Montare Media presents Season 2, episode 17 of the Discover U Podcast with JD Kalmenson: How EMDR Works for Trauma and Grief, with Roger Solomon, PhD.
Learn More about Montare Behavioral Health: https://montarebehavioralhealth.com/about/digital-library/
JD Kalmenson interviews Roger Solomon, PhD, an expert in EMDR therapy, to learn about how this evidence-based modality effectively rewires a traumatized nervous system. Note that Dr. Solomon was traveling to the Ukraine to deliver care to war victims there during
the taping of this podcast, so the audio is not pristine.
Roger Solomon PhD is a psychologist specializing in trauma and grief. He's the program director and senior faculty with the EMDR Institute, an EMDR Europe approved trainer, and teaches EMDR therapy internationally. He currently is a consultant with the United States Senate and has provided services to numerous first responder agencies, following traumatic incidents, including the FBI Secret Service, NASA, the US Attorney's office, and the US Army. For over 40 years, he's worked with families of first responders killed in the line of duty. Along with teaching basic training at EMDR therapy workshops internationally, Dr. Solomon presents workshops on the utilization of EMDR therapy with grief and mourning, complex trauma, and dissociative symptoms. Dr. Solomon has authored or co-authored 47 articles and book chapters pertaining to EMDR therapy. And he has just authored a book published in 2022 in Italian, translated, “Grief and EMDR: From Diagnosis to Clinical Intervention.”
Host Kalmenson is the CEO/Founder of Renewal Health Group, a family of addiction treatment centers, and Montare Behavioral Health, a comprehensive brand of mental health treatment facilities in Southern California. Kalmenson is a Yale Chabad Scholar, a skilled facilitator, teacher, counselor, and speaker, who has provided chaplain services to prisons, local groups and remote villages throughout the world. His diverse experience as a rabbi, chaplain, and CEO has inspired his passion and deep understanding of the necessity for effective mental health treatment and long-term sobriety.
Follow JD at JDKalmenson.com
Welcome to another episode of Discover U, our podcast exploring innovative and effective solutions to issues in mental and behavioral health. I’m JD Kalmenson, CEO of Montare Behavioral Health, a family of dynamic and comprehensive mental health treatment centers in Southern California.
I’m truly honored to introduce you to our very special guest today, Roger Solomon, PhD. As you will see from his bio, Roger is an expert in EMDR therapy, which is especially effective in treating complex trauma and PTSD. At Montare, our therapists are trained in EMDR, and we are big fans of this well-researched modality.
I spoke with Roger about a month ago, while he was literally in transit from Krakow, Poland to the Ukraine, to work with war victims. For the first 15-20 minutes of our conversation, the audio on his cell phone was a bit rough, so I’m going to summarize some of the highlights. But before we get to that, here’s a little background on Dr. Solomon:
Roger Solomon, Ph.D., is a psychologist specializing in trauma and grief. He is the Program Director and Senior Faculty with the EMDR Institute, an EMDR Europe approved trainer, and teaches EMDR therapy internationally. He is currently a consultant with the US Senate, and has provided services to numerous first responder agencies following traumatic incidents, including the FBI, Secret Service, NASA, US Attorney’s Office, and the US Army. Along with teaching basic training in EMDR therapy workshops internationally, Dr. Solomon presents workshops on the utilization of EMDR therapy with grief and mourning, complex trauma, and dissociative symptoms. Dr. Solomon has authored or coauthored 47 articles and book chapters pertaining to EMDR therapy and he has authored a book just published in 2022 in Italian, translated: Grief and EMDR, from Diagnosis to clinical intervention.
As you can see from this brief background summary, Roger knows his subject inside and out.
EMDR is a therapeutic modality originated by a mentor of Roger’s: Francine Shapiro. Roger tells us that she was walking in the park, thinking about a disturbing memory. She noticed that after moving her eyes repetitively in a specific pattern, the memory of the disturbing event lost its punch. Repeating the experiment a few times, she found that it worked every time.
After more research, Francine discovered that the eye movement was actually helping the brain to reprocess the information in the traumatic event.
Let me see if I can explain this reprocessing mechanism as well as Roger did for me, because I find it fascinating. When something deeply painful and overwhelming happens, that memory becomes so distressful that in the brain, we have two sections, generally speaking. The section of past in which we're able to take certain experiences and archive them and relegate them to the past. But sometimes when a memory is so traumatic and painful and overwhelming, it sort of gets frozen in time, stuck in our brains as it were, and never ends up being placed in the past category in the archives and having this memory sort of stuck and lurking there will allow it to fester and pester, and it will inhibit us because it has not been placed in the past. And therefore the lines between past and present are blurred so that it has a detrimental impact on our wellness, on our emotional equilibrium and through the eye movement techniques and auditory tones used in EMDR, the brain's innate information processing mechanism can be stimulated, and it can allow the brain to form an adaptive resolution and finally place it in the past section and archive it properly.
