Talk Therapy is helpful. There is something very reassuring and comforting to have someone hear you and validate your experiences. It made me feel understood and not so alone. Having your feelings normalized in life is an important reminder that we are okay and not as defective as we may think. We are capable. Talk therapy is great but EMDR is really where the magic happens, the alchemy to reclaim the self. — Anonymous client
Psychotherapy is the process of talking to a mental health professional to learn about your moods, feelings, thoughts, and behaviours in order to gain better control of your coping skills. It can take the form of talk therapy or a specialized therapeutic approach like Eye Movement Desensitization and Reprocessing (EMDR). Psychotherapy does not incorporate medication in the treatment process.
EMDR has been the most helpful to me on my journey. At first I wasn’t sure if it would work or how but as I continued to try the process, the more I started to notice a change. The change was gradual but I remember all of a sudden I noticed things I was stuck on emotionally were not bothering me the way they used to…their weight was less heavy and then eventually subsided. It was amazing to see and feel because I didn’t know if I would ever feel better…and then one day I did. I have grown and moved forward so much since I started the process and would highly recommend it to anyone who is struggling and feels stuck. — Anonymous client
What is Talk Therapy?
People come to therapy because it feels good to let go of the thoughts and feelings they’ve been carrying around…it offers safe place to release heavy burdens. Some people have individuals in their lives whom they can speak to but feel they don’t want to wear them out! Others want an unbiased perspective on an issue they are struggling with in their life. Sometimes, people don’t have individuals in their life who will just listen….without turning the conversation on themselves or “one-upping” you.
Therapy is supposed to provide a safe harbour for people to let go, express their thoughts and feelings without feeling judged; to understand that thoughts and feelings are valid (no you are not crazy!); and that it’s normal for them to be feeling/thinking that way.
Therapy offers perspective, a mirror, for people to clarify their thoughts and feelings that get messy inside their head amongst all their emotions. It isn’t dispensing advice but encouraging people to hear what their own self is saying. We all know what we need, we just need help teasing it out!
Therapy provides psycho-education about life topics affecting client’s lives in order to teaches them how to self-regulate and cope with their thoughts, feelings, and behaviours.
Lastly, therapy is about equipping a client so that they can manage on their own. They will help clients learn how to tune into themselves so they can self-reflect and notice what is happening in their life – to be their own mirror.
Julie’s talk therapy approaches include: Person-Centered approach, Cognitive-behaviour therapy, Inter-personal Dynamics, Solution-Focused Therapy, Positive Psychology, Skill Development; and encourages clients to consider affirmations, meditation, acupuncture, yoga, exercise, healthy eating practices, sleep hygiene, homeopathy, light therapy, cardio coherence, social interaction within the community, and healthy communication skills.
Common talk therapy realizations
Trust my intuition to guide me…
I am enough…I have enough to cope…
Think positively….feel positively….act positively….
Feelings are natural….we don’t choose them…they just are…
It’s okay to talk about how I feel…it is my right….it is my responsibility to myself and loved ones…
People are going about their life…try not to take things personally….
I can validate myself….
I can protect myself with proper boundaries….
Put my oxygen tank on first so I can help others….
I am in control of me…I can be vulnerable when I am in tune and in charge…
I am responsible for my thoughts, feelings, and actions
Just the facts, Jack. Be mindful of assumptions…
I’m doing the best I can with what I know…
Strive for balance…
Learn along the way…
What is EMDR Therapy?
Eye Movement Desensitization and Reprocessing (EMDR) is an integrative psychotherapy approach that has been extensively researched and proven effective for the treatment of trauma, panic attacks, grief, depression, disturbing memories, phobias, performance anxiety, stress reduction, addictions, and sexual and/or physical abuse.
The World Health Organization recommends that people suffering from the above issues be referred for treatments using EMDR, citing it as being 90% effective.
The goal of EMDR therapy is to discard the inappropriate emotions, beliefs, and body sensations caused by unresolved earlier experiences and leave you with the emotions, understanding, and perspectives that will lead to healthier behaviours.
EMDR is appropriate for men, and women, and children of any age.
For more information, please visit the EMDRIA website
How does EMDR work?
EMDR harnesses our brain's ability to change - neuroplasticity. The video above helps to explain neuroplasticity. Norman Doidge says, neurons that fire together, wire together. If you've experienced much adversity and trauma in your life, then that information is hard-wired in your brain. EMDR helps the body rewire the brain to a more adaptive stance so that you don't relive or use past information to make sound decisions today.
