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Focusing on the present is often effective but not always sufficient for trauma-based fears.

Traumatic memories can keep the brain locked in a state of helplessness.

A technique called "memory rescripting" can help dissolve fear by replacing helplessness with empowerment.

Content warning: The story you’re about to hear is quite graphic, with references to childhood sexual abuse and sexual assault.

While I've built my whole career on helping people challenge and crush their negative thoughts in the here-and-now, let me tell you the story of a woman whose recovery required us to revisit a traumatic event from her childhood. I used a powerful technique called memory rescripting, developed in the 1990s by Drs. Merv Smucker, Edna Foa, and colleagues.1

Since then, a number of newer studies have supported memory rescripting as a promising treatment for some trauma survivors. Like every technique in therapy, it won’t be for everyone—for certain patients, however, it can be helpful2, 3, 4 as you'll see in this article.

The story features a young woman who came for the treatment of agoraphobia. Her fear was specific and intense: public transportation. Buses, trains, taxis, airplanes—any form of public transportation where she couldn’t immediately escape filled her with terror.

Aside from that, she was doing well. She was a bright student at a top university, highly motivated, and genuinely pleasant to work with. She completed her written homework faithfully, identifying and challenging distorted negative thoughts associated with her anxiety. On paper, she was an ideal CBT patient.

But there was one problem. With anxiety patients, I always include exposure techniques, where you safely and gradually confront feared situations, so you can learn that the feared consequences do not occur. Sadly, I could not persuade her to do exposure.

I tried everything. I even offered an extremely gentle form of exposure—one I thought was almost foolproof. She would get on a Philadelphia bus, and I would be waiting for her at the next stop, just a couple of blocks away. That way, she wouldn’t be moving toward danger, but toward safety.

Even that was too much. She refused.

I was puzzled. She was cooperative, motivated, and clearly wanted help. But fear can be overpowering, much like severe physical pain, and logic alone rarely overcomes it.

One day, she told me something she had never shared with anyone.

She lived with her mother, a single parent and businesswoman. When she was a young girl, her mother often went out for the evening, and an older boy who lived next door would come over to babysit. Once he thought she was asleep, he would creep........

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