Akhter Ahsen’s

Eidetic Therapy for Trauma

Akhtar Ali Syed

Principal Clinical Psychologist
Brothers of Charity,
Ireland
 Trauma in Pakistan
A perpetual state of war, without recognition

No identified or identifiable enemy

No single plausible reason for war

War couldn’t get the Nation united rather got fragmented

No consensus on exit strategy

 Suicide Attacks in Pakistan
Terrorism without being an occupied territory and without running a
separatist movement
Terrorism against people who are irrelevant to the political problem
Muslims attacking Muslims
First suicide attack in November 1995, first Drone attack in June 2004.
Multiple reasons & multiple targets. Elusive objectives
No known identity of attackers
Do you want to buy a suicide attacker? Possible in Pakistan
Terrorist Organizations in Pakistan in comparison with other regions.
 Trauma in Pakistan
 60779 people have killed in terrorist attacks between 2003- 15th July, 2016
(satp.org)

 Children from one region but unexposed to the conflict suffer the same level of
PTSD as those who have a direct exposure to trauma (Fasfous, Ramírez, and García,
2013)

 Participants exposed to terrorist attacks in Pakistan did not significantly differ

from the non-exposed control group regarding their symptom severities (Razik ,
Ehring, & Emmelkamp, 2013)

 It appears that still PTSD is being over diagnosed in the western world and under
diagnosed in the developing countries particularly those under the constant threat
of terrorism. (Gadit, 2010)

 Psychological effects of terrorism on all age groups but alarming impact on

children (Tufail, 2010)
 Trauma in Pakistan
A study found transmission of preconception parental trauma
(Holocaust) to a child associated with epigenetic changes in both
generations, indicating a potential insight into how severe
psychological trauma can have intergenerational effects. (Yehuda,
Daskalakis, Bierer, Bader, Klengel, Holsboer, & Binder, 2015. Journal
of Biological Psychiatry)
The residual effects of post-colonial trauma perpetuated not
only through intergenerational imitation of behavioural patterns,
but also in the hereditary transmission of the colonial condition
via DNA structures and epigenetic profile. (Mac Síomóin, 2014)
 Safety is something that
happens between your ears,
not something you hold in
your hands.
Jeff Cooper
 Post Traumatic Stress Disorder in
DSM5
Criterion A: stressor

 The person was exposed to: death, threatened death, actual or threatened serious
injury, or actual or threatened sexual violence, as follows: (one required) Direct
exposure.

 Witnessing, in person.

 Indirectly, by learning that a close relative or close friend was exposed to trauma.
If the event involved actual or threatened death, it must have been violent or
accidental.

 Repeated or extreme indirect exposure to aversive details of the event(s), usually

in the course of professional duties (e.g., first responders, collecting body parts;
professionals repeatedly exposed to details of child abuse). This does not include
indirect non-professional exposure through electronic media, television, movies,
or pictures.
Post Traumatic Stress Disorder in
DSM5
Criterion B: intrusion symptoms

 The traumatic event is persistently re-experienced in the following way(s): (one

required)

 Recurrent, involuntary, and intrusive memories. Note: Children older than six
may express this symptom in repetitive play.

 Traumatic nightmares. Note: Children may have frightening dreams without

content related to the trauma(s).

 Dissociative reactions (e.g., flashbacks) which may occur on a continuum from

brief episodes to complete loss of consciousness. Note: Children may reenact
the event in play.

 Intense or prolonged distress after exposure to traumatic reminders.

 Marked physiologic reactivity after exposure to trauma-related stimuli.

Post Traumatic Stress Disorder in
DSM5
 Criterion C: avoidance

 Persistent effortful avoidance of distressing trauma-related

stimuli after the event: (one required)

 Trauma-related thoughts or feelings.

 Trauma-related external reminders (e.g., people, places,

conversations, activities, objects, or situations).
 Post Traumatic Stress Disorder in
DSM5
Criterion D: negative alterations in cognitions and mood

 Negative alterations in cognitions and mood that began or worsened after the traumatic event: (two required)

 Inability to recall key features of the traumatic event (usually dissociative amnesia; not due to head injury, alcohol, or
drugs).

 Persistent (and often distorted) negative beliefs and expectations about oneself or the world (e.g., "I am bad," "The
world is completely dangerous").

 Persistent distorted blame of self or others for causing the traumatic event or for resulting consequences.

 Persistent negative trauma-related emotions (e.g., fear, horror, anger, guilt, or shame).

 Markedly diminished interest in (pre-traumatic) significant activities.

 Feeling alienated from others (e.g., detachment or estrangement).

 Constricted affect: persistent inability to experience positive emotions.

 Post Traumatic Stress Disorder in
DSM5
Criterion E: alterations in arousal and reactivity

 Trauma-related alterations in arousal and reactivity that began or worsened after the
traumatic event: (two required)

 Irritable or aggressive behavior

 Self-destructive or reckless behavior

 Hypervigilance

 Exaggerated startle response

 Problems in concentration

 Sleep disturbance
 Complex PTSD
 Complex Post Traumatic Stress Disorder (C-PTSD) is a
condition that results from chronic or long-term exposure to
emotional trauma over which a victim has little or no control
and from which there is little or no hope of escape, such as in
cases of:
 domestic emotional, physical or sexual abuse
 childhood emotional, physical or sexual abuse
 entrapment or kidnapping.
 slavery or enforced labor.
 Complex PTSD
 long term imprisonment and torture

 repeated violations of personal boundaries.

 long-term objectification.

 exposure to gaslighting & false accusations

 long-term exposure to inconsistent, push-pull,splitting or alternating

raging & hoovering behaviors.

 long-term taking care of mentally ill or chronically sick family members.

 long term exposure to crisis conditions.

