brain, mind, psychology

How EMDR (Eye Movement Desensitization and Reprocessing) Therapy Can Help Treat Trauma and PTSD

GINNY GRAY, Therapist, LCSW

EMDR (Eye Movement Desensitization and Reprocessing) was developed as a treatment for the intense and debilitating symptoms that result from a traumatic experience, or from chronic abuse. Flashbacks, panic attacks, and nightmares are all examples of the symptoms that continue to plague long after the original event or abuse has happened. EMDR offers individuals extraordinary treatment and healing from PTSD, whether it is from a single event that has traumatized the individual, or is the result of long term chronic abuse.  EMDR treatment is gentle, non-invasive, and takes great care not to expose the client to past traumatic experiences. It is efficient and time-saving and the chosen modality recognized by insurance companies for treating PTSD. EMDR is not a replacement for traditional psychotherapy, but an extraordinary complement to it.

The Brain has a natural ability to process memories and heal itself and the impact of trauma. Normally experiences become memories through a lengthy process of integration and reinterpretation, a process that automatically happens in the mid/brain area without any input from the conscious self. When the process is complete, an experience is integrated with other life events. Those which an individual will need are saved and those which are not are naturally pruned from memory. However, when a single traumatic event or ongoing traumatic abuse occurs, this process gets hijacked and fails. Instead, the memory remains “live” and the victim continues to feel the pain and terror as if it is happening in the present with all of the accompanying distress and fear. The intense distress reaction can be triggered by a random sound, smell, touch or image. The victim is then left to cope with that ever-present fear and terror in the form of nightmares, flashbacks and panic attacks.  This may cause them to engage in maladaptive coping behaviors, such as drinking and drugs and other numbing behaviors that help them escape their intense distressed feelings.

The brain has the ability to protect and heal itself much the same way our bodies are designed to heal after a physical wound. Initially, when one is subjected to trauma, the mind does its best to respond. The first defense is to protect oneself through fight or flight. However, when one survives a traumatic event sometimes they are unable to return to a feeling of security and safety. One terrible random incident, which would probably never occur twice, can still prevent the individual from FEELING that it is over.  Because of the terrifying ongoing symptoms, they do what they can to cope, feel safe and protect themselves. As a result, they are consistently anxious, hyper-vigilant, and/or avoid seemingly innocuous situations.

Physiologically what happens at the time of the trauma is our senses send messages of present danger, stimulating the chemicals Cortisol and Adrenalin, which trigger life-saving fight and flee reactions. However, this lightning- speed process simultaneously shuts down (blocks) the part of our brain responsible for reasoning and rational thinking. This system is amazing in its design. For in the moment of intense danger our safety depends, not on analyzing the situation but on saving oneself from it. We know the “thinking” part of our brain is also responsible for processing our experiences and making sense of them. The brain puts experiences into a contextual understanding of the event, but because it’s offline, it is unable to process and integrate these experiences in a natural, healthy, and functioning way. As a result, a random terrible experience is not processed as such. Instead, it remains live, never allowing one to feel any sense of real safety because the body and mind have not been able to distinguish safe situations from the dangerous ones of the past. For example, a young girl who is a victim of childhood abuse will not only fear that person, but may live in fear of all men, and when triggered will experience imminent danger and real terror. This is why sounds, sights, smells and touch, triggered by internalized memories, continue to produce the same terror and the same fight, flee, or freeze responses even when one is not in mortal danger.

Why do some people survive and integrate traumatic experiences and some do not?
Not everyone who goes to war witnesses or experiences a traumatic event, or is the victim of abuse or neglect or experiences PTSD.  The belief is that trauma integration is not only affected by what happened but what continues to happen after the trauma and how one makes sense of the event. For example: If a child is lost for a short while, but then found and a loving reunion happens, the child integrates that experience as a singular event, and because it was responded to in a loving and supportive way, the child’s feelings of safety, predictability, agency, control, and hope remain intact and the resulting impression is that there is love and support for when something bad happens. And yes, bad things do happen, but “I am now safe,” and that was then and this is now and the world is generally a safe place.

