RTM Therapy: How Reconsolidation of Traumatic Memories Therapy Can Treat PTSD

There are many mental health therapies for people dealing with trauma and post-traumatic stress disorder (PTSD). Examples include cognitive processing therapy (CPT), eye movement desensitization and reprocessing (EMDR), and prolonged exposure (PE).  

In recent years, a new trauma therapy — reconsolidation of traumatic memories (RTM) — has shown great promise. It was developed by Frank Bourke, PhD, as a treatment for 9/11 survivors. If you have PTSD or have experienced trauma, it may be a good fit for you. 

What is reconsolidation of traumatic memories (RTM) therapy?

Reconsolidation of traumatic memories (RTM) is a type of therapy developed to treat symptoms of PTSD or trauma. It focuses on restructuring a traumatic memory into a reflection of the past that feels nonthreatening. You do this by changing elements of the memory with the support of a trained therapist. For example, you may recall the event in black and white instead of in color.

RTM is designed to help you separate the traumatic memory from the traumatic feelings associated with the memory. In other words, the memory would no longer trigger a severe traumatic response. You could get to a place where you can talk about the event without feeling panic.

What does RTM therapy treat?

RTM has successfully treated people who have experienced traumatic events and have PTSD as a result. RTM has treated male and female veterans and service members who have experienced combat or sexual trauma.

There’s also some evidence that RTM can effectively treat other types of trauma, such as:

• Family violence

• First responder trauma exposure

• Sexual abuse

• School-related traumas such as bullying

• Traffic accidents

RTM may also ease depression and anxiety symptoms associated with PTSD. 

How does RTM therapy work?

RTM deals directly with memories that trigger disruptive psychological responses, such as nightmares or flashbacks. Once you’ve identified a traumatic memory, an RTM-trained therapist will take you through a process to “reconsolidate” or change the memory. 

“We take our clients through a series of visualizations,” said Angelica Villicana, LCSW, clinical director of The Family Connection in Albuquerque, New Mexico, and an RTM-certified therapist. “The visualizations are movies we create to assist in working through the trauma in a safe way.” 

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You typically start RTM with a practice session. Your therapist will ask you to pick a neutral event, like getting dressed in the morning or cooking dinner. Then you turn it into a movie in your mind.

“We would practice the visualizations and create movies that don’t create excitement or anxiety,” Villicana said. “Then we would go to the traumatic event once the client is ready.”

As you work through the memory, you’ll change certain things about your visualizations and your movie. Your therapist may ask you to see it in black and white or change the distance. 

“When we change the movie or things from the traumatic event, it helps us reduce the impact,” Villicana said.

After walking you through the visualizations and making sure your anxiety level is manageable, your therapist would then take you through the protocol steps listed below. 

RTM therapy protocol

RTM therapy can vary slightly from one therapist to the next. However, all RTM-trained counselors typically follow these basic protocol steps:

1. You start by telling your therapist about a traumatic event.

2. If you experience anxiety during the retelling, your therapist will bring you back to the present and guide you through grounding exercises. They’ll also rate your level of distress.

3. When you’re ready to move forward, you’ll give the traumatic event a neutral name.

4. Your therapist will ask you to choose “bookends” — events that happened before and after the trauma.

5. Next, you’ll create a movie theater in your mind and play the “before” event in black and white.

6. Then you’ll watch yourself respond to the events from bookend to bookend in black and white. During this step, you can make changes to the movie until you feel the traumatic memory is less distressing.

7. Next, you’ll step into the last frame of the movie. Here you’ll add sound, color, and dimensions, followed by a 2-second rewind of the entire movie. You’ll repeat this step until you feel more at ease. 

8. At this point, your therapist will evaluate your trauma response and decide if any of the previous steps need to be repeated or if you’re ready to keep going.

9. If your therapist thinks you’re ready, they’ll ask you to create and rehearse versions of the event that don’t feel as traumatizing. They’ll also assess your level of anxiety.

10. Treatment ends when you no longer panic as you recount the traumatic events you’ve focused on. 

Is RTM therapy safe?

RTM is safe when guided by a certified clinician. It’s best not to attempt it by yourself. And it may not be the right therapy for everyone.

If you’re interested in trying RTM, you can look for an RTM-trained counselor using the Reconsolidation of Traumatic Memories Protocol’s provider search tool. 

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Written by:

Ana Gascon

Ana Gascon has over 15 years of writing and editing experience, with 8 years in health and medical content work. She is a versatile health and medical content creator who writes about acute conditions, chronic diseases, mental health challenges, and health equity.

Edited by:

Renée Fabian, MA

Renée Fabian is the senior pet health editor at GoodRx. She’s worked for nearly 10 years as a journalist and editor across a wide range of health and well-being topics.

Reviewed by:

India B. Gomez, PhD

India B. Gomez, PhD, is a licensed clinical psychologist with a certificate in Latin American Family Therapy. She completed her doctoral education at the California School of Professional Psychology/Alliant International University.

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