Case: Agoraphobia Resistant to Exposure

When Trauma Still Hurts: Memory Rescripting

Hosts: Kevin Cornelius, LMFT Dr. David Burns

Content Note

This episode includes discussion of trauma, including sexual abuse and violence, which may be distressing for some listeners.

What Is Memory Rescripting?

Memory rescripting is a therapeutic technique that helps people transform how they experience painful memories.

• Instead of simply revisiting trauma, clients:
  • Re-enter the memory vividly (often with eyes closed)
  • Experience the emotions fully
  • Then actively change the outcome of the scene
• The key idea:Many trauma victims, see themselves, still, as the helpless little child, the victim, and every time they re-experience the trauma, they re-enforced those brain circuits. Memory Rescripting allows patients to establish new brain circuits and new ways of seeing themselves.
• Clients often:
  • Step into the scene as a powerful adult self
  • Protect their younger self
  • Confront or stop the perpetrator
  • Create a new, empowering ending

A Powerful Case Example

David shares a striking case of a young woman struggling with:

• Severe anxiety
• Agoraphobia (fear of leaving home, especially public transportation)

What wasn't working:

• Cognitive therapy helped overall mood
• But she refused exposure to public transportation

Breakthrough moment:

She revealed a childhood trauma:

• A babysitter repeatedly sexually abused her

The Memory Rescripting Process

During a guided session:

1. She vividly re-experienced the traumatic memory
2. At peak emotional intensity, she:
   • Entered the scene as a strong adult
   • Physically stopped the perpetrator (in imagination)
   • Enacted intense revenge fantasies
3. She continued reshaping the scene until:
   • She felt relief and empowerment

Surprising Outcome

After the session:

• She voluntarily booked a solo international flight
• Completed 21 hours of travel alone
• Reported:
  • Zero anxiety
  • Ability to neutralize fear using spontaneous rescripting
• She ended therapy shortly after—fully recovered from her presenting issue

Key Insight

Memory rescripting may work by:

• Shifting identity:
  • From helpless victim → powerful protector
• Allowing expression of:
  • Suppressed anger
  • Emotional truth
• Rewriting emotional memory—not just recalling it

Important Caveat

• This technique is not for everyone
• David notes:
  • He has used it rarely in decades of practice
  • Most patients improve with standard cognitive and exposure methods

Relapse Prevention for Anxiety

A crucial takeaway:

Recovery is maintained through continued exposure—not avoidance.

Key principles:

• Face your fears regularly
• Don't become complacent
• If fear returns:
  • It does not mean failure
  • It means it's time to re-engage the tools

Normalizing Setbacks

• Negative thoughts and feelings will return at times
• This is part of being human—not a sign something is wrong
• You can reuse the same tools that worked before

Core Takeaways 1. Thoughts create feelings

Changing distorted thoughts can eliminate emotional suffering.

2. There is no one-size-fits-all method

Different techniques work for different people.

3. Don't give in to hopelessness

Even long-standing anxiety can be overcome.

4. Avoid rigid "schools" of therapy

Flexibility and multiple tools are key.

5. Memory Rescripting is one powerful method that could help

When the patient rewrites the script on a traumatic memory, new brain circuits are created and the patient is freed from the pain of the traumatic event.

"100% vs 200% Cure"

• 100% Cure: Fear disappears completely
• 200% Cure: You come to enjoy what you once feared

Resources Mentioned

• When Panic Attacks by Dr. David Burns
• Feeling Good by Dr. David Burns
• Feeling Great by Dr. David Burns
• Feeling Great App (free at www.feelinggreat.com)
• Free anxiety resources and classes available at www.feelinggood.com

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Contact Information

Kevin Cornelius, LMFT is a Level 5 Certified Master TEAM-CBT Therapist and Trainer and the Clinical Director of Feeling Good Institute--Silicon Valley. He specializes in the treatment of trauma, anxiety, depression, relationship problems and insomnia. You can reach Kevin at [email protected] and visit his website at www.tools4change.me.

You can reach Dr. Burns at [email protected].

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