EMDR

What is EMDR?

EMDR stands for Eye Movement Desensitization and Reprocessing.  It is a treatment modality that was originally developed to treat trauma/PtSD.  It has an 8-phase protocol that is used to work with the underlying causes of PTSD.

By now, you should have read something about what causes PTSD or how treatment works.  If not, you might want to check out one of those links.

Somatic Psychotherapy

EMDR is a somatic psychotherapy modality, which means that it works with the body (or more accurately, the part of the mind that is most closely connected to the body, the autonomic nervous system, or ANS).  When traumatic events occur, it is the ANS, not our conscious mind, that responds.  The responses are simple and very basic (most animals can do these things):  Fight, Run, Freeze or Disconnect (we call this “Dissociating”).  These responses can be very adaptive, very helpful, when we are in a threatening situation.  Oftentimes, they will save our lives.

The problem comes later–when the threat is gone.  Sometimes (not all the time), people can feel like the threat is still going on.  We call this PTSD.  It’s fundamentally an ANS problem, and to my way of thinking, an ANS problem requires an ANS solution.  That’s why I’m not a fan of just talking about the traumatic events (many therapists, for example, use a Cognitive Behavioral approach, which I don’t generally use for trauma, as I don’t think it really heals the underlying problem).

In somatic approaches (such as Trauma Dynamics and EMDR), you don’t have to talk as much about what happened.  Certainly we need to talk enough so that you can remember and bring up the memory, but it’s not about giving me the details of the event–I don’t need them.  Somatic therapies help allow the body to heal.  We have to somehow convince the body that the traumatic event is over, by allowing that part of the mind to process it.

How does it help PTSD?

EMDR helps the the mind/body resolve trauma by using what’s called bilateral stimulation.  The most common (and preferred) form of this is working with eye movements.  However, it can be done by using sounds or touch, in several ways.  Bilateral stimulation seems to allow the brain to process traumatic memories faster.  It seems to “jump-start” the healing process.

Why does it work?  We don’t know.  Actually, we don’t know for sure why any therapies work–we just know that some of them do.  We think that it has to do with facilitating communication between the two sides of the brain, which process information differently.  The theory behind this is called the Adaptive Information Processing model.  It explains how EMDR helps your brain turn your trauma from something that feels like it’s still happening into something that happened, and is over.

But you don’t need to know this to use EMDR.  All you need is a therapist who is trained in and willing to follow the proper protocol, one that you trust and who has listened well to you as you have described your issues.

Can something as strange as EMDR really work?

Short answer:  Yes.  And when EMDR works, it’s extremely helpful.  It can sometimes remove 100% of PTSD symptoms.  Of course, childhood trauma is tougher than adult trauma most of the time, and can take longer to resolve.  But still, we are talking about much less time than used to be spent on talking therapies.  In fact, many people used to be in therapy just talking for many years, never getting much better.  This doesn’t happen when EMDR works.  And the research says it works well most of the time.

What about when it doesn’t work well?  Usually there are things we can do to enhance it.  But in the final analysis, it’s up to you.  If you are one of the few people it doesn’t work for, or you’d rather not do it, that’s no problem.  There are other ways to work on PTSD that are helpful and promote healing and can allow you to be successful in reaching your goals (a reduction or elimination of PTSD symptoms).

So when we start talking trauma, I’ll start talking about somatic psychotherapies like EMDR or Trauma Dynamics.  I like to go with what works. 🙂

Religion, Spirituality and Therapy

Sometimes people ask if I work with people from a particular spiritual perspective. How do spirituality and therapy go together? What religion or beliefs do I have? Am I a Christian, an Atheist, a Buddhist?  I’ll respond to this question at the end of this post. Hopefully you will be willing to wait a few minutes for that.

Does religion or spirituality matter? It might.

When I think about why my religion or spiritual beliefs and practices can matter to people, there are a number of things that come to mind.  People come to counseling for support. They want a therapist who will be supportive of them. They certainly don’t want someone who is going to tell them that their beliefs are wrong. But there’s more to it than just this. People may want someone who they have something deep and important in common with. They want someone who will understand. Or, it’s possible that people feel that the difficulties they are facing are spiritual, and they want a spiritual solution. Finally, people might just think that if someone doesn’t share their beliefs, they won’t understand, or they can’t possibly have anything helpful to offer.  Each of these can be an important reason why people would ask a question like the one above. Let’s look at these issues.

