The Lingering Effects of Trauma

For the longest time, about 15 years or so, I had the feeling that I wanted to cry or I actually did cry whenever I saw a red car. I didn’t know why I had that kind of strong emotional reaction to red cars, but it was every time I saw one. I would feel terrified and have a tearful reaction. Today I am going to talk about a personal experience that locked me into a trauma reaction for a long time and the best clinical tool that I have to help someone who may be locked into a trauma reaction of their own.

Hello everyone, I’m Mary the OG Woowoo Therapist and I want to welcome you to this week’s episode recorded in my functional but versatile home office that is one block from the interstate where traffic noise is a real thing and can be disruptive. So, I apologize in advance for any noise disruptions.

And as usual, I have to tell you that everything I talk about today is not intended to take the place of counseling or therapy. It is only for informational purposes. And some of it is based on my personal experiences. If you relate to any of the information do not self-diagnose or diagnose anyone else. If you are disturbed by it, seek a professional to talk to about it.

I didn’t realize that I was having a trauma reaction until I went into therapy in the late 1980s. I had a Gestalt therapist who helped me understand what was going on with me. I liked my therapist. She encouraged me to act out, scream, and yell at an empty chair in my sessions and I am quite sure her neighbors may have been concerned that she was being abused and mistreated. We did sessions in her home, but she assured me that her neighbors could not hear and quite frankly didn’t care as long as it was taking place during business hours. She was an awesome therapist and took me to places emotionally by challenging my thinking and behavior to trigger outbursts of emotion to get to what needed to be healed. And that worked for me.

Fast forward 28 years and the advent of virtual therapy due to the Covid era, Gestalt is not something I can do with my clients online, so I had to find an effective alternative that was experiential, loosened up emotions, and had the same healing effect. Something that helped the brain heal itself.

Over the years I have had, and this is not an exaggeration, around 100 to 150 clients come in for this therapy and within a few months find healing and go on to live their lives. They come back occasionally if something else surfaces, but I do not see them very often. That is how good the therapeutic intervention I use is.

So back to my story.

In 1972 I lived in San Diego, in Southern California, because my husband was in the Marine Corps and stationed there. Southern California was the land of convertibles. I drove an MG Midget convertible with the top down almost all the time. I loved that car. It was my second favorite car of all time.

I have a younger sister, 21 months younger to be more accurate, who came down to visit me over the weekend. She lived in Capistrano Beach that was just up the coast about 70 miles from San Diego. Back in that day the speed limits were 55 and 60 on the highways and 25 to 30 in the cities.

While she was visiting, we decided to go somewhere downtown San Diego, which wasn’t as crowed then because there wasn’t a ballpark downtown. The Padres played in a stadium out Interstate 8. But there was traffic. We were coming up the main drag, heading inland from the embarcadero where the Star of India is anchored, toward Interstate 5.

We approached an intersection and as we entered the intersection, just across the crosswalk, the light turned yellow. I thought I would have enough time to get through the intersection, but I was wrong. It was a very fast yellow light, and we were already in the intersection so I had no choice but to continue through because I couldn't stop and back up.

Before I could get through the intersection a car that was about half a block away saw the light turn green and sped up. They T-boned me in the driver’s side of the car, right at the back of the door. The top was down and all I could think about at the time was that my sister was going to get thrown from the car, so I threw myself over towards her and laid on top of her head and shoulders to keep her from dying.

Now, let me give you some context for this. I was 7 months pregnant with my first child and my belly was pretty well wedged against the steering wheel because I am not tall and had to have the seat up pretty close. I knew I probably wasn’t going to go anywhere because of the steering wheel. I was terrified that I would lose my baby but saving my sister was the most important thing that came to mind in the moment.

I did not see my life flash before my eyes, but I did have a vision of us both laying on the pavement decapitated because the top was down and we had no protection if the car flipped. Luckily, we did not flip but we were pushed about 6 feet towards the parked car on the street that headed in the same direction as the car that hit me.

My sister was able to get out of the car on her own, but I had to be helped out because I was wedged and my door wouldn’t open.  It was pretty terrifying to say the least. It is amazing how quickly things happen but yet I had the time to think about saving my sister and worry about losing my baby.

So, the relief was so great that we didn’t die that I did not give another thought to it after we got checked out by the paramedics and got the car towed back to be left “parked” on the street by my apartment building. We were shook up and feeling lucky that we dodged death but not a Dart, a Dodge Dart that was whitish in color. Traveling at 30 miles an hour, as estimated by the police, by the time they hit us. There were no skid marks.

