Cognitive Feedback Therapy: How a Stop Sign Silences the Screams

My EMDR treatments for PTSD  included Cognitive Feedback Therapy, which focuses on the individual’s thought processes and how they affect behavior and beliefs. For example, it did not take much for my mind to swirl with negative thoughts when my husband traveled out of town for music gigs. I imagined him sprawled on the side of the road after being hit by a car. At night, I would wake and watch my husband’s chest for movement. In the dark, it was difficult to see if it was rising and falling, so I’d gently lay my hand on his chest, feeling for life. Or I’d snuggle close to him, waiting for him to exhale. These negative thoughts would lead to other negative thoughts or images: sometimes I’d see myself in a hospital bed struggling to breathe, with doctors hovering over me, sticking needles into my arms.

Like any successful project, cognitive therapy involves homework. My therapist instructed me to keep a log of events that triggered negative thoughts, sensations, and emotions. One day, I felt weak and feverish, as if I had the flu. Even though I did not have a fever, I thought something was wrong: I should go to the hospital, because I might have an infection. What if I need antibiotics? What if I don’t go to the hospital? I might die. As a nurse, it was easy for me to scoot down this irrational path. And since my spleen – an organ that destroys bacteria and is part of the immune system – had ruptured in the farmers’ Market accident, I couldn’t help but be anxious about dying from an overwhelming infection. But an uncountable number of people live productive and healthy lives without a spleen. By categorizing my thoughts into what my therapist labeled “faulty thinking patterns,” such as drawing conclusions or exaggerating the meaning of an event, then forming positive ways of thinking, I learned to halt the unraveling of irrational thoughts. I no longer keep a log, though I’m not completely free of negative thoughts and images. Instead, when they intrude on my sleep, or my daytime routine, I envision a huge stop sign. Sometimes I hold my hand up and say, “Stop!” And just like that, I’m unburdened by blackness, screams, and blood.