 Complex PTSD: Symptoms
 I. Alteration inregulation of affect & impulses
A. Chronic affect dysregulation
B. Difficulty modulating anger
C. Self-destructive & suicidal behavior
D. Difficulty modulating sexual involvement
E. Impulsive & risk takin behaviors
 Complex PTSD: Symptoms
 II. Alterations in attention or consciousness
 A. Amnesia
 B. Transient dissociative episodes &
depersonalization
 Complex PTSD: Symptoms
 III. Somatization
 A. Digestive system
 B. Chronic pain
 C. Cardiopulmonary symptoms
 D. Conversion symptoms
 E. Sexual symptoms
 Complex PTSD: Symptoms
 IV. Alteration in self-perception
 A. Chronic guilt
 B. Feelings of being permanently damaged
 C. Feeling ineffective
 D. Feeling nobody can understand
 E. Minimizing the importance of traumatic event
 Complex PTSD: Symptoms
 V. Alterations in perception of perception of the
perpetrator (not needed for diagnosis)
 A. Adopting distorted beliefs
 B. Idealization of the perpetrator
 C. Preoccupation with hurting the perpetrator
 Complex PTSD: Symptoms
 VI. Alterations in relations with others
A. Inability to trust

B. Revictimization

C. Victimizing others
 Complex PTSD: Symptoms
 VII. Alterations in systems of meaning
 A. Despair, hopelessness
 B. Loss of previously sustaining beliefs.

Schauer, Neuner & Elbert. (2011)

 PTSD: New Horizons
 Due to its symptomatology, the PTSD should be diagnosed under
Dissociative Disorders instead of Anxiety Disorders
 In the proposed ICD-11, diagnosis of complex PTSD requires the
presence of PTSD as well as the presence of at least one symptom in each
of three self-organization features (affect, negative self-concept and
relational disturbance). The affective domain problems are characterized
by emotion dysregulation as evidenced by heightened emotional reactivity,
violent outbursts, reckless or self-destructive behavior, or a tendency
towards experiencing prolonged dissociative states when under stress. In
addition, there may be emotional numbing and a lack of ability to
experience pleasure or positive emotions.
 Evidence for proposed ICD-11 PTSD and complex PTSD: a latent profile
analysis: (Cloitre, Garvert, Brewin, Bryant and Maercker 2013)
 Dissociative Disorders
 Complete loss of the normal integration between memories of the past, awareness
of identity and immediate sensations, and control of bodily movements.

 All types of dissociative disorders tend to remit after a few weeks or months,
particularly if their onset is associated with a traumatic life event.

 More chronic disorders, particularly paralyses and anaesthesias, may develop if the
onset is associated with insoluble problems or interpersonal difficulties.

 The symptoms may develop in close relationship to psychological stress, and often
appear suddenly.

 The possibility of the later appearance of serious physical or psychiatric disorders

should always be kept in mind
 Enduring personality change after
catastrophic experience
 Enduring personality change may follow the experience of
catastrophic stress. The stress must be so extreme that it is
unnecessary to consider personal vulnerability in order to explain its
profound effect on the personality. Examples include concentration
camp experiences, torture, disasters, prolonged exposure to life-
threatening circumstances (e.g. hostage situations - prolonged
captivity with an imminent possibility of being killed).
 Post-traumatic stress disorder (F43.1) may precede this type of
personality change, which may then be seen as a chronic,
irreversible sequel of stress disorder. In other instances, however,
enduring personality change meeting the description given below
may develop without an interim phase of a manifest post-traumatic
stress disorder.
 Enduring personality change after
catastrophic experience
 However, long-term change in personality following short-term
exposure to a life- threatening experience such as a car accident
should not be included in this category, since recent research
indicates that such a development depends on a pre-existing
psychological vulnerability. Diagnostic guidelines:
 The personality change should be enduring and manifest as
inflexible and maladaptive features leading to an impairment in
interpersonal, social, and occupational functioning. Usually the
personality change has to be confirmed by a key informant. In
order to make the diagnosis, it is essential to establish the presence
of features not previously seen, such as: a) a hostile or mistrustful
attitude towards the world; b) social withdrawal; c) feelings of
emptiness or hopelessness; d) a chronic feeling of being "on edge",
as if constantly threatened e) estrangement
 Enduring personality change after
catastrophic experience
 This personality change must have been present for at least 2
years, and should not be attributable to a pre-existing
personality disorder or to a mental disorder other than post-
traumatic stress disorder (F43.1). The presence of brain
damage or disease which may cause similar clinical features
should be ruled out. Inc ludes: personality change after
concentration camp experiences, disasters, prolonged captivity
with imminent possibility of being killed, prolonged exposure
to life-threatening situations such as being a victim of
terrorism or torture.
 Eidetic
Definition
 A normal subjective internal visual image related with past and
present experiences as well as with future and imagined situations

 The Heart of Eidetic Theory States: There is an activated experiential point in

the mind in the form of an eidetic image which reveals personal interactive facts
in a spontaneous fashion”
(Akhter Ahsen PhD)
 Components of Eidetic Image

 Each Eidetic Image is comprised of three components:

 Image (I)
 Somatic Response (S)
 Meanings (M)

 The triple code is ISM

 Variations of Triple Code
(ISM)

Six operational variations of ISM

depicting normal and abnormal modes
of functioning in which, an organism is
capable of operating. If the order is
distorted on a permanent basis due to a
conflict, a malfunction develops
 First Variation
 ISM
 Seeing a rope on the path
 Stop walking
 Start thinking what to do with it

 A person sees the image, responds with emotions

and physiology and interprets the experience
 Second Variation
• IMS
– Seeing a rope
– Perceiving it as a snake because of darkens
– Experiencing fear and running away

• The person sees the image clearly but an inaccurate

thought or error obscures the visible reality, and the
somatic response follows the reality
• (Misinterpretation of reality induces neuroses)
 Third Variation
 SIM
 Person is drunk or tired
 Person sees a snake (which is actually a rope)
 Perceives the rope as a snake
• The physically altered condition causes a
person to see images and experience
thoughts only according to the altered states
 Fourth Variation
 SMI
 A person is drunk or tired
 Person is told that there are (or he expects to see)
snakes on the path
 Person does see a snake (even when there was no
rope)
 The physically altered condition causes a
predisposition, which leads to accepting the
thoughts and images of another person, and
seeing things accordingly
 i.e. hallucination
 Fifth Variation
 MIS
 Person expects to see a snake on the path
 Sees a snake on the path (which is really a rope)
 Experiences fear and runs away
 The person’s thoughts propel him to see, feel
and act accordingly
 (Neurotic rigidity and avoidance to new
perceptions)
 Sixth Variation
 MSI
 Person expects to see a snake on the path
 Walks along the path with fear
 Sees a snake (which is really a rope)
 Preconceived notions alter physiological
conditions in which person experiences
the reality
 (Generalized anxiety and hopelessness)
 Trauma in Eidetic Therapy
Trauma imagery represents a composite of real and fantasied
images pertaining to (a) the relatively sudden and unexpected
physical impact on the organism, (b) the event inflicting physical
and emotional injury and, (c) the generation of many leveled
imagery effects spread in time before, during and after the impact.
 Setting the Stage for Intervention

