Bob Rich’s Self-Therapy Guide: Processing Trauma

In this series, Dr. Bob Rich teaches you how to leave behind depression, anxiety, and other forms of suffering all too common in our crazy world. Recovering the Self published three sections of Bob Rich’s book From Depression to Contentment: A self-therapy guide in a series of posts – the first section ending with the quest for meaning and the second section concluding with The Development of Resilience.

The third section of Bob’s work was marked by special attention to various techniques and practices that are helpful in controlling depression. It concluded with a discussion on values and their implication in therapy. Bob now shares the final section of his self-therapy guide that delves deeper into the practical side of his therapy work illustrating with examples from individual cases of his own patients. In the second post in this section, Change Your World, Bob illustrated the difference between “need” and “want” in the context of happiness. Here, he explains how effective therapy handles processing traumatic experiences.

Processing Trauma

I have previously explained that all adult “mental disorders” are based on childhood traumatic experiences, as seen from the child’s point of view. For clients like Giles, Cyril and Raelene, the relevant event was not something an outsider might identify as trauma, but it’s the kid’s perception that matters. An event, or an ongoing situation, induces the child to develop damaging ways of seeing the world, which then color everything.

There is effective therapy for processing traumatic experiences. It has many versions. All have a high success rate — if the activity is taken to its conclusion. However, especially at the start, doing so is scary, and even overwhelming. So, overall failure rate is high, because people start, then drop out. This often traumatizes them further.

Suppose you’ve had severe, worsening pain for years. An operation will relieve it, but that means going into hospital, being cut open, the pain, discomfort and inconvenience of perhaps months of recovery. That’s also scary, but people do it. As I am writing this, I am recovering from a total hip replacement. It’s not fun, but I know the benefits are worth it.

The same is true for “exposure therapy,” the way to deal with past trauma.

It’s perfectly possible to do it for yourself. A taxi driver came to me under a “victims of crime” program. One night, he picked up two men who gave him an address. When they arrived, it was a dark, lonely spot. They severely assaulted him and took all the money.

He was too badly injured to drive. All the same, the next day, on the way home from his medical appointment, he got his wife to drive him to the location of the assault. He sat there in the car for about an hour. He kept reliving the terrible event in his mind, over and over. He didn’t know that he was doing the well-researched, effective therapy of “in vivo exposure” (exposure therapy “in real life”).

At his first appointment a week later, he could tell me about the crime without any emotional reaction, as if it had happened to someone else. He was keen to return to work and was actively problem-solving on ways of reducing the probability of another assault. He didn’t need my services, having done therapy for himself.

The worst event of my childhood was when four bigger boys smeared feces on my face, trying to get it into my mouth. Until I was 22, I had flashbacks to this incident, dropping back into disgust, helplessness, terror. I developed a way of stopping the recall by mentally shouting, SHUT UP! This is a standard cognitive-behavioral technique called “thought stopping.” I didn’t cover it in the chapter on CBT, because it’s actually counterproductive. Sure, it stopped the immediate distress, but kept the trauma going.

As a psychology student, I volunteered to do palliative care. During the training, the instructor got us to form small groups, and each of us had to disclose an unpleasant past event. When it was my turn, somehow I blurted out this memory, the first time I’d told anyone. I felt my face flame. My guts tied into a knot, and I wanted to run out of the building. To my surprise and relief, the three ladies in my group reacted with loving compassion. One gave me a hug. I calmed down.

I’d learned about exposure therapy not long before and realized that this was what I’d just done. So, when I went home, I relaxed my body, told myself I was safe, then deliberately went back in my mind to being a little boy, in the clutches of those boys. In imagination, I saw, heard, smelt and felt it all.

I rated my distress. As you know, that’s a distancing technique, moving from emotion toward reason. It was 9/10.

I deliberately relaxed again, and repeated. After the third time, the distress was 3/10. I didn’t feel the need for another pass.

Since then, I’ve been able to think about that terrible event, disclose it as I have here, without emotional involvement. There was one exception. In Colleen McCollough’s novel, Tim, a nasty person gives the young protagonist a “sausage sandwich:” two bits of bread with feces in between. I had a flashback, and nearly vomited.

So, what did I do? I repeated exposure therapy for my feces trauma. After two passes, my distress was 0/10. All the same, I didn’t return to reading the book.

Any kind of exposure therapy is much easier with a trained helper. But, alone or with a therapist, you do the work, and once you start, you need to get through the initial high level of distress to the point where there is no distress at all. The trauma has been processed.

One way of making this technique less challenging is to start with a comparatively mild unpleasant experience, not necessarily the one you need to process. Tony was a policeman, referred by Victoria Police’s health service. He’d been diagnosed with PTSD, not for any one event, but for the cumulative effects of hundreds of terrible situations.

When I described exposure therapy to him, he said, “No way. I’m scared to go to sleep because of the nightmares. I pass a spot where I had to fish a mangled body out of a car, and I’m ready to chuck up. No way am I INVITING memories like that!”

I asked if he had memories of any events not related to his work, which had been distressing, but less so. He came up with one: when his daughter was three, she’d caught her finger in a slamming door. Tony had held her on his lap, crying inside, while the doctor worked on the poor little finger.

We used my favorite exposure therapy: “age regression hypnosis.” I talked him into a trance, then got him to become an eagle. He flew back to this event, changed into himself-now, and watched his younger self with love and sympathy. I got him to describe what he saw, then to rate his distress. The first time, it was 7/10, the second time 3, then 0. Seeing it work so well, he was then willing to do it on that fatal car smash, with equal success.

You can do it this way for yourself.

There are other tricks. If even having your present self as the witness to the past event is too challenging, you can see and hear it on a TV. You are your current age, in your safe place, watching the old terrible event as it unfolds like a TV show.

Once you have processed the worst traumas of your past, you’ll probably find that other, less distressing events will also have lost their effect on you. You’ll have become stronger, more resilient, less emotionally reactive, and more compassionate to others. Doing this is an essential step toward a life of meaning and contentment.

Homework

I recommend that you find a person with relevant expertise to be your guide in processing trauma. One option is someone certified to practice Traumatic Incident Reduction. Another is a psychologist trained in hypnosis, EMDR, or other evidence-supported forms of exposure therapy.

As I did, you CAN do it for yourself, but if you do, ensure that you repeat the recall often enough to reduce the level of distress to trivial.

– Dr. Bob Rich