I asked Dr. Solomon whether EMDR could be done by yourself because on the surface, the techniques utilized in EMDR seemed pretty simple and straightforward. And so it would make sense for that the average individual might after learning it, be able to do it on themselves. His response was a very clear, no. It is vital for somebody to work with a licensed therapist who's been trained properly in EMDR therapy because even though it appears simple, there is a lot more to it. A lot of emotions may come up and a person can get stuck somewhere in those emotions or some other buried memory could emerge. That would be overwhelming for somebody to deal with alone.
I asked him what a typical EMDR session looks like. And it seems that it's very similar to a traditional therapeutic session in which the therapist would create rapport, would provide some psychosocial education, and in EMDR, the therapist and the client would work together to select a memory, to begin dealing in doing the EMDR therapy with. Which made a lot of sense for me, because even for a client or a patient to select a certain memory, to identify that this memory is what is leading to so much anxiety, for example, or a lack of confidence or so much depression, even to be able to identify that memory, one would need the help of a professional licensed therapist who would help us sort of work through a lot of the emotional fog to be able to pull that memory out there and reprocess it.
I also learned in our conversation that EMDR can be applied more broadly than I had realized before. According to Roger, EMDR’s efficacy in treating a wide variety of psychological disorders has been validated by a lot of research. It can treat the very painful experiences like big T trauma, a catastrophic event like a fire or something else that was that's incredibly overwhelming and painful, but it also is effective with little T trauma. For example, the repetitive angry look of a mother when we are growing up as a child, which though it may seem minor, could be very detrimentally impactful over time, creating feelings of I'm not good enough, or I don't belong, or there's something wrong with me.
Those self-esteem issues don't come from these big, major, big T trauma, but from a series of small traumas, giving us the sense of rejection, blame, or humiliation. And EMDR therapy protocols, Roger was sharing are helpful for these memories as well. Things that are distressing and have long term residual harm. If we were to go through the EMDR protocols and identify those memories and process them with the maturity and the insight of being able to recognize that this should not make me feel any less beautiful, valuable; I was a child and the, the emotional context that surrounds those memories really helps us neurologically store them in the brain, not only in the past archives, but also in a way that is free from a lot of the heaviness and the negative toxicity that we may have originally processed those memories. When the experiences happened to us as a child, that idea was incredibly counterintuitive to me.
At this point, we're gonna join the live conversation because I think you'll be able to hear Roger's voice clearly. I hope you enjoy it. And we're going to begin where I'm reacting to Roger's description of how EMDR can treat these entrenched lifelong patterns of low self-esteem.
JD Kalmenson: Welcome to another episode of discover you our podcast exploring innovative and effective solutions to issues in mental and behavioral health. I'm JD Kalmenson, CEO of Montare Behavioral Health, a family of dynamic and comprehensive treatment centers in Southern California. I am so excited to introduce you to our expert guest today. Roger Solomon, he's doing us the tremendous honor of calling in while on transit on the way to Ukraine to work with war victims. First, a little bit of background. Roger Solomon PhD is a psychologist specializing in trauma and grief. He's the program director and senior faculty with the EMDR Institute and EMDR Europe approved trainer and teaches EMDR therapy internationally. He currently is a consultant with the United States Senate and has provided services to numerous first responder agencies, following traumatic incidents, including the FBI secret service NASA, the us attorney's office and the us army for over 40 years, he's worked with families of first responders killed in the line of duty and along with teaching basic training at EMDR therapy workshops internationally, Dr. Solomon presents workshops on the utilization of EMDR therapy with grief and mourning complex trauma and disassociative symptoms treating attachment issues in the art of EMDR therapy.
JD Kalmenson: Dr. Salman is authored or co-authored 47 articles in book chapters pertaining to EMDR therapy. And he has just authored a book published in 2022 in Italian translated grief and EMDR from diagnosis to clinical intervention. Welcome, Roger. We know it's late where you are, and so appreciate you taking the time to speak with us today.
Roger Solomon: My, my pleasure to be here, I'm gonna apologize in advance of my propone is power, but it's a pleasure to, to be here with
JD Kalmenson: You. Thank you. And, um,
Roger Solomon: Hello to the audience.
JD Kalmenson: Thank you. We are big proponents of MDR therapy at all of our treatment centers, and I'm so excited to learn a little bit more about it from you and to help educate anybody tuning in, plugging in and listening about this incredible modality. So EMDR for those who are not familiar, what does it stand for? I understand that you've worked with friends seeing Shapiro, the originator of EMDR. Can you tell us a little bit, , about the modality and give us a brief description?
