The Brunet method of reconsolidation therapy (writing) works decently well for ptsd: https://www.ncbi.nlm.nih.gov/books/NBK595367/
The patient writes their traumatic memory, then on later sessions, takes propanolol (beta blocker, to prevent physiological anxiety symptoms) and recopies their writing. There is no requirement at any point for anyone but the patient to review the writing.
After I accepted the idea of determinism - thoughts of shame and regret could be nullified. If you were never in control of your actions - but rather influenced by your environment and your genetics - feeling guilt, or shame is no longer applicable. You might still want to understand what motivated you to do certain things - but the guilt and shame or sense of being responsible for things slips away. You don't just apply this to your own actions - but to everyone else's too - therefore the concept of forgiveness is also nullified - as is hatred or blame. I still feel anger and get hurt... but when I remind myself that nobody is control and that everything is just physics, cause and effect, I feel better.
Once upon a time I was in a very frazzled and vulnerable state. I was leaving a coffee shop and about to hop on my bike to head over to a bar to watch the Steelers game. A homeless guy named Joe[1] started talking to me.
He said I have a nice bike. I thanked him, said I love biking, and asked if he bikes. He said that he does but that his bike had recently been stolen which makes him sad. I mentioned that I’ve had bikes stolen too and we vented a bit about bike theft.
Then he confessed that he’s actually stolen bikes before. And furthermore, that he’s tempted right now to steal a bike. His old bike was stolen and he really could use a way of getting around. But he’s trying really hard to be a good person and doesn’t want to steal anymore.
I found this to be impressive and inspiring. I imagine that in a state as desperate as his it’d be really, really tempting to rationalize that bike theft is justified. And hey, maybe it is. Regardless, I know that I rationalize tons of things when it’s convenient and I’ve never been nearly as desperate as he is. So yeah: impressive and inspiring.
Anyway, he proceeded to confide in me about some of his life difficulties. I smiled and explained that despite surface appearances, he and I are actually not all that different. We looked at each other and I’m not sure which one of us took the initiative, but he ended up asking me if I want to talk, and I said yeah. It’s something I’ve always wanted to do.
Joe hustled over to the exterior seating of the coffee shop where he had all of his belongings. He started clearing space for me to sit. It was as if it was his living room and he had shit everywhere. As if he wasn’t expecting to have company and was trying to be a good host.
We sat down and started talking. He agreed to go first since I was a little nervous. He was strong.
He told me his life story. I won’t go into the details, but it’s a lot of stuff that you might imagine someone on the street to be struggling with, and more. It’s what Woody Allen would categorize as “the horrible”.
Then it was my turn. There was something I had been holding on to for a few weeks and itching to talk about. Something that was really driving me crazy. I considered confiding to Joe about it but it didn’t feel right. The pocket knife, dissociations, history of violence and antisocial personality disorder might have had something to do with it.
Anyway, there was something smaller yet still pretty huge that I was struggling with and wanted to get off my chest. It felt right, so I said it.
It’s a little dark and not something I want to elaborate on. Joe had a follow up question for me that kinda hit the nail on the head. It was something along the lines of, “What is the thing you feel such strong shame about?” He said it with an element of empathy and directness that felt like it was coming from a therapist.
I paused and thought for a few moments. He saw me thinking and said something that I’ll never forget: “You don’t have to answer out loud, you can answer in your head.”
It felt so perfect. Like, if you take the space of all possible responses Joe could have had, I dunno, that one has got to be pretty high up there. It felt very wise, which was kinda funny coming from someone who looked like they had been at a rave for the past 72 hours.
Anyway, that’s what I wanted to share. This idea that “answering in your head” is an option to be considered, particularly when facing hard questions. Most of the time the important thing is finding the truth and acknowledging it to yourself, not necessarily to the other person.
I’ve always kinda coupled the “what you say to the other person” part with the “what you say to yourself” part. In retrospect this is silly: they can be pretty easily decoupled. My having coupled them was some sort of cached thought, or behavior, I suppose. I’m grateful to Joe for busting that cache for me and am glad that I stopped by to talk with him.
Not his actual name.