I was very anxious about today’s session with Liz and the EMDR. The unknown is fearful. I don’t ever want to lose control and I thought that was what EMDR might be about.
Here’s a description of EMDR from the EMDR Institute, Inc.
Eye Movement Desensitization and Reprocessing (EMDR)1 is a comprehensive, integrative psychotherapy approach. It contains elements of many effective psychotherapies in structured protocols that are designed to maximize treatment effects. These include psychodynamic, cognitive behavioral, interpersonal, experiential, and body-centered therapies2.
EMDR psychotherapy is an information processing therapy and uses an eight phase approach to address the experiential contributors of a wide range of pathologies. It attends to the past experiences that have set the groundwork for pathology, the current situations that trigger dysfunctional emotions, beliefs and sensations, and the positive experience needed to enhance future adaptive behaviors and mental health.
During treatment various procedures and protocols are used to address the entire clinical picture. One of the procedural elements is “dual stimulation” using either bilateral eye movements, tones or taps. During the reprocessing phases the client attends momentarily to past memories, present triggers, or anticipated future experiences while simultaneously focusing on a set of external stimulus. During that time, clients generally experience the emergence of insight, changes in memories, or new associations. The clinician assists the client to focus on appropriate material before initiation of each subsequent set.
Eight Phases of Treatment
The first phase is a history taking session during which the therapist assesses the client’s readiness for EMDR and develops a treatment plan. Client and therapist identify possible targets for EMDR processing. These include recent distressing events, current situations that elicit emotional disturbance, related historical incidents, and the development of specific skills and behaviors that will be needed by the client in future situations.
During the second phase of treatment, the therapist ensures that the client has adequate methods of handling emotional distress and good coping skills, and that the client is in a relatively stable state. If further stabilization is required, or if additional skills are needed, therapy focuses on providing these. The client is then able to use stress reducing techniques whenever necessary, during or between sessions. However, one goal is not to need these techniques once therapy is complete.
In phase three through six, a target is identified and processed using EMDR procedures. These involve the client identifying the most vivid visual image related to the memory (if available), a negative belief about self, related emotions and body sensations. The client also identifies a preferred positive belief. The validity of the positive belief is rated, as is the intensity of the negative emotions.
After this, the client is instructed to focus on the image, negative thought, and body sensations while simultaneously moving his/her eyes back and forth following the therapist’s fingers (my therapist uses a light bar rather than her fingers) as they move across his/her field of vision for 20-30 seconds or more, depending upon the need of the client. Although eye movements are the most commonly used external stimulus, therapists often use auditory tones, tapping, or other types of tactile stimulation (I experienced the tapping and auditory with the light). The kind of dual attention and the length of each set is customized to the need of the client. The client is instructed to just notice whatever happens. After this, the clinician instructs the client to let his/her mind go blank and to notice whatever thought, feeling, image, memory, or sensation comes to mind. Depending upon the client’s report the clinician will facilitate the next focus of attention. In most cases a client-directed association process is encouraged. This is repeated numerous times throughout the session. If the client becomes distressed or has difficulty with the process, the therapist follows established procedures to help the client resume processing. When the client reports no distress related to the targeted memory, the clinician asks him/her to think of the preferred positive belief that was identified at the beginning of the session, or a better one if it has emerged, and to focus on the incident, while simultaneously engaging in the eye movements. After several sets, clients generally report increased confidence in this positive belief. The therapist checks with the client regarding body sensations. If there are negative sensations, these are processed as above. If there are positive sensations, they are further enhanced.
In phase seven, closure, the therapist asks the client to keep a journal during the week to document any related material that may arise and reminds the client of the self-calming activities that were mastered in phase two.
The next session begins with phase eight, re-evaluation of the previous work, and of progress since the previous session. EMDR treatment ensures processing of all related historical events, current incidents that elicit distress, and future scenarios that will require different responses. The overall goal is produce the most comprehensive and profound treatment effects in the shortest period of time, while simultaneously maintaining a stable client within a balanced system.
After EMDR processing, clients generally report that the emotional distress related to the memory has been eliminated, or greatly decreased, and that they have gained important cognitive insights. Importantly, these emotional and cognitive changes usually result in spontaneous behavioral and personal change, which are further enhanced with standard EMDR procedures.
