EMDR -- treatment for PTSD and trauma

EMDR is a highly effective therapy for treating post-traumatic stress disorder, or PTSD.  "Trauma" is a term we use to describe what happens to us when we go through a very stressful event.  Traumatic events can be what we call "Big T" events like childhood abuse, rape, robbery, earthquake, or similar situations.  PTSD can also result from the cumulative effects of "little T" events, such as being shamed as a child, too many moves or losses, or anything else that causes a great deal of stress to us.

What is trauma?

Therapists tend to talk about "big T trauma" and "little T trauma". We are all familiar with "big T traumas": sexual, physical or emotional abuse, neglect, natural disasters, war experiences, severe car accidents, rape, assaults, etc. "Little T traumas" can be just as damaging, especially because they tend to occur over time, and build upon each other: experiences of shame, humiliation, being left out, and feeling not cared for. All of these can affect how we experience the world around us, and our relationships with other people.

What is it?

Post-Traumatic Stress Disorder occurs when upsetting events become “locked” in our minds, causing us to react as though the triggering event is still happening, even though we know it is over. PTSD can be caused by long-term or chronic trauma, such as past child abuse, or by recent acute trauma, like an auto accident or robbery.

What are the symptoms?

Symptoms of PTSD fall into three main categories: intrusion, avoidance, and hyperarousal.

Intrusion: Intrusion symptoms arrive suddenly and occur when memories of the past event invade your current life. The most common intrusion symptom is the flashback. Flashbacks are vivid memories that can be triggered by sights, smells, or sounds, and cause you to relive the traumatic experience over and over again. These flashbacks can seem very real and are often detailed and filled with emotion. Another intrusion symptom is the nightmare, which can occur unexpectedly, causing extreme anxiety and fear.

Avoidance: Avoidance symptoms describe a sufferer’s unconscious attempts to prevent remembering anything to do with the traumatic event. These signs of post-traumatic stress disorder often interfere with family relationships, marriages, and careers. You may avoid being with family and friends in order to hide your illness. You may experience an overall feeling of numbness. You may alternate between feelings of intense emotion and simply no emotion at all. Consciously and unconsciously you will avoid reminders of the traumatic events in order to escape flashbacks. Depression is often an avoidance symptom.

Hyperarousal: Hyperarousal symptoms are the result of stimulated nerves and hormones. You may experience severe insomnia, trouble remembering the entire traumatic event, and difficulty concentrating. You may experience irritability or explosions of emotion for no apparent reason and more frequent startling responses.

Physical symptoms are often part of the PTSD syndrome, as well. Headaches, stomach problems, dizziness, and chest pain are all commonly experienced by sufferers of the disorder. You may also experience nausea, diarrhea, skin problems, rapid heart beat, and high blood pressure.
( symptom list thanks to www.epigee.org)

What can help?

Therapy can be very helpful in treating PTSD. As we learn more about how the body and brain work together to process upsetting events, more techniques have been developed to unblock our natural healing ability. Often, when the triggering event is a recent one, and there are no underlying emotional conditions, clients experience resolution in 3 to 10 sessions. You and your therapist can decide together what treatment techniques will be most helpful for you.

You don’t have to continue to suffer from PTSD. Asking for help is the first step on the road to healing.

What does EMDR stand for?

EMDR stands for Eye Movement Desensitization and Reprocessing. This long phrase describes a technique first developed by Dr. Francine Shapiro in 1989. It refers to a method of using "bilateral stimulation" of the brain, either through the client moving their eyes back and forth, listening to tones that alternate from side to side, or lightly tapping the client's hands left and right.   If you think about it, we use bilateral stimulation all the time; for instance, we go for a walk to think through a problem, we enjoy music more when it's played in stereo, we often tap our feet or our hands in time with music or when we're nervous.  And, while we're asleep, our eyes move back and forth while we're dreaming (Rapid Eye Movement, or REM, stage sleep).  Our brains process more information, and process it differently, when both sides are used at once.

Why does EMDR work?