 Preliminary 1:
 First Report of Symptoms
 “We are going to talk about your problems in
detail. Please take your time and tell me what
bothers you”
 Preliminary 2
• Worry and Concern about
Symptoms

– “Think of your symptoms again. Do

you have a worry or concern that your
symptoms are going to become worse and
something will happen to you?”
 Preliminary 3
• Review of Systems
– “You have given me many details about your
symptoms. Now I want you to give more
information about your symptoms in another
way, by thinking about each part of your body.
You may have noticed that sometimes organs of
your body give troubled feelings to you so that
you feel that they are affected by the
symptoms….. We will start with the head and
move on until we reach your toes”
 Preliminary 4
 Subjects Various Names
 “What is your first name? What is your last name?
What is (are) your nickname(s)? Did your parents
address you with any endearing or special name(s)?”
 Preliminary 5
 Symptom Table

Negative Symptoms Positive Symptoms

Psychological Physiological Worry and Concern Opposite of Symptoms

 Ahsen’s Laws of Consciousness

 Ahsen’s laws of psychical growth and expression articulate

how image is stored in the mind, how the natural mechanism
gets disturbed and how it can be restored
 Law of Visio-somatic Association

 Experiences of high emotional significance are stored in mind

in an ISM sequence as an undifferentiated whole. One clue in
Eidetics can re-precipitate the whole pattern of a particular
experience
 Law of Visio-somatic Dessociation

 Because of time or individual’s strategy (i.e. denial) visual cue

of a certain experience gets separated from particular bodily
conditions and psychological themes. It helps the individual
in avoiding constant emotional and somatic upheaval on each
recall. In such a dessociation the body takes the forms of
symptoms
 Law of Visio-Fixation
 For the sake of economy in recall, a significant incident
(experience) gets reduced in the mind to very small visual cue.
However this cue retains the intimate relationship with the
psychophysiological patterns and interpretation that the
person experienced during the original encounter
 Law of Simultaneous Contradiction

 An incident which is recorded this way in mind could be

perceived the opposite way. This dialectical nature of mind
plays an important role in healthy development as well as
symptom formation if it freezes into a certain position.
 Law of Bipolarity
 The ego ties its attention to the positive or negative end of an
event because it cannot fixate on both poles simultaneously
 Magical Laws
 Mental mechanisms in which children in
their spontaneous ways and adults in their
honest mood are involved. Briefly they are
four:
 Part is a whole
 Contact is unification
 Imitation is reality
 Wish is action
 CONSCIOUS – IMAGERY GAP

 Mostly individual’s conscious understanding of symptoms and

its relation with people and situations is superficial. This lack
of awareness operates in the patient’s resistance or limitations
to identify what is really happening or covers up the sources
of great stress.
 Locating the Gap
 The Symptomatology manifests in the first interview when
matched with the material revealed through the first item of
Eidetic Parents Test (EPT) indicate the gap between his
understanding and source of his problem. The gap occurs at
three levels, i.e., image, soma and meaning
 Treating the Gap
 The gap can be treated at all the three levels independently:

 The Image Gap

 The Somatic Gap

 The Meaning Gap

 The Image Gap
 Optical gaps should be overcome along the following
lines.
 Repeated concentration on various optical aspects of the picture
 Repeated attempts to complete incomplete picture, such as absent
arms, eyes or voices of parents
 Repeated introduction of behavior in the picture, which should have
been a part of it such as threatening or loving behavior of a parent
 Repeated introduction of a person into the picture setting who should
have been a part of it but is absent, such as father or sibling
 The Somatic Gap
 By concentrating on body responses to the optical
aspects of an image, an awareness of the
physiological involvement in the image take place

 Allowing body responses to develop through repeated concentration

on the optical aspect of the image
 Repeated experiences of the body response with regard to the
negative or positive effects in the situation represented in the image
 The Meaning Gap
 Concentration on the optical image and the body responses to
it usually gives rise to a new understanding

 Removing misunderstanding caused by current idea

 Developing confidence in new ideas
Eidetic Therapy: Addressing Trauma

 Awareness of Body
 Awareness of Thoughts
 Awareness around the Relationship between
Traumatic Incident & Current State of Body
& Mind.
 Recalling is not Recurrence
 Preamble to manage
resistance
Parental Images
Nursing Image
Parental House
Siblings
Childhood Play Images
 Akhter Ahsen’s
Trauma Model
1. Trauma Imagery

2. Information Phobia Concerning Trauma Imagery

3. Experience Versus Fantasy in Trauma Imagery

4. Defense Against Trauma Imagery

Accident Trauma

Symbolic Trauma
 Akhter Ahsen’s
Accident Trauma Imagery
1. Pre-Diurnal Accident Images 7. Mid-Accident Death Images

2. Pre-Near Accident Images 8. Mid-Accident Support Images

3. Pre-Synchronous Accident 9. Mid-Accident Exertion Images

Images
10. Post-Near Accident Images
4. Mid-Accident Impact Images
11. Post-Diurnal Accident Images
5. Mid-Accident Controlled Images
12. Post-Remote Accident Images
6. Mid-Accident Loss of Control
Images
 Akhter Ahsen’s
Symbolic Trauma Imagery
1. Pre-Diurnal Symbolic Trauma 7. Mid- Symbolic Trauma Death Images
Imagery
8. Mid- Symbolic Trauma Support Images
2. Pre-Near Symbolic Trauma Imagery
3. Pre-Synchronous Symbolic Trauma 9. Mid- Symbolic Trauma Exertion Images
Imagery
10. Post-Near Symbolic Trauma Images
4. Mid-Symbolic Trauma Impact Images
11. Post-Diurnal Symbolic Trauma Images
5. Mid-Symbolic Trauma Control Images
12. Post-Remote Mid-Symbolic Trauma
6. Mid-Symbolic Trauma Loss of Control Images
Images
 Accident Trauma Imagery

