People living with PTSD suffer on many levels — emotional distress, physical ailments, and jumpiness are just a few of the common symptoms. However, the most far-reaching effects involve our relationship to the memories of these traumatic events. As a survivor of Complex PTSD, I have experienced these changes firsthand. Like Alice falling through the looking glass, time and space can appear to break down in bizarre, inexplicable ways after a traumatic event.
Traumatic memories feel like a song stuck on repeat, dogging you day and night. They stalk you while you are sleeping through nightmares or in visual flashbacks while you’re awake. In some cases, traumatic memories remain hidden from conscious awareness. Quarantined from the normal processes of memory, trauma makes itself known through seemingly unrelated issues like physical pain, irrational fears, or compulsions.
In the months after my parent’s murder-suicide in 1993, the power of my repetive memories compelled me to tell my story to just about everyone I met, reliving the horror anew as I registered the shock and dismay on the faces of people unprepared to take on such burdens. In reality, sharing these memories did little beyond providing a sense of momentary relief. Soon after, I’d return to the feelings of emptiness and fatigue that plagued me day in and day out.
Memory and trauma have a fraught relationship that has made them prime targets for misunderstanding and exploitation. During the 1980s, the highly publicized McMartin Preschool case provided a vivid illustration of the ease with which false memories could be implanted into impressionable minds. Responding to allegations of large-scale, ritual sexual abuse, attorneys and parents inadvertently coached young children into describing elaborate tales of sexual abuse that never occured. Complicating this picture, some survivors of actual childhood abuse only come to recognize their traumatic experiences as adults — and then only tentatively — the memories taking on a dream-like quality, untethered from the everyday flow of consciousness.
Much of the reason for this murky picture of traumatic memory is the fact that traumatic experiences can be so overwhelming in their power that they interrupt the normal processes of memory. Like a knight’s protective shield, these interruptions in consciousness are like a fail-safe that protect us when confronted with the threat of physical or emotional annihilation.
Treatment for Trauma-related Memory Issues
During the worst years of my crisis, talk therapy was the treatment of choice for PTSD. The philosophy of this approach was to talk about the traumatic experiences over and over again with a trained professional. The idea was to integrate fragmented and disorganized memories into the normal flow of consciousness. In the years since my recovery, new treatment methods have come into fashion, with one in particular harkening back to the earliest days of trauma treatment.
In the latter half of the nineteenth century, Jean-Martin Charcot, a pioneer in the field of neurology, attempted to cure trauma sufferers through hypnosis. Today, a treatment known as EMDR, or eye movement desensitization and reprocessing, harkens back to the old swinging watch routine, once the stock and trade of hypnotists.
While EMDR involves focusing your eyes on a therapist’s moving finger while describing traumatic memories, there are some key details which differentiate this treatment from hypnosis. Hypnosis involves being put into a trance-like state by a hypnotherapist. Under hypnosis, the patient is guided to a specific goal through suggestions by the hypnotherapist. Hypnosis is sometimes used as a treatment for trauma with the goal of bringing repressed memories into conscious awareness. This remains a controversial approach for the same reason that the McMartin Preschool case fell apart. Much like preschoolers, a person in a state of hypnosis is incredibly vulnerable to suggestion and the inadvertent planting of false memories.
EMDR is different from hypnosis because the patient does not go into a trance-like state during treatment. The goal is not so much about recovering memories, but rather to reframe established memories in a way that decouples them from feelings of shame, guilt, and anxiety. People find that EMDR treatment helps to alleviate their troubling relationships to traumatic memory, decreasing the vividness of images associated with the memory and the intensity of emotions associated with the event.
Why Does EMDR Work?
There are several competing theories about how EMDR might work. Some see a connection between the eye moments (EM’s) triggered by focusing on the therapist’s finger during EMDR treatment and the role of eye movements during a stage of sleep known as REM. During REM sleep — our deepest stage of sleep — our eyes dart back and forth from side to side. Research has shown that EM’s during REM sleep aid in memory processing and the consolidation of memories. By eliciting these same processes while awake, it is possible that traumatic memories — stuck at a level of consciousness that makes us constantly aware of their presence — are then metabolized by our minds in a way that eases PTSD symptoms.
Other researchers see a possible connection between the dual attention tasks of EMDR and the overloading of the storage capacities of our memory. Broadly speaking, we have two types of memory, long term and working memory. Long term memory is what you expect it might be — memories of summer camp when you were a kid or the day you graduated from high school. By contrast, working memory is what we use to remember things like phone numbers or directions to a birthday party. Working memory has a limited capacity and fades quickly if you don’t access it frequently.
Some researchers believe that it is the limited capacity of working memory that might aid in the integration of traumatic memories into long term memory through EMDR. Understanding the limited capacity of working memory is pretty simple — just try remembering three new phone numbers and you’ll quickly see how limited our capacity is. One way EMDR might work is by momentarily overloading our working memory by focusing on the dual tasks of traumatic image recall and eye movements at the same time. It is possible that by overloading our working memory capacity, memories of traumatic events become less intense.
It would be easy to dismiss EMDR as another kooky, New Age remedy, but research into its operating mechanisms is helping reduce these types of prejudices. Nevertheless, public perception of EMDR continues to lag behind the mental health community — a fact underscored by the endorsement of EMDR therapy by mainstream organizations like the American Psychological Association and the Veterans Administration. Given the overwhelming evidence for the effectiveness of EMDR, I’ve pushed past my own reservations. I’m looking forward to completing my EMDR training to help my patients better manage their symptoms of PTSD and the associated challenges of living with traumatic memories.