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Trauma and Memory

According to research by Karim Nader, memories are not stable. Each time we bring a memory to mind, we inadvertently alter it. Think of i this way. You buy something from a store, bring it home, and unpack it. After examining it, you decide to return it. But try as you may, you can't get everything back in the box. You return to the store with the box bulging, or with a couple of pieces outside the box. Memory is like that. Once you take it out from where it is stored, you can't put it back without removing or changing something.

Some memories are so traumatic that remembering them causes great distress; we term this Post Traumatic Stress Disorder. There are at least two competing ideas in how to treat a person who is troubled by an intrusive traumatic memory. One idea is that it is best to leave sleeping dogs lie. Edna Foa of the University of Pennsylvania Medical School says, "There has always been a group that says we could reignite a trauma by asking people to deal with the memory. In this thinking, keeping the memory suppressed was actually better. That was a strong belief in the early era of psychiatry: Put it behind you. Don't deal with it. Go on with your life. The idea behind counseling was to soothe the patient, to find ways to make him as comfortable as possible." The problem with that approach is that - though the original memory may be inhibited - it is still there. Keeping it inhibited is costly. We now know that every effort a person makes to consciously or unconsciously inhibit a memory causes the person to distort reality. As in Watergate, the cover up can cause problems.

Shakespeare addressed traumatic memory, and madness that can result by attempts to inhibit it. in Macbeth; "Out, damned spot! . . . who would have thought the old man to have had so much blood in him?" When Macbeth was unable to put memory of the murder out of mind, he was forced to commit more murders. Finally, he became insane. Freud, too, believed mental problems were caused by cover up. His view was that health could be restored when the person came to grips with what he or she was unconsciously covering up.

Though Freud believed it was necessary to accurately remember what took place, things can also get better, Foa suggests, by rewriting memory for the better. But, to rewrite a painful memory, we have to revisit it. In a New Yorker article, Foa recounts the case of a young woman who had been raped. She suffered from PTSD. She could not maintain relationships. After ten years, she entered therapy. She insisted the rape was her fault. "I didn't fight them. If I had, they would have stopped." In treatment with Foa, she was asked to repeat the story again and again. Foa says as people go through their story repeatedly, they learn that what happened in the past is indeed "back there" and not here in the present. This is a distinction that people may not make until they go through the memory enough times to really establish the past as the past and finished. But also. her memory of the rape changed. She came to see it as not her fault. Was this because she revised the memory to her benefit? Or did she, by recalling what happened, realize she had no choice? We don't know. But, her PTSD cleared up.

Neuroscientist Stephen Porges has pointed out that when a person cannot escape a life-threatening situation, mental and physical shutdown takes place. The person's breathing becomes shallow. Their heart rate slows to the point that the brain almost stops functioning. This is a state like that of an animal that "plays dead." Porges, however, points out that neither the animal nor the human is playing. Rather, when there is no escape, shutdown takes place - not as a conscious choice - but automatically and unconsciously. Porges calls this shutdown the Immobilization System. He says we inherited the Immobilization System from primitive creatures who used it as - not as their last line of defense - but their only line of defense. These primitive creatures, Porges says, were somewhat like the present-day turtle which goes into its shell when threatened.

Though we have no shell covering our bodies, we do, it seems, have a shell covering the mind. Within that mental shell, we are not fully exposed to what happens during an attack. It is as if the attack is happening to someone else. This psychological shutdown - dissociation - might seem benign, but dissociation is like the old ad on TV about getting the oil changed on your car. The ad showed a mechanic replacing an engine ruined by unchanged oil. He says, "You pays me now or you pays me later." If you don't stop and pay for an oil change when it is needed, the engine stops and needs to be replaced, which, in the end, costs a lot more.

A person may be spared feeling the intensity of the attack at the time. But, the cost paid in the future can be enormous. The person's psychology changes. He or she seeks to keep memory of the attack out of mind. Some trauma victims succeed - or seem to succeed - for a while. Some even develop amnesia about the attack. But there are two problems. Just as you have to pay to keep your belongings in storage, amnesia has a storage cost: the cost is anxiety that the sequestered experience will surface. This anxiety can cause unexplained mood shifts, difficulty staying focused, difficulty in relationships, and panic.

When something is going on that begins to bring a sequestered memory to mind, the person may feel an urge to escape. If escape is not possible, the person may panic. For some, fear of flying is due to anxiety that a sequestered memory will erupt during a flight where escape - to keep the memory from surfacing - is not possible. A sequestered memory can cause any place where escape is unavailable to feel threatening; what if a hidden memory surfaces where they cannot run from it (and keep it out of mind). The person seems to fear that is something - and they don't know what - surfaces, they will be overwhelmed, have a heart attack, do something embarrassing, or go crazy.

After years of being hidden away, when a sequestered experience surfaces. the person may worry that what is remembered is only the tip of the iceberg. Disturbing questions arise. How many other experiences are hidden away? With whom did other experiences take place? Did I cause them? If not, why was I not protected? Why didn't someone care? Why didn't someone stop this? Because the questions - and the answers to the questions - are horrendous, they need to be faced over time with the aid of an experienced therapist.

If Porges is right, when hopelessly trapped, shutdown occurs as a reflex, due to our genetic heritage. This doesn't fit what we see in Hollywood movies. It is, though, what therapists hear in the treatment room. If hopelessly trapped, we give up the fight, or we don't fight in the first place, jus as the primitive creatures we evolved from did.

Though it doesn't make a good Bruce Willis movie, this is how we humans are. We are not Bruce Willis. But, the Bruce Willis we see on the screen is not Bruce Willis either. Not convinced? Consider this: if humans always fought when facing life-threat, that behavior would be so typical that no one would want to make, or to watch, a movie about it.

What about fear of flying? Is fear of panic on a plane always due to sequestered memory? No. Somewhere along the evolutionary line, humans developed an ability to sense other humans intuitively, unconsciously, and automatically. When dogs encounter each other, they smell each other out to determine whether to fight or be friendly. When humans encounter a new person, we sense whether the person is threatening or cooperative by what we see on the face, what we hear in the voice, and what we feel in the touch. If the signals we unconsciously sense are threatening, stress hormones urge us to back away. But, if we unconsciously sense that the person is trustworthy, what Porges calls the Social Engagement System overrides the stress hormones the presence of a new person triggers. This override of the stress hormones allows us to work together, play together, or reproduce together. This ability to sense others has allowed humans to achieve things by cooperative effort that exceed what other species can do.

When our ability to automatically and unconsciously regulate anxiety is well-developed - which happens mostly due to good early relationships - we regulate anxiety automatically. We can be calmed by who we are with. If alone, we can be calmed by memories of people we were with, and how they related to us. If benign, early experiences give us the security we need to feel safe without having to be in control or being able to escape. The ability to feel safe when not in control - and when not able to escape - allows a person to fly.

The need to keep traumatic experience our of mind can make it difficult to fly. Lack of development of the ability to feel safe when not in control can also make it difficult to fly. Fortunately, we can increase the ability to feel more secure when not in control via the methods taught in the SOAR Program.

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