EMDR

We provide an overview of EMDR - an evidence-based treatment used to treat symptoms related to past adverse experiences and/or traumatic incidents.

Transcript

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Welcome to the Inner Solutions Podcast. We are your hosts, Donna Hughes and Jessica Heil. We own and operate Inner Solutions, a private practice clinic located in Calgary, Canada. We seek to understand and help our clients by providing empirically supported treatments and evidence-based practices with compassion and expertise. This podcast will provide you with information regarding complex psychological conditions as well as treatments that are available. Welcome back to the Inner Solutions Podcast. I'm Jessica Heil, and today we are going to be talking about EMDR, which is another trauma treatment that we use frequently here at Inner Solutions. EMDR is short for eye movement desensitization reprocessing. It is an evidence-based practice that was developed by Francine Shapiro. Evidence-based practice means that the therapy has been shown in research that it is effective for treating the thing that it was tested to treat. So in our case, EMDR is evidence-based when it comes to treating PTSD or post-traumatic stress disorder, though it's used for a variety of other things as well. It can treat what I would consider to be like subclinical symptoms of trauma or PTSD. So it's like when people are experiencing some symptoms that look related to trauma, but they maybe don't quite meet the threshold for diagnosis of PTSD. Examples of this might include things that were maybe adverse experiences in our past, but that didn't create the full range of symptoms that we see in post-traumatic stress disorder. Adverse experiences might be things like bullying or having things just not go the way that we really wanted them to in life, maybe a job or schooling that didn't end up the way that we had envisioned it. Perhaps we have disappointments in life, bad breakups, bad relationships, any of those types of things, EMDR can treat the residual symptoms of very, very well. It's a great choice for treating memories that are related to pervasive adverse events. Pervasive meaning that it happens consistently, that it's not just a single episode of a traumatic event. It's something that happens kind of like over and over and over again. If you recall from last episode, we talked about prolonged exposure. And I said that that's a really great treatment for single episode PTSD, though it can be used to treat other forms of trauma, like more pervasive forms, but it's not what it's known for. It's known for single episode. EMDR is known to treat events that happen over and over and over again. And again, it can also be used to treat single episode. So both trauma treatments do both, but they're also better known for one or the other, either single episode or pervasive events. EMDR works by choosing a memory that we anchor the trauma work to, but then expanding the work into treating other memories that are related to the memory that we've chosen. So it uses the memory as an anchor, but then it's able to treat things that are related to that original memory that we choose to target. There's something called the adaptive information processing theory that EMDR therapists endorse. It's the idea that the brain has an information processing system that assimilates new experiences into already existing memory networks. For example, if we see, say, like a type of dog that we've never seen before, we are able to conclude that this is a dog because it has four legs, it has a tail that wags, and it has a tongue that hangs out. So our brain goes, ah, like I've seen something like this before. This must be a dog. The brain is making neural connections like that all the time and assimilating new information and making assumptions about what we're seeing, what we're observing, based on the things that we've witnessed before. Problems, however, arise when an experience becomes inadequately processed. So for example, distressing incidents generally become stored in what we consider to be state-specific form, meaning that it gets frozen in time in its own little neural network, like its own little trauma network, and it becomes unable to connect with other memory networks that hold other adaptive information. Over time, that means that each time something then reminds us of whatever the distressing event was that created that original trauma neural network, the neural network then gets triggered over and over again in its original form, which means that we essentially experience the same emotions and thoughts and behaviors and beliefs that we are experienced in that original trauma network. So then essentially anything that even seems like mildly correlated with a cue that reminds us of a past traumatic event will get assimilated into these memory networks because that's just what brains do. It'll pick up on cues and go, oh, I've seen this before. This must be this thing, just like it does with dogs, right? So we see something that looks like a dog and our brain goes, ah, it's a dog. Our brain's going to do the same thing with trauma-related cues. In EMDR, what we're really trying to do is help the brain kind of pause in that assimilation process and instead start to connect to different neural networks that are more adaptive for us, that they might help us see the world through a different lens than this trauma-related lens that our brain starts to see everything through when we have undergone a traumatic incident. We are really hoping that the brain will eventually connect with, say, like a network of like resiliency that the person experienced in other parts of their lives, or that the person might start to realize that because they've gone through the trauma, there's a lot of strengths that they've been able to build. There's a lot of skills that they've learned because of this incident, as opposed to seeing the incident as being purely negative and damaging. Processing in EMDR