Roger Solomon: Yes. A of the R stands for eye movement, sensitization and reprocessing, and it did originate with Francine Shapiro in 1987, which he was taking a walk in the park, thinking of something very disturbing. And what she noticed is that the disturbing thoughts disappeared in which she brought it back. This memory no longer had the same punch. She brought up something else that was bothering her. And the same thing happened. And she realized what was happening was that her eyes were moving rapidly in an upward diagonal direction. And this was happening spontaneously ly. A third time, she deliberately brought up the memory, moved her eyes in the same way. The same thing happened. Then she grabbed every warm body. She could get her heads on and said, think of a disturbing memory and move your eyes like this. And she showed them how to move her eyes, but most people could not do it the way she could.
Roger Solomon: So she simply said, follow my finger. And at that time it was called I desensitization. And she later did research, which was published in 1989. The R was added later reprocessing cause it was realized that when a person breaks up a disturbing memory, not only is there reduction in tension, but there's the thoughts, new images, you know, adapt images and thoughts and resolution. So a memory indeed it's reprocessed. So just to elaborate a little bit more, we have an information processing mechanism in our brain that that will store memories, process memories. And usually if something bothers us, we think about it. We talk about it, dream about it, and it gets integrated. But when something very distressing happens, that's beyond our capacity. The memory can get functioned in the brain, stuck in the brain, unable to process that memory gets stuck with the original thoughts and emotions, sensations, unable to integrate into the wider memory. There's an AMDR standard protocol procedures that involve bringing up the memory and moving your eyes in a certain way. But we also find we can do auditory tones or, or taps. And what this seems to do is stimulate the brains innate or the inner or information processing mechanisms, allowing that brain to go from, , state specific form to an adaptive resolution.
JD Kalmenson: Wow. That was so interesting and a beautiful, you know, a succinct description of it. So in a nutshell, what she discovered by accident was that through moving her eyes in a certain way, she can desensitize herself to that painful memory. But then what you, you, you started to describe a little bit of how that memory sort of gets frozen in time when that memory is too hard to process and to, I guess, release or to allow it to be integrated with the rest of our memory. So it sort of gets frozen there. And that leads to a lot of subsequent dysregulation, I guess, you know, trauma symptoms. Could you elaborate on that a little bit more?
Roger Solomon: , yes, it does route like of exactly why? So what will happen is there'll be some kind of a reminder of the, of the, , memory and it will, this present situation can trigger the unresolved memory. And that comes the, um, images, thoughts, behavior, sensations. This is, , responsible for the nightmares flashbacks that we get. So the past is present. In other words, um, a situation or, or inner thought in an external or inner reminder can trigger this unprocessed or not. Adaptably stored memory and that's influences our behavior. So present problems are the result of maladaptively stored memories. So, and maladaptively stored memories under my post traumatic stress disorder and really so many psychological disorders. Let me say along the way, there's a lot more procedures to EMR therapy than just the eye movement. It is important, but there's a lot more, there's a lot more too.
JD Kalmenson: That's amazing. I mean, if somebody were to master the art of being able to do EMDR on themselves, is this something that becomes a coping skill every time we want to get rid of even a non excruciatingly traumatic and painful memory, just so that we can, he, it can really just help us release certain things and allow them to be, become past and sort of move on with them.
Roger Solomon: So I, I think you, you were asking if people do this themselves well, no, because what can happen is a person starts to bring up the memory and it can really start to trigger too much. And it can be very difficult to stay present and, you know, with the memory of trying to do the yourselves. So it's very important that a person being with a properly trained MDR therapist who is a licensed, you know, therapist, who's been trained properly in EMDR therapy, it's it appears to be simple, but there's a lot more to it. because a lot of emotions may come on up knowledge, special knowledge, your procedures are needed to help a person through it. Also, a person could get stuck in somewhere. There could be some kind of a block because there's other memories that start to emerge or something else that's very powerful starting to come up that a person's not ready to deal with.
Roger Solomon: So the therapist has to be able to help the person work through the block or understanding what's blocking the process. So let's understand that indeed, what happened is something very distressing happened that, , occurred to the person that's too much to deal with and talking alone is helpful, but it's not enough. Sure. Also doing the bilateral stimulation can start to bring up very powerful emotions. Integration occurs when a person can experience now, what was too much then, but it's got to be within if I may use the term, their window of followers. So this can take some preparation, um, learning how to, to, , , calm oneself. Also, it, it takes some psychosocial education before EMDR procedures are, are conducted.
