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How To Create A Healing Story (meichenbaum's Approach)

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The Albatross

MyPTSD Pro
Not sure if I'm putting this in the right place, it was either PTSD Discussion or here in Therapy. Was digging through some of what I have from Donald Meichenbaum... and have had the experience of being in on some live webnars with him. Much of his recent PTSD work is about "resilience".

Donald Meichenbaum, Ph.D. is a founder of Cognitive Behavioral Modification and has been voted one of the 10 most influential psychotherapists of the Century. Dr. Meichenbaum is Distinguished Professor Emeritus at the University of Waterloo, Ontario, Canada, and maintains a private practice as a clinical psychologist and is an expert in the treatment of PTSD. Below is from a presentation
Road Map to Resilience: Ways to Bolster and Well-being by Donald Meichenbaum, Ph.D. and Lisa Firestone, Ph.D:

“Beware of the stories you tell, you will be lived by them.”
We don’t just tell stories, stories tell us. The tales we tell hold powerful sway over our memories, behaviors and even identities. Stories are fundamental to our being.

How to Create a Healing Story
1. Following exposure to traumatic events, up to 30% of individuals may evidence chronic distress, and even develop Post-traumatic Stress Disorder and related problems. For such distressed individuals, their memories are over-generalized (lacking in detail) that intensify their sense of hopelessness and impairs their problem-solving abilities. Their traumatic narrative is inadequately integrated into their autobiographical memories. Their stories have an inflated sense of responsibility with accompanying excessive guilt and shame. They misperceive their distressing reactions as signs that they are “going crazy” and that they are “worthless” and that they are a burden on others. Their stories convey the belief that the world is unsafe and unpredictable, unjust, and that people are unappreciative of their sacrifices, untrustworthy and unsympathetic. They may feel marginalized, isolated and rejected.
  • Stories are filled with “hot spots” and “stuck points” and their thoughts and accompanying feelings are viewed as unwanted.
  • Suppress such thoughts and feelings - BACKFIRE and BOOMERANG. They may try to cope by self-medicating (using alcohol, drugs), by trying distraction of engaging in high-risk reckless behaviors (withdrawing, isolating themselves, being hypervigilant
2. In contrast, RESILIENT individuals are psychologically agile and flexible in how they tell their stories. They include in their story-telling examples of what they did and how they coped and survived. They tell the “rest of their story.” They weave into their story-telling the upside of what happened, as well. They view any traumatic events that they experienced as a “turning point”, a “fork in the road”, a “temporary detour” on their personal journey. Their stories are rich with healing metaphors, mottos, and examples of pain, but also survival.

3. Resilient individuals may take some time to experience grief or unhappiness, distress, anger and loss, sadness and anxiety which improves their abilities to better appreciate the world in all of its complexity and richness.

4. Resilient individuals tend to tell stories that have redemptive sequences versus contamination sequences.

5. Resilient individuals slow down how they tell their stories and break their experiences into pieces versus “Monday morning quarterback.”

6. Resilient individuals are on the lookout for unexplored “open spaces” that act as a guide to new goals and alternatives. Redemption stories bolster hope, strengthen self confidence. New solutions.

7. Resilient individuals tend to tell COHERENT STORIES that create meaning out of their stressful life experiences and in which they see themselves as “personal agents” often with the assistance of others. These COHERENT NARRATIVES are clearly articulated, detailed, logical and well organized. Such COHERENT stories are salutary and help reduce distress. They increase the survivor’s sense of control, reduce feelings of chaos and increase the sense that the world is predictable, orderly and beneficent, provide a degree of “closure” by helping make sense of what happened and how people responded, self-efficacy and points a direction to the future. Help individuals create a trauma narrative, but it is also essential to help individuals integrate such thoughts and feelings into a consistent coherent meaningful experience and story. Trauma is only one part of an individual’s life, rather than the defining aspect.

8. Resilient individuals have the ability and penchant to tell their fragmented stories in a chronological narrative with before, middle and post-trauma exposure or post-deployment parts. They are able to integrate what happened during deployment into their autobiographical memory and let the “past be the past.”

9. Resilient individuals avoid “thinking traps” that can derail their story-telling. Instead they incorporate in their story-telling “cherished recollections”, “fond memories”, a “heritage of remembrances”, “change talk,” “RE-verbs.” Resilient individuals tell stories that enrich their lives and help them get past their personal challenges. They tell stories that they can pass onto the next generation, as “lessons learned.”

10. Resilient individuals tell their stories first and then they live their way into them. They may act “as if” they are characters in the stories that they tell. There may be a certain amount of “fake it, until you make it.”

11. Do your stories include: 
  • Redemptive (positive ending) sequences
  • RE-words and change talk action verbs
  • Goal statements and “how to” pathways thinking
  • Problem-solving strategies Expressions of optimism
  • Meaning-making statements (“Making a gift”, “Sharing lessons learned” statements)?
Ask yourself and others, if the stories you tell are elaborate, organized, coherent (having a beginning, middle and end) that are now integrated as part of your autobiographical memory? Does your story open up new possibilities for change and provide a positive blueprint for the future? If not, how can you begin to change your story?
 
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Ack... should have said "Meichenbaum's" in the title (capital M) oh well.

Though I don't have a concept of "before PTSD" I have generally found this and much of the rest of his material helpful and assistive.

Also the boldface "coherent" is the author's not mine.
 
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I believe that resiliency (though maybe not spontaneous resilience like non-PTSDs may have) and that the approaches in CBT are assistive and are a worthy endeavor to attempt. Neuroplasticity of the brain can not necessarily heal but improve. It's been very helpful for me.
 
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Oh I can't argue with that at all!
It's absolutely sensible to try and deal with this in an helpful way.
However it does seem very obvious to me that the resilient person this dr talks of is obviously someone who has had a resilient sense of self at some point before the trauma occurred. Perhaps even has had some supportive people in their lives. Perhaps someone that might listen to the coherent story of their experience?
Perhaps is not someone with developmental trauma?
 
Meichenbaum is one of the world's leading PTSD/CBT specialists. Have you read his material? There is far more to it than the bit I've posted above.
 
Oh I just had a lengthy reply and the Internet has lost it fir me. Oh how annoying. I might seem inexpert :p

I must admit the said Dr could have more qualifications than anyone at all and I'd still feel he was talking of people who had had some kind of helpful relationship in their lives, if not as infants then certainly at some point to help them grow.
 
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