The Results of Non-Integrated Experiences:
If one does not get the opportunity to process a traumatic event or abuse that is unrelenting and chronic, the mind and body have nothing but its own internal system to protect itself. All the body and mind can do is be on high alert all the time. Thus, it is understandable that these victims are hyper-vigilant, avoidant, and may engage in behavior that helps them escape the constant terror which may be maladaptive.

The mind can also disassociate to protect oneself when there is no other escape. This means when one is trapped and has no choice but to be continually victimized, the only life-saving mechanism there is, is for the conscious brain to separate itself from what is happening to them. It is not uncommon for one to report the feeling of having left their own body during abuse, watching, but not feeling what is happening to them.

During these experiences, the cognitive, (the thinking and processing part of the brain) is disconnected.  The body is left to respond to the danger and does what it can to feel safe. It is common for the mind to block out traumatic events, which is why abuse may hide or remain blocked from conscious memory for years. Because the memory is stored in the senses, a person may find themselves responding to a sensory stimulus with a fear and panic they don’t understand because they cannot relate the present situation to any past memory. Furthermore, the rational part of the brain’s learning has been compromised and it is unable to distinguish a safe place or person from an unsafe place or person. When the thinking part of the brain comes back online, one may adopt a negative, maladaptive, and inaccurate meaning about the event. Again, in the case of childhood abuse, instead of realizing one was a helpless victim who holds no responsibility for what happened to them, they may believe they are in part responsible or did something to deserve the abuse. They may experience life as a proverbial war zone and feel in ever-present danger.

To illustrate this point, I had a client who was a survivor of childhood incest, a victim of rape and assault, and whose parents continued to verbally abuse her, her entire life. Despite working in their family business, excelling in school, putting herself through college and law school with honors, she lived every minute in a state of impending terror. Though she tried as best she could to escape her pain productively, the debilitating panic was inescapable. Ultimately, she discovered alcohol, and for a little while she could escape the demons. She drank till she blacked out, often getting in her car and driving till she passed out, ending up in hospitals, often in places far away. Once she drove from Connecticut to Indiana, a place she had no reference to. While this seems unthinkable to the average observer, when looking at her through the lens of coping with the pain of her trauma and terror, which she lived in “real-time”  every day, this makes complete sense. What else could she do to flee the war zone which was her daily internal existence. She sensed and felt danger from almost everyone she met. If one’s family is not a safe place, who and where does one go?

How Does Healing Occur?
These disturbing events are stored in the brain within an isolated memory network.  Because the processing area of the brain was shut down at the time of the trauma, learning and healing are prevented from taking place.  As a result, the oldest memories keep getting triggered over and over again and the individual is left suffering endlessly.

BUT, in another part of the brain, in a separate network, is the information needed to resolve it. Trauma prevents the two from linking up and the brain cannot embark on its own healing process. EMDR processing allows the two networks to link up and the appropriate thinking and processing can take place. The brain can begin to accurately make sense of the past, giving the client the opportunity to live in the present, experiencing life in real time, not through the experiential lens of the painful past.

The experience:
A clinician uses bilateral stimulation, replicating what happens during the REM (rapid eye movement) stage of sleep. The REM phase appears to be involved in the processing of unconscious material.  This is where the brain prunes, processes and integrates experiences into a healthy data bank that one can draw from to inform about how to handle life. The clinician asks the client to watch their fingers move side to side, listens to a sound which pings in one ear than the other, or perhaps taps on their knees back and forth as they bring up a pre-determined image that represents a past traumatic event. The dual stimulation triggers the reprocessing mechanism of the brain to resolve and integrate the unprocessed memory that is triggering and causing distress. “The important thing to remember is that your own brain will be doing the healing and you are the one in control”.

– Adaptive Information Processing: AIP

The suggestion is that the trauma itself is in some way causing an imbalance and preventing adequate processing. EMDR enables difficult experiences and memories to be processed properly allowing the client’s sense of self-worth, agency, and control to automatically return. Thus, EMDR has the ability to facilitate profound therapeutic change in much less time than traditional therapy.  The individual will reap the benefit of leading a healthy and productive life by viewing the world and their place in it from a place of safety. EMDR is an extraordinary tool for many trauma sufferers.If you are interested in knowing more or feel that this may offer hope and help, please reach out.

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