It went well she told me. It started with me thinking of several scenarios that would have contributed to the “I’m not good or smart enough, I’m a fraud and it’s my fault.” Basically it confirmed what I already knew…I don’t allow myself to feel. I have put up such walls around my emotions or take detours to avoid feeling because I don’t want to get “in trouble”. I learned very little on that to become angry was to lose control. My mom was a screamer. It was acceptable. I would get so mad especially at my one brother who could push all my buttons. Then it was acceptable because that’s what mom did. That’s how anger was expressed in my world. It’s how I was at times with my own family as they grew up. The simmering pot eventually boils over. Now I just don’t let myself go there. I didn’t want to be like that. I just don’t get upset at things most people would because I play devil’s advocate. I can understand where the other person is coming from; why they would be acting as they do. But yet, it does affect me. I thought I was just so accepting. Maybe I am…anger is a normal emotion. Expressing it is OK in an appropriate manner. Talking about it is appropriate. Hurting someone else with your anger is not.
So many times in my life I’ve conjured up the appropriate emotion because that is what you do. Cry? When I was young, especially at a funeral…I could make myself. I just didn’t feel it. Now my family will disagree because I do get touched by many things. I do. I shed tears reading touching stories, watching certain movies, and watching hallmark commercials. I can empathize with others or stories that I read and then the tears will come. Tears don’t come easy though when it’s about me. Anger more so when something is related to me because it’s all my fault so I gotta be mad at me. So they are angry tears. I have yet to let Liz see more than just a glimpse of tears. I just don’t go there. During my session today when I described what I was experiencing, I made the statement, “I feel like I should cry, but I won’t let myself.” Very revealing.
Another thing I have trouble with is being so serious. To be able to laugh when something is funny rather than squelch it and pretend it’s not. I’m getting better at that one. I appreciate those in my midst that use humor. I do love to laugh. It increases the endorphins that help reduce pain. Depression is pain-filled even though one thinks they’re numb.
Here I thought I was so in control…well, yeah…I’ve been scared by the intense emotions in me that sometimes come out. Oh, some really push their way out at times and it really scares the crap out of me. I didn’t know and my family surely didn’t know when the ‘other’ me would show up. I was losing control very quickly. Bipolar explained a lot. The bipolar behaviors that others experience with rage and intense emotion I don’t show on outside. I feel them more on the inside before I push them away. I would look bad if I let others except those that I allow in to see. Now, it floors me when I have a strong emotional response that is not at all related to what is at hand. “where did that come from?” is the question that EMDR helps to answer.
“Gotta keep all feelings in check. It has to be acceptable. Don’t rule your life by your feelings. A good christian doesn’t give in to their feelings.”
oh those tapes have made really deep grooves…
This learned behavior started when I was 3 or 4 when I was a scared, shy little girl who would do anything not to disappoint or avoid punishment. I had to be responsible. I was the eldest. I was depended upon. I equated being good with calm…staying in control…don’t let anyone know you are afraid or unsure or sad or angry or disappointed. At least I don’t ‘check out’ like I used to even though at times I still want to run away from myself! I learned so many ways to cope. I am ‘strong’ because I don’t let things get to me. Well, that’s the impression I leave anyway. In reality it just makes the anxiety or the depression worse. It takes lots of energy to stay in control.
So my assignment for this week is to note anytime I feel anything, especially the ‘negative’ emotions. I’m to be a curious observer. Try to name the feeling. What is the picture associated with the feeling? When did what I’m picturing occur? What age was I? What is my body doing? BE there with it. Don’t do the ‘natural’ thing by trying to reason or analyze it away. Don’t push it away. It’s going to be difficult because it’s what I learned to do more than 45 years ago!
I did shed a few tears after work as I thought of that poor little girl way back when who decided that having feelings wasn’t allowed. I feel sorry for her.
Eventually I should be able to feel yet not get overwhelmed by the feeling.
- Feeling What You’re Feeling (thetruthwarrior.wordpress.com)
- “Emotions aren’t inherently good or bad. It’s how we react and act based on them that makes them so.” (dailyteacher.wordpress.com)
- Interview with EMDR Creator Francine Shapiro (psychcentral.com)