Exposure to traumatic events can lead to PTSD (post-traumatic stress disorder), an anxiety disorder characterized by flashbacks of the traumatic event, avoidance of situations or settings that could serve as reminders of the trauma, emotional numbing and a tendency to isolate oneself from others. Those suffering from PTSD often live in a state of hyperarousal constantly on the alert for signs of threat or danger.
Although persons exposed to traumatic events, such as but not limited to combat, terrorist attacks, sexual assault or childhood abuse can recover and heal, according to The National Center for PTSD and The Department of Veterans Affairs, 20% of the women and 8% of the men will develop PTSD.
PTSD is a serious disorder with physical as well as emotional manifestations. Timely diagnosis and treatment can prevent the occurrence of comorbid conditions such as alcohol or substance abuse, depression or acting out.
Someone suffering from PTSD can feel estranged from others and hopeless about being able to fit back into the fabric of society. This type of mindset often takes its toll on relationships, family harmony, successful employment and the willingness to participate in social/recreational activities.
Although there are a number of therapeutic approaches available to help those suffering from PTSD, Eye Movement Desensitization Reprocessing (EMDR) is often the treatment of choice.
Keep in mind when considering treatment options for your PTSD that according to a March 2, 2012 NY Times interview with Francine Schapiro PhD, EMDR has been shown to be effective in twenty randomized controlled research studies conducted to evaluate its efficacy. Additionally, a number of national as well as international mental health and trauma organizations, including the American Psychiatric Association and The International Society for Traumatic Stress Studies, have identified EMDR as one of several recommended treatment options for PTSD.
EMDR is a comprehensive treatment approach that addresses the past, the historical antecedents of the distress, the present, internal and external triggers that serve as reminders of the original trauma and the future, identifying what tools and coping skills are needed in order to achieve healing and happiness.
EMDR was invented accidentally in the 1980s by Washington State psychologist Francine Schapiro. Dr. Schapiro was taking a walk when a painful thought crossed her mind. She moved her eyes back and forth from left to right and noticed that the thought was deleted. Dr. Schapiro then purposefully brought the unpleasant thought back into awareness and discovered that the thought now had much less of a negative impact. Out of this moment was born a psychotherapy modality widely and consistently backed by research to be effective in the treatment of trauma.
In applying EMDR, the certified EMDR consultant is thought to stimulate a process akin to that experienced during the REM cycle of sleep, which is thought to be a very active phase where memories are consolidated. One way this process can be initiated is by the therapist slowly moving his fingers back and forth in front of the client’s field of vision. Bilateral stimulation can also be initiated through use of a tec/audio scan. In this way, the client can choose their preferred sensory modality and either listen to tones that can vary in terms of volume and speed or opt for tactile stimulation called tapping.
Following extensive history taking and preparation, a client is asked to define the most difficult (“the worst” in EMDR language) part of a traumatic memory to target with EMDR. This is used as a starting point for reprocessing traumatic memories on an emotional, cognitive and physiological level. The goal of EMDR is to replace painful traumatic memories with more adaptive ones.
EMDR follows an eight phase manualized approach in which phases one and two are used to gather historical information, formulate a treatment plan, explain the procedure in detail, give you an opportunity to ask questions and ensure that you, as a client are ready to begin treatment and have access to stabilizing and self soothing techniques.
In phase three through six the trauma itself is targeted. In addition to asking you to briefly access the worst part of the trauma through either imagery, sound, smell or touch, you will be asked to rate the intensity, describe where you feel that in your body and the emotions that go along with that memory. You will also be asked to identify a negative belief about yourself that you associate with the trauma.
The therapist will then instruct you to think about the worst part of the trauma, your negative belief and the emotions and bodily sensations experienced as part of that memory, and to hold all of that together in your mind at the same time while she initiates bilateral stimulation to allow the reprocessing to begin. You are also asked to pinpoint a positive belief.
The therapist will ask, “What would you like to believe about yourself now?” in reference to the trauma and to rate the validity of that belief on a scale of 1 to 7. Reprocessing is not complete until the intensity of the trauma reaches a rating of 0 or 1, there are no noticeable disruptive bodily sensations, and the positive belief has replaced the negative belief, which is now valid and believable beyond a doubt.
During phase two, when the therapist assesses your readiness to begin EMDR, she will be able to determine whether you have an adequate array of coping skills at your disposal and a strong support network. Should the therapist determine that it may be beneficial for you to learn some self soothing and stabilizing techniques, she will instruct you accordingly.
EMDR frequently works more quickly than other treatments for PTSD. For adult onset or simple trauma PTSD, EMDR has shown positive results following three 90 minute sessions in addition to the preparatory work required by the protocol. The length of treatment is, of course, individualized and does follow a longer course for cases of complicated trauma. After you are comfortable and willing to undergo EMDR, ask your practitioner how many sessions and what exactly is going to be required to heal.
In phases three through six you will be asked to briefly focus your mind on the worst part of the trauma experience in order to initiate reprocessing. Following a set of dual stimulation (bilateral stimulation along with your holding the traumatic image, emotions, belief and bodily sensations in your mind) most often about 20 to 30 seconds in length, the therapist will ask you to clear your mind.
You will then be asked if any new associations or insights have emerged. Your answer to this question determines what part of the trauma needs to be addressed next. Since EMDR contains elements of many different therapy approaches, it is not yet clearly understood which components are responsible for its success. Some researchers are convinced that the mere act of holding a traumatic memory in mind and then erasing the memory can help to instill a sense of control.
With EMDR, you don’t have to expose yourself to situations, events, or people who are reminders of the traumatic event in order to heal. This therapy takes place within the safe confines of the therapist’s office and follows a set protocol.
If the therapist finds that you don’t have adequate stress management techniques at your disposal, she will delay the onset of treatment until such techniques have been acquired and mastered. EMDR treatment is not complete until the therapist has worked with you on a future template to determine what behaviors and skills are required to assure happiness going forward.
The therapist does not offer insights, but only acts as a guide, stimulating reprocessing while providing a calm, encouraging, safe atmosphere. Your therapist will teach you how to self soothe and tolerate your emotions so that you can use these techniques at home. The purpose of EMDR is to replace traumatic memories with adaptive ones, which is mainly done through an internalized process.
EMDR is a comprehensive treatment approach that incorporates components of a number of different psychotherapies. It proposes that a traumatic event can be so overwhelming that it freezes the information processing center of the brain. The memory becomes embedded on a guttural level including the raw emotions, physical sensations and accompanying beliefs. EMDR is believed to stimulate the information processing center facilitating reprocessing by allowing memories to be transferred from episodic memory to semantic memory.
EMDR does not confine itself to alleviating symptoms of PTSD, but rather strives to replace painful memories with adaptive ones and to provide a blueprint for a fulfilling, happy future. Keep this advice in mind when considering treatment for PTSD or healing from traumatic events of the past.
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