EMDR: Eye movements help trauma victims

EMDR

For those who have followed the blog for a while, you might know I mostly work as a trauma therapist, and that I use, among other methods, EMDR to integrate traumatic memories. EMDR stands for eye movement and desensitization and reprocessing.That is a long and complicated name that basically means that you move the eyes back and forth, while you think about a stressful memory at the same. I will try to explain this a bit more, but we got to remember that we still don`t know exactly why it works (the best article is still

EMDR: A putative neurobiological mechanism of action, 2002) according to “Robbie” who I emailed just to be sure I was not missing important literature.

EMDR2Why so little research on EMDR? 

In the health sector we sometimes see that doctors only prescribe meds without offering alternative treatments. This happens far too often considering that several studies have shown that medicines work better if supplemented with psychological treatment. Some of the arguments for using medicine, is that it takes less time to prescribe a pill, than give everyone therapy. Of course, this is true in the short time, but what about the long-term effects?  Some of the EMDR studies so far, shows that it is an effective method for treating traumatic material. In some cases, it can take just 1-2 hours to make a memory (like from a traumatic accident) bearable. When a doctor told me how much it costs to transfer a suicidal patient from her home to the hospital, I had to shake my head in disbelief. Why isn`t it obvious that using more time like the patients say they need, actually reduce costs in the long-term? I could discuss in length what I think about the system and how it uses its research funds, but it won`t help you in understanding what EMDR is all about. This post will continue with exploring more of EMDR.

Sleep and EMDR

Even if we have studied sleep since mankind noticed its dreams, there is still no certain answer to why we dream. We know that it is vital for our general health, that is likely connected to memory consolidation and that, without it, we are more prone to accidents.  But again, we cannot say for certain why. We also know that the eye movements while in REM have something in common with the eye movements that we make in EMDR. What’s so interesting is that a scientist found that flashbacks—the remembrance of the events from these films—are much lower if people have been sleep deprived. And of course this has real implications for post-traumatic stress disorder; what one normally does with post-traumatic stress is put people to sleep, encourage them to sleep and what that will do is, it seems, combine the memories of these unpleasant events rather than help the brain forget them.

I had a casual conversation with a psychiatrist in an elevator in a hospital when I was still working in London. He said: “Well, everyone knows that patients with schizophrenia have terrible sleep, but of course they have terrible sleep. It’s because they don’t have a job, and so they go to bed late, get up late, miss my clinics, don’t have friends.”

I thought that was a very odd thing to say and that it didn’t make sense. Then I started looking into it and realized that people have been talking about people with really disrupted sleep with mental illness since the 1880s. So it’s a well-described phenomenon, but largely ignored. When people did start thinking about it in the 1970s,  they assumed that the abnormal sleep was a result of the antipsychotics that were being introduced at the time, but of course ignoring the fact that for the previous 100 years people had been talking about poor sleep without any antipsychotics. And then the other argument was that it is not the antipsychotics — it’s because of the socialized relations.

EMDR and reading

Like I said earlier, a lot is still not known about EMDR. Many doctors shake their heads in disbelief because there still is little research on it, and some are skeptical. Skepticism is healthy, of course, but at the same time; Openness to new possibilities is equally important. If no one questioned the status quo, the world would never change. 

Just like muscles, the brain benefits from a good workout. And reading is more neurobiological demanding than processing images or speech. As you’re absorbing, say, this article, “parts of the brain that have evolved for other functions—such as vision, language, and associative learning—connect in a specific neural circuit for reading, which is very challenging,” says Ken readPugh.  A study from the Netherlands, also shows that reading can make us feel empathy  towards other, and empathy is a key ingredient for “reading others mind”. Many studies show that mentalization and empathy often are connected to each other. The better you are able to find different meanings behind people`s behavior, the easier it is to feel good about oneself. I remember my own experiences as a student. Reading social psychology, and realizing how little people actually notice about others, since mostly they walk around in their own thoughts, there is no real reason to be too stressed about how one behaves. After seeing programs, and hearing lectures about how con artist use this inattention on purpose, I am convinced in the truth of the thing we say to clients with social anxiety: Most people simply do not notice small things like the hand shaking, or staring blankly out in the air. I have also been an eager reader since I put my eyes on a page and understood its meaning, and what I have always felt, is that I cannot judge the truth of things, since there are so many different truths out there, none of them more “real” than others. This makes me calm. I know some will hate what I write, and some will like it. How people judge this, depends on their ways of seeing the world, and has little to do with me. I cannot say for certain if the back and forth movements of the eyes while reading, are a funny coincidence, or if there really is some element of calming and integration in it, but I know it would be interesting to research it further. 

