One of the most popular and highly recommended forms of therapy for treating Post Traumatic Stress Disorder is EMDR, Eye Movement Desensitization Reprocessing. The information available on this topic is vast and expands the reaches of the internet – or you can read the first part of this series – EMDR Therapy & PTSD Pt 1: The Basics.
Everyone talks about the history of the technique, the eight phases, and the statistics for success. What about the EMDR process itself and what it is really like behind closed doors for a trauma survivor in the throes of a battle with PTSD. I am going to tell you about the curve balls you might experience through this process based on my two years (and counting) of EMDR treatment for childhood trauma.
So what isn’t talked about when it comes to EMDR therapy?
One EMDR session (phase 3-6) can include many periods of eye movement as you move through an emotional disturbance:
You begin with a painful or difficult thought/image, you close your eyes (or follow your counselor’s fingers) and as your mind responds to the bilateral stimulation new visions, memories, and emotions may surface. Your therapist will have you identify the biggest emotions, sensations, or memories and then focus on that for the next few seconds of additional eye movement. As new memories and emotions surface with each episode of eye movement your therapist will continue to have you refocus, go through the eye movement, and then evaluate on a scale of 1-10 how strong the disturbance is as you work to decrease it.
This is how EMDR helps your brain reprocess.
Anxiety at the actual process:
What if I do it wrong? What if I remember more than I can handle? Is my therapist staring at me? Am I making weird faces? I have thought all of this. While EMDR therapy doesn’t focus on memory retrieval, it is a side effect of focused work like this because it naturally encourages the brain to process. Your therapist will help you with intense emotions. There was one time during an EMDR session that my memories took me down a path I wasn’t ready for and it sent me into a panic attack right there at that moment. My therapist worked with me to recall my safe place, she did some breathing work with me to calm me and then went straight to phase 7 in order to send me home as calm as possible with the plan to readdress the following week.
Yes, your counselor is watching you, to help guide you through the reprocessing. They will likely encourage you when they see emotions to stay with it, to let you know you are doing well. To remind you that you are safe.
The actual process can be a little awkward, even in a safe space, and it can definitely spike anxiety. Be honest with your therapist about what you are feeling; what you are going through is normal and they will help you.
You aren’t going to do EMDR every time you visit your therapist:
there is plenty of talk therapy involved. EMDR is used to target very specific and deeply ingrained thought and behavior patterns and to address somatic symptoms and reconnection to the body. All in addition to other traditional forms of therapy. I also have a goal structured treatment plan and work on self-care and coping in addition to reconciling and processing my childhood trauma.
Sometimes your mind isn’t going to cooperate:
I have a tendency to avoid and suppress, disconnect if you will. It happens a lot when I am facing emotions bigger than I believe I can handle. There will be times when you are sitting there, tears streaming down your face, 100% feeling everything – until the minute you close your eyes to begin reprocessing the issue. Suddenly you have a blank mind that is fully conscious of the vibrating paddles in your hands. You see nothing, feel nothing, have processed nothing.
It happens. Totally normal. No expectations! Your therapist will likely ask you to focus on the fact that you feel nothing and continue with additional eye movement to see if they can get your mind to play along. Oh, and by the way – it was still working even though you didn’t think it was.
Wait! I didn’t finish processing that issue:
yes, this happens. You’ve just spent 45 minutes with your counselor working to reprocess a disturbing memory and due to avoidance issues (see #4) you’re still topping the charts as far as levels of stress. This is where your therapist will simply work on phase 7 with you, closure. The two of you will work on coping and breathing techniques to bring you back to the present. The couple times I have had this happen, my therapist has even stayed with me a few extra minutes until I am ready.
Once you leave your session, the reprocessing doesn’t stop. This is why coping and your safe place is so important. One thing that EMDR does, is it gets your brain moving, even when you don’t think it is working. There is something to be said for the back-and-forth eye movement. Expect flash memories, dreams, heightened sensitivity, and continued processing and reflections, even when you aren’t actively trying.
The more complex and long-term your trauma, the more layers you have to sort through.
If you are like me, you will find that for every painful memory or heightened emotion you address, inevitably another one linked to the first makes an appearance. It wears on my patience, it will likely wear on yours. Don’t lose focus, be patient with yourself, and remember that treatment for PTSD has no time limits
These are the few things that have tripped me up as I navigate recovery through EMDR therapy. I was unaware of how the eye movement sessions went, I had no idea how my mind would actually respond, and no one told me how my brain would continue to work in between my counseling sessions. I wish I had been prepared for the awkwardness of watching my counselor’s fingers in front of my face in those first few sessions or been aware that when I feel nothing at all – that that is actually quite normal for someone with C-PTSD like I have.
EMDR has been one of the most interesting and interactive forms of therapy I have ever tried (not that I have tried SO many) and despite these few things that still occasionally throw me for a loop – I swear by it.
Be sure to check out part one of this series and when you are done with that check out EMDR Therapy & PTSD Pt 3: The Benefits for my final write up on the many things I have realized over my two years of EMDR therapy.
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