Trauma Therapy: Stepping Out of the Past through EMDR
Trauma is not a new concept. As many folks know, trauma has been with us for generations. For as long as humans have been encountering danger; we have been experiencing trauma. While trauma and trauma treatment are being talked about and facilitated more than ever; it is something we have always needed. Traumatic events can happen in our lifetimes and the physiological effects of trauma can be passed on through generations with events such as the enslavement of African people and the Holocaust (source).
Understandably, when we think about the horrors our ancestors have endured, the pain and suffering of our parents or grandparents, it is sometimes hard to think of ourselves in our very modern lives as people who experience post traumatic stress. The most common refrain I hear from survivors is “it wasn’t that bad,” or “other people have had it worse.” The thing is, your pain does not need to measure up to anyone else’s in order to be valid and to have had a meaningful impact. You still deserve healing, recovery and compassion. You also don’t need to be a “perfect victim.” Perpetrators of harm are often victims of harm themselves. You too deserve to heal.
Trauma, PTSD and CPTSD
It may sound strange but not all traumatic events result in what we call Post Traumatic Stress Disorder (PTSD). To put it simply, PTSD occurs when a person is not able to complete a stress cycle that was caused by a traumatic event. Hypothetically speaking, let’s say that I am a child who experiences a single traumatic event. I am put into the care of someone for a short period of time who hurts me. On one path I have caregivers who have created a culture where I feel safe enough to share that I have been hurt, or they inquire and show interest in how I feel about the time spent with this person. My caregivers then have the opportunity to protect me and offer space to discuss and process that event in as much detail and for as long as I need until I feel it is truly behind me. In this scenario, I am unlikely to experience post traumatic stress because I went through the scary thing, found safety, and had that safety affirmed. In addition, any lingering distress I experience would be verbally processed and I would have access to emotional regulation skills. In addition to moving past this event, I may also develop resilience because of the support I received and the confidence I was able to build in my ability to understand reality and the role I played in a scary situation.
On a different path, I may have caregivers who did not create a culture of safety around disclosure, are not inquiring about my experience, and may even reject me when I share that I was hurt. If I am not able to find safety after feeling afraid and if I cannot process and therefore understand what happened to me; I am now left to wonder if it was my fault. I may think “I should have stopped this,” “if I was better this wouldn’t have happened to me,” “my parents don’t love me enough to protect me, so I must be unlovable.” I never get to end the stress cycle because I do not feel safe. I also will not be able to process the event and it may stay locked in my mind and body as if it was still happening, or it could happen at any time. Random stimuli that remind me of the person and what happened may trigger me and make me feel as if I am back in that same place being hurt again. The constant heightened stress could affect my health and cause issues with digestion, blood pressure, and my ability to concentrate and complete tasks. I may internalize the belief that it is my fault because no one has told me otherwise.
Furthermore, if this neglect continues and I am put back in the care of the person who harmed me for months or even years, I am likely to develop what is called Complex Post Traumatic Stress Disorder (CPTSD). The complex modifier indicates that the trauma is chronic, compounded and ongoing. There is no recovery period, and safety may only be reached for short periods of time. Additionally, due to this neglect by caregivers and ongoing emotional dysregulation, I may encounter other traumatic incidents and unsafe people on top of the pre-existing abuse. Disturbingly, I may even attract people who want to hurt me because they are able to sense that I am not able to find or feel safety. It may feel like every person and experience is dangerous, and it must be something that is wrong with me that allows the abuse to continue.
During this time survivors of CPTSD may experience what is often referred to as splitting. Our personalities are fragile in childhood, and ongoing trauma can cause our personalities to fracture into parts so that we are able to survive. One part shows up to school and appeases teachers, one part is fearful and quiet in order to stay safe at home and takes the abuse, and there may even be one part that acts out and misbehaves in order to gain some semblance of control or attention. As we grow up, these parts drift further apart, and as adults we may seem to people like our moods are erratic, we may be prone to impulsive behavior or have low self esteem and impaired judgment around relationships. We may rely on drugs and alcohol just to tune out the constant barrage of disturbing images and numb the physiological effects of stress.
In all likelihood, the version of me on the 2nd path will be an adult who has a lot of challenges in relationships, physical health, and financial instability. If I have the resources, I may reach out to a trauma therapist to help me to make sense of it all and heal.
