Talk therapy and medication may not be enough to make a difference in how you feel
Do you feel held back by post-traumatic stress disorder (PTSD) symptoms (e.g., flashbacks, panic attacks, nightmares) that talk therapy and/or medication has failed to improve much? Is the prospect of trying to fully communicate your pain exhausting, or terrorizing?
Have you had experiences that others might not consider traumatic, but that impact you through some persistent form of anxiety? Are you looking for a more effective way to begin healing these even though you’re not sure you qualify for ‘’trauma therapy?’’
Are you interested in trying a mind-body intervention, but skeptical? Are you looking for a new therapy approach, but only if it’s supported by a lot of research?
Talk therapy engages only the prefrontal cortex to reason about experiences and feelings, and though it can be beneficial to have support, it can also re-traumatize by bringing emotions to the surface without resolving them. Talk therapy also primarily focuses on coping skill development, which can feel helpful, but inadequate, like band-aids on a gunshot wound. Medication often improves symptoms, the biological expression of emotional experience, but it may not improve feelings. It can also stop working, or cause unacceptable side effects.
What is EMDR Therapy?
Eye Movement Desensitization and Reprocessing (EMDR) is a form of somatic, or mind-body, treatment for PTSD and other forms of anxiety and associated depression. It can improve both negative feelings (e.g, shame, despair) as well as biological symptoms (e.g., the hyperventilation and elevated heart rate associated with panic, or a ‘’pit’’ in your stomach). It also provides the opportunity to begin reframing your identity if trauma has damaged your self-esteem, or made you feel hopeless about the future.
If you’ve landed on this page first, you can read this overview of the somatic therapy approach.
It doesn’t take much for the body to develop a trauma response
Seventy percent of adults in the U.S. have experienced some type of traumatic event at least once in their lifetime. Unfortunately, our culture tends to highlight certain obvious categories as ‘’trauma’’’--such as military combat and physical child abuse beyond spanking--and minimize other types to a certain degree. This is particularly true for men brought up in households conveying a message that ‘’boys don’t cry,’’ and although progress has been made in recent years due to the ‘’Me Too’’ movement, it’s still a problem for women in the context of non-consensual sexual encounters.
The truth, however, is that our nervous systems simply aren't aware of these cultural norms. The commonality of PTSD and other anxiety disorders indicates that the range of experiences that disrupt the limbic system is very broad. It’s not necessarily deep, however--it doesn’t take much ‘’severity’’ to leave people with a persistent inability to feel calm or well-being, day after day. This can be agonizing if you identify as being strong-willed or having a lot of faith, as it may seem as if these traits should be enough to get past the issue.
You may particularly feel guilty if you have a loving support system that tries their best to help. Yet often, the trauma response causes irritability, outright hostility, or a need to ‘’check out’’ from relationships. This can make it hard to preserve a marriage, or make you feel as if you’re traumatizing your own children somehow despite your love for them.
EMDR goes deeper by engaging physiological systems, not just the conscious brain
EMDR is a highly evidence-based therapy used by the Veterans Administration and a number of organizations to treat PTSD, and it isn’t typically described as a mind-body or somatic intervention. Yet, it is in the sense that it taps into the limbic system, which coordinates our emotions and memories with physiological responses throughout the body.
During a traumatic event--particularly if we ‘’freeze’’ in response to distress (which is not a failure, but a parasympathetic nervous system response to overwhelm)--the brain fails to process the experience normally and file it away as a non-essential memory. As a result, as far as the body is concerned, the event never stopped occurring. Thinking that danger must be ever-present, the stimulating biochemicals needed for the fight or flight response stay perpetually activated. This leaves a person vulnerable not only to triggers that resemble the original experience, but to situations where there is simply extra stimuli for the body to process. Common examples are crowded stores, loud sporting events, or driving in bright sunlight.
