Your week was a rollercoaster. Friday's work email sent you into a spiral of anger. Wednesday brought an anxiety attack that felt like it came out of nowhere. And somewhere in the middle, a trauma memory exercise dropped in intensity from 100% to 30%.

So which is it—are you getting better or worse?

If you're interpreting that anxiety attack as evidence that therapy isn't working, you're not alone. Most people assume that healing should feel like steady improvement. Good day follows good day. Symptoms gradually fade. Progress looks like a smooth upward line.

But that assumption is wrong. And it's keeping millions of people from recognizing real healing when it's happening.

What Research Shows About Symptom Spikes

Here's what the research actually shows: temporary symptom increases during trauma therapy occur in only about 11% of clients. That's the first surprise—most people don't experience them at all.

But here's the bigger surprise: when those increases do occur, they actually tend to predict better outcomes. Not worse. Better.

Research published in clinical psychology journals found that a specific pattern—symptoms that increase and then decrease—predicts more improvement in post-treatment outcomes. The inverted U. Things get worse, then they get better. And that temporary worsening? It's a sign you're doing the work, not a sign the work isn't working.

Think about what happened with that memory exercise. Before you engaged with it, the intensity was at 100%. Overwhelming. Your therapist asked you to stay with it, not pull away. And afterward?

30%.

A 70% drop. That's exactly what evidence-based trauma treatment predicts. Studies on prolonged exposure therapy show that 83% of people who complete this process no longer meet the criteria for PTSD six years later. Six years. With large effect sizes regardless of what type of trauma they experienced.

You already have proof that engagement works. The anxiety attack isn't evidence against that proof—it's what happens when you're doing deep work and stirring up material you've kept buried.

You Can't Clean a Wound Without Opening It

Consider the analogy your therapist might use: you can't clean out a wound without first opening it up. The opening hurts more than leaving it sealed. But which one actually leads to healing?

Leaving it sealed feels safer. Less painful in the moment. But the infection stays trapped inside.

That Wednesday anxiety attack? That was the wound being opened. It felt worse than your normal baseline. But baseline wasn't health—baseline was a sealed-over wound that never healed.

Your therapist told you this would happen. "When you really allow yourself to go into it properly, emotions get worse and everything gets raw." And then it happened. That's not a setback. That's the process working exactly as predicted.

Why Small Things Trigger Big Reactions

Now let's talk about Friday. Someone who'd been silent for two weeks suddenly emailed demanding something by Monday. You felt disrespected, disregarded, like you don't matter.

And then you noticed something: "That's exactly how I felt as a child."

That recognition is significant. The email was annoying, sure. But the intensity of your reaction didn't match what actually happened. A normal response would be irritation. You felt devastated.

There's an invisible mechanism at work here.

Psychologists call them Early Maladaptive Schemas—patterns that form in childhood when core emotional needs aren't met. They're like templates your brain created to make sense of the world when you were young. And they don't know you've grown up.

When something in the present resembles something from the past—being disregarded, dismissed, treated like you don't matter—the schema activates. Your nervous system doesn't respond to the 2024 work email. It responds like you're still that child who was made to feel invisible.

This is why Greek colleagues trigger you but Austrian colleagues don't. The Greek interactions are happening in the language of the original wound. Same words, same cultural context, same hierarchical dynamics around formal and informal speech. Your schema recognizes the pattern and fires.

Austrian colleagues are like a different operating system. The schema doesn't recognize them as relevant to the old injury.

The Hidden Cost of Cultural Avoidance

Here's where we need to talk about Greece.

You haven't been there in 18 years. You won't travel there. You won't visit your hometown. You won't see your parents. You don't listen to Greek music. You never express love for the Greek things you actually love.

Eighteen years of avoidance.

Most people would call that self-protection. Staying away from things that hurt. But here's what most people don't understand about avoidance: it doesn't resolve trauma. It maintains it.

Every time you avoid something Greek, you're sending a message to your nervous system: "This is still dangerous." The fear never gets updated. The brain never learns that Greek music won't destroy you, that images of your hometown won't break you, that the language of your childhood can exist without the pain of your childhood.

The wound stays sealed. And infected.

Cultural avoidance is a recognized form of PTSD avoidance behavior. It shows up in research alongside other avoidance patterns—avoiding places, people, conversations, memories. And the clinical evidence is clear: approaching what you've avoided, not running from it, is what produces lasting symptom reduction.

You've been protecting yourself for 18 years. That protection was real. Your system was trying to keep you safe. But the protection that served you at 25 is now keeping you stuck at 43.

You Already Have Proof This Works

Look at what you already know:

• Before engaging with the memory: 100% intensity
• After engaging with the memory: 30% intensity
• Reduction: 70%

That's not hope. That's data. From your own experience.

Now apply the same logic to Greek culture. If engagement leads to reduction and avoidance maintains the wound, what happens when you start engaging with all those Greek things you've been avoiding?

The same thing. It will feel intense at first—like going into the memory did. But then it should start to lose its grip on you. The music, the language, thinking about your hometown—they won't carry the same charge anymore.

Your therapist's homework isn't random: listen to Greek music, watch Greek TV, look at images of your hometown, spend Christmas in Greece. These are exposure exercises. The same principle that dropped that memory from 100% to 30%.

How to Face What You've Been Avoiding

This changes how you might think about that Christmas trip.

Instead of something to endure, it becomes an opportunity—the biggest exposure exercise you could do. You can approach it with intention: notice what gets triggered, track the intensity, see if it changes over the course of the visit.

And here's what you already discovered: you have things you actually love about Greek culture. Music that used to make you feel alive. Parts of your heritage that bring you joy. You've been suppressing them along with the pain.

Exposure doesn't mean forcing yourself through misery. It means allowing yourself to feel all of it—the difficult and the beautiful. Letting yourself enjoy the things you love about being there instead of bracing for impact the whole time.

What the worst case looks like: You might feel sad. Overwhelmed. You might cry. But you felt all of that during the memory exercise too. And you survived. And afterward, you felt better.

What you have that helps: Your partner of eight years. Your Austrian colleagues. Relationships that don't trigger the old patterns. You can use these as anchors when the Greek interactions get intense. You don't have to do this alone.

What Actually Counts as Progress

You came in thinking the anxiety attack was evidence that therapy might not be working. That you might be fooling yourself.

But the anxiety attack isn't the data point. The memory exercise is the data point.

And that data is good. A 70% reduction is exactly what the research predicts for successful trauma processing. The temporary intensity is part of the process, not a contradiction of it.

The path forward isn't about eliminating all discomfort. It's about walking toward it strategically, knowing it's the way through. The avoidance that felt protective was actually keeping you stuck. The engagement that feels scary is actually what heals.

You already proved this works. Now you get to apply it more broadly—to the music, the language, the hometown, the culture you've kept at arm's length for 18 years.

Not because you have to endure it. Because buried under all that avoidance are things you actually love. And they've been waiting for you to come back.

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What happens when those old schemas get triggered in real-time—not during planned exposure exercises, but in the middle of your workday when a Greek colleague's email hits that childhood wound? That's where the next level of this work begins: learning to recognize the pattern as it's happening, so you can choose how to respond instead of being hijacked by a reaction that's decades old.

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What's Next

How do you handle it when exposure work triggers schema activation in real-time—like when a Greek colleague interaction hits that 'disrespected child' wound during the workday?