Human beings have three different "brains": a reptilian brain responsible for automatic processing like breathing; a mammalian/emotional brain to protect us using the "flight, fight, freeze" response; and our “newer” more evolved/ thinking brain that is unique to humans.
Our daily mental health is derived from a constant attempt to find balance between these brains. When we sleep, our body repairs. During REM (Rapid Eye Movement) stage of sleep, we coordinate between thoughts and feelings to file the days events: we keep what is important and file away what is not important for survival. We call this our Adaptive Information Processing System: our natural compass that guides the healing process. It is exactly like how our body innately knows how to heal a physical cut – with an emotional cut, our body uses eye movements to repair the emotional wound.
So how does the brain store trauma material that EMDR will rewire?
When we experience an upsetting event, our limbic system in our mammalian brain takes a picture of the situation and attaches thoughts, feelings, body sensations, smells, sounds and stores it.
If we are operating at an optimal capacity, or if we feel supported in our life, our brain will process and file the information very easily.
If we are living under constant stress, if the event is very traumatic, or if we've endured many smaller traumas, the brain may not process the information properly. It gets behind in paperwork! When this happens, we end up responding inappropriately to the current situation.
For instance, let’s say you are driving home, stuck in traffic, when you hear a siren and you immediately launch into a panic attack. Even though you can rationally tell yourself that you are safe, your body is reacting as if it is re-living an accident that happened in the past. Or let’s say you need to make a presentation at work in front of your co-workers, when you start to shake, can barely breathe, and you feel like vomiting. Your cognitive brain knows it is good at presenting but your emotional brain remembers when your former boss criticized you for your last presentation and blamed you for the loss of the account. You feel threatened and respond in a matter to protect yourself whether it makes sense or not for the current situation.
When clients come into therapy feeling stuck, we use eye movements, the body’s natural way of healing, to finish processing the life event that the body feels it keeps reliving. Once the information is filed properly, the client will notice they don’t think negatively, respond emotionally, or act inappropriately because their brain found its resolution about the upsetting event and moved on.
What does EMDR Therapy actually look like?
The beginning of EMDR therapy is just like talk therapy. The therapist learns about the client and their problem(s) and they develop a comfortable, safe relationship (history-taking). The therapist then helps the client find some stability in their life, so they that when the emotional work of EMDR is underway, the client will still be able to cope with their daily life (preparation).
Once a client is well resourced, the therapist then does a “limbic system scan” to find the “misfiled” trauma information. It works just like a Google search: the thoughts, feelings, and bodily sensations that distress clients will be identified to “pull up” earlier life events that felt the same way. Clients use their emotional memory rather than their cognitive memory to recall these events, when guided by the therapist. The reason the therapist needs to identify these earlier cues is so that any association with the negative event is removed. For instance, if you have a weed in your yard, you will use a shovel to dig the root out, otherwise if you just pull out the top it will grow back. Negative associations are the same: we need to take it out at the root – the first time it happened in a client's life – so that it doesn’t happen again.
Once the events are identified, the client then processes the earliest event they remembered. The therapist asks a series of questions like, when you think of that upsetting moment: what image comes to mind; what words would you use to describe yourself; what emotions do you feel and where do you notice them in your body; and how upsetting does the event feel when you think of it now on a scale of 0-10 (where 0 is not upsetting and 10 is the most upsetting you can imagine).
Once this assessment is complete, the client thinks about those cues while watching the light on the light bar go back and forth, and/or holding paddles that vibrate in one hand and then the other, and/or hearing a beep in one ear and then the other. These back and forth movements stimulate the emotional and thinking brain to cooperate with each other to process and file away the information about the event. We call this back and forth, bi-lateral stimulation (BLS) and the client is conscious or aware during the whole time. It is not hypnosis. The client is always in control and able to stop whenever they choose. It is important that while processing the traumatic event, that the client remain in dual awareness (aware of present moment and the traumatic moment at the same time) in order to avoid re-traumatization.
When thinking of an upsetting event and undergoing BLS, a client may notice thoughts or feelings about the event, or nothing at all. After a few moments of BLS, the therapist checks in with the client to see what they notice now when they think of the upsetting event. Sometimes the client notices thoughts like, “I was just a kid. I didn’t know any better. Its okay that I was scared” and may notice they don’t feel as upset as they had when they first thought about the event. This is when our cognitive or adult perspective can lend a better perspective to the younger, emotional self that was trapped in the felt experience of the traumatic event.