JD Kalmenson: So how much of the session will there be traditional talk therapy or just processing what that memory has been for you and what it might be after the EMDR is there, is, does it, does it contain the traditional components of a sh of communicating in the shearing of, of content or is it more of a behavioral therapy where, you know, we're just, we're going through this exercise and there isn't, , so much, , content and information being shared,
Roger Solomon: Well, EMDR therapies, integrating psychotherapeutic approach. And of course the therapist is gonna integrate EMR and within the therapeutic framework, so a person will come on in and EMDR therapy starts right then with taking a history, building a therapeutic rapport, providing psychosocial education. So the therapist will do what they've been trained to do to do psychotherapy. So of course you, this is gonna involve talking as well. And after taking a history and preparing the person for EMDR therapy, then memories will be selected to process with EMDR therapy.
JD Kalmenson: That makes a lot of sense because even for a client or a patient to select a certain memory, to be able to identify which memory is still, you know, unresolved and is standing out there and is, is lurking and is, you know, blurring the lines of past and present and not allowing the individual to move on with their life to properly release that traumatic event, that itself would require therapeutic intervention. So it's, so going back to the point that you said earlier, EMDR is not intended, is not, is not DIY do it yourself, sort of thing. It really has to be done within a traditional therapeutic context, but with the aid of the eye movement, desensitization, there is a tremendous ability to be able to, I guess, neurologically, physiologically, , you know, intervene and, and help the therapeutic process of, of, of, of putting that memory aside
Roger Solomon: Well said, rabbi really well said.
JD Kalmenson: Thank you. Other
Roger Solomon: Thing to mention here is that is well researched at this point. There's many studies that have validated, , EMDR efficacy with traumatic memories and, , not only PTSD, but a variety of disorders. And the reason EMDR can be widely applied is quite often at the heart of a psychological disorder are very distressing memories like it's stored now adaptable.
JD Kalmenson: That makes sense. So, so EMDR is, is, is, is primarily treating trauma. And as I understand from your work, very painful experiences that we might not usually refer to as traumatic like grief and loss. And that's where it shines as a, as a really powerful intervention to help us move onward from them
Roger Solomon: In indeed and not just major trauma, big tea trauma, but also small tea trauma. For example, mothers angry look is seemingly small, but could be very impactful if somebody starts thinking I'm not good enough, I don't belong or something wrong with me. These self-esteem issues that doesn't come so much from a major trauma as a bunch of small, , small trauma rejection blame
Roger Solomon: Humiliation that occurred within the family and the EMDR therapy protocol can also be used on these memories. So we're talking about memories that get now adaptably stored in the brain and of your therapy can change the way that that memory is stored in the brain, but becomes adaptably stored. And what was, you know, what, before was very distressing that could get resolved. It could go from it's all my fault to, I was just a child. It's not my fault. I'm okay. As I am, a person can feel I'm not safe that after processing that memory, I'm safe today or distressing memory from childhood where the belief is like powerless can be processed and the person comes to to realize that, well, maybe back then, I didn't have any choices. I was just a child, but I have choices today. I have some control. So we're talking about changing the way these memories are neurologic restored in the brain.
JD Kalmenson: I love that. I mean, it's actually counterintuitive when you say that EMDR also works for small T trauma and it also is effective for series of accumulative memories that contribute to a small Tetra to a lack of, of, of affirmation and validation from a parent to an angry look, to a toxic relationship. And the reason for me it was counterintuitive is because when you're dealing with such a sheer large volume of potential memories that contribute to a certain feeling, feeling to a certain lack of safety or to a certain, you know, perception that one has of oneself, because nobody ever told them that they were special and that they were, and that they were beautiful and that they have meaning and purpose, and that their lives have so much potential. It's almost like, wow, where do you begin with this vast array of 1850
Roger Solomon: Years? Maybe we're, we're approaching the border of Ukraine. So the connection may be, be a little difficult as we cross into Ukraine.
JD Kalmenson: Okay. Sure, absolutely. So, but until, until we, we until, so, I mean, the idea is that just to go back to that point for a second, it just seems so counterintuitive that something which is predicated on helping us process memories could also be effective when you're dealing with potentially hundreds or thousands of memories that have contributed to a certain self-image to a certain orientation. And that's, it's mind boggling that EMDR…. and I guess that's why EMDR is probably not a one-time session, but it is an, it can be an ongoing journey to really try and address this plethora, this huge volume of memories and process it in a healthy way and allow it to be put in the past.
Roger Solomon: Um, exactly. That's why EMDR is very efficient, but it's not necessarily a, a shortcut for simple trauma, or single episode trauma research has shown that maybe one to three sessions, may be sufficient to eliminate PTSD symptoms. But when we're talking about a childhood full of negative memories, negative attachment memories, of course, a higher dose is going to be needed. And certainly when we're talking about complex trauma and dissociate disorder, then EMDR therapy along with a variety of different methodologies is, is going to be needed.
