Some therapies involve various forms of imaginary reenactment, where you heal a trauma by first recalling the memory of it and then imagining how things could have gone differently. Sometimes the imagined alternative can be quite fantastical in nature, such as your current adult self traveling back in time to when you were a child and saving your child self from the bullies tormenting you. (Here by trauma I mean to also talk about “small-t trauma”, e.g. various painful experiences that might not be what we’d ordinarily call trauma, but are still a little unpleasant to think about, or have left some other kind of a negative effect on your psyche.)

In my experience, imaginary reenactment works, at least assuming that I’ve managed to get an emotional hold of what exactly in the memory it is that made it feel so unpleasant. (Did I feel like I was alone? Or inadequate? Or that I did something wrong? Etc.) Also assuming that the memory of the old trauma isn't so painful as to be completely overwhelming and leave no room to imagine any alternatives.

Here’s my current guess of how and when this works:

The basic process by which any emotional learning gets changed is memory reconsolidation. There’s a generalization that your mind has drawn about the meaning of some past event that feels true to you. E.g. “nobody helped me when I was in that situation, so nobody cares about my suffering”. If you can bring that felt truth to mind while also experiencing a contradictory belief – e.g. the belief that you have a friend who does care about you – as true at the same time, your brain will notice that it believes in two contradictory things at the same time, and will revise its beliefs to fix that inconsistency.

Often, this takes the form of concluding that what it considered to be a general truth isn’t the case after all – e.g. changing the previous assessment to “nobody helped me in that situation, but there are still people who care about me and who I can reach out to for help”.

Now, you can also imagine things that feel true, if they’re the kinds of things you feel could happen. For instance, maybe you have a friend who buys a lot of products from the Acme Corporation, and you then imagine your friend excitedly telling you about the Acme Super-Duper Toothbrush that they bought. Even if they have never done this, the imagined scene can still feel real because it involves the kind of a thing that your friend could do.

I suspect what’s going on in therapeutic reenactment is that you are imagining something that feels like it could have happened and thus serves as counterevidence for the emotional belief in your trauma, but the “could be true” is on an emotional or symbolic level rather than on the level of physical possibility.

So for example, suppose that I had a childhood experience where I was being picked on by bullies and nobody helped me. From this experience, my brain might form the generalization “nobody helped me, so nobody cares about my suffering”.

Now if I manage to recall this experience in such a way that I can feel empathy towards my past self, then the act of feeling that empathy now proves that someone does care. Then if I imagine a scene in which I travel back in time to when I was a child and I beat up my bullies, it doesn’t matter if the literal content is physically impossible. Because what matters is the emotional feeling of “someone cares so someone could have helped”, which is evaluated as true.

(My adult self caring about my child self doesn’t mean that my adult self could actually have helped my child self, but one person caring is enough to disprove the generalization of “nobody cares”. So then if at least one person cares, then that implies that there were also others who would have cared, and they would have helped if they’d known and had the opportunity to. More broadly, the reason why we draw generalizations from past experiences is to predict the future, so what really matters is knowing that it’s possible to get help from people in general, and that people don’t think that your suffering is intrinsically meaningless.)

That said, if I try to do this and I haven’t really gotten a good intuition of why the memory is so painful, it usually doesn’t work – the generalization that I have formed from the experience needs to be at least somewhat explicit. Otherwise I can’t experience that generalization as real (as is required for the memory reconsolidation process to work), nor can I find the right emotional flavor that I need to imagine for the new scene to count as counter-evidence for the generalization.

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As someone heavily prone to dissociation (I could probably be diagnosed with OSDD-1B if I were to go to a psychiatrist), I am interested in but skeptical of things like this. I have a very hard time holding my various contradictory emotionally-charged beliefs in my mind at the same time, because their accessibility to memory is dependent on which ego state I am in at the moment, and I often don't even realize when I switch from one to another. (Other people sometimes do, of course, such as when I start arguing against an opinion I argued in favor of just a few minutes before.) Even when one version of me fully understands things like "I have people who care about me", this does not stop my traumatized child-self from once again taking away the microphone when something bad happens and refusing to listen. That is... this method does not seem likely, to me, to actually have any permanent effects but only to be a temporary solution approximately along the same lines as telling oneself to shut up.

This makes me think of IFS, and how the symbolic unburdening ritual the standard IFS procedure includes only really does anything if you've managed to coordinate with your Protectors well enough for them not want to jump in the way / disrupt it, and if you've connected with and empathized with the Exile strongly enough for the symbolism to resonate for the exile, and for the exile themself to feel ready for and want the changes an unburdening would entail.
Without all those pieces in place, it does end up falling flat and doing approximately nothing except maybe feeling nice for a brief period — because in essence you're just doing some thing over here on the side in a way that isn't actually interacting meaningfully with the parts it's supposedly meant to heal.

Getting all of these pieces in place is actually quite hard and takes a lot of extended inner relationship-building and development of understanding, as far as I can tell. I'm still working on it myself, and have only had little bits and pieces of successful unburdening type results so far.