Or sometimes after the BLS has paused, a client may notice that their heart isn’t racing as fast and they may feel a calmness in their muscles. The client the continues with BLS until when they think of the upsetting event, it feels 0/10 upsetting and they usually say something like, “well it’s just something that happened and it doesn’t upset me anymore”. This stage of processing is called desensitization.
At that point, the therapist will then ask the client to what thought describes themselves when they think of the situation now. It is usually changed from negative to positive. The clinician will add a set of BLS so that the brain will then file that new positive thought with the event. Once the client feels 7/7 sure of themselves, the therapist will have the client think of the situation, the positive thought, and notice the sensations in their body. If the body does sense discomfort, then more BLS is done until that feeling is gone. If nothing is felt in the body and the client still feels 0/10 about the event, BLS will be used to associate the new body sensation with the event.
When a client then thinks of the upsetting event, the image, thoughts, emotions, and body sensations will have changed to a more adaptive resolution. The event is now properly filed or reprocessed!
Once the earliest event is reprocessed, then the client chooses the worst event from his or her “limbic body scan” or “Google search” of their mammalian brain. The reason we want to process the worst event is so that most of the negative associations are properly filed. Or if we use the weed analogy, that the strength of the root is broken. The therapist will then assess the event just as before and do the BLS until the event feels 0/10 upsetting, the positive thought is 7/7 strong, and the body is clear of any upsetting sensations.
Then the therapy is focused on the current upsetting event that the client identified is upsetting them the most in life. The same assessment is completed as the earliest and worst event. Once the current event is finished processing and is properly filed, the therapist will ask the client if there are any present triggers and will process them as needed. Finally, the client will do a “Google search” of future life events that may have already been associated with the negative event. For instance, if a client has been in a car accident, they may feel scared about being in a car again. Once that event is assessed, it too will be processed until it is no longer upsetting.
EMDR therapy can be completed in as little as 6 sessions or several years, each client is different. How long therapy takes depends on several factors like: whether one’s childhood felt safe and supported by loving parents or caregivers, if trauma was consistent in one’s life or sparse, whether the traumas were big or small, whether one feels supported in life now, whether one is well resourced, or how ready one feels for therapy.
For more insight and to hear client stories, consider reading, The EMDR Revolution: Change your life one memory at a time – The clients guide by Tal Croitoru
What are the possible side effects of EMDR?
As with any therapy, clients feel a sense of relief like that have shed some “emotional pounds” although they may feel tired after processing so much upsetting emotion. They are usually encouraged to take the rest of the day to practice self-care as if they were sick. Usually the following day, clients feel refreshed as if they had just received a massage.
Just as if you were to exercise, one may feel distress when doing lots of push-ups, but afterwards, they feel the rush of endorphins. In therapy, if an upsetting event is not finished processing in one session, the client will feel continue to feel distress until the event is completely processed. During the preparation stage of therapy, the client learns how to container and cope with upsetting emotion and if they are not able to manage emotion or maintain a state of dual attention in therapy, desensitization is not started. Re-traumatizing or making someone feel unsafe in therapy is not okay. Therapy is supposed to teach clients that they can trust and manage difficult situations. The utmost care and concern for clients is always on the therapists’ mind. Sometimes clients choose to do an intensive EMDR session that is longer than the standard 90 minutes to ensure that they completely process the event before going home.
Dissociation or disconnecting for the here and now can also happen. If the therapist is trained in dissociation, they will recognize the symptoms and reconnect the client using the grounding techniques they learned in the preparation stage of therapy.
What are the limits of EMDR?
EMDR is not as effective with individuals who have organic trauma to the brain like sustained in an automobile accident or chromosomal abnormalities. The training of the therapist may also limit the effectiveness of EMDR. For instance, one would need advanced training in assisting individuals with severe depression, bi-polar, borderline personality disorder, dissociative identity disorder, schizophrenia, Alzheimer’s, or dementia. When individuals have neurological disorders, they should consult their physician before starting therapy.
EMDR seems weird. Is this for real?
EMDR was developed by psychologist, Dr. Francine Shapiro in 1987 and was originally used for veterans of the Vietnam War struggling with PTSD. In his book, the Instinct to Heal, psychiatrist David Servan-Schrieber, noted that most used database for PTSD (at the Veterans Administration Hospital in the US) showed that more controlled clinical experiments used EMDR than any other treatment for PTSD. People use what works and EMDR works! He also said that three “meta-analyses” (studies that analyzed previously published studies), showed that EMDR was at least as effective as the best existing treatment, seemed the best tolerated by clients, and was the fastest treatment method.
