What Keeps Post Traumatic Stress Going?
Therapy for PTSD: In the simplest of terms, PTSD is maintained by the intense, almost phobic, fear of a memory. When the memory of an event carries with it so much emotional content that it overwhelms us with fear, we may invest a huge amount of effort in trying not to remember it. This avoidance of thinking about the event, what we call thought suppression or cognitive avoidance, means that our brains struggle to deal with the memory properly, leading to the memory remaining “raw” and unprocessed. This means that whenever our the memory gets activated (i.e., when we remember it), we get the full, emotionally intense version of the memory, as though the event was happening again in the here and now.
Take a look at the following example to understand this process further…
Imagine that your brain is like a factory. The main task of this factory is to take all of your sensory experiences (the raw materials) and run these along a conveyor belt, where they are processed and packaged into nice little units which can be stored in our long term memory store for remembering later.
The process involves the brain-factory putting a sort of “date-stamp” on the memory, to let us know that this is an event that happened and it is now part of our story – part of our past. When we want to, we can then go into the long term memory store-room and take out a memory, remember it and forget about it again, knowing that we can remember it again if we ever need to again in future.
Your brain is doing this all of the time and we don’t really ever think about it.
A trauma event is a little different. Whereas our everyday experiences are generally small, ordinary and easy to process without any special effort, a trauma event comes with uncommonly intense (and frightening!) imagery, emotions, sensations and thoughts, all of which require additional processing from the factory to get it into the long term memory store.
That is, the factory needs to put on overtime to process this traumatic experience and get it into the into the long term memory store.
However, because this memory is so out of the ordinary, with all of its unique scary features, whenever the event gets placed on the conveyor belt, we can become overwhelmed by it and shut down the factory. The processing stops before it is finished.
And so, instead of the memory being processed, date stamped, and packaged into the long term memory store-room, in PTSD we get a raw materials memory, with intense emotion, imagery and sensation at the same intensity as the initial event, as though the event was happening again, in the here and now.