JD Kalmenson: That's amazing. And it's just so important to identify the basic mechanism of what you're describing here is that for us to be traumatized by a certain event, we have to have allowed that event or that episode, or that relationship to gain a certain measure of control over us. And the real mechanism of how it gains control over us is when the memory of that event is lodged and stuck somewhere in our brain. So that's when it really cripples with our functionality. And it sort of paralyzes us to perpetually be experiencing that pain to a certain degree and not allowing ourselves to move past it. But what's amazing is that we naturally have the gift of moving past things and not being traumatized, except when something like this happens when this memory becomes just so painful and something, non-organic or not natural happens, and the memory isn't processed, and it sort of gets stuck there.
Roger Solomon: Yeah, that is correct. And it gets, and talking therapy, talk therapy is usually not sufficient. Talking does not get to the part of the brain where that trauma is stored. And yes, what happens is something happens, or an event occurs that's beyond the integrative capacity of the person. So the need gets stuck and gets triggered and plagues the person. So there is trauma therapy that is available that can help a person through these traumatic experiences. And when these traumatic experiences get processed, they get stored in an adaptive way, and that helps guide adaptive future behavior.
JD Kalmenson: I mean, from the perspective of, let's just, if we unpack the word memory for a moment, it's not as if after somebody goes through an EMDR session, they're forgetting that experience. So what's really happening is that it seems from what I'm understanding, from what you're saying, that the memories have different compartments in the brain where they can be stored and unless they're processed and stored in a compartment, which will for the, for, you know, simplistic purposes will label past, unless we put them in the past category, which helps us compartmentalize them, they're going to be sort of stuck or frozen or lurking in the present category. And that is, what's really disrupting our equilibrium and not allowing us to move on. Right. So it's not the memory itself. It's where the memory resides in the brain.
Roger Solomon: Yes. And you use some very nice metaphors on that because the past memory is still present. It's like, there can be, the memory is stored in a way that it's not over for the person. It's like, it continues, it's not over.
JD Kalmenson: Right. I mean, when we talk about grief and mourning, and I know that this is something that's a major part of your work, and it seems to be effective, , you know, is there any limitations, are there restrictions? Why isn't it as widespread as Tylenol in terms of dealing with grief and mourning?
Roger Solomon: Well, that's a good question. Well, first of all, I think it may be more widely utilized with grief in mourning than we realize because there's a lot of EMDR therapists, but it may be that a lot of the EMDR therapists may not be aware of how it can be applied to grief and mourning. Certainly the loss of a person is a traumatic event, and we can go in and utilize EMDR therapy with the loss, starting with the ground zero, maybe when the loss began. And now what happens when we do EMDR with grief in mourning, we can process the trauma of the loss and then what starts to happen when a person can realize that the person is gone, not coming back and deal with the pain of that, then adaptive information can start to link in. And usually this is in the form of positive, meaningful memories that form an adaptive inter representation. In other words, good grief is when we think of our loved one and we experience the joyful, meaningful memories and the meaning of that person in our life. And we carry that with us.
JD Kalmenson: Right.
Roger Solomon: So EMDR can facilitate the formation of this adaptive inner representation.
JD Kalmenson: Yeah. That makes so much sense. And you know, it, I don't know if this is directly connected, but it just is an idea that the sprung up while you were talking, I mean, as long as we have the association and the relationship with the deceased in the arena and the domain of the brain as being in the present, the fact that we can't see them, and the fact that we can't talk to them makes it all the more painful. There's this interesting, you know, sort of Talmudic expression that you, you will never be able to properly mourn and grieve over somebody who's still alive. Even if you don't, if you think someone's dead, but they're really alive, you'll never be able to go through the mourning process and find acceptance because they are alive. They really are in the present. I think the same thing as similar ways with the memory I get from what I'm hearing until you properly store it and process it only then can the next phase of acceptance and reintegrating the positive memories and the affectionate and enduring ones, and allow that to replace the pain.
Roger Solomon: Yes. Well said rabbi. However, sometimes the person who died, what can be bittersweet, there can also be negative memories associated with the deceased, and of course, EMDR therapy can be used to process these memories as well.
JD Kalmenson: Yes. I mean, I understand you work in some very extreme conditions, whether it's with the Senate, NASA, the army, the FBI. Can you tell us a little bit about what you do with those organizations? I imagine those folks can deal with, you know, dealing with heavy trauma.