Brain lateralization and mood

So, what do we know about how our brain works, and might this help to explain EMDR? For me it makes perfect sense to integrate what I know about the brain, with what I do in therapy. Did you for example know, that different sides of the brain are connected to different moods? The left site of the brain is often connected to good mood, and the right to negative mood. The right is also connected to more artistic abilities, and the left more to “logical” tasks and to language. Did you know that women have a thicker “bridge” that connect the right to the left brain? The right “feels” more and the left “understands” things. The video shows how a woman who has experienced a stroke to one site of the brain, and how that feels.

Moreover, one of the most acknowledged neuroscientists got the chance to monitor the brain activity of dalai lama, and discovered that the waves in one side of his brain, were 30 times stronger than in normal students normal students. He later showed that people could train themselves through meditation, to show similar patterns. Meditation is an important part of Mindfulness, another type of psychological treatment, that many use today. What I like about EMDR, is how it connects many of the former thoughts and ideas into ONE theory that makes sense. Can it be that EMDR is just one way to move from an emotional state to a more “logic” state in a way that give us peace at mind? I feel that the answer is not so far away. I have been in intense emotions myself, and even if it can be lovely when its good, it can also be too much, in other times. Can EMDR be one of the mediators, that helps us live a good life even after experiencing something truly terrible? 

There is still no definitive answer to my question: How does EMDR work. I hope that this has still been interesting to read, and maybe spurred people`s curiosity. I will write more on this subject later, and a lot of new knowledge will probably be collected in the years to come. I will continue to put pieces together, both in my life and others. Because the truth is: We function best when we feel whole. 

.

Sources:

BBB News Center

How-Reading-Can-Improve-Your-Memory

Speculations on the neurobiology of EMDR

Når terapien går i stå

Når terapien går i stå
Suzette Boon deler av sine kunnskaper i traumeseminar den 30. august.

On Sleep: Brooke Borel : August 14, 2013 at 2:30 pm EDT

Parents and children reading books together

EMDR: A putative neurobiological mechanism of action

The 7 Psychological Principles of Scams

ESTHER ENTIN, OCT 26 2011, 11:06 AM ET

14 responses to “EMDR: Eye movements help trauma victims

  1. Dear Mirrorgirl,
    I have quite a few posts on my blog re my response to EMDR. My therapist uses knee taps to help me shift the trauma memories from my right brain to my left brain so I can process them and release the trauma energy. It works! The insights I get from EMDR are different from the insights I have gotten and am still getting from Ego State Therapy. Both types of insights seem to come from my right brain. I go into a light trance state to do my work in EST, and the bilateral tapping facilitates my EMDR work. I have found that both types of work have been necessary to my healing. The EST work brought me relief from my PTSD symptoms; the EMDR is bringing me relief from anxiety and other trauma-related problems. I began treatment three years ago by doing the EST work, and that served to help me organize and “defrag” my mind. After three years of that preparation, I was ready for the EMDR work. After working with one or the other or both types of therapy, my left brain helps me make sense of the results. Then I’m ready to move on to the next phase of my work. My posts on EST and EMDR are the most popular ones on my blog, according to my stats page. Evidently, a lot of people want to know more about these topics, so I’m doing my best to put out more information on the topics–from the client’s point of view! Thanks for writing from the therapist’s point of view! Jean

    • Thank you Jean! The response made perfectly sense to me, you explain in a clear way how therapy has been meaningful to you. Since I have been in the patient chair myself, I also know how that feels, and I can remember that “feeling of something being different” but without language to actually express WHAT was different. Today, when I have learnt and thought it over, I think it was the feelings that really changed, and made me feel safer, but the logic was equally important to feel more sure about WHAT has happened. It can be uncomfortable for us humans, to not explain in words what has happened (and many of my clients struggle with this, in the start they can not put their finger on exactly what has helped them, but after a time they come with more and more reasons as to why it might have helped, even after I have seen they changed in some way in how they relate to me and others). Not sure if that made sense, but I think, like you said, that we need several ways of processing difficult experiences, and trauma is some of the worst experiences of them all.

      Nina

  2. Another fascinating article. I am always amazed at the inner workings of our brains and bodies. There is a funny thing that just crept into my head and this is going to sound strange. I and my wife know you as mirror girl. In fact when we discuss your articles we say that was by mirror girl. Would you be averse to us knowing at least your first name? And if it is mirror so be it.