 Manoeuvre: A clear description of the specific dimensions of the

image involved in the manoeuvre followed by a sequential
description of the manoeuvre itself
 Result: A report on the manner in which the maneuver
transformed the subject or the situation, and on the extent to which
the goal of the maneuver was achieved
 Formula: The exact imagery formula clearly stated in capsule style
presenting an objective equation of events or cause-effect
relationships which can be easily put to use, or tested, by another
independent observer
 Trauma Imagery
 Problem: The subject had been suffering from a variety of symptoms following trauma from a car
accident. Two years ago when he was riding a bicycle he was hit by a car, resulting in his hospitalization for
brain concussion and internal injuries, later followed by an ulcer condition, general light-headedness,
occasional severely painful spasm of the spinal muscle and postural bending to the right side, and choking
due to accumulation of phlegm in the throat. The recollection of events prior to, during and after the
event was poor and haphazard, ridden with contradictions, guesswork and hearsay.

 Maneuver: The subject was encouraged to recall various phases of the event through slow and repeated
projection of each image pertaining to the trauma until the images began to interconnect and evolve a
complete picture of the incident.

 Result: The subject became aware that there were many gaps in his recollection concerning the incident.
He was helped in developing the complete scenario of the trauma, a process which resulted in
management and healing of the presenting symptoms.

 Formula: Trauma imagery represents a composite structure of real and fantasied images spread in time
before, during and after the trauma, and the resolution of the trauma involves filling of gaps and
development of a consistent trauma scenario over these time
1. Information on Phobia Concerning Trauma
Imagery
 Problem: During discussion of the trauma the subject's fear concerning the related images was
displayed in many signs such as sweating of palms, denial that his present symptoms were in any
way connected with the incident and avoidance of especially painful details. He, however, admitted
that he was somewhat afraid of recalling the events after he had put in so much effort to forget
them.

 Maneuver: The subject was asked to remember the traumatic event and to explore all the available
details. He was told that recall of the incident did not mean recurrence of the incident. After his
attitude concerning the remembrance and meaning of recall was corrected, the appropriateness of
his current fear concerning the event was discussed.

 Result: The subject became aware of the obstructive nature of his fear associated with reactivation
of the event imagery. During projection of imagery the necessity of overcoming this fear was made
clear to him, and he became favorably oriented toward recall of the details.

 Formula: Information phobia concerning a trauma confuses memory with reenactment and treats
past information as if it were a current event, and safety is projected in the absence of recall.
2. Experience Versus Fantasy in Trauma
Imagery
 Problem: The subject, in order to suppress traumatic detail, tended to use fear from outside of the
experience rather than go through the fear from inside the experience of the actual trauma. To keep
his distance from the trauma, he had even developed fantasy images which were superimposed over
the real experiential images of the event and provided the desired control over the accident.

 Maneuver: The various images of trauma were repeated in order to decipher which images were
authentic and had a deeper core of information and which images were superficial and did not
render any authentic detail. The images which showed a tendency toward growth of detail were
selected for elaboration of the trauma.

 Result: As the difference between fact and fantasy was clarified based on the principle of
availability of growth in detail, access to the trauma imagery was established. Following this the
general picture of the real trauma began to be assembled and associated affects were ready to be
developed and discharged along the way.

 Formula: The fear of past information and its enactment creates indifferent or less or more
frightening fantasied images of trauma which serve as a defense against true experience of imagery
concerning trauma.
 3. Defense Against Trauma Imagery

 Problem: The fear in the subject concerning trauma imagery was manifested in overt anticipatory
fear, or in the suppression of detail concerning the incident. The subject needed to see clearly that
the experiential fear arising from contact with the factual imagery was more appropriate, and
anticipatory fear was a defense.

 Maneuver: An attempt was made to overcome the defense of anticipatory fear concerning the
trauma by asking the subject to relax and then recall various phases of the incident in the form of
images. The anticipatory fear was not analyzed but whenever possible replaced by experiential fear
arising from accurate imagery recollection.

 Result: The fear continued to surface during imagery recall in the form of either anticipatory fear
or experiential fear. These two forms of fear were distinguished during the experience of imagery
and were accordingly managed. Each time the subject froze in imagery recall due to fear, he was
encouraged to project the obstructed imagery over and over again until the details emerged.

 Formula: Resolution of anticipatory fear as a defense against traumatic imagery is not achieved
through examination of anticipatory fear, but through exposure to experiential fear during imagery
experience aided by relaxation and an atmosphere of confidence.
 4. Accident Trauma Imagery
 Problem: During the car accident the subject had suffered physical injury involving brain concussion and
internal bleeding, as well as emotional shock. The accident details comprised a fast moving series of
events with the central and most important event of impact occurring over only a split second. This overly
compressed status of imagery was difficult to re-enact, and was further covered over by false imagined
details and confused time sequences.

 Maneuver: The details of the accident were developed in the form of a complete imagery scenario. The
overly compressed event of central impact was developed into fully elaborated details as were the events
which preceded and followed the impact in both recent and remote time formats.

 Result: Through stepwise replay of accident imagery scenarios participating in the central physical
impact, the general load of anxiety concerning the accident was distributed and reduced. The potential of
natural defense present in the imagery components against the accident was also exploited along with
correction of misinformation which had been introduced into the general memory of the accident.

 Formula: Accident trauma imagery represents a composite of real and fantasied images pertaining to (a)
the relatively sudden and unexpected physical impact on the organism, (b) the event inflicting physical and
emotional injury and (c) the generation of many levelled imagery effects spread in time before, during and
after the impact.
 5. Pre Diurnal Accident Images

 Problem: The subject considered that the final impact of the accident was the only real and important
event, and that events prior to the accident carried no significance. He, however, clearly remembered that
on the day of the accident, as was his habit, he did not go to play ball in a nearby park but instead went to
his friend's house to borrow his bicycle. He had no idea why he remembered this in particular and forgot
other details.

