When the past is over but your body hasn’t got the message

A difficult experience doesn't have to be happening now to keep affecting us.

Sometimes people come to therapy because of something recognisably traumatic: an accident, abuse, violence, bereavement or another frightening event. At other times, there is no single dramatic incident. Instead, there may have been years of criticism, bullying, rejection, instability, emotional neglect or relationships in which it never felt entirely safe to be yourself. The circumstances may be long over, yet their effects can remain surprisingly present.

You might know intellectually that you are safe, for example, while your body reacts as though danger is close. A particular tone of voice may make your stomach tighten. Conflict may leave you disproportionately shaken. You may avoid situations without fully understanding why, struggle to trust people, become highly alert to signs of rejection, or find yourself repeatedly thinking about events you would much rather leave behind.

Difficult past experiences are among the factors that can contribute to anxiety.

Why can the past still feel present?

Our brains are very good at learning from danger. If touching something hot burns us, remembering that experience is useful. Psychological learning can work similarly. After threatening or painful experiences, we may become particularly sensitive to situations that resemble what happened before.

The difficulty is that resemblance is not the same as danger.

A person who was repeatedly criticised may become unusually sensitive to disapproval. Someone betrayed in an important relationship may find themselves scanning a new partner for signs of abandonment. Someone who experienced frightening events may react strongly to sounds, places, sensations or situations associated with them. These reactions are not necessarily conscious decisions. Sometimes the emotional or physical response arrives before we have had time to think.

This can produce a frustrating experience: I know there is nothing to be frightened of, so why do I still feel frightened? The answer may be that knowing something and emotionally experiencing it as safe are not always the same thing.

Trauma does not look the same for everyone

It is important to recognise that people can experience and respond to difficult events in many different ways. Experiencing adversity does not automatically mean that somebody has post-traumatic stress disorder (PTSD), and diagnosis should be left to appropriately qualified professionals.

Nevertheless, difficult experiences can affect people in many ways. Problems may include anxiety, shame, guilt, anger, avoidance, disturbed sleep, intrusive memories, difficulties in relationships or feeling constantly on guard.

For PTSD, established psychological treatments recommended by NICE include trauma-focused cognitive behavioural therapy (CBT) and eye movement desensitisation and reprocessing (EMDR). Hypnotherapy should not be presented as a substitute for appropriate specialist assessment or treatment where this is required.

However, for some people affected by difficult past experiences, hypnotherapy may form part of a broader therapeutic approach to changing the thoughts, associations and emotional responses that continue to cause difficulties in the present.

How might hypnotherapy help?

Hypnosis is a state of focused attention in which a person may become more absorbed in internal experiences such as thoughts, sensations, memories and imagery. You remain able to think, respond and make choices; hypnosis is not a state in which somebody else takes control of your mind.

In therapy, this focused state can provide an opportunity to work with some of the automatic responses associated with past experiences.

For example, imagine somebody who grew up being frequently criticised. As an adult, they may understand perfectly well that making a mistake is not dangerous. Nevertheless, criticism from a manager or disagreement with a partner might immediately produce anxiety, shame or the urge to withdraw.

Hypnotherapy might be used to help that person practise experiencing such situations differently: noticing the old response without automatically following it, imagining responding with greater calm or confidence, and reinforcing alternative ways of thinking about themselves and the situation.

This is one reason hypnosis can be particularly interesting when somebody says: “I know this logically, but I don't feel it.” Therapeutic work can involve helping the emotional response begin to catch up with what the person already understands intellectually.

Working with associations and triggers

Our reactions are often influenced by associations. A smell can suddenly remind us of childhood. A piece of music can evoke an emotion almost instantly. In the same way, experiences involving fear, humiliation, rejection or helplessness can sometimes leave powerful associations behind. Later, something sufficiently similar may activate the old response. 

Depending on the person's needs and the hypnotherapist's training, hypnosis may be used alongside therapeutic techniques intended to weaken unhelpful associations and develop new responses.

This might include using imagery to rehearse encountering a previously difficult situation while remaining calmer, developing a stronger sense of safety in the present, or imagining responding to a familiar trigger in a different way.

The aim is not to pretend that the original experience did not happen. It is to help reduce the extent to which an old experience automatically determines a present response.

Changing beliefs learned from experience

Difficult experiences can also influence the conclusions we reach about ourselves.

Someone who was repeatedly rejected might conclude: "There must be something wrong with me." Someone who grew up around unpredictable anger might learn: "I must keep everybody happy." Someone who experienced betrayal might decide: "I cannot trust anyone."

These beliefs can make sense in the circumstances in which they developed. The problem comes when they continue operating long after those circumstances have changed.

Hypnotherapy can provide a focused setting in which these beliefs are explored and alternative perspectives rehearsed and reinforced. Rather than simply repeating positive statements that somebody does not believe, the therapeutic work should be relevant to that individual's experiences and the particular meanings they have attached to them.

Do I have to relive what happened?

This is an understandable concern. Hypnotherapy does not necessarily require somebody to recount every detail of a difficult experience or repeatedly relive it. What happens in therapy should depend upon the individual, the nature of the problem and the therapist's training.

It is also important to be cautious about memory. Hypnosis should not be used on the assumption that memories recovered during hypnosis are necessarily accurate. Memory is reconstructive and can be influenced by suggestion.

A responsible hypnotherapist should therefore assess what somebody is experiencing now, discuss what they would like to change and work within their professional competence. Where symptoms suggest PTSD or another condition requiring specialist assessment or treatment, referral or collaborative work with an appropriately qualified professional may be more suitable.

“But other people have it worse”

One of the most common ways people minimise their own experiences is through comparison.

Perhaps somebody else experienced more severe abuse. Perhaps your childhood looked perfectly ordinary from outside. Perhaps the relationship was not always bad. Perhaps you survived something that other people appeared to cope with more easily.

None of those comparisons tells us very much about how an experience affected you. A more useful question is often: "What did I learn about myself, other people or the world because of what happened?" And, perhaps more importantly: "Is that lesson still helping me now?"

Something learned as a way of surviving or coping at one point in life can become unnecessarily restrictive later.

You do not have to erase the memory

The purpose of hypnotherapy is not to make somebody forget what happened. Memory is part of our personal history. What may change is our relationship with that memory and the automatic responses associated with it.

An event may remain something you would never have chosen, while becoming less capable of determining how you feel about yourself today. A reminder can become a reminder rather than an alarm. A belief learned in one relationship can be reconsidered rather than automatically carried into the next.

Perhaps one of the most useful questions is therefore not: “Why haven't I got over it?” but: “What did I have to learn then that I no longer need now?”

The past cannot be rewritten. But with appropriate therapeutic support, the way it influences the present may be able to change.