In this interview with trauma expert Bessel van der Kolk, author of The Body Keeps the Score, he discusses how EMDR and other mind-body therapies are better suited for trauma than talk therapy due to the impact of trauma on our animal or ‘’survival’’ brain (the limbic system), which doesn’t respond to reason. Trauma, and in most cases anxiety--is not something you can ‘’just get over,’’ because it’s not ‘’all in your head.’’ It's literally throughout your body as well.
EMDR works by mimicking the brain’s natural process for integrating experiences
EMDR therapy uses eye movements or another form of alternating stimulus to re-engage the brain’s hemispheres, and by extension the broader limbic system, in the processing of a traumatic memory. (Since eye movements can be problematic for reasons such as eye strain, vision problems, or headaches, painless hand stimulation is used by the Center for Holistic Behavioral Health.)
EMDR could be described as providing the body-mind with a second chance to fully integrate an event into a memory, enabling both biochemistry and intense feelings to be desensitized to some degree at the same time.
As this occurs, it usually becomes easier to view the event with a broader, more detached lens that helps you make an intentional choice about the identity associations you carry forward. As psychologist and EMDR creator Francine Shapiro notes, ‘’emotions, physical sensations, beliefs--all of those shift to a level of learning and resilience.’’ As one person described it, ‘’I feel like I worked through trauma through the eyes of my younger self with the help of stable, real-time me.’’
You can read a more detailed explanation of how EMDR works in this blog post How does EMDR Therapy Actually Work? A More In-Depth Explanation.
You may still have concerns about trying EMDR
If I have to revisit a memory, won’t it still make me feel worse like talking about it has in the past?
EMDR fundamentally provides a very different experience for trauma than talk therapy by targeting more than the cerebral cortex, or reasoning part of the brain. Although it does require you to be present with distressing memories, the process is designed to monitor the intensity of your distress throughout, and to decrease the intensity as the session proceeds. Although multiple sessions usually result in deeper, more enduring improvement overall, clients almost always report feeling better by the end of the first one, not worse. On some occasions the work triggers something more difficult than the memory you are targeting, or overwhelm can occur, but we will do a preparatory coping exercise to prepare for that possibility. I require at least one preliminary session to explore your coping resources.
What if I feel really ashamed or embarrassed to share the details of what happened?
EMDR is a good choice if going into detail about a traumatic incident is your biggest obstacle, as it does not require sharing much about the memory itself in order to be effective.
Really, nothing that bad has ever happened to me, but I do have anxiety anyway. Should I really try a form of trauma therapy like EMDR?
Although you might have never experienced an incident routinely categorized as traumatic, EMDR can be used to address adverse life experiences--i.e., more common life stressors-- as well. As EMDR creator Francine Shapiro states, ‘’childhood experiences, humiliations, divorce, conflicts in the home--these things can be a source of chronic PTSD.’’
Many people feel guilty for struggling with anxiety, depression, addiction, or other issues when they lack major trauma history, and while this outlook is admirable, it’s outdated to the extent that science supports a mind-body connection. We all have biochemical responses to stress, which is simply part of being human, and depending upon who you are, even moderate stress can cause big problems. Learning about the increasingly influential field of epigenetics--how lifestyle and stress interact with our genetics, or how nurture impacts nature--will be empowering if you struggle with a persistent mental health issue despite lack of significant trauma history.
You may feel resigned to the idea that you’re damaged forever, but you’re not
My career has been dominated by the observation that most of the time, talk therapy and medication don’t even scratch the surface when it comes to trauma. Using EMDR to help people actually feel better, not just heard, has felt like a privilege, and it motivated me to create a practice centered on what actually makes a difference.
I want anyone doing trauma work to feel trust in me. After getting to know you, identifying your treatment goals, and discussing any concerns about working with challenging feelings (in one or more sessions), we would go over the EMDR process and address any questions you may still have. After that, we would move forward if you feel ready.
I would be honored to hear your story and facilitate your change.