Ellert R. S. Nijenhuis and Onno van der Hart
Traumatized individuals alternate, in varying degrees of mutual exclusiveness, between states of consciousness in which they experience their trauma over and over again, as if it were happening here and now, and episodes in which they are relatively unaware of trauma, on the surface undisturbed. This basic pattern of posttraumatic stress has been noted for the past hundred years by students of psychotraumatology ( Brett and Ostroff 1985; Freud 1919; Horowitz 1986; Janet 1889, 1898,1904; Kardiner 1946; Krystal 1969; Lindemann 1944; Myers 1940; Spiegel, Hunt and Dondershine 1988; van der Kolk and Ducey 1989).
In a little-known but important work, Myers ( 1940, 67) aptly referred to these alternating states as the "emotional personality" and the "apparently normal personality," metaphorical expressions we will use throughout this chapter. Studying severely traumatized combat soldiers with posttraumatic stress disorder (PTSD), Myers observed that the "emotional personality" suffers vivid, painful memories and images associated with overwhelming and threatening experience. As van der Kolk, van der Hart and Marmar put it: "'Memories' of the trauma are initially reexperienced as fragments of the sensory components of the event -- as visual images; olfactory, auditory, or kinesthetic sensations; or intense waves of feelings that patients usually