I guess you are wondering where the red car comes into this story. My MG Midget was fire engine red. And now it was mangled sitting on the street and as long as it sat there it was a reminder of how we escaped death that day. Eventually it was towed up to Capistrano Beach where my dad and my husband rebuilt it, but I never drove it again.

It was about a year later when I was piggy backing my daughter along the beach in San Clemente, where we moved when my husband discharged from the Marine Corps. We were by the pier which was about half a mile from our apartment, and I was crossing the street with her on my back and a car nearly hit us. I froze in the crosswalk staring at the red car that was right next to me. The driver got out to make sure I was okay and was all apologies and that was what snapped me out of my freeze state. When we got to the other side of the street, I started crying and cried while I walked all the way back to our apartment.

That is when crying whenever I saw a red car started. Let me qualify that, if I was on the road, and I was driving or walking, and there was a red car approaching I would have that reaction. Sometimes the reaction would be so strong that I had to pull over if I was driving until I regained my composure even if I was on the Interstate.

That went on for a long time and then when I ended up in therapy in the late 1980s I finally figured out what the deal was with red cars. They triggered the terror I felt in the moment with my sister and the moment in the crosswalk with my daughter on my back. I had been stuck in that first moment of trauma way back in 1972. I had PTSD from the car crash and red cars triggered the terror from that moment when I thought my sister and I were going to be decapitated.

What I found interesting was that it took over a year for me to start being triggered. I had a hard time accepting that something “that long ago” could bother me so long afterwards. Now because my therapist was a Gestalt therapist it was not an easy task to process that terror, but over many months we finally got it done and red cars no longer trigger me. In fact, I have owned two red cars since then.

Let me introduce you to another client topic about Eye Movement Desensitization Reprocessing or EMDR and what a session is like. Dr. Francine Shapiro was the developer of this modality, and the story is that she discovered it sort of by accident. The story goes that she was walking in the park and was feeling disturbed by some things in her life. She was looking from side to side as she walked and thought about those things and she noticed that the disturbance had lessened. The rest is history and worked out in her research to develop a protocol that works for almost everyone.

EMDR is an experiential therapy in that the client is required to participate in the bilateral stimulation either by eye movements, tactile stimulation, or audio stimulation. And the really good news is that the client can’t do EMDR wrong. Many times my clients are concerned that they are not doing EMDR correctly when all they have to do is not move their head while moving their eyes. The brain with do the rest as long as I did my job correctly.

EMDR has eight phases and when following the protocol it takes several weeks to be ready to do an EMDR session. The process is based on the idea that trauma information is maladaptively stored in the brain during trauma once the amygdala, which is the smoke alarm of the brain that triggers fight, flight, freeze, or fawn, has stopped doing its job in the process of adaptive information storage during trauma. Adaptive information storage results in that information becoming a memory of there and then.

When it is maladaptively stored, it makes the there and then stuff feel like the here and now because the emotional and factual information during the traumatic event, that continues to come in to the brain, is disconnected and not a complete memory resulting in heightened reactivity to emotional triggers based on facts that are disconnected. Like in my case where I would cry when I was on the road with a red car but had no idea why. The red car triggered the emotion of terror from the traumatic moment, and it felt like it was happening here and now instead of 15 years ago. EMDR is not about erasing memories it is about changing how they feel.

The eight phases include history taking, preparation, assessment, desensitization, installation, body scan, closure, and reevaluation. For this episode I want to focus on the desensitization, installation, and body scan phases. The others are pretty much self-explanatory.

Desensitization uses bilateral eye movements, or the eyes moving from far left to far right without moving the head. In a way this bilateral stimulation mimics the processes in the brain during REM sleep. REM sleep is when your brain does deep emotional and memory work while your body stays safely still.

The similarities between REM sleep and EMDR include rapid eye movements, vivid images, and an active brain with similar patterns to wakefulness. During REM sleep the rapid eye movement helps with processing emotions and memories, or reconciling old and new information in the brain, and can help with resetting emotional responses. This is basically what is happening in the brain during EMDR. Only during the reprocessing in EMDR the memories are reconsolidating and adaptively storing the emotional and factual information of trauma.

With EMDR there is little activation of the amygdala and the brain can safely recall emotional and factual information from trauma without triggering a trauma reaction. That allows the brain to fully and completely reprocess the information and reconsolidate it as a memory from the there and then. When it is thought about in the here and now it stays a there and then experience without triggering strong emotions attached to it in the present moment. I might have strong feelings about the traumatic incident but they are not the feelings I experienced during the trauma.