 Maneuver: The subject was asked to concentrate on the image in which he was playing ball in the park
instead of going to his friend's house to borrow the bicycle. Although the event of playing ball had not
actually taken place, this alternative image was very lively and reduced the subject's general anxiety level
appreciably. The subject was asked to concentrate on the alternative image and allow the pleasurable
emotions to develop.

 Result: The alternative images of playing ball in the park were so lively and pleasurable and bright, that
the subject experienced astonishment. After seeing them he felt appreciably relieved but the symptoms of
muscle cramp in the back and choking in the throat were still unresolved.

 Formula: Images resolutory to the accident trauma may be found somewhere in time from the start of
the day of the accident to many hours before the events were set on the course of the accident; and these
images represent the alternative course of events which might have taken place but did not evolve, and
follow the course of this alternative image reality.
 6. Pre Near Accident Images

 Problem: The images near the time when the accident took place were unclear and the subject did
not clearly image the route he took on the bicycle, only the spot where the impact phase began.
These images needed to be fully developed.

 Maneuver: The images of riding the bicycle, making turns and going into various streets were
repeated. These exploratory repetitions helped the subject to recall clearly the actual route he took
until he came to the accident spot. During this phase he was also asked to recall if he had thought
of taking an alternative route and doing something else, rather than going to the spot where the
accident took place.

 Result: The subject using exploratory image repetitions successfully recalled that near the accident
spot he had wanted to turn back, go to the park and do some bike riding near the park. If he had
followed this alternative near the accident time, the accident would not have taken place. This image
of turning back and bicycling near the park was repeated with further feelings of relief from
anxiety, but no other symptom resolution took place.

 Formula: Images resolutory to the accident trauma may be found somewhere near the time of the
accident, when the progress of events was set on the course of the accident but an alternative also
appeared which was not followed; and the resolutory images follow the course of this alternative
near the time of the accident.
7. Pre Synchronous Accident Images
 Problem: The images near the point of physical impact during the accident were found to be most
condensed and on the surface appeared to be synchronous with the impact. However, on close
examination, these images appeared to be earlier in time and contained muscular patterns aimed at
averting the impact through an attempt to oppose it, or avoid it, through a maneuver. The sequence of
these images was unclear.

 Maneuver: The subject was asked to repeat the images near the point of impact, to develop information
on the muscular posture, the defense maneuvers against the impact and the time sequences involved.
Details concerning all the muscular patterns operating at this point were evolved thoroughly.

 Result: As a result of imagery exploration near the point of impact, the subject saw the car which had hit
him coming from his right, turned his bicycle to the left to avoid it, lifted his feet high and exerting his full
strength, put his heels into the spokes of the wheel to stop it. In this way he succeeded in saving his legs
from direct impact with the car. The last two images provided immediate relief from the muscular cramp
in his back, which turned out to be the muscular pattern of stopping the bicycle by putting his heels into
the spokes in order to avert a more dangerous impact with the car.

 Formula: Images resolutory to the accident trauma may be found a split second before the impact of the
accident and represent a maneuvering muscular posture aimed at avoiding the impact.
 8. Mid Accident Impact Images
 Problem: The subject putting his heels into the spokes of the bicycle wheel, involving a muscular
posture of defense, was the last image before impact. If this image was prior in time to the impact,
then which image developed at the time of the impact? This point needed to be clarified next.

 Maneuver: The subject was asked to repeat the sequence of images so far developed. As the
images were carefully repeated it emerged that the subject had maintained his efforts to stop the
bicycle by putting his heels into the spokes, right up to the point of impact. The image was
repeated in order to clarify his posture during the impact phase.

 Result: The imagery revealed that the subject attempted to stop the bicycle by digging his heels
into the spokes until the car hit the bicycle, swinging it to the left and throwing the subject into the
air and against the windshield. As he turned slightly to the left, he soon fell toward his right side,
and his face, nose and shoulder hit the windshield of the car.

 Formula: The impact images of accident represent the first series of images involving the actual
physical impact in the accident and the muscular pattern and emotions which participate in it.
 9. Mid Accident Control Images
 Problem: The image in which the subject lifted his feet, dug his heels into the spokes of the
bicycle and exerted to his fullest near the point of impact demonstrated that he was in
control of the situation. However, the subject was not fully aware that this control was
carried into the impact phase, and needed to repeat the image to see it.

 Maneuver: The subject was asked to repeat the image of control and experience the control
through revisualization of the muscular posture in the image. He was asked to replay the
imagery sequence to see how this control was operating in the image at the point of impact.

 Result: Repetition of the image showed the subject that if he had kept his feet down on the
pedals he might have been thrown under the car and then he would have suffered more
serious injuries. By experiencing this control, he felt more secure during the impact.

 Formula: Control images during the impact phase of the accident represent the function of
stabilization and are aimed at organization of the haphazard release of situations and
muscular response patterns during the accident.
10. Mid Accident Loss of Control Images

 Problem: During experience of the control images, certain imagery effects emerged which showed
a simultaneous loss of control concerning the accident. These images remained to be developed for
a complete re-enactment of the accident process.

 Maneuver: While experiencing the images involving control the subject was asked if he also
experienced lack of control during this phase. From this point, the absence of control was
developed into images, by asking him to experience and to allow complete and clear details to
emerge.

 Result: The subject experienced the loss of control all along the accident, as a soaring feeling of
release with a touch of unpredictability. A mild feeling of loss of control began before the accident,
became more evident near the accident, and was most pronounced in the middle of the impact. All
these images were marked by feelings of enhanced muscular flexibility.

 Formula: Images embodying loss of control during the impact phase of the accident represent the
function of flexibility and allow an uninhibited flow of the haphazard situations and muscular
response patterns during the accident.
 11. Mid Accident Death Images
 Problem: During the impact phase, most of the subject's images dealt with life and the
subject's desire to hang on to the possibility that he would live. However, a part of the feeling
displayed apprehension that he was going to die, and the subject needed to elaborate this also.

 Maneuver: The subject was already aware of the fear images from the initial stages of the
accident. He was now asked to concentrate on these fear images, allow the images of panic to
develop from them and, as he experienced the images of panic, to see if fear of death was
present in the images.

