Table 2.

Example hotspots and updates for ICU trauma memories

	Example update
I’m going to die, I’m never going to see my family again	I didn’t die, I’m alive. I can show myself this by looking in the mirror and moving about. I see my family most days. I can remind myself of this by looking at a recent photo of us together
I can’t speak/no-one is listening to me	I couldn’t speak because I had a tracheostomy/was on a ventilator. I needed it at the time to help me breathe. Even though I couldn’t communicate with them, people were looking after me. Now I can speak and people listen to me. I can prove this by saying this update out loud
I can’t breathe, I’m suffocating	It was difficult for me to breathe because I had pneumonia in my lungs. I was on a ventilator which was helping me breathe. Now, the illness has gone and I can breathe. I can show myself this by taking some deep, slow breaths or exercising
I can’t move, I’m in danger	I couldn’t move because I was in a hospital bed with lots of medical equipment connected to me, and I was on lots of sedating medication. Although I was very ill, I was being given the treatment I needed to save my life. People were looking after me. I can move now. I can show myself this by standing up and moving about freely
I’m on my own, nobody cares	There are lots of staff in ICU but they are very busy and they had lots of people to look after. Visitors weren’t allowed, but I didn’t know that so it makes sense I felt alone. Lots of people care about me. I can remind myself of this by reading all the nice ‘get well’ cards and messages I have had
The doctors and nurses are trying to kill me	I was experiencing delirium which is very common in ICU because of all the medication. People often believe staff are trying to kill them. The things they were doing were part of my medical treatment to keep me alive, but I didn’t know this at the time. They were trying to help me. I can prove this to myself by watching videos of staff in ICU, by returning to the ward and reading the information about emergency tracheotomies the nurse/other expert emailed my therapist
I’m being sexually assaulted	The nurses needed to touch me intimately for medical reasons, like washing me, changing/cleaning my catheter and taking a swab to test for infections (my partner told me this happened at least once). In my confused half-sleep/half-wake medicated state, I didn’t understand why they were touching me then. If someone touches your private parts and you don’t understand why, it makes sense that you might think they are sexually assaulting you, especially because this happened to me in the past. I know now that they weren’t assaulting me. I can remind myself of this by watching the video of the friendly ICU nurse explaining how they care for patients. No-one is touching me now. I have control back over my body and who touches it. I can remind myself of this by looking around to see that there is no-one there, and by gently stroking my skin
I have been abducted	I believed I had been abducted because I woke up in an unfamiliar place and my mind was playing tricks on me because of the drugs I was given. I wasn’t abducted, I was safe in hospital the whole time. I can remind myself of bringing to mind an image of nurses caring for me kindly, even though I wasn’t aware of them at the time
I was in a spaceship/floating down a river/on a journey	Beds in the ICU move to prevent pressure sores. This made me feel like I was moving, and it got mixed up in the dreams I was having. I can remind myself of this by imagining that the spaceship landed safely/I washed safely out of the river/I got home at the end of the journey. I can look around to show myself I am safe in my home now