When difficult experiences stay with us

We tend to think of memory as a record of what has happened to us. An experience takes place, it is stored, and later we remember it. Yet memory is more complicated than this. The emotional significance of an experience can influence how it is remembered, how easily it comes to mind and, in some circumstances, how strongly we respond when something brings it back into awareness.

Some memories remain vivid for years. A particular sensory reminder (such as a sound or smell) may unexpectedly bring an experience to mind, sometimes accompanied by an emotional or physical response that seems out of keeping with what is happening in the present. This does not necessarily mean that something is wrong. Difficult experiences can remain meaningful without becoming a mental health disorder.

For some people, however, the effects of what happened continue long after the original experience has ended. A memory may become intrusive or distressing. Situations that resemble something from the past can also trigger a response that feels disproportionate to what is actually happening.

Understanding why this can happen helps to explain conditions such as post-traumatic stress disorder (PTSD) and complex post-traumatic stress disorder (CPTSD), as well as the place that therapies such as EMDR can have within treatment.

Memory is not a perfect recording

Memory is not simply a stored copy of an event that can be played back unchanged. Remembering involves reconstructing an experience using information that has been stored alongside its emotional and personal meaning.

This becomes particularly relevant when something has been frightening, threatening or overwhelming. During an emotionally intense experience, attention can become focused on what seems important at the time, particularly anything connected with danger or the need to respond. The experience may therefore be remembered differently from an ordinary everyday event.

Some details can remain unusually vivid, whilst other parts of what happened are less clear. A person may remember a particular image or physical sensation very strongly without necessarily understanding why that detail has remained so powerful. Someone involved in a serious road accident may remember the sound of braking or the sensation of the seatbelt against their chest particularly vividly, whilst other details of the journey are much less clear.

The meaning of an experience also matters. An event that fundamentally changed how safe a person feels in the world may continue to carry emotional significance long after the circumstances themselves have changed.

A difficult memory is therefore connected not only to what happened, but to what the experience came to represent. It is not always experienced simply as a thought about the past. Something in the present that resembles part of an earlier experience can sometimes bring aspects of the associated emotional or physical response into awareness before the person has consciously identified what has triggered it.

A particular environment or somebody’s tone of voice may become associated with what happened. So can a bodily sensation. The response can then seem confusing because the person may recognise that the present situation is different whilst still feeling affected by something that belongs to the past.

Why emotionally significant experiences can stay with us

The brain is constantly assessing what matters and what may require a response. Experiences associated with danger or intense emotional arousal can therefore receive considerable attention. Remembering something that was threatening can have a protective purpose because it may help us recognise similar circumstances in the future.

Most of the time, difficult experiences become integrated into our broader understanding of the past. We may remember what happened and still feel sadness or discomfort when we think about it, whilst retaining a sense that the event has ended and belongs to another part of our lives.

After a particularly frightening or overwhelming experience, that process does not always happen in the same way. The memory may remain closely associated with some of the sensations or sense of threat that accompanied the original event. Later, something that resembles part of the experience can activate a response even when the circumstances are objectively different.

This does not necessarily mean that the person believes they are back in the original situation. They may understand very clearly that they are safe. The difficulty can be that their emotional or physical response does not always reflect what they know intellectually.

That distinction becomes particularly important when looking at trauma-related difficulties. Knowing what happened and understanding that it is over are not always enough to change the way an experience continues to affect someone.

When difficult memories become more than memories

Having a distressing or vivid memory does not in itself mean that someone has PTSD. Many people experience traumatic events and, over time, are able to incorporate what happened into their understanding of their lives without developing a trauma-related disorder. 

PTSD can develop after experiencing or witnessing an event involving actual or threatened death, serious injury or violence. It can affect people who have experienced an event directly, witnessed something happening to another person, learned that a traumatic event happened to someone close to them, or been repeatedly exposed to details of traumatic events through their work.

The condition involves a persistent pattern of symptoms rather than simply having an upsetting memory. These can include unwanted recollections, nightmares or flashbacks, avoidance of reminders of what happened, and changes in emotional and physiological responses. Some people become particularly alert to possible danger, while others may feel detached or emotionally numb. Sleep, concentration, mood, and everyday functioning can also be affected.