Roger Solomon: Our first responders are exposed to terrible problems. They have to be not only risk their life, but their witness to other people's traumas as well. And being human beings. This can certainly take a toll on them. So it's, it was, , certainly been a wonderful part of my career, starting actually in the seventies as a graduate student to start understanding trauma and working with, friends and colleagues, starting to build programs for first responders in including the, you know, agencies that you talked about so that there are, when there is some kind of a critical incident, there are now programs to help our first responders deal with the trauma.
JD Kalmenson: It's amazing. I mean, it's such an incredible blessing that you can provide healing in that way to such extreme, you know, incidents. EMDR as a whole, let's go back just for a second is so well researched. I mean, it's recommended as an effective treatment for trauma, PTSD by the American Psychiatric Association and the Departments of Defense, and the VA. Could you share any of the high-level data on the efficacy of the treatment? What's the success rate? I mean, and even on a broader level, how do you define success?
Roger Solomon: So there are a number of studies that have shown EMDR to be effective. Studies that go out for one year. And there's also been randomly controlled studies, comparing EMDR with wait lists over some other therapies that have shown its efficacy as well. So, and more and more EMDR is being researched for a variety of disorders. For example, more and more data is coming in on depressive disorders and anxiety disorders. And there's also research now on how EMDR can be part of the treatment with psychotic disorders, cuz people that, for example, that suffer from schizophrenia may also have traumatic events, which can be dealt with, with the EMDR therapy.
JD Kalmenson: That's so interesting. I mean, there's, um, I'm sure you're, you're familiar with MDMA, right?
Roger Solomon: Yes.
JD Kalmenson: Now one of the fascinating things about MDMA is that it reduces the amygdala and allows people after the dose to really open up and access memories that they've consciously suppressed because of how painful and how overwhelming that memory would be if they were to process it in a regular conscious manner. So they take eight hours and they just tap into certain memories that otherwise they wouldn't even necessarily be aware of. Not similar to hypnosis, but the result is sort of similar where the content that gets communicated is things that afterwards they listen to it, and they're surprised. The reason I bring this up is because if EMDR is predicated on properly processing a certain memory that's painful, a prerequisite to processing that memory in a session would be to be able to identify that memory. And it would therefore seem that all memories that we're not consciously accessing because of how painful they might be, that we suppressed them so many years ago or that we've simply forgotten even though how it would be impossible to forget something so painful, but nevertheless is not consciously accessible to us. I'm just wondering if EMDR in conjunction with something else that helps tap into those consciously inaccessible memories would really have like a, a compounded, incredible therapeutic effect.
Roger Solomon: I think the potential is, is, is there, and research needs to be done. There's already some therapies that have been combined with MDMA and have had some successful results. And I have heard that some research is going on with EMDR therapy as well, but again, there needs to be research, but theoretically, as you talk about certainly these two different methods can enhance each other.
JD Kalmenson: Right. Because if you, you can only deal with a memory that you can consciously access, right. How, how, unless…
Roger Solomon: Stay present with.
JD Kalmenson: Right. Right, right. So yeah.
Roger Solomon: To access it and be able to stay present with it. That's true.
JD Kalmenson: Right. Right. I mean, with talking about memories and early childhood memories, when there's trauma, we all know that a person's sense of safety is often, feels threatened. Have you noticed in your work that early childhood attachment difficulties come up in the EMDR treatment, do attachment disorders have a direct effect on how dysregulated or traumatized the client can become?
Roger Solomon: Absolutely. And the more I do the work that I do, the more that I see how important it is to get to these early attachment memories. Cause, you know, beginning with Freud who first pointed out the relationship between problems and what happened in childhood. Now there's a lot of research on the attachment relationship between the child and the caregiver. So certainly with the EMDR therapy, it's important that, you know, can be important to get to these early childhood memories
So, I do a lot of work on attachment and certainly there's research that shows that disorganized attachment underlies complex trauma and dissociative disorders. So a very important part of treatment, including EMDR treatment is not only processing adult trauma, but also being able to get through the underlying attachment memories, having to do with the child and the caregiver. So there's other frameworks that may be involved in guiding EMDR therapy, but once we're able to get to an early memory and that our therapy can indeed be helpful. Also, we may start with a memory that happened at age, you know, five or six that the person remembers, and it can start to evoke earlier material in the form of feelings, sensations, non, you know, nonverbal ways.
JD Kalmenson: That's amazing. So it could have, it could have a domino effect, meaning to say once we properly process some of the more recent painful memories that have been lodged and sort of stored. And now that they've been put aside and processed in a healthy way, we can then avail ourselves to some of the earlier memories that were painful, that we weren't even, you know, equipped to deal with. But right now that's gonna be coming up. So it's a process. It's a journey.
