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EMDR therapy: A pathway for trauma-focused care

September 20, 2016
by Jamie Marich, PhD, LPCC-S, LICDC-CS, REAT
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When I had two years sober, I wanted to stay sober.

I also wanted to die.

Sound like a total paradox?

My active addiction was about trying to destroy myself. Even though I learned the skills to stay sober and ultimately to better my life, that desire to destroy myself never totally went away. At two years sober, I noticed the suicidal thoughts intensify as I was working on my counseling internship and watching how young children were being mistreated in the residential mental health unit where I was placed. A trusted colleague of mine suggested more therapy. But even though I knew something had to be done, the thought of going back into counseling after getting sober and actively working a 12-Step program troubled me.

I protested, “I know everything the counselor would say; I know that I’m good enough and that I need to let go of the past.”

From going to so many meetings and working with two excellent sponsors in my early years, I quickly learned healthy solutions to my problems, yet I felt powerless to implement them. To add icing on the cake, I was a counseling student, learning “technique” and being schooled in all of the right things to share with people who were suffering. Yet I still wanted to destroy myself.

I went to a local counselor who was recommended to me because of her reputation for approaching therapy in a new and innovative way. In our first session, she recommended Eye Movement Desensitization and Reprocessing (EMDR) because of my history of trauma and dissociation. I was willing to give anything a try that didn’t seem like the same old clichéd therapy practices challenging me to confront my thinking errors or to write more gratitude lists to help me stay positive.

History of EMDR

EMDR therapy traces its origins to the late 1980s, when California-based psychologist Francine Shapiro took a now famous walk in a park. Shapiro, a cancer survivor who became interested in mind-body medicine as a result of her own experiences with treating chronic disease, began to notice some distressing thoughts during her walk. Keen on experimenting with her own mental and somatic processes, Shapiro also noticed that her eyes began to move back and forth, rapidly and diagonally, as she noticed these thoughts.

Later in the walk when she brought up the same thoughts again, they simply did not carry the same charge. Curious about whether that process she had engaged in with her eyes had anything to do with her shifts, she began informally experimenting with colleagues, eventually developing and researching an early protocol that was published in 1989 in the Journal of Traumatic Stress Studies.

I learned from my own EMDR therapist that EMDR did not rely on eye movements alone to work. For instance, she gave me the choice of using one of various forms of bilateral stimulation. Because I found the eye movements annoying and even painful, I was relieved when she was able to control a machine that made relaxing pulses in my hand in a back-and-forth manner. In a way, it felt like drumming!

In the early years of EMDR, Shapiro and other clinicians discovered that eye movements could not be tolerated by everyone and could even be risky for people with seizure disorders or other medical concerns. Thus, they developed the two main alternatives: alternating audio tones and alternating tactile stimulation. To this day, debate remains among EMDR therapists over whether the eye movements work best just because they’ve been the modality most likely to be used in research studies, or if clients should be able to self-select the bilateral modality of their choosing based on preference and comfort.

After I selected the tactile modality for myself and engaged in some prerequisite stabilization, grounding and relaxation exercises to help me handle what the process might reveal, my EMDR therapist led me to focus on certain representational memories behind my “hot button” negative beliefs. “I’m not lovable,” “I’m permanently damaged,” and “I’m not safe in the world” were all early targets that we explored, as we might have done in standard talk therapy. However, there was much more of a somatic and mindful focus to the way she asked me questions about these memories. I didn’t have to recall specific detail. I didn’t have to analyze. My job was simply to notice my experience, my emotions and my bodily sensations as she applied the bilateral stimulation.

For me, EMDR therapy was cathartic, draining, yet empowering all at the same time. Within a few sessions, the main reason why I presented for counseling again in the first place—the suicidal ideations—lifted. I stayed connected with the EMDR therapist off and on over the next two years as the process helped me through graduate school, sustaining my first long-term relationship, and ultimately achieving a greater degree of wellness overall as I built my career.

A mainstream practice

Once written off as a fringe or even “new age” therapy, EMDR therapy is now in the mainstream, appearing on the Substance Abuse and Mental Health Services Administration's (SAMHSA's) national registry of evidence-based practices for the treatment of post-traumatic stress disorder (PTSD) and as one of two preferred trauma therapies recommended by the World Health Organization.

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