As we're working with the memory of the trauma itself, one of the parts of recovery is helping people with the emotional processing about the traumatic event. Since PTSD is a disorder where avoidance is such a big piece of maintenance of the disorder, what we want is to help the person approach the emotions that are part of the traumatic memory. It's always funny to me when I hear people describe cognitive therapies as being cold or as ignoring emotions because to me, so much of the work I do as a cognitive therapist is focused on the emotional experience. It's telling me where I need to go, and it's telling me if we've done our job right in therapy.
When we think about how we use emotions when we're doing cognitive therapy, working with PTSD, emotions are like a thermometer. They tell you that you're at a place that's important. The other piece around where emotions are helpful is they let me know whether the therapy process is working. So, when I get a shift in a cognition, a belief changes, what I should see is a change in the emotion. I should see that as a belief moves to be more balanced and more flexible, I should either see the intensity of the original emotion come down or I should see a new emotion show up.
So, for example, you might see someone move from shame or guilt to sadness. You might see someone move from anger to fear, or you might, especially towards the later sections of therapy, start seeing positive emotions that you haven't seen before. I feel hopeful. I feel lighter. I feel happiness. One of the places that's magical in doing this kind of therapy is seeing the look of surprise on someone's face as what they're noticing is a decrease in negative emotions and positive emotions that they may not have felt in a really long time, all of a sudden showing up.