In Personalising Trauma Treatment: Reframing and Reimagining Scott (2022), I suggested that we can retrieve memories of extreme trauma, in our ‘Dr Who, Tardis’, and that this may lead to the persistence of PTSD. But we also retrieve, lesser traumas such as bullying at work or being publicly-shamed, that result in ongoing debility. I argued that it is the centrality accorded to these experiences that produces dysfunction rather than the negative event per se. Such experiences may become the window through which the individual views themselves and their personal world. Treatment involves consideration of viewing the self and personal world through other windows, including the pre- trauma window.
A just published study by Kredlow et al (2025), has found that negative autobiographical memories are also related to patient symptoms in the anxiety disorders and OCD. Nonresponse rates in CBT are estimated to be 34-50%. Thus, targeting negative life events that are related to an individual’s symptoms may improve treatment outcomes. Patients could be asked whether there are any key memories from their lifetime that they believe have contributed to their fears ( SNAMs, Symptom Relevant Negative Autobiographical Memories).The SNAM Event itself may not be as clinically relevant as to how an individual remembers and interacts with the SNAM.
Formulations can be enhanced by an awareness of mental time travel. Examining in session how homework compliance may have been coloured, by ‘Tardis excursions’ since the last session.
Dr Mike Scott