Supportive Therapy

Here is an issue that I feel pretty strongly about—if someone comes to me for therapy, I have no business trying to change any of their beliefs to match my own. That’s a bottom line for me. And that sounds simple, but there’s another part to this. All of us have a lot of beliefs. We have beliefs about the world, about God, about other people, about politics, about relationships and more. Lots of beliefs….and all of us have some that work better for us than others.  So sometimes people come in with a problem that they want help for and they have some beliefs about it that seem like they aren’t helping. (These may be spiritual beliefs or other beliefs.) Those beliefs might come up in our conversation. But that’s because they’re relevant to your problem, not because I might disagree with them. (Any two people are going to have different beliefs about something.) And you always get to decide what you want to discuss and what you don’t. It’s my job to be helpful, with you getting to decide what helpful means to you.

So, do religious beliefs sometimes come up in counseling? Yes. Does it matter what my opinion might be about them? It shouldn’t.  You have a right to be supported, and that’s always my goal.

Something in Common

People might feel that if someone doesn’t share their beliefs, they won’t understand their situation. That’s quite possible in some cases. If you have a spiritual problem and you are looking for spiritual guidance, well, I’m not a minister nor a spiritual counselor, so I’m not the person who is going to be most helpful to you.

But one thing that’s very important to ask here is this—is the problem you’re facing really, fundamentally, a spiritual or moral one? Some problems are, but some aren’t. Having a broken arm, cancer or diabetes isn’t a spiritual problem, it’s a physical one. Many psychological problems can have spiritual or moral causes, but many are simply physical (i.e., they are a problem with brain function). If you’ve been relentlessly beaten as a child or ever sexually abused, then there may be spiritual issues involved in some way (the issue of forgiveness could be an example), but the fact that you start shaking when you drive by a certain place or see a picture of it is not—it’s a physical reaction to being traumatized (read about PTSD or childhood trauma here). That’s the part I specialize in.

Treating trauma isn’t fundamentally a matter of spirituality. It’s a matter of helping the brain begin to heal. (Read about trauma treatment.) Like a medical doctor, I’m there to address a certain kind of injury. I’m not there to interfere with your spiritual or religious beliefs. And let’s remember, we all have a lot in common. We’re all people, and we all know struggle and suffering.

Spirituality and Therapy

All that being said, spirituality is important to many people who come to therapy. How will I relate to you as a spiritual person? One word: with respect.  I respect everyone’s right to their beliefs. Of course, there will be some beliefs of various kinds that will change during therapy–our beliefs always change a bit as we go through life and learn its lessons. But your beliefs belong to you. Everyone has a way of finding meaning in life, and whatever that is, it’s your resource.  Strengthening resources is important in trauma therapy (really, in any therapy). So you don’t have to worry about bringing your spirituality and beliefs into the room. I’ll try to support you in your journey as best I can.

So What am I?

I’m a therapist, a professional who works primarily with trauma/PTSD, addiction and anxiety. I generally don’t disclose many other details about myself—whether it’s politics, religion or other matters. The main reason is this—I don’t want you to think that the only reason I can help you is that I’m like you in some way, or that I can’t help you if I’m different.  Neither of those are true, in my experience. I have clients with a lot of different religious beliefs and spiritual practices, many of them different from my own. It all works just fine.

And if you’re working with me on trauma, or PTSD, or something else, and some spiritual issues come up, that’s fine.  I’ll support you as a therapist–which means I support you to solve your problems using whatever method you think will be helpful.  Your spirituality is an important resource for you, and I always encourage people to use their resources.  If you feel you need support on truly spiritual matters, you might be able to get what you need from your minister or a trusted friend.  If not, we can look for a religious or spiritual counselor who might help you.

How Trauma Therapy Works

What should I expect from trauma therapy?  How will I feel?  Will it take long?  How do I know if it’s going well? These are natural questions about how trauma therapy works.  Let’s dive in.