 Result: The feeling of panic in the images contained an expectation of death through
accident. This was displayed in steps by images of a horrifying impact and his smashed body
drenched in blood, then a sudden soaring feeling of release, euphoria and termination of life.
He saw that he was dead, but in another image he was alive and walking along on the road,
away from the dead body.

 Formula: Images of death display two levels: (1) at the initial level they display the
experience of horrifying impact, giving up and dying during the accident, and (2) at the next
level they contain images of a second life which represent a state of renewal, euphoria and
safety.
 12. Mid Accident Support Images
 Problem: The image in which the subject dug his heels into the spokes of the
bicycle was the strongest positive image and gave his mind a sense of support.
He was not clear about this and needed to experience its full significance
through its imagery manifestation.

 Maneuver: The subject was asked to see the image of himself digging his
heels into the spokes of the bicycle and experience whether it felt like a
support. The image was repeatedly projected and the underlying feeling of
support was elaborated for concentrated awareness.

 Result: During repeated projection of the image, the feeling of support from
within the image emerged. This feeling gave rise to a resurgence of confidence
which was very gratifying to the subject. He felt less threat from the accident.

 Formula: Support images in the accident represent the images of objects,

ideas and emotions which act as a support against the full impact of the
accident and provide a feeling of survival during the impact.
 13. Mid Accident Exertion Images
 Problem: While projecting the image in which he dug his heels into the spokes of the
bicycle, the subject saw that he was exerting very hard. He needed to become aware that this
exertion, which appeared very uncomfortable in the image, had saved him from a more
dangerous impact with the car.

 Maneuver: The subject was asked to see the image of himself digging his heels into the
spokes of the bicycle and exerting very hard. This exertion was developed to the point of
exhaustion. The feeling that this exertion was absolutely necessary for his safety was
emphasized in order to enhance his willingness to exert even more in the image than he had
actually done in reality during the accident.

 Result: As the subject saw the image of himself digging his heels into the spokes of the
bicycle, he saw that he was exerting his utmost, to the point of smashing the spokes. This
latter portion of the image was repeated over and over again to develop the maximum
exertion possible in the image until he felt exhausted.

 Formula: Exertion images during the accident represent the maximum physical attempt to
survive during the full impact of the accident, and involve maximum effort with
accompanying signs of fatigue and exhaustion.
 14. Post Near Accident Images
 Problem: The subject remembered hitting his face and nose on the windshield of the car and
then a feeling of blankness. Full details regarding this blank phase were not yet available and a
complete picture of the accident imagery was required in this area.

 Maneuver: The post-accident phase of blankness was focused upon in order to develop its
content. The focus of blankness was repeated over and over again and some details began to
emerge. Finally, the subject reported seeing a fireman wearing a red hat looking at him as he
lay on the sidewalk.

 Result: On closer examination the image pertaining to this phase turned out to be a fantasy
image. In fact, the accident had happened in the middle of the road so that the subject had
fallen near the sidewalk, not on the sidewalk, and no fireman wearing a red hat had actually
come to look at him. This image came from another accident which the subject once
witnessed in which a fireman did pick up an accident victim and was wearing a red hat.

 Formula: Post-near accident images immediately follow the active phase of the accident and
involve personal feelings, ideas, and images as well as comments from other people at the
scene of the accident.
 15. Post Diurnal Accident Images
 Problem: After the enactment of images pertaining to the main accident, the images
pertaining to the first day of awareness following the accident needed to be developed. These
images were to be assembled and repeated next as one of the final phases of accident
treatment.

 Maneuver: The subject was asked to describe all the experiences which he could remember
involving his first day of vague or clear consciousness following the accident. These images
were developed in full detail and carefully examined as to impressions, personal
apprehensions and comments from others.

 Result: The subject said that he remembered somewhat vaguely that a doctor near his bed
commented on the accident by saying that the subject was at fault and should not have
borrowed the bicycle from his friend. Could the doctor have made such a comment, or was
the subject somewhat delirious at the time? The subject remembered having headaches and
being somewhat confused, and finally admitted that this image of accusation was his own
thought concerning the accident.

 Formula: Post diurnal accident images pertain to the events of the first day of consciousness
following the accident and involve personal feelings, ideas and images as well as comments
from other people, including physicians.
 16. Post Remote Accident Images
 Problem: By now the main images and details of the accident trauma had been
systematically enacted and resolved, resulting in healing of the symptoms. The last
detail to be treated, however, was the subject's guilt complex, which developed after the
accident, and his theory concerning it.

 Maneuver: The idea of guilt on the part of the subject was examined in the light of
previous imagery work and exercises. The symptoms were again discussed in the exact
imagery context in which they occurred. The subject's guilt was examined in the light
of this re-evaluation.

 Result: The subject became aware that his symptoms were a revival of the actual
events during the accident. This phase was found to be important for tying up various
loose ends in the accident scenario. As a result, the subject no longer felt guilty. He was
now free of all the symptoms,

 Formula: Post remote accident images represent favorable or unfavorable

interpretations and conditions in the period following the first day of consciousness
during recovery from the accident.
 Symbolic Trauma Imagery
 Problem: The subject suffered from longstanding severe anxiety states, work block and fear
of heart attack. During his growing years, he had suffered a prolonged emotional trauma
which involved his father's not earning and the family having extreme difficulty in paying the
bills. The trauma, which was connected with father's negative symbolic figure, was
amorphous and compressed in detail, and needed to be experientially developed.

 Maneuver: The amorphous and overly compressed imagery structures were developed in
steps through slow and progressive repetition of available imagery pertaining to, preceding,
and following the subject's encounter with the negative image of father.

 Result: The potential of natural expression present in the imagery components before,
during and after an encounter with the negative symbolic figure was exploited. The
problematic effects which had been introduced into this symbolic structure were corrected at
the point where they had occurred.

 Formula: Symbolic trauma imagery represents a composite of real and fantasied images
pertaining to (a) the impact from a negative symbolic event on consciousness, (b) the event
inflicting emotional injury and (c) the generation of many-levelled imagery effects spread in
time before, during and after the main negative symbolic impact.
 1. Pre Diurnal Symbolic Trauma
Images
 Problem: It had been noticed in the imagery that the subject's anxiety attacks from the negative image of
the father would usually begin around the first week of each month when the bills would come in the
mail. However, the subject was totally unaware of this connection and the depth and extent of his anxiety
over the whole issue.