For some people, this can begin to affect ordinary parts of life. They may find it harder to concentrate at work, sleep properly, or feel comfortable in situations they previously took for granted.

What matters clinically is therefore not simply whether someone remembers something vividly. Clinicians need to consider the wider pattern of symptoms, how long they have persisted and the extent to which they are affecting the person’s life.

PTSD can follow a single traumatic event, but it can also develop after repeated or prolonged exposure to trauma. The nature of the experience is only part of the picture. People respond to traumatic events in different ways, and experiencing trauma does not inevitably lead to PTSD.

PTSD and CPTSD are not quite the same

Complex PTSD, or CPTSD, is recognised as a distinct diagnosis within the World Health Organization’s ICD-11. It includes the core symptoms of PTSD alongside what are described as disturbances in self-organisation. These involve difficulties with emotional regulation, a persistently negative sense of self and difficulties in relationships.

CPTSD is often associated with prolonged or repeated experiences of trauma, particularly circumstances that have been difficult to escape. However, it would be misleading to suggest that prolonged or repeated trauma automatically results in CPTSD. The ICD-11 diagnosis is based on the pattern of difficulties a person is experiencing, rather than simply the nature or duration of what happened to them.

The distinction between PTSD and CPTSD can be useful because it recognises that the effects of trauma may extend beyond memories and responses to perceived danger. For some people, what has happened may also have affected their relationship with themselves or their ability to regulate emotions. It may have changed what they expect from other people.

This can be particularly important clinically. A person may seek help because of anxiety, difficulties in relationships or a persistent sense of worthlessness without initially connecting those experiences with events from much earlier in their life. Equally, not every difficulty in these areas has a traumatic origin.

Understanding the history behind a person’s difficulties therefore matters as much as identifying individual symptoms. Trauma-related problems can overlap with other mental health conditions, and a person’s experiences may be complicated by other psychological or psychiatric concerns.

At Ibiza Calm, psychological assessment takes place alongside psychiatric input where appropriate. This allows trauma-related symptoms to be considered within the wider context of a person’s mental health rather than in isolation.

Knowing that you are safe does not always make you feel safe

One of the more difficult aspects of trauma-related symptoms can be the gap between intellectual understanding and emotional experience.

Someone may know that an event happened years ago. They may know that the person involved is no longer in their life, or that the circumstances that once placed them at risk have changed. Yet a particular situation or reminder can still produce a strong reaction.

This can be confusing, particularly when someone feels that they should have moved on because they understand what happened and can recognise that they are safe now.

Previous experiences can influence how the brain and body interpret what is happening in the present. When something resembles an earlier threat, a response can sometimes be activated before the person has consciously connected it with the past.

This may help explain why someone experiences a racing heart, heightened alertness or a powerful emotional reaction without immediately understanding where the response has come from. The reaction may make more sense once it is considered in the context of the person’s history.

Clinically, this distinction is important. A person may understand their circumstances perfectly well whilst still experiencing responses that feel outside their control. Exploring what someone understands about their experience, alongside the way they continue to respond to it, can give clinicians a more complete picture.

This is one reason trauma-informed assessment is rarely limited to asking whether someone remembers an event. The clinician also needs to understand how the experience is affecting the person’s life in the present.

Understanding this does not mean that every strong reaction has a traumatic explanation. It does, however, offer another way of making sense of symptoms that can otherwise feel confusing or difficult to control.

Where does EMDR fit?

EMDR, or eye movement desensitisation and reprocessing, is an evidence-based psychological therapy used in the treatment of PTSD. NICE recommends, EMDR for adults with PTSD or clinically important PTSD symptoms in specified circumstances, and recommends that it is delivered according to a structured approach by trained practitioners with ongoing supervision.

The therapy involves bringing aspects of a distressing memory to mind while engaging in bilateral stimulation, most commonly guided eye movements. Other forms of bilateral stimulation, such as alternating sounds or tapping, may also be used where appropriate.

