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December 11, 2009
judith-beck_1024w.jpgThere was an interesting discussion on the Academy of Cognitive Therapy listserv about rewriting the script of flashbacks. I briefly described a related technique to help patients with traumatic memories. I use imagery to help patients change the meaning of a traumatic event (rather than changing, in imagery, what actually happened during the event). First we discuss the event at an intellectual level, identifying and modifying the core belief(s) that originated or became maintained as a result of the event. Then I have the patient relive the experience, as if she were the age at which it occurred and as if it’s occurring right now. I use Socratic questioning, couched in terms her younger self would understand, to identify thoughts, emotions, and beliefs. Next I ask the younger self what is happening immediately after the trauma. Usually she has retreated to a safer place. I then ask the younger patient if it’s okay for her older self to come to this place and explain to her what has happened. I facilitate a dialogue between the younger patient and her current self. Her current self helps the younger self change the meaning of the experience. This technique seems to help patients who have changed the meaning of the event intellectually but don’t yet believe it emotionally. I learned the fundamentals of the technique back in the 1980s from David Edwards and have described it in Cognitive Therapy for Challenging Problems.