Desensitization is useful for PTSD, anxiety, phobias, childhood trauma, and complex trauma. It allows the brain to safely recall not only the single event but also any events that have contributed to the same emotional trigger. So, in my case, the car crash was the initial event where I experienced the terror of dying, but the crosswalk incident, even though different, triggered the same terror of dying. Same emotion, different events with the common fact of a red car.

To set up desensitization there are a few elements that need to be discussed to activate the neuro-networks the trauma information is stored on so that the brain knows what it is to work on during the eye movements. Because I work with dissociation, I set it up a little in reverse from the steps of the protocol.

The first step is to identify the event for reprocessing and bring to mind an image of the worst part of it. When someone has ongoing trauma from childhood it is difficult to identify one event so we go with the first worst that they can remember. The second step is to identify the negative cognition they have about themselves as a result of the event. Step three is to identify a positive cognition they would rather have about themselves when they think about the event and assess how true or valid the positive cognition feels to them in that moment of a scale of 1 to 7 with 7 being completely true. Step four is to identify the emotions that come up for them when they think about the event and the negative cognition and assess how much disturbance or tension they feel when thinking about it and rank that on a scale of 0 to 10 with 10 being more than they can handle to give a measure of subjective units of distress. Step 5 is to identify where they feel that disturbance in their body. Step 6 is the reprocessing where they are asked to bring to mind the event image, the negative cognition, the emotions and notice where they feel the disturbance in their body and begin the bilateral stimulation at a rapid rate. They are only to start with what they are asked to bring to mind and then allow the brain to bring anything else to mind that could be related. Bringing all of that to mind is getting their working memory to activate which is where we want the brain to be during reprocessing, just like in REM sleep.

During this process I check in with them to get some feedback about their process and after several sets of the bilateral stimulation I check in to see if the image of the event has changed in any way and to reassess the level of disturbance the image has now. We continue the eye movements and check ins until the disturbance level is down to 0.

Once the disturbance level is 0, we go to step 7 where there is a check to see if the positive cognition they identified at the beginning still fits or if something fits better. I find that it is not unusual for the positive cognition to change. Then we assess the validity of the positive cognition on that scale of 1 to 7 and begin the instillation process with much slower bilateral stimulation where they are thinking about the image of the event with the 0 disturbance and the positive cognition only. The slower bilateral stimulation allows them to continue to think about what they were asked to bring to mind.

When the validity, or how true it feels, of the positive cognition has reached 7 or completely true we have completed the instillation process and can go on to Step 8 or the body scan. This is where they are asked to close their eyes and bring to mind the image from the instillation and the positive cognition and scan their body noting anything that they feel and report that to me. If they still have some disturbance or tension in their bodies, I have them bring to mind and focus on the instillation image and the positive cognition while doing some more bilateral stimulation. I speed up the bilateral stimulation a bit to alleviate the disturbance or tension. We do that until they feel positive sensations in their body, like peaceful, calm, or relaxed and then we do one more set of bilateral stimulation at the slower rate to complete the instillation of the positive cognition by connecting to positive sensations in the body.

This is how an actual EMDR session is conducted. I have modified the way I do it with my CPTSD clients because most of them time they have a hard time picking the first worst when everything was bad. I start them with the negative cognition and then ask for the image that comes to mind. Sometimes it is an actual event and sometimes it is an image that is representative of the worst the negative cognition could get. Then I follow the rest of the steps in order. I stick to the protocol steps because they work, and they have worked well for hundreds of thousands of clients over the years who have done EMDR.

Now that I know about EMDR I wonder how my therapy in the 1980s would have gone if my therapist had been trained in EMDR. It has been around and used since the 1980s and some say even earlier than that. But if she had known it, would I have gotten to all of the stuff I needed to get to for healing in my brain. I was a stubborn one who was quite comfortable in my denial. I think it took the highly confrontational style that my therapist had to break down the barriers I had to real healing. I appreciate her for letting me be temperamental and difficult to work with until I wasn’t.

Well, that’s it for today. I hope you got something out of today’s episode and will consider seeing an EMDR therapist if you have stuff that is lingering with you or things that are triggered emotionally for you. Go figure out the what so you can let the there and then stay in the there and then.

If you liked the topic today, please give it a like and consider subscribing. I’ll be back next week with another client suggested topic.