EMDR is not intended to erase a memory or alter the historical reality of what happened. The person will still know what happened. The aim is to help distressing memories become less emotionally overwhelming and less disruptive in the present.

One way of understanding the process is that the person attends to aspects of the past while also paying attention to something happening in the present, such as the therapist’s guided eye movements. The therapist supports the person throughout the process, helping them notice what arises and allowing the memory to be approached in a structured and contained way.

The precise mechanisms through which EMDR produces its effects continue to be studied. It is therefore more appropriate to describe its clinical purpose than to present one particular explanation of what is happening in the brain. Current WHO guidance identifies EMDR alongside trauma-focused cognitive behavioural therapy among the psychological interventions with the strongest evidence for PTSD.

EMDR is also not simply a matter of revisiting a difficult event. Deciding what to work on, when to approach it and whether the person is ready for reprocessing requires clinical judgement. This can be particularly important where trauma exists alongside other psychological or psychiatric difficulties, or where a person’s experiences have been prolonged or complex.

Before reprocessing begins, the therapist considers the person’s history, current difficulties and whether EMDR is appropriate. Preparation may include psychoeducation and developing ways of managing distress before difficult material is approached. NICE recommends a phased approach that includes preparation, identification, and treatment of target memories, and strategies for managing distressing memories and situations.

The treatment is structured and may take a number of sessions. NICE states that EMDR for adults will typically be provided over eight to twelve sessions, although more may be appropriate when clinically indicated, including where someone has experienced multiple traumas.

EMDR within a wider clinical approach

At Ibiza Calm, EMDR forms part of a broader clinical approach to mental health and trauma-related difficulties. The therapy is supported by members of our clinical team who have specific training in EMDR, alongside experience across a range of psychological and psychiatric approaches.

Our Medical Director, Dr Manuel Rodríguez, is trained in EMDR as well as psychotherapy, relational psychoanalysis, strategic therapy and psychodrama. His clinical work also includes the care of people with severe mental health disorders and addictions, bringing psychiatric experience to the assessment and treatment of complex presentations.

Paula Gálvez, our Assistant Manager and Clinical Psychologist, is also trained in EMDR. Her wider training includes Sensorimotor Psychotherapy, Prolonged Exposure, Interpersonal Psychotherapy, Intensive Short-Term Dynamic Psychotherapy and Radically Open DBT, alongside specialist training in the treatment of dissociative disorders.

That breadth of experience matters because trauma rarely exists in a neat clinical category. Someone may arrive for treatment because they are struggling with depression, anxiety, substance use, or relationships, without initially seeing those difficulties as connected to what happened to them. The presence of trauma does not necessarily make trauma-focused therapy the first or only priority.

Treatment therefore needs to begin with an understanding of the individual circumstances in which the difficulties have developed. A trauma-informed approach does not assume that everyone who has experienced trauma needs the same therapy, at the same point, or for the same reasons.

The wider clinical picture can influence how treatment is approached and what needs to happen before particular therapeutic work begins. This is where psychiatric assessment and psychological formulation can be particularly valuable. They help clinicians understand not only what symptoms are present, but how those difficulties fit together.

When the past continues to affect the present

The fact that an experience remains vivid does not, by itself, indicate PTSD or CPTSD. Some memories remain powerful because they were important, painful or life-changing, whilst others may continue to cause significant distress and require clinical support.

Understanding the difference matters. It allows difficult experiences to be taken seriously without treating every painful memory as a disorder, whilst recognising that trauma can affect people in very different ways.

For someone experiencing persistent trauma-related symptoms, appropriate psychological treatment can provide a way of understanding what is happening and working towards a different relationship with distressing memories. The most appropriate approach will depend on the person’s history and current circumstances.

At Ibiza Calm, this assessment takes place within a multidisciplinary clinical environment, where psychological and psychiatric care can be considered alongside one another. EMDR is one of several therapeutic approaches available, and is supported by clinicians with specific training in the therapy and experience across other evidence-based psychological approaches.

The aim is not simply to revisit what happened. It is to understand how past experiences may still be affecting a person’s life, and to provide appropriate clinical support for addressing those difficulties.