leads to adaptive shifts in all components of our memory. So it's going to start to change like the symptoms that we experience, but it'll change things like our sense of like time and our sense of age. Sometimes in trauma, we when we re-experience trauma, we feel really small. We feel quite little because it takes us back to the way that we felt at the age that we were of the trauma. So processing is going to start to shift all of those types of things and we'll start to feel more like our age. We'll feel more like adults if if we are indeed adults. It also shifts things like our behaviors, our beliefs about ourselves, the world and others, our sense of self altogether, our self-respect, self-esteem. So it's a pretty cool process. It's really quite beautiful to see the progress that people can make. But of course, it takes time to get there. But most people, many people who do EMDR, they will get there eventually. Our goals in EMDR would be to shift and decrease the distress associated with past events and to shift away from experiencing negative beliefs about the self, the world, and others, and instead start to believe something more positive or adaptive about ourselves and the world and others. There's strategies that are used during EMDR that will help us maintain our presence in the current moment and help to reduce dissociation for anybody who does experience dissociation. Dissociation is when we start to feel like we are not real or that we're like stuck in a dream or that we're losing track of time. How EMDR helps with this is that they use something called bilateral stimulation, which is essentially a back and forth movement that we use. It's known, if you think about the title of EMDR, eye movement desensitization reprocessing, where EMDR started in its original form was using back and forth eye movements to help a person create that bilateral stimulation rhythm. EMDR has evolved since then to using all sorts of different bilateral stimulation now. There's lots of people who use tapping, so tapping back and forth stay on their knees. There's people who use buzzers, so having like a machine that does a little buzz in each hand back and forth, buzz, buzz, buzz, buzz, buzz. And there's a variety of other different methods that are out there using a variety of different technology as well. But ultimately, that bilateral stimulation helps you keep one foot in reality while one foot is also in the past. So helps to reduce dissociation. It also helps to mimic REM sleep, where what we know about REM sleep is that when we experience it, it helps the brain start to store emotional content from the day before and make sense of it. It will start to categorize things and put that emotional content in kind of like a sequential order so that we're able to understand our own narrative about what happened throughout the days and wake up feeling refreshed and ready to start the new day. Think about the days where you don't get that good REM sleep, you often feel quite a lot more dysregulated. So REM sleep really helps to enhance emotion regulation. And something about that eye movement, scientists know, helps with that. It assists with the process of REM sleep. So that's the other piece of the bilateral stimulation in EMDR is that we are trying to mimic REM sleep to get a little bit of that adaptive effect from that back and forth eye movement. In EMDR, we're really letting the brain go on a bit of a train ride where your role is really just to sit on the train and watch the scenery go by. The scenery is a metaphor for your thoughts, your emotions, body sensations, whatever it might be. Sometimes the scenery can be nice to look at, and other times it can be quite distressing. But if you stay on the train long enough, the distressing scenery will pass and you'll no longer feel uncomfortable and things start to become a little bit more uh just more back to that word adaptive. Like it starts to become easier and you might have different, more positive thoughts and emotions that'll show up. The first few sessions in EMDR are quite, they can be quite distressing. Usually we're gonna see a lot more of that distressing material showing up in earlier sessions, especially the first one. And then after a couple sessions, we're gonna start to see more of that adaptive processing start to show up and thoughts about resiliency and how we can get through difficult situations, et cetera. But it does take time. So in those first sessions, again, just really expecting that the memories, emotions, and thoughts and body sensations that are occurring may not necessarily be the most pleasant. And they're important to experience because part of being able to treat trauma is to be able to experience emotion and not run from it. Once we start to get through some of that distressing material, we'll really start to see more of that adaptive information emerging throughout the sessions where you'll start to notice that you're thinking about yourself in a different way, thinking about the world in a different way, and you're going to start to be able to link your memories back to more positive memories. So it's a really, really cool process and is absolutely worth I think anybody's time if they have been experiencing either clinical or subclinical PTSD symptoms. This can be absolutely life-changing. There is a really great website, which is emdri.org. This is the official website for EMDR. And on the website, you'll see that there's lots of resources that will explain what the therapy is, as well as links to a variety of articles that show the research behind EMDR. So definitely worth taking a look at. But I think that's it for today. So thank you so much for listening and looking forward to seeing you next episode. Thanks so much for listening. If you found today's episode helpful, please go ahead and leave us a review, and you can also follow the show so that you don't miss out on any future episodes. For more information about us, you can check out our website, www.innersolutions.ca.