John Condron is a Certified Clinical Trauma Professional, and is trained in several approaches to the treatment of Posttraumatic Stress Disorder (PTSD) and other trauma-related disorders. This includes Eye Movement Desensitization and Reprocessing (EMDR), which is an evidence-based treatment for PTSD and other trauma-related disorders. It is supported as a treatment for trauma by more scientific research than any other non-pharmaceutical intervention. Based on empirical evidence as well as thousands of client and clinician testimonials, EMDR has proven a rapid and effective treatment. It is listed in the current Department of Veterans Affairs & Department of Defense Practice Guidelines “A” category as “highly recommended” for the treatment of trauma, and has received a high level of recommendation by the American Psychiatric Association and by the mental health departments of Israel, Northern Ireland, United Kingdom, France, Sweden and more.
EMDR assists in the processing of traumatic memories, resulting in enhanced integration – and a more adaptive perspective on the traumatic material. The use of EMDR has been shown to eliminate the need for some of the more difficult abreactive work (i.e., reliving the trauma over and over) often associated with other treatments, such as Prolonged Exposure Therapy. Theoretically, EMDR is about integration – bilateral hemispheric (right / left brain) integration; triune brain (brain stem, limbic system and cerebral cortex) integration; and at least some type of mind / body integration. But practically, it’s about convincing the mind and body that the traumatic event is, indeed, over, and that the person is safe.
Strictly speaking, “EMDR” is a misnomer, because the alternating bilateral stimulation of the brain on which it hinges can be provided in ways other than just eye movement, As a result, I prefer to refer to the technique as “Alternating Bilateral Stimulation (ABS).”
- Eye movement – client follows therapist-controlled movement from side-to-side with her or his eyes, using a finger, light-bar, etc.
- Auditory – using stereo headphones or earbuds
- Tapping (Not to be mistaken for the discredited “Emotional Freedom Techniques” popularized by Gary Craig, which are considered pseudoscience)
- Butterfly technique – one form of hand-tapping in which the client crosses her hands over her heart and taps her shoulders in an alternating way
- Thera-Tapper (TM) – two small pulsers, held in the hands vibrate in an alternating fashion to provide a gentle tactile stimulation
ABS/EMDR helps to put the past in the past, where it belongs, instead of staying stuck in it, feeling like it is happening all over again in the present, with the same frightening thoughts, emotions and body sensations that accompanied the event in the past.
Of course, ABS/EMDR involves more than just wagging a finger in front of a person’s face! Any trauma therapy must involve all of the following steps:
- Psychoeducation – General information about the specific type of trauma experienced, as well as common emotional and behavioral responses to the event, both immediate and delayed. The therapist may also provide information about the client’s diagnosis, symptoms, and the usefulness of the model in treating that condition.
Relaxation – training in specific techniques for bringing about the “relaxation response.” This is critical, because it is not possible to be both relaxed and tense at the same time.- Affective (emotional) expression and modulation (control) – Many of us were taught from an early age to carefully control our emotions, keeping them “in check,” so as not to disturb other people. This is especially true of persons who have experienced traumatic events. For example, children who are traumatized often hide their emotions, to avoid hurting their parents. During this phase of treatment, the client is taught and encouraged to express those emotions safely.
- Cognitive (thinking) coping and processing – Many trauma survivors learn to avoid thinking about the traumatic event; however, this is rarely completely successful, with “intrusive” thoughts interfering with their day-to-day lives. During this phase, the client learns to manage those thoughts, controlling when they occur and coping with them when they do, by learning simple and effective techniques that can be used anywhere.
- Trauma processing — This is where the bilateral stimulation of EMDR comes in. One of the goals of treatment is for the client to think about or tell the story of the traumatic event(s) without experiencing any of the troubling symptoms that brought them to treatment.
- In vivo (real life) mastery of trauma reminders (triggers) – During this phase of treatment, the client learns to manage the events in their lives, such as sounds, smells, touches, places, times of day, seasons of the year, holidays, etc., that might remind them of the trauma, triggering intrusive thought and emotions.
- Conjoint sessions (with parents, partners, or other appropriate persons identified by the client) – In some cases, the client desires assistance in helping other persons in their lives to understand what has happened to them, and how those traumatic events affect their behavior and needs today. This phase is optional for adults, but can be very helpful to the client and their family, friends, etc. It can also help to make additional support available to the clent.
- Enhancing future safety and development – Research shows that trauma survivors may be at increased risk for future traumatic events. During this final phase of treatment, the therapist will assist the client in developing a “safety plan,” to prevent future trauma, or reduce the severity of such trauma. If the client is in danger, this phase of treatment may occur sooner in the process.
Though the order of these steps is a bit arbitrary (You might have noticed that the steps spell the word “PRACTICE”), each of these components is critically important, and must be available to every client. If you go to a therapist for “EMDR” and they immediately start wagging their finger in your face (except, perhaps as part of an assessment process), find another therapist!
ABS/EMDR can be provided equally effectively in the office or online.