A thousand kinds of trauma

Because trauma can come in many different forms–physical, psychological, sexual, short-term or long-term–trauma therapy will look different for each person.  Some of it will depend on the symptoms you’re facing.  It will depend on your resiliency and your resources.  Yet, no matter what kind of trauma and exactly how it affected you, there are some important similarities.  (For a list of classic PTSD symptoms, read here. Or learn about childhood trauma and its impacts.)  Because of these similarities, all effective trauma treatments share some basic themes.

How trauma therapy works–safety first

The first thing that’s needed to address trauma is safety.  Without it, there can be no recovery.  Why should there be?  Trauma reactions are adaptive–they are actually helpful if you are under threat.  If you’re in the war zone, you’d better wake up at the slightest noise and grab your rifle without thinking.  If you’re in an abusive relationship, you’d better be hypersensitive to your abuser’s moods.  And if you’re being repeatedly beaten or raped week after week, then it’s best if your brain finds a way to just not be there.  Your mind checks you out of reality–it’s the only way to tolerate the intolerable.

But when it’s over, and the traumatic experience isn’t happening anymore, these things, these things that were so helpful while it was happening–they suddenly become symptoms.  You’re avoiding crowds and jumping at small noises, you’re hypersensitive to those around you and fly off the handle at tiny provocations.  Or you find yourself constantly checking out of work, checking out of your marriage.  You don’t feel like you’re there; and that’s because you aren’t.

So where are you?  Well, you’re back in the trauma.  You know it’s over, but your body doesn’t.  It’s not enough for it to actually be over.  You have to somehow fully experience that.  That’s why we start with safety.

Safety means several things.  First, you have to feel safe with your therapist.  If you don’t, find a different one.  Second, you have to be safe in your life.  You can’t still be living with your abuser, you can’t still be tolerating their denial.  You also have to get free from toxic relationships that will trigger your abuse reactions.  For some reason, when we’ve been traumatized, we sometimes unknowingly seek out situations that are similar.  That’s got to stop.  You have to be in control of your life in order to heal.

Remembering

Next comes the heart of how trauma therapy works.  In the past, we used talk therapy alone.  This can work, but it takes a long time (sometimes many years).  Nowadays, we have powerful techniques which are based on working with the body, such as EMDR.  They’re often very effective, and usually shorter.  Sometimes a lot shorter.

Trauma therapy helps your brain/body process the memory of the trauma.  Even though you may not remember it well, your body remembers it.  Your body remembers every blow, every word, every move your perpetrator made, and it remembers not only what happened and what you did to try to help and defend yourself, but also what your body wanted to do.  The problem is, this memory is stuck.  The brain hasn’t put it into place, the way it does with normal memories.  Once it has done this, the trauma goes from being something that is still happening to something that happened in the past.  It’s a bad thing, for sure, but a bad thing that is finally over.

Why use special techniques?

There are a number of special techniques that can be helpful here.  I’m trained in several of them, and they can be very effective.  They work with what is happening in the body–I teach you how to pay attention to it, and how to start letting it resolve itself (remember, the body wants to heal).  So in our sessions, we’ll jump-start that positive, healing process. The techniques help us get “unstuck.”

There’s a lot to do here.  The charge has to be let out of the body, and the sadness has to be let out of the soul. Trauma therapy work takes some time and effort.  You don’t feel better after every session.  Sometimes you feel a bit worse.  But gradually, as you go through the process, you begin to get relief.  As a result, you begin to feel lighter, more clear, more present, more confident and capable, more (dare we say) normal.  You begin to feel more like yourself.

Reconnecting

Once this happens, you can begin to rejoin your life.  You reconnect with others, build new relationships, engage in new activities (or dust off the old ones).  Love, work and play:  All the things that were on hold while you were suffering so much.

How long does it take?  No one can say.  But if it’s going well, there should be things happening at almost every step that are helpful to you.  And it can take a lot less time than it used to, again, if it’s done well.  Some of the modern therapies seem strange (actually, all of the ones that seem to work well seem strange), but they’re pretty powerful.  If you don’t feel anything is happening or changing after a few months, you might want to re-evaluate.  On the other hand, you can’t put a time limit on it, either.  It takes what it takes. Just keep walking downhill and you’ll eventually make it to the river.