Roger Solomon: That's correct. It's very important that these early childhood attachment memories be dealt with and EMDR therapy is effective with the big T trauma, your tsunamis, your bank robberies, assaults. But it also is very helpful for these childhood memories. So certainly in a lot of my work with the dissociative disorders and complex trauma, we're not only dealing with the childhood traumas that they remember, but also the attachment memories, the neglect, the humiliation and the big one is being alone.
JD Kalmenson: Hmm. Can you elaborate on that?
Roger Solomon: Yes. Well, loneliness is, is very pervasive in the world. And childhood, when there's humiliation or there's shame or, or neglect, or abuse, a child often has to go through it alone. And as a child, I'm alone can lead to a sense of what's called annihilation anxiety. I'm alone can be worse than I'm gonna die. It's like, I'm, I'm invisible. I'm not seen, I'm gonna disintegrate. It can really be too much. So, let's keep in mind that when there is criticism or there is abuse, or there is neglect, or beatings, there's not only what happened to the child or what didn't happen to the child, like comfort, but that child's alone with it. And we're wired to seek comfort from, caregivers. And when that comfort is not there, that's when there can be that sense of I'm alone, I'm not safe. There's something wrong with me and I'm powerless.
JD Kalmenson: I totally understand how putting the memory aside and processing it will finally allow us some closure and for that memory to cease taunting us or haunting us. But as far as let's just say, what all those positive social support systems would do for us as far as character development, what love, what positive relationships, what confidence, what empowerment, validation, and affirmation would do for us, EMDR is not seeking to circumvent that and say, this is gonna solve all the absence of all of those positive attributes that would have come about had you had a healthy household and a, and a good family unit of support, right? It's not seeking to sort of proactively give us all of those, you know, social, , forms of capital. It's rather just seeking to, I guess, , diminish and restrict what the negative memories would be doing as far as trauma. Is that correct?
Roger Solomon: Yeah, that's correct. You know, of, of course psychotherapy in present time isn't totally gonna make up everything that happened in childhood, but with the therapeutic, with the therapeutic relationship, you know, which is very important, that provides a different kind of relationship than the person had as a child, along with, you know, reprocessing, the more negative memories, big ones, and small ones helps the person develop a sense of efficacy and today's life increases their self-esteem, and this is gonna increase their, ability to find joy in relationships as well. So the big three, the big three symptoms are affect regulation self-esteem and relationships, and yes, the early childhood trauma, you know, certainly disrupts all three realms. So we can make a difference. For your listeners that were out there, that as you say, we're not gonna create, not gonna make up for a happy childhood, but life can be better. There, there is help. There is hope. Your sense of efficacy and relationships can get better.
JD Kalmenson: That's beautiful. And that's, and that's, and that's so evident in your trip right now, as you're entering the Ukrainian border, and you're going to work with war victims. I mean, this trauma that they're experiencing is so fresh is so recent. How much time has to lapse if, you know, before the EMDR is effective? Is there any timeframe when it's optimal to treat that type of a memory with EMDR, even if it's only yesterday or a week ago?
Roger Solomon: Well, EMDR therapy has really evolved. There are now a number of recent event protocols to help people who've been distressed, or the trauma occurred, you know, yesterday or last week. Also, not only can we do it individually, but there are group protocols that can offer relief. And these have been widely applied into Ukraine. There’s been a lot of support from so many different countries, you know, training and, and also providing direct clinical services over the internet. What I'm gonna be doing in Lviv is training new EMDR therapists and also providing some advanced training on complex trauma and dissociation, where I certainly will teach the importance of attachment, understanding these negative attachment relationships and how to work with complex trauma with EMDR therapy. And yes, I will be doing some direct clinical work with people
JD Kalmenson: That's unreal. It's an amazing thing that you're doing. And, I hope you stay safe and it's, it's just, it's extraordinary when you train all those folks out there, the compounding effect of how many people will be healed in the process is immeasurable. It's an incredible thing. Um, just last, last question, but not least. Can you give us a two-minute description of the protocols of what a session might look like? And I do understand that there's so many variations of EMDR. So I guess what would be the protocols of the most standard form of it?
Roger Solomon: Sure. Well, after history taking and preparation, what will be done is to identify the memory to re, to reprocess and we access it. We're gonna ask you what image represents the worst part. We will get that also access and identify the negative self belief one has, the meaning to the self. “I'm not good enough. I'm not safe, I'm powerless.” And then we identify a goal, a therapeutic goal, an adaptive, positive cognition. We call it, “I am safe. I have control. I have, you know, some control. I am good enough.” And we take a measure. How true do the words “I'm safe today,” feel to you on a one to seven scale, one false, seven true. And in the beginning? Well, my head knows it's true. It's a seven, but in my guts, oh, it feels like a two. We all know people that no, that tell you, I know it's not my fault, but inside it feels like it is.