According to Servan-Schrieber, EMDR appears to be well accepted in France, Holland, Germany, and England, but is still controversial in the United States because it is “natural” and the actual science behind the eye movements is not yet understood. He sites a similar example as Dr. Philippe Semmelwise, a Hungarian physician, who showed the importance of sterile techniques in childbirth 20 years before the concept of germs was discovered by Lister and Pasteur. If we don’t understand how things work, they must not be real! Or if the answer is so simple, it must not be right! Servan-Schreiber also provided the sample of the FDA taking 20 years to recognize the benefits of Lithium for bipolar disorder because it is a “natural mineral salt” and the way it affects our central nervous system isn’t fully understood.
Today, the following entities recognize recognizes EMDR as an effective treatment, as cited in the Instinct to Heal:
- The American Psychological Association,
- The International Society for Traumatic Stress Studies,
- The Department of Health in the United Kingdom,
- The Department of Health in Israel,
- The Department of Health in Northern Ireland,
- Medical Schools and Departments of Psychology in France, Sweden, Germany, and Holland
What is trauma?
Listen to the podcast where Krista Tippett interviews psychiatrist, Bessel van der Kolk, about trauma, how it is stored in the brain, and how we can heal from traumatic experiences.
Trauma is an unexpected event in which we are unprepared for and thus are left feeling helpless and out of control. How each person perceives trauma is based on the their personality and life experiences. As a result of experiencing trauma, we may feel disconnected, unsafe, and fearful of receiving or giving to other people and ourselves. 90% if Canadians have experienced at least one trauma event in their life.
The most common response to trauma is to avoid… leaving our house, going to certain places, seeing certain people, dating, or just feeling at all. We can numb out with addictions or anxiety. Some people after trauma experience hyper-arousal where our nervous system stays in high alert to watch out for another trauma. Others may develop a feeling of depression where a negative perspective on life pervades their thoughts and feeling which leads to difficulty with thinking and functioning.
Trauma can be a one time event or a series of small, persistent events. Reactions to trauma or normal. Trauma is not. People may notice physical reactions to trauma like headaches, sudden sweating, heart racing, change in sleep, appetite, digestion, and illness. Or they may experience emotional symptoms like shock, fear, disorientation, anger, mood swings, helplessness, difficulty concentrating, shame, etc. The majority of issues clients present with in therapy, like anxiety, depression, eating disorders, alcoholism, and drug abuse, originate in trauma. Thus PTSD is not the only disorder that benefits from focusing and processing past events that have left emotional wounds. Using EMDR, clients can eliminate the emotions and symptoms of the trauma so that their real selves can function.
Regardless of how the trauma was incurred, all people can heal from trauma. The first step is to find a sense of safety through support and then acknowledge the mourn the impact of trauma through therapy. The last step is to reconnect with life with exercise, yoga, massage, humour, medication, music, art, and people. In 30-70% of trauma experiences, people develop a sense of positive growth or resilience in life that they didn’t have before – post traumatic growth. They may be more aware of who they are, how they interact with others, and how they move through the world.
To determine your level of childhood trauma, visit the website www.ptsd.va.gov to complete a brief trauma questionnaire .
What is dissociation?
When we go through an upsetting event, we react with our fight, flight, or freeze response. But sometimes the trauma is so scary that we disconnect in order to cope with the situation.
Dissociation may feel like we are in a dream, disconnected from our body. We may feel like a robot, zoned out, or may even “lose time”. Everyone dissociates but it is the extent to which we do and how often that is concerning. Some people may dissociate when they are driving to work and wonder how they got there. Others may dissociate and feel like they are no longer in the here and now and may feel like they are back in the traumatic situation. Then when they reconnect, they can’t remember how they arrived at their destination and may have lost a few hours of time.
In therapy, there are assessments and behaviours that a therapist will look for and assist the client in noticing so that they can ground themselves in their body in the present moment. To determine your level of dissociation, visit, CounsellingResource.com. Or share your concerns or observations with your therapist.
How to choose an EMDR therapist.
Consider answering these questions before choosing a therapist:
- Do you feel understood by the therapist?
- Do you feel hopeful that the therapist can help you?
- Do you feel safe and trust the therapist?
- Have they undergone their basic EMDR training?
- What advance training in EMDR have they completed?
- Are they supervised or do they consult with anyone about their work? And how often?
- Do they follow the EMDR protocol?
- Do they use EMDR by itself or in addition to other therapies?
- How often do they use EMDR in their practice?
How do you know EMDR is working?
- Positive attitude
- Coping skills
- Success at work, home, and in the community