ONLINE MINDFULNESS THERAPY FOR PTSD
Online Mindfulness Therapy provides one of the best approaches available for reprocessing traumatic memories and healing from the emotional suffering associated with PTSD.
Learn how to reprocess traumatic memories so that they do not continually reactivate emotional trauma.
Learn how to reprocess and heal the intense underlying traumatic emotions that are associated with PTSD.
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Post-traumatic stress disorder (PTSD) can be defined as recurrent episodes of anxiety and panic in reaction to a past experience that was overwhelming at both the sensory and emotional levels. The mind was unable to process and assimilate the experience, and the emotional trauma becomes repressed, only to reoccur in the future.
The basic direction of psychotherapy for PTSD is to help the client re-process these emotions into a form that can be re-assimilate; essentially completing the process that was left undone. However, the methods for doing this are problematic for two main reasons.
Firstly, the intensity of the associated emotions and resistance to re-experiencing the trauma; and secondly, the complex superstructure of secondary reactivity that accumulates around the primary traumatic experience, which makes it difficult for the client to access and work on the core emotions.
One approach, which I have found particularly helpful, is a form of psychotherapy that combines mindfulness and experiential imagery, called Mindfulness Meditation Therapy (MMT).
A recent client wrote:
“I had three sessions with Peter (4 hours total) and am very glad I had a chance to do therapy with him. Even after one session, I already felt better about some of the trauma I have had since I was young. With him, I learned to dissolve the trauma and came to terms with what happened in the past. I very much appreciate Peter’s kindness, wisdom, and patience.”
Step One: Form a Non-reactive relationship with the traumatic memory
In this approach, the client is taught how to form a non-reactive relationship with his traumatic memory. The individual literally learns how to “sit” with the felt-sense of the trauma, without becoming caught up in the contents. The purpose here is not to simply re-experience the traumatic memory and emotions, but to learn how to experience them differently.
This Mindfulness Based Relationship creates a therapeutic space around the memory imagery and associated emotional energy that allows the client to gradually stop the secondary reactivity of resistance and avoidance. Now a new creative space is created which allows the emotions, which have been confined and frozen in place, to become malleable and change. This process of inner change leads to the eventual resolution and transformation of the trauma. In short, reactivity inhibits change, whereas mindfulness facilitates change and healing.
Mindfulness has of course attracted a great deal of attention in recent years, although there has been little systematic attempt to describe, let alone define, mindfulness.
In my view, mindfulness describes the quality of conscious relationship with experience in which there is complete presence for the experience and the absence of any form of habitual subjective reactivity. This is invaluable in psychotherapy, because it allows the client to investigate the deep structure of his trauma, rather than staying stuck at the superficial surface structure.
Indeed, when one begins to investigate the internal structure of a traumatic memory, it is always surprising to discover the wealth of subtle feelings that lie just under the surface. Differentiation of the feeling structure of an emotion like anxiety or panic is an essential part of any successful therapy and the conscious experience of this inner structure is transformational.
Step Two: Mindfulness-based Image Reprocessing
In addition to feelings, traumatic memories also have a specific internal structure in the form of intense experiential imagery. This imagery may be photographic in quality, revealing the actual memory of the traumatic event, but more often the imagery has an abstract structure with specific colors and shapes, in something resembling a surrealistic collage.
Emotional energy is encoded in each of these specific sub-modalities of size, color, intensity, movement and texture. An intense emotion is likely to be encoded in intense colors, such as red and orange, and the imagery is likely to be large and close in the person’s inner visual field, whereas neutral emotions are likely encoded in neutral colors, such as pale blue or white, and appear small and distant.
The investigative dimension of mindfulness provides the best approach to uncover the detailed inner structure of the emotion and provide meaningful content. This is called the Structural Theory of Emotions, which goes on to propose that by changing the structure of the imagery it is possible to change the intensity of the emotional reaction.
When you change the traumatic imagery you change the emotion
Thus, if the color changes from intense red to soft yellow, and the imagery becomes smaller, it is very likely that the emotion will become much less intense. However, for this to work effectively the imagery must arise experientially from the emotional felt-sense, rather than be created through deliberate visualization.
Similarly, the direction of change must arise experientially, rather than be imposed externally. This is why mindfulness is such an important part of the transformational process, because it allows the client to be exquisitely sensitive to what is meaningful and what is not.
A central focus in MMT is to uncover this internal structure of the traumatic memory and then to investigate this experiential content. There is no attempt to interpret what arises, only to experience fully and know completely whatever arises. This process essentially de-constructs the emotional complex into smaller parts that the psyche can digest and integrate into more stable configurations that do not continue to generate emotional suffering. Of course, this requires considerable preliminary preparation so that the client can experience the internal imagery without becoming overwhelmed.
Therefore, the preliminary phase of MMT is focussed on establishing the Mindfulness Based Relationship (MBR) in which there is sufficient stability and non-reactivity to allow the imagery to unfold into present awareness. There are many approaches to achieve the right MBR, such as watching the imagery as if projected on a screen or placing the imagery at some distance in front. Through mindfulness and careful investigation, the client can discover for himself what works best for establishing the MBR.
However, once a client begins to witness specific details about the imagery, he inevitably finds it much easier to observe the imagery without becoming reactive, because the specific structural details give him a specific focus and this tends to prevent hyper-reactivity. The MBR is an essential part of the transformation process for many reasons, the primary reason being that it allows the compacted emotional complex to unfold into more manageable parts. At another level, the MBR allows the client to fundamentally change the way that he relates to his inner emotional experience and he begins to break free from seeing himself as a victim of the emotional trauma. This in itself is an essential requirement for change.
