The assumption that the goal of trauma treatment is to process traumatic event memories has been unquestioned for many decades. Now, advances in our understanding of trauma have directed us toward a somewhat different goal: the resolution of the implicit components of memory that continue to intrude long after the events are over. From that perspective, traumatic experiences do not have to be processed unless necessary to resolve the implicit memories that are still activated in present time. To further complicate the issue of memory, fragmentation of the personality results in confusion of past and present. Some parts block acknowledgement of the trauma, while other parts are desperate to tell someone what happened, still fearful that they are in danger even now.
Each part anxiously anticipates a repetition of the past without any sense that ‘it’ is over. How do we help patients resolve their past when the past is still the present for the parts?