 Maneuver: The subject was asked to concentrate on the image in which he saw that it was the first week
of the month and the mail containing unpaid bills was being delivered to the house by the mailman. He
reported some experience of anxiety at the sight of the bills. With more concentration on the image of
bills, he experienced pain and a sinking feeling in his heart.

 Result: As a result of concentration on the image of bills arriving in the first week of the month, the
subject was able to accept the connection between anxiety and unpaid bills. The demonstration of this
connection explained to the subject that his relationship with father needed to be explored further to
understand the subject's emotional outbursts in the house which occurred periodically, and apparently
without cause.

 Formula: Images constituting the symbolic trauma may in part occur prior in time to the final encounter
and may be found at the beginning of the season, month, week, day or hours prior to the encounter, and
represent the initial phases of development of the trauma.
 2. Pre Near Symbolic Trauma
Images
 Problem: The idea that anxiety was related to the negative image of the father was now accepted
by the subject, but awareness of its full depth was not yet available to his consciousness. The exact
set of images belonging to this needed to be developed to elucidate the effects participating in the
trauma.

 Maneuver: The subject was asked about the exact chain of images which tended to lead to the
traumatic image of the father. He reported the image of mother opening the mail during the first
week of the month and looking at the bills. The image immediately brought into focus the image
of his father not making a living to support the family and the subject's anxiety became available at
the feeling level.

 Result: The image of the mother looking at the bills revealed that she was worried. While
concentrating on this image, the subject became aware of a wave of anxiety developing in him,
along with feelings of inner crying. But the anxiety appeared to be still under control.

 Formula: Images constituting the symbolic trauma may in part occur prior in time to the final
encounter, and may be found somewhere near the time of the encounter when the progress of
events was set on the course of the trauma, and these images represent a consistent phase prior to
the occurrence of the symbolic trauma.
3. Pre-Synchronous Symbolic Trauma
Images
 Problem: The subject's anxiety concerning the negative image of the father became available but it was
still supervised by severe control. The subject needed a deeper experience of anxiety to evolve a true
picture of his emotions as they participated in the trauma.

 Maneuver: The subject was asked to see the image of the mother in which she was opening the bills and
then to concentrate on father's reaction, and allow the image to develop to the next step. This step in
imagery was repeated over and over again until the next set of images evolved. These images generated a
stronger wave of anxiety in the subject, with deeper feelings of inner crying.

 Result: In the progression of the image, the mother was looking at the father but the father was not
responding. The subject experienced inner crying as well as shame concerning his father because he was
not involved with the family. He experienced deep concern and told his father in the image "to be more
responsible and to get with it." Then the subject felt pain in his heart and got angry in the image.

 Formula: Images constituting the symbolic trauma may in part occur prior in time to the final encounter,
and may be found a split second before the impact of the final encounter and represent phase of the
symbolic trauma.
 3. Mid Symbolic Trauma Impact
Images
 Problem: The subject had experienced anxiety, pain and anger as a result of the images,
but he was still feeling inhibited and constricted inside. He needed to experience a
further expansion of emotions at this point to remove his constricting hold on feelings
and develop a more open expression of emotions.

 Maneuver: The subject was asked to see again the previous set of images of mother
opening the bills, looking at father and father not responding. He was asked to
experience his feelings of anger and allow the images to develop around the anger. He
was helped and supported during projection of these images because he felt that his
anger toward father needed to be kept under control, as it was improper.

 Result: When the subject told father to be more responsible, the father answered in the
words, "Mind your own business." At this point the subject experienced deep pain, then
his anger flared up and he grabbed father by the neck and shook him. The two wrestled
and rolled around on the floor.

 Formula: Impact images of symbolic trauma represent the first series of images
involving the actual impact of the final central state of the symbolic trauma and the
emotions which prevail in it.
 4. Mid Symbolic Trauma Control
Images
 Problem: The subject was using control during most of the imagery experience because he was
afraid that his emotions would get out of hand. He was not accessible to the experience of full
emotional release in order to fathom his reactions to the trauma imposed by father's negative
image.

 Maneuver: Since each stage of imagery experience was controlled and arrested from full
expression, the subject was encouraged to examine the condition of control in his imagery. The
control in images was repeated and he was asked to assess if it performed any positive function, or
only kept him from access to his emotional life.

 Result: The subject opined that control was a positive function in him: he wanted things to happen
morally and without too much chaos. This position was accepted in principle, but it was also
explained to him that lack of freedom in the expression of emotions posed another problem: the
danger that his life would become devoid of emotion. The subject suggested as a compromise that
he would allow things to happen in imagery, and would accept a simultaneous interplay of control
and expression.

 Formula: Control images during the impact phase of the symbolic trauma represent the attempt at
stabilization and embody the fear that emotions are getting out of hand as situations and affects are
released during the symbolic trauma.
 5. Mid Symbolic Trauma Loss of
Control Images
 Problem: The subject displayed a severe control on his emotions and would not allow a
spontaneous expression of his feelings to occur during projection of imagery. Spontaneity in the
imagery process needed to be developed, and he needed to give more play to the mechanism in
imagery which created expression.

 Maneuver: The images were studied in order to find which mechanisms in imagery helped the
subject to let go of his control. Most of the time the loss of control was sparked by father's anger
when the subject questioned him over the issue of his not earning. The images of father's reactive
anger were replayed over and over again as a tactic to loosen the subject's control and surface his
own underlying anger.

 Result: As a result of the above maneuver of loosening the control on his emotions, the subject
wanted to kick the father in the pants and punch him in the nose. As the control was further
loosened, the subject became more and more angry and felt like punching the walls. These images
were repeatedly projected for a thorough development of the affect contained in them.

 Formula: Images enacting loss of control during the impact phase of the symbolic trauma
represent the function of expression and allow an uninhibited flow of situations and affects to be
released during the symbolic trauma.
 6. Mid Symbolic Trauma Death
Images
 Problem: The subject had finally experienced sufficient expression through the imagery process.
However, his fear of the loss of control and what would happen if he really expressed needed to be
developed in the imagery process. The underlying apprehension needed to be clearly established:
what was he really afraid of that he needed to control so much?

