Trauma and PTSD When events happen in our lives, memories are formed and those memories are connected to feelings and thoughts. What usually happens to memories is that they are processed by the mind and the brain and are placed into long-term memory where they are more or less ready for recall. For the most part they have little if any particular emotional charge. Most of the time trauma is processed in a similar way and any severe reactions are short lived.
Sometimes, though, traumatic or difficult events can get “stuck” in the processing, often because the event is so overwhelming to the senses. When this happens, the memories, feelings and thoughts may be easily reactivated by events that are in some way similar to the trauma. This can even happen subconsciously, without remembering the initial event or realizing why you’re feeling or behaving this way. The memories, feelings and thoughts may be experienced as if they are happening in present time. This can lead one to repeat dysfunctional patterns of behavior, sometimes without knowing why. This “stuckness” can also result in PTSD. PTSD is a collection of symptoms including re-experiencing the traumatic event, avoidance or numbing, increased anxiety and emotional sensitivity.
EMDR EMDR is a therapy designed to promote insight and reduce the intensity of disturbing, difficult, or traumatic feelings, thoughts and memories. For instance, it is possible that a frightening childhood encounter with a dog still carries the immediacy of the event even into adulthood leading to a habit of anxiety and avoidance of dogs. With EMDR it is possible to reduce the urgency and fear that is part of that memory and, therefore, change one’s anxiety about dogs.
EMDR can be effective in addressing a wide variety of issues including trauma, grief, disturbing memories, stress and the dysfunctional behavior patterns that may interfere with the enjoyment of life. It uses imagination and rhythmic stimulation of sight, vibration or sound to help process disturbing feelings, memories or thoughts. EMDR can be thought of as a healing inner journey that "reprocesses" stuck emotional reactions to past experiences. It engages the mind and the body to shift one's experience of life difficulties.
EMDR stands for Eye Movement Desensitization and Reprocessing. Early in its development, EMDR involved rapidly shifting one’s gaze back and forth. Since then this dual-attention stimulation is often achieved through handheld “pulsers” that alternate vibrations similar to a cell phone between the right and left hands. Desensitization refers to reducing the intensity of the feeling, thought or memory. Reprocessing indicates that the memory, feeling, or thought wasn’t completely processed at the time of the event and describes placing the memory in long-term storage rather than keeping it at hand as though the event were still imminent.
The EMDR Session EMDR does not depend on understanding one’s experience by talking about it. Instead, relief and insight comes as the difficult memories, thoughts and feelings are reprocessed in a way that compliments the brain’s natural memory processing.
EMDR also does not require long periods of multiple repetitions of the story of one’s trauma in order to dull the experience of the difficult memory, thought or feeling. EMDR works instead to integrate the memory fragments, processing them and storing them in long-term memory, where they belong.
The goal with EMDR is not to change your memories but to help the nervous system stand down from its fight, flight, or freeze response to the unprocessed distress.
If you’d like to explore EMDR you and I will have a conversation first in order to gauge whether EMDR is suitable for your concerns and a good fit for you. It is possible that, before beginning EMDR, you will need to do some preliminary work such as learning to tolerate difficult or intense emotions.
In preparation for EMDR you will be lead through a process to create some inner resources such as an inner peaceful and calm place and a protector figure. Then we will come up with a list of memories, thoughts or feelings to work on. This preliminary work usually takes one or two sessions.
In your first EMDR session I’ll explain how the therapy will work and that you are in control and can stop at any time. You will be invited to sit comfortably and recall an image and it’s associated emotions and body sensations. I’ll begin the dual attention stimulation and invite you to picture the distressing image in your mind’s eye. During the dual attention stimulation you may be silent or you may describe what’s happening for you; in any case, your job is simply to notice what comes up. You do not have to try to remember or figure anything out, just let what comes up, come up. I will be checking in periodically and may re-focus your attention depending on your progress. Progress is measured on a 0 to 10 scale that describes your level of distress. Often there is a marked decrease in distress over the course of a session. If the trauma is more complex it may take multiple sessions to clear an experience.
How EMDR Works Researchers are not certain how EMDR works. There are many theories including:
The eye movements may replicate REM sleep, a stage of sleep associated with processing memories.
The rhythm of the dual attention stimulation may promote a feeling of calm that helps the mind to process traumatic events.
The dual attention stimulation may simply distract the mind from reacting defensively during the desensitization process.
Stimulation of alternating hemispheres of the brain may help to process distressing memories.
No single explanation seems to account for everything that happens with EMDR, but research on EMDR has demonstrated its effectiveness in study situations. You can explore the research for yourself at the EMDRIA.org website, go to the “Resources” tab and click on “EMDR Related Research.”
How Do I Know if EMDR is For Me? As with any therapy, the fit between the client, the therapist and the type of therapy is important. You should get a good idea of these during the first couple of sessions.
For EMDR to be effective you need to have an issue that is distressing enough (we’ll talk about this), be willing to use your imagination, and be able to tolerate the paradox of holding the original distressing memory and a re-imagined version of that memory at the same time.
Other Therapies to Address Trauma There are times when EMDR is not going to be an appropriate therapy. This could be due to client readiness, or the degree of PTSD being experienced among other reasons. In these cases there are other therapies that may be employed including conventional talk therapy, the Flash Technique, and visualizations.