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  D e s e r t   E x p o s u r e   May 2010


Getting Unstuck

EMDR helps people deal with experiences in their lives that for some reason their brains were not able to completely process at the time.

By Molly Gierasch

It had been six months since Mary had been in the car accident. Physically, she was greatly improved, but when she considered driving she could not escape the memory of the deafening sound of screeching tires and breaking glass. Her arm, which had been broken, often would throb with pain. She felt a continuous lump in her throat. Her doctors told her there was nothing more that they could do and they could not understand her continued pain. As time passed, her flashbacks increased and she was having difficulty sleeping. When she came to me for therapy, she told me she could not drive without becoming extremely anxious. She couldn't drive from Boulder to Denver. She restricted her driving to very familiar routes and drove only when absolutely necessary.

She came to me having been told that I specialize in EMDR, or Eye Movement Desensitization and Reprocessing (these days, EMDR involves other bilateral techniques such as tones, tapping or hand-held buzzers). In our first session, Mary described her problem and told me more about her history. Now 32 years of age, Mary operated her own bookkeeping business, had good friends, was close to her family and enjoyed a solid relationship with a supportive man. Of course, like all of us, Mary had experienced challenges in her life, but felt she had learned from her experiences. Before the accident, she had felt strong and confident. Now, she said, "I feel like a failure."

Mary was able to begin EMDR in our second session. By the end of four sessions, Mary was driving comfortably, her sleep problems had disappeared, the pain in her arm was gone and she had no more flashbacks. Mary once again felt a sense of confidence and strength. She told me that she had driven to Denver and back with no problem: "I know the accident happened, but I'm alive, I'm strong and I can deal with what comes my way."

EMDR is not just for those of us who might experience "single incident trauma." Many people have experiences in their lives that for some reason their brains were not able to completely process at the time. Perhaps they were too young, too overwhelmed, or the experience could not be dealt with because there were too many other things going on.

When an experience does not completely process, the memory with all associated sensory information seems to get stuck in the limbic system in the brain. The unprocessed memory material can get triggered in later situations and may be confusing and even frightening. This can result in depression, sleep problems, anxiety, behavior problems or just plain feeling "stuck." It can even result in Post Traumatic Stress Disorder (PTSD). EMDR may be useful in all of these situations.

EMDR is not a quick fix. It is well-researched, good solid therapy done by an experienced clinician who has completed a training lasting more than 50 hours. The EMDR technique, involving a carefully directed protocol, is only part of this therapy. As in any good psychotherapy, the therapist and client need to establish a trusting relationship. The therapist must take a complete history so the therapist and the client can become detectives working together toward healing. The therapist helps the client develop stronger resources, skills and understanding to cope better in day-to-day life.

Together they begin to discover what past events in the client's life still feel disturbing and might be contributing to present-day difficulties. These events can be "targeted" with EMDR when the client is ready. The client will begin, then, to see the results and changes in present-day life as healing proceeds.

How was EMDR developed?

In 1987, psychologist Dr. Francine Shapiro made the chance observation that eye movements can reduce the intensity of disturbing thoughts, under certain conditions. Dr. Shapiro studied this effect scientifically and in a 1989 issue of the Journal of Traumatic Stress, she reported success using EMDR to treat victims of trauma. Since then, EMDR has developed and evolved through the contributions of therapists and researchers all over the world. Today EMDR is a set of standardized protocols that incorporate elements from many different treatment approaches.

How does EMDR work?

No one knows how any form of psychotherapy works neurobiologically or in the brain. We do know, however, that when a person is very upset, the brain cannot process information as it does ordinarily. One moment becomes "frozen in time," and remembering a trauma may feel as bad as going through it the first time because the images, sounds, smells and feelings haven't changed. Such memories have a lasting negative effect that interferes with the way a person sees the world and the way they relate to other people.

EMDR seems to have a direct effect on the way that the brain processes information. Normal information processing resumes following a successful EMDR session, and a person no longer relives the images, sounds and feelings when the event is brought to mind. The past experience no longer negatively affects the present. Many types of therapy have similar goals. But EMDR appears to be similar to what occurs naturally during dreaming or REM (Rapid-Eye Movement) sleep. Therefore, EMDR can be thought of as a physiologically based therapy that helps a person see disturbing material in a new and less distressing way.

What is an actual EMDR session like?

When the client is ready for the EMDR treatment, the therapist directs the client to call to mind the disturbing issue or event and related sensory associations, thoughts, feelings and beliefs that are currently held about that issue or event. The therapist facilitates the directional movement of the eyes or other dual attention stimulation (DAS) of the brain (bilateral tapping, tones, hand-buzzers, etc.) while the client focuses on the disturbing material. The client just notices whatever comes to mind without making any effort to control what is happening. Each person processes information uniquely, based on personal experiences and values. Sets of DAS are continued until the memory becomes less disturbing and is associated with positive thoughts and beliefs about one's self. During EMDR, the client may experience intense emotions, but by the end of the session, most people report a great reduction in the level of disturbance.

How long does EMDR take and does it really work?

Getting to know each other and deciding whether EMDR is an appropriate treatment can take one or more preperatory sessions. A typical EMDR session lasts 60 to 90 minutes. Often treatment takes only a few weeks; more complicated situations take longer. EMDR may be used within a standard "talk" therapy as well, and generally shortens the required length of treatment.

There are consistent findings that EMDR effectively decreases/eliminates the symptoms of traumatic stress. Clients often report improvement in other associated symptoms such as anxiety. EMDR can be an efficient and rapid treatment for many issues. It has shown to be 100% effective for phantom-limb syndrome, for example.

What kind of problems can EMDR treat?

Scientific research has established EMDR as effective for Post Traumatic Stress Disorder (PTSD). Clinicians also have reported success using EMDR as treatment for many other problems including: panic attacks, complicated grief, disturbing memories, phobias, sexual and other abuse, pain disorders, anxiety, chronic illness, depression, stress reduction, performance enhancement, and feeling just plain "stuck."

The current treatment guidelines of the American Psychiatric Association and the International Society for Traumatic Stress Studies designate EMDR as an effective treatment for post-traumatic stress. EMDR has also been found effective by the US Department of Veterans Affairs and Department of Defense, the United Kingdom Department of Health, the Israeli National Council for Mental Health, and many other international health and governmental agencies. Research has also shown that EMDR can be an efficient and rapid treatment. For further references, a bibliography of research may be found through the EMDR International Associations' website, www.emdria.org

Molly Gierasch, PhD, has been a psychotherapist for over 25 years. She has been using EMDR for over 20 years and had an EMDR training organization in Colorado for over 12 years. Now living in Silver City, she is a Licensed Psychologist here and has begun a private practice. She is a Medicare and Medicaid provider and is becoming a provider for other insurance companies in this area. Contact her in Silver City at 534-2856 or by email at molly60g@indra.com

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