When Memories Intrude: About Anxiety and Trauma
Anxiety takes a lot of forms. You can have a specific phobia about heights or crowds, you might have social anxiety or you could have general anxiety about lots of things. Some people seem to be wired for anxiety (you might feel like you were born anxious or even like an anxiety gene runs in your family) and there is evidence that experiences during childhood development lead to anxiety symptoms as an adult.
Sometimes, however, anxiety symptoms can be traced back to a specific traumatic incident or experience that seems to be intrusive and unresolved - events in your past that you keep replaying and that have an impact on your current life.
What is trauma?
Trauma refers to an event or series of events that have caused some kind of psychological injury and which still have an effect on your mental health and well-being. It can be a significant event like a car accident or being a victim of a crime, or it can be years of ongoing events like being bullied as a queer youth or witnessing domestic violence in your family.
Trauma is different than a regular painful experience. If you have a bad day at work you may feel anxious, angry or sad, but you know that once you get a good night of sleep or talk about it with a friend that things will get better and your bad day will become a distant memory. With trauma, the experience is so upsetting that normal brain processing doesn't happen. In some ways, the memory becomes frozen in time and feels just as painful, scary, and vivid as when it happened. The car accident may be over, your body is healed and your car is repaired, but you cannot seem to get in your car and drive. Just the thought of doing so brings up the experience, as if you were living it again.
How is trauma related to anxiety?
Everyone has different and unique responses to trauma, but anxiety often plays a role. Using the car accident example, perhaps after a period of time things seem to get somewhat better and you're driving again. But it is just not the same, you find yourself worrying about driving, worrying about accidents, limiting your driving and noticing that it is never a pleasureable event in your life. It was never like this before and now anxiety seems to be a much bigger thing than it used to be.
At this point, we could work together to treat your anxiety symptoms and there are lots of great tools and treatments that we can use. However, when trauma is the cause for the anxious symptoms, I think it is important to address the traumatic memory as well.
How do you treat trauma?
There are a variety of ways to treat trauma. One thing to note is that treating trauma isn't about somehow erasing memories or forgetting what happened to you. Instead, it is about addressing and processing the memory so that it feels less intrusive and psychologically charged and becomes integrated with your other memories. You are able to recall the car accident without experiencing powerful emotions in the present.
There are a variety of approaches to this, including gradual exposure to the traumatic memory without experiencing the consequences you fear might happen, identifying and changing problematic thoughts that show up because of the trauma, and learning to use relaxation exercises and mindfulness to relate to the traumatic experience differently. Another powerful approach that I use is EMDR.
EMDR stands for Eye Movement Desensitization and Reprocessing. Years of research has shown it to be highly effective in treating traumatic memories and the anxiety that often accompanies these memories. It is a physiological approach that uses sounds, lights, and taps to engage your brain in reprocessing traumatic memories. EMDR seems to work in a similar manner to healthy dream sleep (where rapid eye movements occur). Ultimately, EMDR allows you to experience the traumatic memory in a less distressing way.
Once trauma has been addressed, anxiety symptoms related to the traumatic memory often subside. You can recall what happened with less distress, and the memory doesn't intrude as much. Treating both trauma and anxiety can help you get back to a richer, fuller life.