Background: There are well-evidenced and effective psychological treatments for posttraumatic stress disorder (PTSD), but reliving or re-processing of the trauma memory isusually a key element (Seedat & Stein, 2001). Evidence from the field of traumatic braininjury and drug-facilitated sexual assault has shown that it is possible to experience PTSDwithout being able to recall the preceding traumatic event. Apart from two recentpublications (May et al., 2022; Woodward, 2020), there is limited guidance for therapistson whether psychological treatments are appropriate or how they should be implemented.Objective: This study aimed to understand the experiences of therapists who work withclients without trauma memories. Method: Interpretative phenomenological analysis was7used to explore the lived experience of ten therapists who worked with clients withouttrauma memories. Participants were recruited via social media and completed semistructured interviews via videoconference. Results: Three superordinate themes wereidentified: i) the differences in presentation and understanding of PTSD when clients lackmemory; ii) the challenges for the therapist; and iii) what works in therapy. ‘Differences’included acknowledging the specific clinical presentation of PTSD without memories; themeaning of clients’ memory gaps and what remains; and clients without memories makingtherapists think differently about PTSD. ‘Challenges’ in managing their own emotionalresponse and uncertainty over how best to support clients without memories led toreluctance in some therapists to let go of their preferred approach. Therapists identifiedthat ‘what works’ with clients without trauma memories includes accepting andnormalising the fallibility of memory and refocusing interventions away from memoryand onto impact of the trauma. Therapists highlighted that core trauma therapy skills arestill relevant but may need adapting. Conclusions: Whilst therapists described a range ofuseful ways to effectively support clients without memories, further research is needed toassess the appropriateness and acceptability of PTSD therapy for this client group.Keywords: PSTD; post-traumatic stress disorder; memory; therapy; IPA; interpretivephenomenological analysis.
- post-traumatic stress disorder
- interpretive phenomenological analysis
- military mental health
- traumatic brain injury