 Maneuver: The images involving expression and loss of control contained severe anxiety and
unbridled emotions of fear and anger. The subject was encouraged to experience these emotions
and was asked to allow them to develop in their natural direction in the images. For this purpose,
the images were repeatedly projected and developed.

 Result: As the images developed, the anger against father was further evidenced and experienced
to the point that the subject felt that he could kill him on the spot. The anger was also diverted on
to his own self in the image. He said, "I see myself and father as the same." At this point the
subject also wanted to hurt his own self. In the next image he started screaming and flew out of the
window, into the open air outside.

 Formula: Images of death in symbolic trauma involve the person's own death, the murder of the
threatening person or object, or both, and represent release from a state of union with the
traumatic object.
7. Mid Symbolic Trauma Support
Images
 Problem: The negative images surfaced during the death phase were particularly traumatic and
needed to be developed fully without compromising the subject's ability to function appropriately in
life. As he practiced these images, the subject needed a supportive mechanism, such as of reality, to
provide continuity between his inner fantasy and the outside world.

 Maneuver: It was discussed with the subject that images of death and murder are purely mental
reality, and that to experience them as such does not mean that an actual death or murder is taking
place. It was further added that images provide safe experience of reality when reality is too
dangerous. This discussion was expected to provide a positive feeling of confidence and support
during experience of negative images.

 Result: The subject's need to treat images as reality was brought into perspective following
discussion and he could now relate to images of death and murder with a feeling of support. The
fear of the negative images was consequently reduced and contact with threatening mental
experiences was made more possible.

 Formula: Support images in the symbolic trauma represent objects, ideas or emotions which act as
a support against the totally destructive impact of the symbolic trauma signifying death or murder,
and provide a basis of faith in survival during impact.
 8. Mid Symbolic Trauma Exertion
Images
 Problem: The experiences represented in the death images were traumatic and support was
needed to discharge them fully. Unless contact with death images was experienced and
further deepened with full support and vigor, the possibility of their resolution was slim due
to overwhelming factors of passivity, fear and control.

 Maneuver: The subject was asked to repeat the death images and images representing
support alternately, and to put vigor and exertion into the experience. This special
arrangement was aimed at developing the death images against the background of faith and
confidence in reality and the meaningfulness of a deep experience.

 Result: The vigor and exertion put into the death images and the images of support surfaced
more traumatic content and more ability to tolerate it. While projecting these images the
subject went through images of hysteria, crying and shrieking as control was given up.

 Formula: Exertion images during symbolic trauma represent the maximum attempt to
experience and express during full impact of the symbolic trauma, and involve maximum
surfacing of detail, affect and effort with accompanying signs of fatigue and exhaustion.
 9. Post Near Symbolic Trauma
Images
 Problem: The images in which the subject wanted to hurt his father as well as his own self were
followed by images of screaming and then flying out of the window, representing the peak of the
symbolic trauma. The last imagery sequence of flying out of the window required development of
detail in order to determine whether it represented a negative escape from trauma or a positive
development.

 Maneuver: The images of flying out of the window were developed in detail. They were repeated
at the point of origin in order to surface new information concerning the terminating phase of the
trauma, and what it represented.

 Result: The subject reported that the image of flying out of the window was like breaking out of
glass which contained him. He said, ''I had to leave father in order to get going on a new concept
of life. I had to fly out of the trap. In flyng there is a feeling of beginning somewhere else. The
release of flying gives the feeling of a new beginning. It removes congestion and confusion in my
head."

 Formula: Post near symbolic trauma images represent events immediately following the peak phase
of the symbolic trauma and involve personal feelings, ideas and images concerning the symbolic
trauma.
 10. Post Diurnal Symbolic Trauma
Images
 Problem: After surfacing various images in the period immediately following symbolic
trauma, the images pertaining to the first day after the peak of the trauma needed to be
developed. Since the events during this phase could partly determine the final outcome of the
trauma, this phase required elucidation.

 Maneuver: After the image of the subject flying in the air was repeated, emphasis was placed
on images involving the next day. The subject was asked to image the next day, report on the
details, and allow the details to develop from this source. He was asked to report everything
that happened that day and follow the course of events to see if any detail threw further light
on the trauma.

 Result: The subject saw images in which he was going away from his parents' house to start a
new life. In the images he started the day in a new place by looking for a job and facing a new
life. These images brought a feeling of insight into new possibilities offered by life.

 Formula: Post diurnal symbolic trauma images pertain to the imagery events of the first day
following the peak of the trauma, and involve feelings, ideas and images concerning the day
after the symbolic trauma.
 11. Post Remote Symbolic Trauma
Images
 Problem: The subject had experienced a whole set of imagery details concerning his
symbolic trauma and explored their impact on his general ability to handle life. Did he find
his life perspectives change following the experience? How did he now propose to handle
future adjustment? Was he ready to apply what he had learned from traumatic nuclei to the
future? All these questions needed to be explored.

 Maneuver: The new education concerning traumatic nuclei was introduced through
discussion of life concepts and through examination of each phase of imagery. The
repetitions of previous imagery were again conducted, coupled with discussion of the
imagery content, examination of reactions and so forth. Re-evaluation of imagery material
was expected to exert an educational influence on the adjustment functions so that more
adaptive responses would be provided in the future.

 Result: The repetitions of imagery details with systematic discussion increased the
subject's understanding of the symbolic trauma and removed blocking concerning the
painful material. The procedure also helped the subject evolve a deeper perspective on life
which had been unduly narrowed down because of pressures imposed on it in the past.

 Formula: Post remote symbolic trauma images represent correctness of awareness

concerning favorable or unfavorable conditions following the negative event and the whole
imagery sequence appearing in the symbolic trauma.
True & False Trauma Imagery
 Treatment of Ptsd
 stellate ganglion block

 http://www.veteranstoday.com/2010/08/17/doctor-
treats-ptsd-with-injection-to-block-memories/

 http://www.thedoctorstv.com/articles/2796-injection-
to-cure-ptsd
We were here to sing the
songs of deliverance.
Enjoy