Narrative Exposure Therapy

When my counsellor and me were working through my PTSD I had some homework that I needed to complete which was to write a script of the trauma from when it started through to when it ended and then mark my anxiety level (on a scale from 1-100) as I was reading it through. This is called Narrative Exposure Therapy (NET) and it is a type of treatment used for those suffering from trauma disorders, particularly those suffering from complex or multiple traumas.

I’ve mentioned before that there were two traumas that I worked through during my *CBT*. We worked through each trauma individually but using the same technique for both. My first couple of months were spent on one trauma and once that was processed we moved onto the second trauma. At the start of my therapy I obviously broke down to my counsellor about the subjects that I wanted to talk about so the first few sessions were spent going over what to expect and ways of coping then my first lot of homework was to write a script of the trauma and bring it to each session.

The aim is to process the trauma but remain connected to the present moment. Writing the script was both easy and hard. The trauma had been there for the majority of my life and as we are aware PTSD keeps that trauma alive in our minds, so writing it was easy because I knew every detail and I knew exactly what had happened from start to finish, the hard part was actually writing the acts of trauma and re-reading it through. As I read through the script I would score my anxiety as I went. My anxiety usually started off at around 60 on the scale. I was anticipating what I was about to read so my heart would beat faster than a resting heart beat, my throat would be dry and my body would be tense. When I reached the 70-80 mark I’d be sweating, full body shakes and almost in tears. The highest I rated my anxiety was a 90 and that was when I couldn’t read anymore and I was on the verge of a panic attack. How I ended my scripts was just as important. By coming to an end of the trauma meant that once I had finished writing/reading the script then that was that, it was finished.

Memories can be split into either a hot or cold category. Cold memories deal with context and facts where as hot memories deal with emotions, sensory information and physiological feelings. What happens with PTSD is that sometimes hot memories are involuntarily received without any links to cold memories (For example, I used to get extremely vivid flashbacks if I could smell a parka coat (nothing to do with the trauma but it was a smell I always associated with my dad), my dads aftershave was another and seeing the inside of his shed). NET helps to provide context and create a link between the hot and cold memories in order for us to process the trauma as a whole. During NET our fear response is activated by the trauma. This is actually a good thing as it allows us to relive the trauma but see it from a present perspective which results in the trauma being processed correctly.

After I had finished my script I handed it over to my counsellor and she read through it (all 6 pages). She was able to pinpoint 3 areas of the memory that we needed to focus on. We’d go through the trauma around 2 or 3 times in each session, each time I would close my eyes and take myself back to that day. Using my script, my counsellor would guide me through the events. On the sections of my script where I wrote in a lot more detail (could be details around me, others or the surroundings. It was usually what I could hear, touch or smell) she would pause me. These were usually the more traumatic moments so we’d focus on those sensations. With PTSD you relive every little detail and it can feel so real even if it isn’t happening in the now. For example, if we were focusing on what I could smell on the day my dad died (which was the smell of what we had for tea, the scent in the car or the smell at the hospital), my counsellor would ask me to take a deep breath through my nose (still with my eyes closed and focusing on the trauma). This would allow me to still relive the trauma but remain in the present moment. The more times we did this the more I began to remain in the present moment each time. Same for any other sensation that was tied to the traumas and eventually it all gets processed as a memory which you are then able to choose whether you want to revisit it or not.

My counsellor told me to imagine the trauma as a wardrobe. The type of wardrobe where you can’t fully close the door and when you open the door a shit load of clothes come falling out on top of you. You take each individual item of clothing, carefully fold it up and place it neatly back in the wardrobe till everything is all neat and tidy. Then you’re able to close the door and if you want to open it again, you can without having everything fall on top of you. It made absolutely no sense at the start of my therapy but now it’s probably the best description I have heard.

Mix NET with everything else I did/learnt during CBT and I have a happy life. I have the ability to revisit my traumas on my own terms and not get stuck in the loop. There is understanding for what had happened and if my mind wanders I am able to bring myself back into the present moment and remain there!

Thank you for reading,

Sending so much love to you all,

Emma xo