We are learning more and more about how the brain processes information. To put it simply, our brains are designed to process information and experiences, so that we can learn from them. Most of our experiences are stored in what is called "explicit memory". When you think about something that happened to you, and are able to recall it without becoming upset or experiencing disturbing body sensations, you are probably retrieving explicit memory. Explicit memory is similar to remembering a story or a movie.

Some events, commonly called "traumas", are so disturbing to us for various reasons that our brain becomes overwhelmed by emotion and unable to properly process the event. It becomes "stuck" or "locked in" to what we call "implicit memory". When we find ourselves reacting almost or completely unconsciously, or having flashbacks or nightmares about an event, or fears or emotions that don't make sense to us, it is likely that we are experiencing the results of unresolved trauma. Implicit memories don't feel like they are in the past. When they are experienced, they feel as though they are happening now. Because they can feel very uncomfortable, we often avoid talking or thinking about these types of memories, but they still affect us in our daily living.

EMDR seems to work by helping the brain to "unlock" these stuck implicit memories, and allow them to be reprocessed and appropriately stored.  The combination of bilateral stimulation, while being helped by a therapist to think of the troubling event, and allowing the experiencing of the emotions connected with the event, seem to stimulate the brain into doing what it was designed to do -- in this case, heal the trauma.

What else can EMDR help with?

EMDR is an extremely well-researched technique that has been shown to be effective in the treatment of post-traumatic stress disorder, which is a set of symptoms remaining after severe stressors that include intrusive thoughts or memories of the event, avoidance of emotions and situations that are reminiscent of the event, and hyper-arousal symptoms, such as irritability, panic, sleep disturbances, and extreme startle reactions. It may be helpful in other disorders that originate following a distressing experience, such as phobias, anxieties, pain disorders, and performance anxiety.

EMDR is a clinical tool, and only one of many that a qualified therapist might use. Before using EMDR, the therapist will assess the client by taking a detailed history, and assess the client's ability to tolerate strong emotional feelings inside and outside of the therapy session. Preparation may take one session, or it may take a longer period of time, during which the client will be learning many other important skills to help handle emotional material. It is extremely important that treatment with EMDR be done only with clinicians who have been properly trained, as evidenced by listing on the official EMDR website (http://www.emdr.com).

What happens in EMDR therapy?

During an EMDR session, the client will, with the therapist's help, select a target memory to work on, generally one that is causing some disturbance or upset. The therapist will help the client focus on the memory of the event, its attendant emotions and sensations, and beliefs that the client has formed about themselves as a result of the event. Some form of bilateral stimulation, whether eye movements, tapping, or sounds, will be used.

The client is asked to uncritically allow their thoughts and associations to flow. It may well be that the original target memory leads to other memories or related issues. As each association is processed, bilateral stimulation continues, until the original issue is no longer disturbing.

Clients may experience strong emotion during an EMDR session, and they may also continue to process information between sessions. This is why preparation and assessment with a properly trained clinician is essential. Preparation will include helping the client develop and strengthen skills in self-calming and the containment of strong emotion.

Where can I learn more about EMDR?


The EMDR Institute -- especially the General Information section.  Therapists trained in Levels I and II can be found here.  Deborah Tucker, MA,  MFT is trained in EMDR Level I and Level II. Information especially for clients can be found here.

The EMDR International Association -- the link goes to sections for the public, describing EMDR in detail.  Therapists who have gone on to be certified in EMDR can be found here. 

How do I set up a session?


Please contact Deborah Tucker, either through email* or by phone at 805-583-3976, ext 33.

* I am happy to provide information.  If you choose to do so via email by contacting me in that manner, you are recognizing that email is not a secure form of communication.  There is always some risk that any individually identifiable health information and other sensitive or confidential information that may be contained in such email may be misdirected, disclosed to or intercepted by unauthorized third parties, such as other family members (who may access your email) or employers (if you use your employer email address).  I will use the minimum necessary amount of protected health information to respond to your request for information, and I ask that you do not put highly sensitive information into an email.   Please contact me by phone at 805-583-3976 x 33 if you decide against corresponding via email.

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