was how to take that response and differentiated into something that was reasonably skilled so that the next time someone pulled a stunt that was like the stunts that led to his humiliation in high school he was ready to act.

You can think if a memory that you have that's old well or a problem that's bothering you right now that won't let you go you can look at your fantasies because they'll often give you a clue as to what the appropriate response needs to be not that that's necessarily the response you have to manifest and then the trick is to implement the response in a manner that stops you from falling into the same hole that you fell in many times before these stories that the psychologists students wrote about their past traumas were Curative because if they used words that indicated understanding comprehension Etc then they were remapping the territory that they hadn't mapped properly the first time they walked over it and your your all of you is very much concerned with this your stability and your safety from betrayal and malevolence and the probability that the necessity to avoid unnecessary tragedy.

So any past behavior that indicates that there's a hole in the map that you're using to orient yourself in the world Lets All That Terror shine through and that's what the alarm is and the reason it goes off is because it's saying to you you have a map it's got some bad holes and the holes are places you probably are going to have to go again and so if you go there again and the hole's still there you're going to fall in the hole and the last time you fell in the hole it wasn't good for you and so you should be alert to that.

So that's the reason that memories of that sort won't go away it's actually a good thing although it can be very bad if you don't know what to do about it and it isn't merely a matter of expressing the emotion that's associated with the past catastrophe because often not not only does that not help it can actually make it worse because the mirror expression of your frustration, let's say if you were bullied in high school doesn't stop you perhaps from still being the sort of person that might be bullied by your co-workers and that's not a positive outcome by any stretch of the imagination.  So a program we wrote it's sort of like psychotherapy for free essentially, it asks you to and I used it on this client of mine who had been bullied into a psychotic state when she was in high school.  She could hardly even talk when she first came to see me and she was hallucinating in all sorts of strange ways.  She was really badly fractured by this person who tortured her three-quarters to death and we went through her whole life she could talk a little bit and she could write a little bit and I sat her behind my desk, my computer and we opened this program and what it does is it has you divide your life up into epochs whatever you want maybe it's kindergarten grade one to grade three grade, three to grade six you know, you can do it numerically like that you could do it by age I had people who were more agreeable in temperament they would divide their life up into relationships that was really how they conceptualized the stages of their lives each relationship.

It depends on you.  It doesn't really matter however.  You conceptualize your life and then the exercise has you walk through and describe significant events positive and negative to lay them out and then to analyze them it's like well what did you do...

Write that enabled the positive events to occur and what did you do that you might be able to alter or that you learned to alter later or that you could alter now that would help you avoid the negative events so it's it's not merely the recounting of the negative it's in some sense it's the extraction of the moral of the story you know there's this old idea I'm sure you've heard me talk about it before the dragon's guard gold it's a very strange idea very old idea Treasure of one sort or another that they threaten the city eternally that's a dragon and the city in some sense is the Citadel of your memory and the chaos that's outside of the Citadel of your memory can always emerge to threaten The Citadel and that's the same story as the Garden of Eden and the snake it's exactly the same idea and if you confront the thing that threatens then you can find the treasure and you can use that to rebuild the Citadel but also to turn yourself into something that can confront the dragon and that's the real treasure right ? is to turn yourself into something that can and is willing to confront the dragon.

I did a lot of work with people in my clinical practice on assertiveness therapy and uh assertiveness training and these are often for people who are very agreeable and they're more likely to be bullied and the reason for that is that they don't like conflict but there's another reason too which is that they don't have enough faith in the truth and enough fear of the consequences of not telling the truth and so they'll pretend that things are all right when they're not all right and then forestall catastrophe for later.

Let's say your boss is kind of a bullying type and pokes at you a bit takes advantage of you a little bit and you think well that's not really worth making a fuss about but you go home and you're kind of resentful but you you don't pay any attention to that.

Maybe you think you shouldn't be resentful but probably you don't think that you just don't want to confront your boss and the thing is though if you do it when if it's on the first foray and you say you know here's the reason I won't do that well maybe you'll get fired but probably not not if you're careful. Generally someone like that will think 'oh you're not as easy to pick on as I thought you were' and they'll go find someone else or maybe they'll even learn something from the encounter you know and then and that takes a fair bit of courage and that's part of that confrontation that we just described is that you're resentful because you've been taken advantage of and you have something to say and so you need to say it.

When I was doing a assertive just training with my clients I often talk to them about their resentment that would be the kind of resentment that might have someone generate murderous fantasies four years later it's people who go out and do murderous things.

They've harbored an awful lot of resentment there's a lot of things they didn't say when they should have said them that's for sure and so you know when if you let the people around you who you love hypothetically take advantage of you then you're going to Harbor resentment and that's going to come out in all sorts of ways that are really not positive in the least for you or for them and so it's better just to have the it's just better to draw the line when it you know when all there is of the Dragon is one tooth say no here's why leave me alone or here's how I want to be treated instead and insist upon that right you draw a line and it's not like that's nothing and then right suggested to this man with murderous fantasies that you think about what he could have done different in high school I mean principle you know maybe he needed to get stronger so he was more confident.

I'm not saying this is easy that's irrelevant lots of things aren't easy that end in catastrophe and the problem was that he was humiliated and now he's murderous and that's not a good outcome.  So even if it's difficult that doesn't mean it's unwarranted but even more particularly in a situation like that you ask well how did how did you allow it to come to such a path and what could have you done differently?

And maybe you might find that there wasn't anything that you could do differently back when you were in high school but by the time you're in University you're not in high school anymore and the world shifted quite a bit and generally you're around more sophisticated people and that kind of bullying is less likely and so you still might have some aggression to integrate within you so that you're not a pushover.

If you do that well then those memories in all likelihood are going to stop long as you're confident that now you know what to do.  Those memories are very likely to stop plaguing you and then hopefully those murderous fantasies will go away and you won't be inclined to act them out.


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