Intrusive Memories and Catastrophic Thoughts - With Love from Dr. G.
Some of you may be noticing that your “baseline” – what you would consider as “normal worry” – has gone way up. Now you have a heightened sense of worry all the time, you feel as though you are looking over your shoulder everywhere you go (hypervigilance), and perhaps you have intrusive memories (images of your traumatic experience that insert themselves unexpectedly into your day, maybe while you’re in the car driving, getting a coffee, or just having a normal everyday unrelated conversation with a coworker). Perhaps some of you always felt a little antsy, but now things are just over the top. Some of you may have been cool as a cucumber previously, and now there is a noticeable change from your “before.”
DON’T LOSE HOPE! Just as things changed for the worse, they have the ability of changing back or even to better, and the more effort you put into this change, the more effective it will be and the faster it will happen. And don’t forget that at the end of all of this, we don’t necessarily want to return back to our baseline. Perhaps our baseline was not as healthy as possible and there was room for growth. (If we make this change now, we can call it posttraumatic growth). And certainly we can argue that none of us should simply stagnate...we all have the potential to benefit from constantly growing and evolving throughout our lives.
First, we have take a hard look at our situation and be honest about a few things. Consider what your anxiety looked like before Route 91. Did you already tend to be a little more on the high-strung, tightly-wound up, “Type A” side, super busy all the time (and loving it)? Did you tend to worry about a lot of things before that life-changing weekend? Perhaps you had anxiety that preexisted Oct 1, 2017, but it was hibernating, in what we might call a subthreshold range, or perhaps it was your “norm” so it did not bother you or negatively impact your functioning too noticeably. If this sounds like you, then it means you likely had a sensitive brain going into this traumatic event. Blaming all of your current difficulties on Route 91 probably will not serve you well. A traumatic event can simply amplify whatever type of thinking, emotions, or behaviors preexisted, so now it’s a lot more obvious because it has passed threshold and your anxiety is too high to camouflage from yourself or others.
On the contrary, some of you may not feel like the same person you were before Oct. 1st. And to reframe this in a slightly more optimistic way, perhaps it is not realistic to think a person would emerge from a massacre exactly the same. And perhaps you would not want to? We could hope that following an event like this, once the trauma has been fully processed, you are more mindful, insightful, compassionate (see the article on Why Compassion Matters), and psychologically minded. So, let’s look ahead and see how we can identify what might still be getting in the way, regardless of whether or not you have a sensitive brain. Hopefully you’ve read all the previous posts and some of this will be a review of tools.
There are three common errors of thought that we default to under stress (and with a sensitive brain) that generate chronic feelings of anxiety and even panic:
1) We OVERESTIMATE the likelihood of a negative outcome. Here are examples of thoughts you may have: If I go out to a crowded event there is a high probability that something bad will happen. If I open up to someone, there is a high probability that they will not care or understand me. If I let my guard down there is a high probability I’ll get hurt, someone I love will die, or I’ll have a complete meltdown and not be able to function.
2) We catastrophize (we think of the WORST-CASE SCENERIO). Here are some examples of thoughts you may have: If I go to another country concert, I will die (and remember thanks to conditioned learning, we generalize country concert to any large crowded event). If I have a panic attack at work, it will ruin my day, people will think I’m crazy, I’ll get fired and end up divorced and homeless. If I open up to someone and they don’t understand, it means I’ll never be understood and I’ll live a meaningless, lonely life unloved.
3) We UNDERESTIMATE our own ability to cope. Here are some examples of thoughts you may have: If I have a panic attack in public, it’ll ruin my day and I’ll end up at the ER. If I open up to people and they judge me, I’ll never be able to talk to them again. If I go out and have a meltdown or freak out, I’m not gonna be able to handle it.
The bad news is, if you’ve been doing this a lot, it’s probably become your new least favorite HABIT. The good news is, habits can be changed. And YES, even thought patterns can be habits, as can feelings or emotional states. So how do we challenge these errors of thought? Well, we remind ourselves of two important things: First, all problems are MANAGEABLE. How do I know this? Well, you’ve been managing so far and you’re still here (and even “barely” counts!). Also, maybe you’ve been through worse and handled or survived other traumatic life events or crises. Finally, keep in mind that others have managed horrible things and are managing, and if they can do it, then you can too. The second fact we want to remind ourselves of is that all problems are TIME-LIMITED. Think about it, nothing lasts forever, and no problems last forever either. They tend to morph, change, evolve, and often end at some point.
A word about INTRUSIVE MEMORIES (and feel free to reference the very first article posted in Oct2017, on TRAUMA 411). Intrusive memories are normal. We have intrusive memories all the time. We hear a song that played when we fell in love for the first time, and it evokes emotion even decades later. We smell something and remember mom’s home-cooked meals, and it makes us feel happy. Intrusive memories occur because we are triggered, and sometimes we are not necessarily aware of those triggers. Remember, as you move through life, and your amygdala (in the Limbic system of your brain) is reacting emotionally, and the hippocampus (the amygdala’s roommate) is taking notes. We cannot realistically make triggers go away, and since many of our triggers are positive ones, I’m not sure we would want to eliminate them all. What we hope happens through recovery from trauma is that people no longer react to those negative triggers in unhealthy or unhelpful ways. Also, remember, that the more you think about something (unintentionally or deliberately), the stronger and the more automatic the thought becomes. It’s like you are digging a deeper and deeper rut that makes it a permanent part of the thought roads (neural network) in your brain.
So how do we deal with intrusive memories? Well, we know that avoiding them or trying to push them away will not help us. Try it. EXERCISE: For one minute, try to NOT think about a purple elephant. Try to think about anything else but keep reminding yourself that you are NOT allowed to think about a purple elephant. Did it work? NO! Because trying to avoid thinking about something actually makes it a stronger thought. It’s counterintuitive but it happens about everything. And we don’t typically have negative thoughts about a purple elephant, but replace that image with images from your massacre that hold great emotional content with them. Now try pushing those away. Does it work? No. We all know this ALL too well.
When an intrusive memory inserts itself into part of our day, activity, conversation, the most helpful thing you can do is attend (i.e., pay attention) to it. That means, take a moment to pause, reflect, “look” at that thought or image or memory. Allow yourself to FEEL your feelings, and acknowledge and accept your pain in that moment. Cry if you need to. You can aid your need for compassion by using the compassion statement (i.e., I am having a moment of suffering. Suffering is a part of life. May I be kind to myself.). It is in this self-validation that you will be able to move through this pain (because remember there is no short cut) and feel better.
Thoughts cannot hurt us unless we allow it. Bullets can hurt us, but thoughts do not need to turn into bullets. We may not have been able to control the bullets coming towards us, but we CAN exert some control over changing thoughts once we recognize the automatic unhealthy ones (i.e., see post on How To Change Unhelpful Thinking).