EMDR: Completing the Cycle
One of the many fascinating functions of EMDR (Eye Movement Desensitization and Reprocessing) is to help clients complete the stress cycle and correctly file traumatic memories into the past where they belong. EMDR helps clients desensitize traumatic memories so they are able to remember and think about upsetting events without feeling as if the events are currently happening. Clients will also identify the negative beliefs they have about themselves that accompany the traumatic memories such as, “it’s my fault” or “I’m unlovable.” Through reprocessing and using bilateral stimulation, clients can sit with and remember a traumatic event with an outside perspective. Often when we do this, we may notice things we weren’t able to see or understand before. Such as, “how can a child be responsible for the actions of an adult?” If we stick with the path two scenario: this whole time I have believed implicitly that the abuse I suffered as a child at the hands of an adult was my fault because that is how I was able to make sense of what happened. If I do something differently I can control the outcome, therefore; it is my fault it happened in the first place. This false sense of control is absolutely necessary for someone who is enduring abuse and it has unfortunate consequences if it is never challenged. The truth is, I did not have control over the decisions of adults and caregivers. It wasn’t my fault.
It may sound simplistic that a change in perspective can be so life altering for folks; but these scripts harm us in ways we are not always aware of. If my implicit belief, running like a software virus in the hard drive of my mind, is “it is my fault when other people harm me” then I am unlikely to notice or be alarmed when someone is harming me. I am more likely to be taken advantage of at work, to partner with someone who emotionally and or physically abuses me and I may also tolerate sexual abuse or not believe that I have a right to say no when someone coerces me. I may also internalize all of these actions by others as my fault and never share with people and avoid trusting others. These beliefs really impact the way we view ourselves and how we are able to navigate abuse, manipulation and stressful situations.
If I learn that the harm done to me was not my fault, I am less likely to tolerate harm in other areas of my life. I am more likely to choose partners who treat me with respect, I’m less likely to stay in a workplace that treats me poorly and I am more likely to hold myself in a positive regard. I may even have better physical health outcomes and a longer life.
But, How Does it Work?
EMDR has broad applications; however, it is not the appropriate model for every situation or every person. Your therapist will spend time getting to know you, and you should also be assessing how safe and comfortable you feel with your therapist. After this initial phase, you both may agree to begin EMDR treatment. For those with less resources and who experience higher levels of dissociation, you may spend more time “tapping in.” Tapping in is a concept created by Laurel Parnell for her EMDR modification modality, Attachment Focused EMDR. Tapping in involves identifying feelings and associations of calm, safety and secure attachment figures (which can be fictional) and literally tapping while thinking about and feeling the bodily sensations of safety, calm and connectedness. Bilateral stimulation, which is what we use in EMDR, activates our slow thinking which allows us to be present with our feelings and with tapping in, we are creating and deepening new neural pathways for much needed positive associations.
EMDR has multiple phases, but the phase you will spend most time in is called reprocessing. During this time you will identify a memory, negative belief and associated bodily sensations. Your therapist will guide you through bilateral stimulation and stay present with you while you sit with the memories and bodily sensations as they pass through your mind (a favorite metaphor of EMDR trainers is watching the scenery pass you by on a train). The therapist may ask you what you are noticing, or allow you to report as you reprocess what images, thoughts, sensations and feelings occur to you. During this phase you should begin to notice the desensitization and your ability to sit with the traumatic memory and allow it to pass you by while also picking up more context and content that had been previously lost. Sometimes this context is positive, memories of being loved, having fun or meaningful experiences that have been overshadowed by the trauma. You will also notice associations as you create your associated memory network. For example, something that happened in childhood that was a formative experience may be connected to something that is happening in adulthood. We aren’t aware of the patterns that have been playing out throughout our lives if we are not questioning and examining the negative beliefs we carry. This process can be quite liberating.
Overtime, through treatment, the intensity of the upsetting memories should fade and while you can still think about those memories, you will no longer feel the intensity of emotion and bodily sensations while you recall it. You may also find yourself unaffected by stimuli that used to be triggering. You will likely also find closure with this process. Your negative beliefs will turn to neutral or positive ones, you may notice and remember more fondly people who were there to help you in dark times, and you may finally feel as if that stress cycle has completed. It’s over, you’re safe, you’re here now and you are going to be okay.
You Deserve to Feel Safe
EMDR therapy is a highly effective model for those who are suffering with PTSD. For folks living with CPTSD, the modification of Attachment Focused EMDR helps heal attachment trauma and clients are able to sort through the compounded hurt in order to find themselves as people who are worthy of love and care. Tapping in can help those less resourced, and a therapist will help clients who may still need higher levels of care to access proper treatment programs.
Unfortunately, not all practitioners of EMDR are capable of treating folks with more severe cases of CPTSD and dissociative disorders. While this modality can work for a wide range of clients, there are other forms of trauma therapy and resources for accessing safety and healing. Trauma Focused Cognitive Behavioral Therapy, Internal Family Systems, Narrative Exposure Therapy and relational, collaborative therapy are a few evidence based practices. Restorative yoga and other forms of somatic work have been shown to be effective as well.
Ultimately, what matters most in the therapeutic process is the relationship, trust and report that exists between client and therapist. Regardless of the therapeutic model, you can find healing and repair with a therapist who provides safety and positive regard. You have power in this relationship too, in deciding what feels safe and right for you and your journey.
