First off, let’s clear up these acronyms. Many people already know about PTSD, or post-traumatic stress disorder. This refers to a multitude of responses to experiencing or witnessing traumatic events that can occur and continue long after the trauma itself. EMDR stands for Eye Movement Desensitization and Reprocessing, which is a relatively new type of psychotherapy for helping those suffering from PTSD. The therapy uses techniques which mimic the movement of the eyes during REM (rapid eye movement) sleep cycles, to help the brain process traumatic experiences and memories.
What causes PTSD?
It’s important to note that PTSD is not only triggered from one singular trauma, but can also result from a traumatic period of time or multiple traumas. Additionally, almost everyone at some point suffers from post-traumatic stress, which is a totally natural and normal response to traumatic events. But not everyone will experience post-traumatic stress disorder, which is an imbalance in normal brain function, triggering intense and debilitating responses to traumatic memories. Additionally, those diagnosed with PTSD, will have been suffering symptoms for months and sometimes years after the initial event, while post-traumatic stress usually doesn’t continue more than a few days or weeks after trauma.
A common misconception surrounding PTSD is that it mostly affects people who have witnessed or experienced extreme violence such as war, rape, abduction, and torture, to name a few. While it is more likely that people who experience these types of events may suffer from PTSD, there are other severe traumas that are less frequently identified as causes for PTSD including psychological and emotional abuse, serious health problems, traumatic childbirth, and sudden loss. Many of us suffer from PTSD but don’t recognize the symptoms or don’t consider our experiences as ones which can cause PTSD, so it often goes undiagnosed and untreated, or diagnosed as something else entirely, as was the case for me. It’s important to note that what causes trauma in one person, may not trigger the same responses in someone else, so my experience may happen to many other people but not cause them to suffer from PTSD. There are also many other factors that can increase the likelihood of developing PTSD after a trauma including pre-existing mental health conditions such as depression, anxiety, and addiction.
How PTSD develops
OK. Ready for some light science? Here’s what happens in the brain of PTSD sufferers. The amygdala—the part of the brain that triggers fear responses—becomes overactive. We need this trigger, it keeps us safe from danger by alerting the brain of a threat to our safety. Once a danger trigger is activated, our pre-frontal cortex—the decision maker—will assess the situation, rationalizing the perceived fear and deciding on an appropriate emotional response. In people with PTSD, the pre-frontal cortex is under-active, so it is unable to distinguish perceived danger from actual danger, causing sufferers to have what seems like extreme reactions to reminders and associations to the original trauma. Additionally, the hippocampus—where we store our memories—often doesn’t store or process traumatic events accurately, which is why we often find it hard to recall and explain a traumatic event even soon after it has happened. It’s also the reason that negative experiences can be hard to forget, because the hippocampus takes longer to process it, meaning it is swimming around in our thoughts for longer than normal. FUN.
How EMDR therapy works
All right, so EMDR. If you’re thinking it sounds a little bit far-fetched that replicating REM while you’re awake can help you process traumatic memories…..I’m with you. I was skeptical AF before I started, to say the least, especially as I was already dubious as to the PTSD diagnosis. But after reading into the symptoms, of which I was exhibiting many, and looking into EMDR treatment, I really came around to the idea and was excited to get started.
First off, I had no idea that during our REM sleep, our brain is processing experiences and memories, categorizing and filing them away like a loyal personal assistant. The problem with traumatic experiences, aside from being incredibly sucky, is that they take much longer to process. And ironically, just when we need more sleep to process these memories, we are probably losing sleep because of these memories. YAY.
So the memories can remain unprocessed and in a state-specific form, meaning they continue to bring with them the same negative feelings and sensations first experienced with the trauma. Each time this happens, it further reinforces the brain to associate the trauma memory with a fear response, hence why it can last for such a long time if left untreated. EMDR works to assist the brain in unsticking the memory from its state-specific form, allowing it to be rationalized accurately based on actual danger rather than perceived danger.
In time, this lessens the extremity of emotional and physical responses by relating positive and safe experiences during traumatic memory recall using horizontal eye movement. Sounds simple right!? I tried not to get my hopes up, especially since having once been given a wrong diagnosis and therefore seeing zero improvement….but it was hard to contain my excitement at the possibility of no longer reaching panic attack level anxiety on a frequent basis from some lasting trauma triggers. And so we began!
My experience with EDMR
The therapist talked me through what would happen and outlined the 8 stages of the process. The actual eye movement technique takes place between stages 4-7, depending on how many sessions are needed. This may not sound like much, but let’s not forget that during the sessions of eye movement, you are required to recall the traumatic memories. NOTSOFUN. However, the main point of the eye movement is to slightly divert your attention by following the movement (usually lateral) of the therapists finger whilst recalling memories, so the focus is not fully on the memory itself. Additionally, compared with most therapy sessions lasting 45 minutes to an hour or more, EMDR sessions take just a few minutes, making it hella appealing.
Stages 1-3 include identifying the traumatic memories to work on, introducing the EMDR technique, deciding how many sessions are needed, and developing coping strategies for when the negative sensations and emotions arise from recalling the traumatic memories. These strategies will vary depending on the therapist and patient, but include deep breathing, visualization, and mindfulness that will be implemented at the same time as eye movement and memory recall. You are asked to describe the sensations experienced when implementing the relaxation technique and to assess the current level of actual danger. Additionally, patients are often told how long they will be in session for, helping to identify the memory recall, associated sensations, and perceived danger as temporary. Combined with the distraction of the eye movement, patients can then rationalize their current actual danger against their perceived danger. The final stage is an evaluation process for both the patient and therapist to assess the progress made and conclude if any further sessions are required.
After beginning the eye movement sessions, it’s quite possible patients will experience some effects such as vivid dreams, lost memory recall, and heightened emotions. Check, check, and check. All of these happened to me in the days after each session and to say it was intense is an understatement. However, I knew that this was evidence that my brain was beginning to process the traumatic memories in the correct way. WIN. They were being gradually disconnected from the negative emotions associated with the initial trauma and allowing them to settle as memories that would, over time become much less painful and traumatic to recall.
I had to cut the process short because COVID, sigh. I had no idea when we would be able to continue, which was incredibly disappointing and slightly terrifying as I was afraid all my progress would be lost. But once I stopped to really look at how far I had already progressed, I realized that at the very least, the sessions I had done had triggered the healing process and the difference in my emotional state was already immense. The trauma triggers were not provoking such intense physical and emotional responses anymore. I didn’t feel the same overwhelming need to avoid certain places, topics of conversation, and memories in order to maintain my emotional stability. The desensitization had really started to work and I was ecstatic. I have never before had such respect and appreciation for the power of the mind and I’m so grateful for having access to the mental health specialists who identified what was really going on. I felt so unbelievably lost and helpless before I started the process. Nothing I tried seemed to make any difference and I was becoming exhausted with trying and feeling stuck in my past. My mental state is totally different now and I live each day more peacefully, looking to the future without my past holding me back, and with a new appreciation for the power of the mind.
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Photo: Marina Vitale via Unsplash