Trauma, PTSD, & EMDR Therapy

Trauma:

Trauma can be defined as anything that overwhelms the body's ability to heal itself. 

 

In the medical field the definition might be:

1, a body wound or shock produced by sudden physical injury, as from violence or accident.

2, the condition produced by this; traumatism.

 

From a psychological perspective we get something similar:

1, an experience that produces psychological injury or pain.

2, the psychological injury so caused.

The body is amazing in its ability to heal itself from everyday bumps, bruises, cuts, scratches, infections, mild food-poisoning, burns, etc. But if a wound or illness is serious enough (broken bones, cuts that need stitches, infections, high fevers, etc.),  the body needs help to overcome the trauma.

The same is true for the brain.

Scientists believe that the brain processes the things we've experienced as we sleep, especially during the rapid eye movement (REM) sleep cycle. As we sleep our brain 'makes sense' of what we've experienced, it makes connections or associations to similar things we've encountered before and then files everything neatly in our memory where we can retrieve it if/when we want or need to. Normally, this happens without our being aware of it and we take it for granted, but traumatic experiences can overwhelm the brain and the memories associated with the traumatic event get stuck.

I see this as being similar to what happens if I ask my computer to do too many things at the same time and it freezes. When this happens the only thing that helps to get the computer up and running again is to reboot it.

PTSD

Post-traumatic Stress Disorder (PTSD), is a disorder that is diagnosed when someone isn't getting past a traumatic experience. The brain is wired to protect us, so when we experience a threat it activates the "fight or flight response," which is like setting off a fire alarm in your brain. When this occurs, all sorts things happen in both the body and the brain to prepare to defend ourselves or run. When the threat is real, like being mugged or witnessing a terrible accident, the fight or flight response helps us to take action so that we can deal with the situation, eventually returning to a place of calm, knowing we are safe.

For people with PTSD, their brains are overwhelmed and cannot make sense of what they have experienced, and much like the computer example I used above, the memories get stuck and are not processed. Individuals remain in a state of high alert and future threats (real or imagined), trigger the unprocessed memory, bringing back a flood of emotions that tell them they are not safe, when in fact, they are.  These memories are called flashbacks and they can include sights, sounds, smells, tastes, and/or emotions from the original traumatic experience.

Someone standing in line at the grocery store can be triggered by another shopper who reminds them of someone connected to a traumatic event. They can feel suddenly hijacked into the past, feeling all the emotions (fear, terror, helplessness, can't think, can't speak, can't run, etc.) that they experienced when the traumatic event first happened. Some people experience these symptoms for decades without knowing what's happening.

 

 

The form of PTSD that most people are familiar with is that experienced by soldiers who have been in combat and suffer violent flashbacks that make them feel they are right back in the war.  Other forms of PTSD include chronic PTSD, which is more about being in an unsafe environment for a long time or repeatedly experiencing something distressing. For instance, kids who grow up in neighborhoods where there is violence or gangs, hearing frequent gunshots, may develop chronic PTSD. Living in a home with domestic violence can also cause PTSD for children and victims.  Sexual assault and childhood sexual abuse are also linked to chronic PTSD.

How do we reboot the brain?

EMDR Therapy - putting the pieces back together again.

EMDR stands for Eye Movement Desensitization & Reprocessing. You can learn about it here:  EMDRIA  When first discovered by Dr. Francine Shapiro in 1987, it was thought that moving the eyes back and forth (which might replicate REM sleep) was responsible for an increased ability to process information. Thirty years - and much research - later, Dr. Shapiro said that if she were to name the treatment today, she would name it Reprocessing Therapy. This is because research shows that bilateral stimulation (BLS) of the brain is what activates (or reboots) the brain and allows it to reprocess memories that are stuck.  This activation can also be accomplished through physical or audial means and many EMDR therapists now use small buzzers/tappers or headphones to create bilateral stimulation as alternatives to eye movement.

Memories are normally stored away in a 'whole' form. When we think about past events we can "see" them as they happened, including the images, sounds, feelings, tastes, and smells associated with them. We can think of them as a snapshot in time.

Traumatic or unprocessed memories are stored in pieces or fragments, like a photo painted on glass that's been dropped and shattered.

 

People with PTSD may have foggy or vivid pieces of a memory, but they can't connect them to the whole event. For instance, I had a clear memory of part of a conversation with my mom, but I couldn't remember what the conversation was about until other memories were processed, allowing me to remember the whole event. Other times I've had vague memories where I wasn't sure if things really happened or not.

EMDR therapy can put the pieces back together and it's not necessary to go deep into the memories for this to happen. In a nutshell, clients identify an image that represents the worst part of the memory or event, then a negative belief about themselves that comes from the event (I'm in danger, I'm not important, It's all my fault, etc.), then bodily sensations and/or emotions associated with the event are identified.

 

As the client holds these three things in mind the therapist will start BLS and direct the client to just notice what is comes to mind. This is the rebooting part. BLS is done in sets of about 30 seconds after which the therapist will stop the BLS, ask the client to take a deep, cleansing breath and then provide a brief report of what came to mind for them. Then another set is done using that information. Sets of BLS are done until the therapist notices that the client is reporting positive or more adaptive information. Progress is measured as the client rates their level of disturbance before and after the processing is done. Amazingly, things that were causing great disturbance in someone's life can become just a bad memory in a short mount of time.

There is MUCH MORE to EMDR therapy than this. The information provided here is to provide a brief overview how the treatment works - helping the brain to process and store traumatic memories in a more adaptive way so that the memories no longer intrude uninvited into their life.

It is also important to know that, while many people find relief with EMDR therapy, it doesn't work for everyone.