In a relatively short time, the client begins to discover the detailed internal structure of the trauma and associated emotions in the form of experiential imagery. Now he can begin to investigate what changes need to happen in the imagery that allow the emotion to resolve. Mindfulness helps this transformational process by creating a therapeutic space in which there is no interference from the ego. The client begins to discover intuitive changes that can be very subtle and beyond rational deduction, but are clearly felt to make a difference.
Experiential imagery frequently differentiates into parts, often with different colors and textures and the internal interaction of these parts can be very important for resolution. One client described her anxiety as a black pulsating blob, located on the upper left of her inner visual field that sent tentacles out to her throat, literally strangling her. As she focused mindfulness on this black blob, I asked her what needed to happen next. To her complete surprise, the answer that came up was that the black blob wanted to be allowed to die. It was strangling her to get her attention! Eventually, through continued presence and complete attention to the black blob, it felt sufficiently reassured that it could let go of her throat and proceeded to die. It became white and brittle like ash and crumbled into a small pile on the ground.
One could spend many hours trying to interpret and understand this process, but what was much more important, was her direct experience of the resolution process at the subtle and concrete level of experiential imagery and this is made possible by mindfulness, the sensitive attention to detail and the investigation of the deep structure of experience.
Throughout the whole process of MMT, the client is repeatedly exposed to the source of his or her fear, but in new ways that don’t involve being overwhelmed. This exposure desensitization effect is regarded by most schools of psychotherapy as an essential part of overcoming PTSD and Mindfulness Meditation Therapy provides a very subtle and specific way of doing this through the client’s internal experiential imagery.
ONLINE THERAPY FOR EMOTIONAL TRAUMA
Trauma can arise from any experience that cannot be resolved and integrated and may include violent assault, rape, childhood abuse as well as the experience of natural disasters and, of course the intense traumatic experiences of war. Typically traumas are so foreign to our everyday experiences that the mind has no way to categorize them and integrate them into subconscious memory.
Not surprisingly, children are particularly vulnerable to Post-Traumatic Stress Disorder. Whether the trauma occurred during childhood or adulthood, the central issue remains the same, which is that the individual has to complete the resolution and integration of the traumatic memory, and this is why Exposure Therapy of one form or another is a central part of the healing process.
As the term suggests, ET involves re-experiencing the trauma in a controlled and safe way until the client can experience the memories and other triggers without becoming emotionally overwhelmed and without becoming reactive. The point of ET is actually NOT to simply re-experience the same painful emotions and memories, but to experience them differently, and this is a very important point to understand.
You are actually trying to establish a functional relationship with the trauma so that you do not become consumed by emotional reactivity and, most importantly, so that you can establish what I call an inner “therapeutic space” in which the emotions can unfold and change. In the reactive state, all that emotional energy is effectively frozen in place; trapped inside with nowhere to go. In this unresolved state, the emotional energy creates tremendous inner tensions and conflicts that adversely affect our thinking process, our belief systems and our outward actions and behavior.
Mindfulness is a very subtle form of conscious awareness in which you pay attention to the fine details of how you experience things. The emphasis is not so much on the content, but on the process of experiencing.
Normally, we tend to condense the details of experience into abstract reactions and remain stuck at the superficial level of experience. Emotional reactions are like this; they are very abstract and intangible and this is why it is so difficult to transform and resolve anxiety and fear.
As is commonly said, it is the fear of the unknown, the fear of fear itself that creates the most suffering. Therefore, in order to make useful changes, we must move from the abstract to the specific. We must focus in on specific details of the traumatic imagery so that we have something tangible to work with and change. Interestingly, when people are able to see subtle details like this, they become much less reactive and find it easier to work with their emotions without becoming overwhelmed.
When I work with clients in the office or online through Skype sessions, I teach them to refine their attention so that they can begin to have a meaningful exposure experience with their memories.
We do this in a very controlled way, applying very close attention to each moment of experience and the associated feelings that accompany each experience. We don’t try to take in the whole monster at once, but start by examining the color of the monster’s toenails! Little by little, we progress from foot, to legs and so on. At each stage, you gain more successful therapeutic exposure, and strengthen your ability to relate to painful emotions while maintaining a strong sense of self.
Mindfulness Meditation Therapy is a very subtle and focused way of working with problems at the core level; not talking therapy, but experiential therapy, where we explore the actual details of how you experience emotions internally. Not surprisingly, this can be a very effective approach to making changes in patterns of emotional reactivity.
CONTACT ME NOW!
Does this interest you? Send me an email now. Tell me about yourself and how I can help you. Schedule a trial session via Skype now.
Peter Strong, PhD is a professional psychotherapist, online therapist, teacher and author based in Boulder, Colorado, who specializes in the study of mindfulness and its application in Mindfulness Psychotherapy for healing the root causes of anxiety and depression, traumatic stress and Insomnia.
Email inquiries welcome
- About Post-Traumatic Stress Disorder (PTSD)
- The role of traumatic memory in PTSD
- Mindfulness-based Image Reprocessing for Traumatic Memories in PTSD
- Mindfulness Psychotherapy for Post-Traumatic Stress Disorder
- What non-medication treatments are available for PTSD?