So how does one access the inner trauma sanctum? As it turns out, images help where words fail. In some cases, even images of the trauma: Exposure therapy, to name one now-established type of what's called cognitive behavioral therapy, has the patient imagine the trauma repeatedly -- under strictly controlled circumstances -- until the concomitant reactions (panic, etc.) begin to abate. It's more than a matter of telling yourself, "See, it's over, I'm safe now"; it's training the body to not go into panic mode.

Therapists may also use metaphors to soothe and dislodge trauma, to "sidestep the [verbal] booby traps that set symptoms off and create more distress," says Naparstek. One of many image- or metaphor-based techniques is "guided imagery," which Naparstek calls "deliberate, directed daydreaming." It's kind of like meditation, only with someone guiding your experience: a voice (live or recorded) suggesting that you imagine certain safe spaces or soothing sensations, each specifically designed to address a particular condition. Research has found that guided imagery can help alleviate ills including diabetes, bulimia and anxiety -- and that it may be particularly helpful for trauma. Even though words are its medium, the language of guided imagery isn't directly processed by the brain's advanced speech and thought centers. Rather, the sensations and associations that listening to it produces -- such as the presence of a benevolent, protective companion, along with reassuring voice tones and soothing music -- are absorbed directly into the primitive brain: exactly where the trauma has set up shop.

Numerous other image-related therapies are gaining in respect and reputation, including eye movement desensitization and reprocessing, in which the patient is gradually desensitized to an image of personal trauma by envisioning it while also being distracted by an additional stimulus: moving the eyes back and forth, being tapped on the body or hearing tones from a headset. The Department of Defense has approved the use of EMDR as one of several therapies for treating soldiers with PTSD.

There's also a method called somatic experiencing in which patients are not asked to "describe exactly what happened" from beginning to end but, rather, are asked to imagine -- and physically mime -- elements of the trauma, sometimes resulting in an imagined alternative outcome. "The body doesn't like surprise," says Nancy Napier, a Manhattan family and trauma therapist who uses somatic experiencing in her practice. She explains that when we're startled by a loud noise, for example, our reflexive "orienting response" causes us instantly to look for its source. If someone comes up behind you, say, "the body gets caught in that moment of surprise," she says. "So part of the [SE] treatment is to complete the orienting response." Napier might, for example, have an attack victim go, inch by inch, through the motions of looking behind her, focusing on her feelings each time, only to ultimately confirm that there is no longer an attacker there. Somatic experiencing "works to bring the nervous system up-to-date so that it's no longer locked in unresolved moments of trauma," says Napier. Mentally and physically re-creating -- and reimagining -- the situation, practitioners say, is much more effective than, say, just telling yourself you're going to be OK. It's a matter, once again, of circumventing the verbal and accessing the physical, primitive and intuitive areas where trauma -- and the means to heal it -- is stored.

As for Frannie, her ultimate breakthrough came when Naparstek suggested she visit someone who works with "somatic psychotherapy" -- a means of helping patients work through trauma (or other issues) via perceiving and describing internal sensations in the body. "I thought it was bullshit," Frannie says. "Then one day I was lying on the table and [the therapist] asked me to describe my heart. And I said, 'Well, it's a boulder in my chest, a frozen stone, a cannonball; you can't penetrate it.' And I realized that that was the place where I could start working, to 'melt' that heart of stone."

Sure, it's just a metaphor, and it might even sound corny, but for Frannie, discovering the "stone" was progress. Frannie found she could describe the stone in a way that she could not describe her feelings, at least not without triggering flashbacks. It served as a stand-in for her emotions, a metaphorical repository for the effects of her experiences. "It was a way of getting to the same place that words would have brought us to had her language capacity not been so hobbled," says Naparstek.

Over time -- in Frannie's mind's eye -- the "stone" went from hot and ugly to soft and malleable, and ultimately melted away, leaving an image of her real-live heart in its place. "My heart is back," says Frannie, who is virtually symptom-free but for a still overprimed startle response. "I'm connected to myself now."

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