Roger Solomon: So again, we have that image, that negative cognition, positive cognition, then we get the emotion and then we ask the person, how disturbing is it? Zero, which is calm, 10 the worst, and where do you feel in your body? So we're accessing that memory. Then we ask the person think of their memory while we do the bilateral stimulation for 20, 30 seconds. And the therapist for the most part stays out of the way will do, because you know, what's happening is we're stimulating the brain's information processing system. And it's a very natural, organic, you know, approach. So after 20, 30 seconds of bilateral stimulation, we'll ask you, what do you notice now? And what happens with EMDR therapy as there's a chain of associations, other thoughts, other emotions, other memories start to come on them. This is the organic healing process. So the therapist will just say, go with that or stay with that.
So this is the sensitization phase where we're doing these sets of bilateral stimulation, and we measure the effect by that zero to 10 scale. And the goal is that it it's zero or calm. Now, zero's not the absence of emotion and zero doesn't mean you feel good about it. Zero means you can think about it, and be calm. Not that everything will go to zero. We're not gonna take away appropriate emotions. So that's the desensitization phase. Next is the, we call it the insulation phase. So remember I talked about that positive cognition. “I'm safe. I'm good enough. I have some control”. So now we bring up the memory and we pair it with that positive cognition. And we continue doing the bilateral stimulation, measuring the effects on that one to seven scale. And so the goal is for the person to be able to bring up the memory with that positive cognition, “I'm safe today”, or “have some control,” or “I'm a good person,” “I am lovable.” And to bring up that memory and to feel it's true in the body. So in this way, EMDR therapy is a paradigm of resilience, but we're not done yet. What we're gonna do is a body scan, bring up that memory and that positive cognition from safe today, for example, and scan your body. Let me know if there's any tension or tightness or usual sensation. And if there is, we'll continue to process it. Then we have closure. We wanna make sure the person's grounded at the end of the session. As Francine Shapiro put it, we wanna be sure the person can go out into the real world and, and deal with, handle heavy machinery. And we explain to the person that other memory spots, emotions may come on up. In other words, the processing can continue. It's like scraping out a beaver damn, water starts to flow. Things may come on up. And we also talk to the person, teach the person how to calm themselves in procedures and, techniques and imagery that can be used to calm, to calm oneself. Then the last phase is where your evaluation at the next session we have the person bring up the memory. We see if the treatment effects have maintained. And also we, we ask what else has come on up? And we go from there.
JD Kalmenson: I love that. I absolutely love that. You know, in the Hebrew language, I'll just conclude, there's certain terms that are very often interchangeable, “thou shall not forget,” and that “you should remember.” And it always struck me that they seem to be repeating the same thing. If you don't forget, then you're remembering if you're remembering that you're not forgetting, but then it occurred to me that they're actually very different from each other. You can only remember that which you have forgotten when we say don't forget, we're saying never release that memory to begin with, because remembering with presuppose that you released it, you forgot it. And now you're re-engaging with it. And I love how there's a duality of what you're describing with the EMDR that on the one hand, we want to allow the negative, painful experiences and memories to be forgotten, to be stored, to find closure, to be processed and to be released from their toxic implications and stranglehold on our wellness and equilibrium. And then the positive cognition, the memory, the identity, the perception of all strong character assets that we have that make a special and beautiful and valuable and unique. We never wanna forget that, we wanna bolster that. And that's really, that becomes the source of the resiliency. So that's a, that's a, that's a beautiful duality and a fusion that's going on here.
JD Kalmenson: Thank you so much, Roger. This has been such an amazing experience to hear this insight and the work that you do. So enlightening. I just truly wish we had the opportunity again, when things are a little calmer, and the world is a little safer and you're a little less busy
Roger Solomon: Indeed, indeed I be happy to elaborate on it and maybe, show you, be able to show you a video.
JD Kalmenson: I would love that.
Roger Solomon: Rabbi, I, I very much enjoyed our, our conversation. You have a good grasp and insight on the therapeutic process. Thank you so much for what you do and those who are listening. Thank you very much for, for listening.
JD Kalmenson: Of course. Thank you and much, so much success with your mission, with your holy mission and, really stay safe. And thank you to our audience for joining us too. I hope you've learned something from today's episode of Discover U and that it enriches your life. At Montare, we want you to know that you're not alone on your journey, and to find out more about our programs, you can always find us on the web at Montarebehavioralhealth.com, and you can listen to this podcast, Discover U on iTunes, Spotify, or wherever you get your podcasts. Wishing all of you, thriving health and a safe and truly fulfilling day. See you next time.