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Treating Trauma Differently

Trauma is a pervasive problem. According to the National Council for Mental Wellbeing, 70% of adults in the US have experienced some type of traumatic event (intense and distressing experience) at least once in their life. Trauma is simply the lasting emotional response to that event. And while people often downplay the impact a traumatic experience has on their lives, for fear of stigma, in the United States alone, 31% of adults will experience anxiety, nearly 10% of adults will suffer a depressive illness, and 6% will have clinical PTSD at some point in their life.

EMDR stands for Eye Movement Desensitization and Reprocessing. Developed by Dr. Francine Shapiro in 1987, EMDR uses a technique called Bilateral Stimulation (BLS), by following a consistent pattern back and forth, often your eyes following a light, to impact the biochemical reactions (trauma responses) in the limbic system and brain stem, located deep in your brain.

While traditional talk therapies like Cognitive Behavioral Therapy (CBT) can have some benefit, most people with significant trauma will hit a roadblock that they can't move past using CBT alone. Biochemical responses generated deep within our brain cannot simply be reasoned away. If logic and reasoning worked for every problem, salad would be a comfort food.

Bilateral




Stimulation

Bilateral Stimulation (BLS) is simply a rhythmic stimulation back and forth crossing the midline of your body, often your eyes following a light. BLS helps stimulate both sides of your brain so you can make new connections and process traumatic memories that have gotten "stuck" in a biochemical loop. BLS helps your brain accomplish these tasks by activating transitions between the limbic regions of your brain to the cortical regions so you can interpret what happened and move forward.

Researchers are not certain why BLS works. Some think it mimics REM sleep, which is when your brain is actively processing during sleep. Some think it taxes our working memory and in turn decreasing our biochemical response. But even with some mystery as to why, everyone agrees that it is effective for processing trauma.

Why is Treating




Trauma Different?

Those who have experienced traumatic events often feel "stuck" with the initial perceptions of the events because the biochemical responses we experience (adrenaline, cortisol, etc.) put our body into survival mode which blocks the brain's ability to fully process the information. Even if you know it's not rational, we can't logic away our biological processes, which are driving our feelings.

Because the processing is blocked your brain and body is getting trapped in a moment of time. Think of it like a VHS tape. If you stop a tape at the scariest part, even if you talk through what happened, every time you hit play (experience something that triggers that memory) you are right back in the middle of that scary scene. No amount of talking can fast-forward the tape.

What to Expect

Unlike hypnosis, in an EMDR session you are fully conscious and in control.

Think of EMDR like taking a train past a traumatic event. You are not reliving it, but simply in proximity, able to notice specific feelings and your body's physical (biochemical) responses. You will go back and forth, in cycles, between quiet moments of bilateral stimulation and then talking through what you are noticing and making new connections.

A lot of people are tired at the end of an EMDR session. And as their brain begins to solidify the neurological pathways for the new information and connections, clients often have strange dreams or feel physical sensations in their body at the same places that were impacted in the trauma, for a few days after the session.

The Phases of EMDR

1

History & Treatment Plan
  • Identify Targets for Treatment
  • Discuss triggers and goals

2

Preparation
  • Understand treatment steps
  • Practice entering "safe space"

3

Assessment
  • Activate the memory
  • Assess image, cognition, affect, and body sensation

4

Desensitization
  • Cycles of Bilateral Stimulation with specific focuses
  • Report what you're noticing

5

Installation
  • Replacing a negative cognition with the preferred positive one using bilateral stimulation.

6

Body Scan
  • Observe current physical (biochemical) response and identify any residual responses causing distress

7

Closure
  • Practice techniques for containment of the memory
    to ensure safety until the
    next session

8

Reevaluation
  • Reevaluate current level of distress
  • This is where future sessions will start.

Frequently Asked Questions

How Long Until I'm Cured?

There are a lot of factors that contribute to how effective a treatment will be. Just like you would expect a 20-year old with a minor fracture to need fewer sessions of physical therapy to heal a broken ankle than a 65-year old with a shattered ankle, the more complex the trauma, or the more rooted the negative pathways, the more EMDR sessions will be needed to alleviate all distress. That being said, most people see some improvement after just one session.

It is recommended to commit to an initial series of EMDR sessions (6 or 9), so you don't unintentionally add pressure to yourself to heal faster than is reasonable, while still giving you specific evaluation points.

In several studies of EMDR on Post Traumatic Stress Disorder (PTSD), 90% of people with single-event traumas saw PTSD symptoms clear in 4 to 7 sessions. For those with multiple traumas, 77% saw PTSD symptoms clear after 12 sessions. And extensive therapy was needed for those with complex trauma such as childhood abuse or neglect.

Does EMDR replace My Regular therapy?

No. EMDR is a short-term trauma-specific technique in therapy that is best used when it comes alongside another type of therapy. We are complex beings who need to be treated in our entirety, which is why Reframed Mental Health uses the Whole Person model of therapy. It is also important to note there is a big difference between thriving and simply alleviating symptoms enough that someone no longer meets the clinical definition of PTSD. Your treatment plan should set you up to thrive as a whole-person over the long-term. To learn how the different therapy modalities work, click here.

Do the results last?

If you complete the full treatment, then yes.

There have been 12 studies assessing the effects of EMDR over time (9 with civilians and 3 with only combat veterans) and they followed up at 3, 4, 9, 15 months and again at 5 years. The studies show that if a person only has a couple of sessions the results diminish over time. People who had 12 sessions overwhelmingly maintained the results.

The key point that the studies revealed is that in order for results to be long-lasting, you must "close the loop" on all of your significant traumas. While you may see significant improvement, or even alleviation of symptoms, after a few sessions, if you stop without completing or have other traumas you left unprocessed, those unresolved pieces will work themselves to the forefront over time and diminish your results.