  3. We, in New Zealand, discuss Mirror Girl too. Although our accents sound different, I am sure the conversation is similar.

    I know a few people trying this process, as PTSD “patients”. They are addicts to alcohol and opiates whom have had various clean times over the years.

    Interestingly enough (to me anyway) I have been reading a number of neuroscience books published in 2012 or 2013. The science behind the dark art of psychiatry is slowly being explained. Although Nina says, above, that brain activity is kind of a right & left activity, there is ample evidence to show that the brain can develop and learn functions all over again. For instance – stroke victims being able to start controlling parts of their bodies that they should not be able to. *AND* believe it or not, the “bridge” between the hemispheres is not the only way the two halves communicate. You can completely chop the bridge and there is still some communication between the two.

    I am merely thinking, in my uneducated way, that you are not merely moving a memory (trauma) from one side of the head to the other, but you are really re-processing them. By putting those damn memories back into the brains kitchen blender and maybe adding a fresh handful of berries before pouring out your new smoothie.

    • THank you for this enlightening comment! You said there are trials on addictions, do you know the results of them? I have heard they try it on different patient groups, but there is still so much to research and I haven`t got a proper overview of it, so far.

      I have also heard that there are other pathways between the left and right hemispheres, and have no doubt that our brain is extremly plastic, all things considered. I also think something new happens to the memories during EMDR. WHen we do EMDR, we say we reach different “channels”, which means that one associates something new with it, like the understanding that one couldn`t have done anything else, and the feeling of who one is today. Even if I have tried EMDR on several patient, every person reacts in their special way, and I am always taken aback with the brain/minds ability to find strength in the strangest places. We are built to find possibilities and thrive, must like we must if experiencing a stroke, like you say. Emdr is just one way to work with the mind/brain, but I don`t believe its the ONLY way or even the best way:)

      • Yes, you would be silly to think of any single way being “best” or “only”. There are many techniques, all of which should be measured in relation to the individuals requirements. Also, you would be silly to discount the therapist or treatment providers experiences and ideals too.

        Hmmmm, I just gave myself a very familiar headache when thinking about that. Not an unpleasant feeling. But one that does get annoying over time.

        The sides of the brain can also communicate through channels belonging to nerve pathways (the bits that usually just go out to the spine actually have some ability to crossover – which explains some stroke motor recovery when the brain has not recovered) and also through chemical processes. In order not to give myself further headache, I am limiting myself to typing very little here. This, in itself, proves that I am developing as a human! ;-)

        I am new to all this, not realising I am human until 89 days ago, but some books read since do explain that if you cut the Corpus callosum completely in half, the brain sides will still communicate. This, in theory, should not happen as you have just destroyed the bridge between the two.

        Put it this way – For years and years it was considered that the left eye went to the right side, and visa versa.
        http://en.wikipedia.org/wiki/File:Gray722.png
        In fact, the view of the left side of both eyes goes to the right side of the brain, and the view of the right side of both eyes goes to the left. This has complications in stroke victims as they may recognize someone to their right, with their right eye, but not to their left, or with their left eye. The facial recognition has gone. As has their ability to interact with various parts of their body. Some restoration in motor function can occur, even though the brain is permanently damaged, the “plastic” in this case is not responsible – new pathways through odd routes, most likely, are.

        To get back on track a little – by taking a memory out of deep space and examining it, you can allow for re-processing. 100% agree there.

        Even if the original memory has gone, THE FEELINGS THAT MEMORY CREATED HAVE NOT. These feelings are still playing havoc. EMDR *may* actually allow you, as a practitioner, to bypass the actual real event(s) and deal with reprocessing the feelings, the hurt and the coping mechanisms.

        The coping mechanisms we threw up to protect ourselves could be functioning in a negative manner now we are no longer subject to the same issues and “attacks” that caused them.

        Example – Puppy gets hit. Dog now cowers when someone raises hand to tickle its ears. Even though dog wants ears tickled, dog gets upset when tickler cannot connect properly with dog. Tickler is confused why dog wants ears tickled but moves away.

        Dog and handler file for divorce shortly thereafter.
        ;-)

      • I hope your headache is better!
        Again, thank you for alot of interesting information about the brain. There is certainly much to learn, and the good thing is that new things are discovered all the time. I am a bit impressed by how we slowly find out more and more about our inner life!

