Still less than three days since the most intense, prolonged, potentially catastrophic experience of my life.  What have I learned ... both personally and as a therapist?  Gratitude ... of course.  Gratitude to the mountain rescue service, gratitude to my wife & family & friends, gratitude for my health, for the extraordinary beauty of this world, for being able to walk, to breath, to smile.  And gratitude can even help me process what happened better. 

It's really early, and paradoxically I should be sleeping beautifully because I'm in a comfortable room at the Sligachan Hotel on the Isle of Skye.  However I'm not too fussed - acute sleep deprivation may well affect memory consolidation and reduce the risk of posttraumatic stress disorder (PTSD) following trauma.  And why the possible PTSD?

Working as a psychotherapist or counsellor, practising as a doctor, participating in interpersonal groupwork, and at the heart of relating deeply with another human being - I have internal reminders, charts, ways of helping myself be present in as constructive a way as I can.  One inner chart or internal reminder is the jazz trio metaphor.  A bit like a musician revisiting and making fresh again their playing of a well known classical work, the jazz trio metaphor takes another look at the key, so often explored territory of the therapeutic relationship - which overlaps to a huge extent with the more universal territory of how to be profoundly present in any deep relationship with another human being. 

(A handout of the key points in this blog post is downloadable both as a Word doc and as a PDF file)

I have written a series of blog posts on Nick Grey's expert workshop on CBT treatment of posttraumatic stress disorder.  The day's focus was particularly on treatment approaches involving the trauma memory itself.  Nick highlighted four interlinked memory-focused methods - exposure & reliving, written narrative, site visit, and discrimination of triggers.  This post is the text of a client handout I subsequently put together discussing how best to go about the written narrative.  

This is the third in a series of posts triggered by Nick Grey's workshop on memory-focused approaches in CBT for adults with PTSD.  In the second post yesterday, I wrote about " ... treatment structure".  In today's post I want to step back for a moment and get a broader perspective.  These trauma-focused treatments have much wider applicability than just for DSM-IV-TR congruent, single episode traumas, and it's this wider applicability that's a major reason for me doing this workshop.

Yesterday I wrote an introductory post on this "Memory-focused approaches ...

I've just arrived from Scotland off the sleeper for the two days of the British Association for Behavioural and Cognitive Psychotherapies (BABCP) Spring Workshops and Conference. Today it's workshops and we have a choice of five. I'm going to Nick Grey's on "Memory-focused approaches in cognitive therapy for adults with PTSD" . The publicity reads:

"Guidelines from around the world for the treatment of PTSD in adults recommend trauma-focused CBT as a first line treatment. In essence ‘trauma-focused’ means placing an emphasis on discussing the details of the traumatic memories. This can be emotionally demanding for both patient and therapist. Despite the treatment guidelines many therapists still do not use ‘trauma-focused’, i.e. memory-focused, approaches.