Workshop 2: Wednesday 15th July 2020

Relived, Re-remembered, Reconstructed: Working with Complexity in PTSD Memories and Non-memories

Sharif El-Leithy, Traumatic Stress Service, London and Hannah Murray, University of Oxford


While CT-PTSD is a powerful empirically-supported treatment, there are many ways in which working with memories can become complicated. This can include when the patient finds it hard to recall, tolerate or articulate the traumatic memories. Equally, clinicians can struggle to know how to use memory-focused strategies when symptoms seem not to relate to specific memories, or may not reflect actual events. This can become particularly challenging when working with "non-memories" that include hallucinated or imagined material, "flash-forwards", and worst-case scenarios.

This workshop will bring together cognitive models of PTSD and memory with advanced therapeutic techniques, to help clinicians formulate and adapt for complexity when working with traumatic memories and associated imagery. Case illustrations will be used, including those reflecting PTSD that has developed following the COVID-19 pandemic, such as patients who have survived the illness and intensive care unit admissions, healthcare workers, and traumatic bereavement in those who have lost a loved one.

Areas we will cover include:

  • Clinical update on models of memory in PTSD, and the range of intrusive re-experiencing phenomena found in PTSD, including "non-memories"
  • Memory activation issues including managing in-session flashbacks and affect without recollection.
  • Timelining and target selection when working with multiple, fused and representational trauma memories.
  • Using "map the gap" to address fragmentation and recall problems including memory gaps, psychogenic and organic amnesia.
  • Issues about what is "real" - intrusive memories of hallucinated and imagined events.
  • How to use memory-focused techniques with non-memories including out-of-body memories, constructed traumatic imagery, and "flash-forward" scenarios.
  • Relevant examples from clients experiencing PTSD related to the COVID-19 pandemic, such as constructed memories of loved ones dying, and hallucinations experienced in ICU.

The workshop will help clinicians identify, formulate and adapt for a range of complexity when working with traumatic memories and intrusive non-memories in PTSD. Participants will acquire the following skills:

  • Identifying the wide range of PTSD re-experiencing and imagery phenomena that can confer complexity.
  • Understanding how traumatic memories are reconstructed through remembering, creating a pathogenic current memory that may not reflect reality but feels nonetheless real.
  • Adapting CT-PTSD to effectively target, activate and update traumatic memories that challenge the patient and/or clinician with some complexity.
  • Formulating and working with non-memories in PTSD treatment.

Dr Sharif El-Leithy is Consultant Clinical Psychologist at the Traumatic Stress Service in South-West London. He was a member of the NICE (2018) PTSD guideline update committee. Dr Hannah Murray is a Research Clinical Psychologist at the Oxford Centre for Anxiety Disorders and Trauma, University of Oxford. She is currently involved in developing and evaluating internet-based therapies for PTSD. Between them they have 30 years of experience in working with PTSD using cognitive therapy. They supervise, teach and research widely in the field.

References

Ehlers, A. (2015). Understanding and treating unwanted trauma memories in posttraumatic stress disorder. Zeitschrift für Psychologie/Journal of Psychology.

Rubin, D. C., Berntsen, D., & Bohni, M. K. (2008). A memory-based model of posttraumatic stress disorder: evaluating basic assumptions underlying the PTSD diagnosis. Psychological review, 115(4), 985..

Oulton, J. M., Strange, D., Nixon, R. D. V., & Takarangi, M. K. T. (2018). PTSD and the role of spontaneous elaborative "nonmemories". Psychology of Consciousness: Theory, Research, and Practice, 5(4), 398-413

Wednesday 15th July 2020

Registration Fees: BABCP Members Non-Members Student Members
Workshop £80 £100 £60

Register now