The coherence that underlies panic and severe anxiety disorder has a neurobiologically distinct form: flashbacks of unresolved, unconscious traumatic memory.
Flashbacks are part of the reptilian brain’s way of recognizing and responding to extreme danger previously experienced. A flashback of traumatic memory can consist of any separate somatosensory component of the original experience. Sometimes only the feeling of fear flashes back, unaccompanied by any perceptual memory, so it’s not at first apparent to the client or therapist that the intense fear is a flashback.
Angie, an aspiring actress, came to see me because she was experiencing stage fright so intense that it was seriously interfering with her rehearsals and threatening her career. I began the discovery process with methods designed to reveal an unconscious purpose underlying her anxiety, but without much success.
Then Angie mentioned having had a high-anxiety dream in which she was a terrified passenger on a wildly careening bus driven at high speed by a crazy old woman. To search the dream for how the coherence of the stage fright might have been appearing in it, I used Gestalt experiential dreamwork with Angie to relive the dream action.
In the midst of the process, she suddenly said that an extremely frightening childhood memory was resurfacing. She was in the car with her family when her father was driving drunk. She felt the car swerving around, scraping against the guard rail. Angie sat in the back seat, consumed by terror and a sense of doom as she saw a bridge ahead.
I was struck by the common feature shared by both this traumatic memory and her stage fright: heading straight toward a frightening place with no escape. Her stage fright could be a flashback of that traumatic car ride.
The trauma-creating element was young Angie’s assumption of being imprisoned in the death car and powerless to get out. To dissolve that key construct, I guided Angie to vividly relive the original situation in the car, but this time, to do whatever it took to get the car to stop and get out.
She flung open the car door, her father slammed on the brakes, and she jumped out, yelling for help. The police arrived. In about five minutes of revising the original action, Angie intensely experienced her power to exit the car’s doomed trajectory and get to safety.
Two weeks later, Angie reported a complete cessation of her stage fright. I asked her whether there was a connection between approaching the performance and approaching the bridge. She confirmed: “Once you get there—onto the bridge or onto the stage—there’s no turning back. You have to make it all the way to the other side or die up there!”
It’s important to note that the reenactment technique is only appropriate for traumatic memory situations like Angie’s. With traumas that lack perceptible signs of impending danger and plausible forms of physical rescue, reenactment will only be retraumatizing.
Bruce Ecker
Bruce Ecker, MA, LMFT, is codirector of the Coherence Psychology Institute, co-originator of Coherence Therapy, and coauthor of Unlocking Emotional Brain and Depth Oriented Brief Therapy.