        It is true that the things that worked earlier , might not have the same effect today. It is truly a relief for many abused to finally breathe again, not having to watch every step they take :)

  4. Really interesting.

    A few years back,I leapt at the chance to have EMDR. At that time, I was diagnosed with PTSD and couldn’t work out any way to manage the flooding of intrusive thoughts/memories.
    EMDR was not a success for me, however I remember prior to each EMDR session being asked to link an emotion to the memory before rating it somewhere between 1-10. (Is that normally done?).That got me stumped, since I was (still am) ‘distanced’ from emotion.
    Somehow, the EMDR did something unexpected and seemed to break down some of the dissociative walls between my*self* and my dissociative *parts*.

    Apologies for going off on tangents Nina.

    I would be interested to find out if EMDR can be used safely with D.I.D patients. Instinctively, we/I feel that somehow it must be a possibility, though, at least where I am, EMDR is not recommended for use with the client group we fall into.

    • Dear BBBR

      I always appreciate your comments and thoughts, be sure of it. What you say is really important, and you are very right to share your experiences. It is true, that we usually rate the emotions (or the “bad” feelings”) from 1-10 (we call it “units of discomfort”) and use this as a guideline, and of course, that can be very hard for some people to do. It is also true, that EMDR can “go through” walls pretty fast, and sometimes that is not the right thing to do, because it can be too much. I believe that most things can be done, if tried and done properly, but of course one must take different things into consideration. When one is really tired, EMDR can be tough, since people get even MORE tired, and sometimes we are simply not ready to feel intense emotions or remember a lot at the same time. When doing EMDR one should ALWAYS consider safety first, for example by “installing” resources, like a safe place and train on grounding teqniques. As long as one knows that dissociation might happen, and easily so, one must be sure that the patient is ready for it. Sometimes we want to explore things, sometimes not, and there must be room for this ambiguity. It is hard, though, of course, to always know when it`s right and when its not. In did its not even easy to know what the “gut” feeling is, there can be “many”. Tomorrow I am going on a course in Bergen with the author of “the haunted self” who will talk about treatment of dissociation. Hopefully I will learn even more about it then. I will without doubt write more about it in the future :)

      • Look forward to seeing how the conference goes.
        Read the haunted self some time ago but like many things, I can’t teally remember much of it.
        We use another book edited by the same author in therapy (the coping with trauma related dissociation one).

        Like I said, really look forward to reading anything you have to share after attending the conference.

        x

  5. Ego State Therapy, my own version of it, anyway, seems to have alleviated the PTSD symptoms. I no longer freak (dissociate or experience a flashback) when I hear loud, angry voices, for example, and I no longer have a problem riding public transit. I’m no longer stuck in my apartment due to the fear that something will trigger my PTSD symptoms, and I no longer dread social events as I used to do. Along with Ego State Therapy, the EMDR seems to have cut down my general anxiety. It’s as if by rendering the emotional load of certain specific traumatic events less active, I have reduced the emotional load of the whole accumulation. My head is a whole lot easier for me to live with now.

    These two therapeutic modalities have helped me by themselves, without medication. I did not want to use an anti-anxiety medication because I was afraid I would not be able to separate the benefits of therapy from the benefits of medication. I wanted to be clear as to the effects of therapy alone. I am! The mind, I have found, is capable of healing itself given the opportunity! Doing this without medication may take a lot longer than doing this with medication, but I believe the therapy route is a permanent fix. I suppose a combination of the therapy and medication might be quicker, but, again, I wanted to be able to separate one benefit from the other so as to gauge my progress effectively.

    What I really appreciate is the fact that if I backslide, if my PTSD symptoms recur, I now know how to manage them. Being self-sufficient has always been important to me, and now I feel I have the tools to help myself through hard times. And I have learned so much in the process of getting these tools!

  6. I found your blog through the Trauma and Dissociation blog. Thank you for this enlightening post about EMDR.

    Since you work so much with trauma patients, (complex trauma also?) I wonder if you are familiar with Dr. Bessel van der Kolk. I became interested in the topic of trauma and healing when I heard his interview with Krista Tippett on On Being a few months ago. Fascinating stuff!

    You can listen online here if interestes further..

    Restoring the body: Dr. Bessel van der Kolk on yoga, EMDR and treating trauma

    http://www.onbeing.org/program/restoring-the-body-bessel-van-der-kolk-on-yoga-emdr-and-treating-trauma/5801

  7. Pingback: Why didn’t you tell someone? | Trauma and Dissociation·

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