For First Time Visitors

If you are a first time visitor to this blog, I invite you to start from the beginning, especially if you are unfamiliar with the potential emotional impact of long-term child abuse.

Trigger caution to unhealed survivors!

Understanding the Incomprehensible

Children of incest or long-term sexual abuse grow up to be wounded adults with complicated emotional issues. Unfortunately, some symptoms are misinterpreted or often dismissed as "crazy", only serving to maintain a tormented victim status. We, as a society, have the power to change this dynamic. Each of us can make a difference.

Nov 16, 2008

More on EMDR

I'd like to respond to two comments made on my previous post regarding EMDR. Working with EMDR and DID requires additional steps than the typical protocol which can quickly resolve current or past distress. The example given in the comment was a child with a great fear of shots and surrounding triggers such as the smell of alcohol. EMDR can be used to reduce and/or eliminate anxiety for phobias, among other issues, quite effectively.

If the therapist does not have the proper training which first teaches grounding skills to the survivor and is certain sufficient grounding skills exist to attempt EMDR, and other symptoms are controllable, only then should EMDR be tried. What was described in the comment sounds like an untrained therapist. Being certified in EMDR is not sufficient. It would be good to ask if the therapist is specifically trained to use EMDR with dissociation...and possibly how many other clients with DID has the therapist worked with using EMDR and the outcome. Understanding that some therapists may overstate their skill, the best thing to do is to stop the EMDR if it feels uncomfortable. You know best what is right for you. I know it is very difficult for survivors to be assertive. But you must assertive about what is being done to you and your body. If you are uncomfortable, you have the right to say so. You also have the right to say you will try it and see what it is like for you.

My suggestion is, as long as you have faith in the person leading you through it, allow for a complete session which gets to a resolution or a calming place to stop for later work. You don't want to stop when you are feeling distressed because EMDR is like a wave you ride. It begins with intense emotions and/or images in a controlled environment and takes you to a place of calm. If it feels too overwhelming to continue, say "Stop". The therapist should ask you to do a grounding exercise to take you back to a good place before continuing.

I was asked to describe what EMDR was like for me. Let's see if I can give a description. Each survivor is going to process information differently, so please hear this as my personal experience only. I was initially afraid of EMDR "doing something to my brain". But after my experience with drumming, that was no longer an issue. I understood it was a good thing. Engaging both sides of the brain is a good thing under normal circumstances.

I will first describe a conscious trauma I had that was resolved during my EMDR training--because we practiced on each other. Not knowing whether anything I chose might lead to the DID trauma, I was rather cautious but made the trainer aware of my concerns just in case. I had taken my own EMDR buzzers (tactile stimulation) with me since I don't like the eye movements. The incident I chose was something that had happened when I was 12 years old. Recalling the incident brought up huge feelings of embarrassment and betrayal and shame. I had been in the girls room where several other girls had gathered. I did not know my skirt was tucked up inside my undies. No one told me. I entered the school library and had walked halfway through when the librarian came up and helped me get everything in order. We all have those kinds of things in our past. Even singletons ;-O

Part of the protocol is to identify the most distressing moment of the event and to focus on that moment. Initially the emotions welled up as tears and streamed down my face. Following the direction of the therapist, I refocused as suggested until, in bringing up that most distressing moment, I no longer felt any distress. And it has remained that way since that one "practice session" during training. That's how simple EMDR can be.

With DID, there needs to be a very specific behavior or trigger that the survivor wishes to understand or change. The entire system can't be the target or it will wreak havoc as described in the one reader's comment. I had all my grounding skills and trusted my therapist to handle whatever response I might have. Later in my healing, when processing yuck memories became "same old, same old", I was able to say that I had a memory brewing that was interfering with my life and wanted EMDR to get the answers and get it over with. A neat thing about EMDR is you can be as comfortable as you want. My typical therapy session is lounging on the sofa with several pillows behind me and a quilt on me. I can hold the buzzers in my hands under or on top of the quilt.

Sometimes I only had a physical sensation like an aching in my gut or a twitch that I knew went with an alter. Whatever was "active" in the therapy session is what I knew was to be the starting place. So I would focus on the aching in my gut and my therapist would start the buzzers which give a short buzz in one hand and then the other, alternately at a regular speed and intensity of my choosing. While the protocol is for the therapist to ask questions of what is happening, someone with dissociation can have messages or images come out of nowhere. I usually just started describing what I was seeing, hearing, feeling, sometimes smelling. Fear almost always was/is the first emotion to rise and my therapist always knows what to say to alleviate fear of current safety and reassure the alter(s) having the memory that it was okay now to yell or scream or talk or move the body to allow my body to do whatever was needed.

My suggestion to my clients and what I did for me was internally to watch on the screen in the projector room (see earlier post). Sometimes there were very quick flashes of some trauma while other times it was if I were watching a scene from a movie. Often I was coached to fastforward through the yuck. The resolution, for me, was when I would get to the needed detail of yuck that the alter was holding so s/he could heal. Or to the message (lie) that the alter was still holding onto as the belief so my therapist could guide me through undoing it. EMDR wears me out. It wore my clients out whether they were dissociative or not. Engaging both sides of the mind apparently is exhausting. I had no ill effects except that I felt like an airhead for several hours after the session and learned not to go shopping when the brain was on EMDR. There was no balance of logic to counter emotional spending. lol.

Emotions come up and can be intense but also process quickly. The effectiveness really lies with the training and experience of the therapist. I had a great role model before I went to my own training. I hope this answered the issues addressed in the comments. Great questions!


Secret Shadows said...

I am scared. I want to do it, but I am scared. I am scared of the feelings still, even though I know I can handle them know. I'm afraid of going to the most distressing part of the memory. I'm afraid to be asked what I see and answer it. I'm afraid to cry. And cry. And cry.
Secret Shadows

Lana said...

Thank you, Grace. Now that I've calmed down I think my therapist had the best of intentions, but probably didn't know what she was getting into. You're right, saying "no" or "stop" is really hard for me. It never even occurred to me. With the first EMDR session I don't think she knew it was DID. She didn't mention anything about that until later. I think it really can be a useful tool, we're just going to have to be more careful with it. Thanks again for the explanation. That helps.

Grace said...

Secret Shadows, this is just an explanation of EMDR. Going to the most distressing part of a memory is in the course of treatment through EMDR. It's not something I'd recommend ever for a person to focus on consciously because it will bring up all that hurt. You have a good therapist. She will do what is right for you. Sorry if the post upset you.

Do not try this at home ;-O