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.
How does EMDR work?
Human beings have two hemispheres in their brain: one is our “old”, mammalian/emotional brain that we have in common with other animals and the other hemisphere is 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 two sides of our brain, and it does so using eye movements when we are awake and mostly during Rapid Eye Movement (REM) sleep.
Our mammalian brain’s primary mission is to help us survive and it does this unconsciously, without us thinking at all! It controls many of our automatic functions like our heart rate, blood pressures, hormones, digestive system, immune system, and our limbic system (which is responsible for our fight, flight, freeze response). It is able to make decisions quickly so we can protect ourselves – but sometimes it will make decisions haphazardly with information that may not be the most accurate. Imagine learning that you are having company coming over and you need to clean your house quickly, so you throw stuff in different places so your house looks clean. The problem is, you don’t know where anything is and most people know what when life is quick and unorganized, we make mistakes. In times of stress, our mammalian brain may make these same mistakes – it may program us to react in ways that don’t make logical sense. For instance, if we failed an exam before, we may believe that we will fail it again and our heart rate will increase, we may feel nauseous and find it difficult to think. If we hear a siren, we may have a panic attack because we think we are back at the accident scene again. When we are touched on the shoulder, we may jerk away automatically because our body instinctively about a previous sexual assault. Thus this side of our brain seems to have a direct path to our bodily responses. Our thinking brain takes a back seat.
In our thinking side of our brain, our logic is used to regulate our emotional reactions so we aren’t controlled by emotional reflex – we aren’t animals after all! When we are not under stress, we are to reason and take action in a way that makes sense for the situation. Our prefrontal cortex is responsible for attention, concentration, impulse control, and social relations or moral behaviour. This side of our brain is very organized and intelligent like a microprocessor but has a slow reaction time as a result. It does not seem to have a direct line to our bodily responses. Thus it may be very difficult to “reason” our way out of a feeling or a behaviour because our body just acts without thinking! Sometimes we can reframe our thoughts using CBT for months and still have the same behavioural reaction in the moment. Because of the way our brain is structured, we can’t think our way out of feeling.
When we experience an upsetting event, our limbic system in our emotional hemisphere takes a picture of the situation and attaches thoughts, feelings, body sensations, smells, sounds and stores it. Just like on a computer, there are protected files that cannot be manipulated. These files in your limbic system are the same. Sometimes your brain uses old software to make present decisions, which don’t make logical sense. 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 the accident. Or let’s say you need to make a presentation at work in front of your co-workers and you start to shake, you 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 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 – 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 motional wound. If we undergo a very upsetting situation when we are sick or feeling alone, our brain has difficulty processing and filing the information. Sometimes it gets stuck, and it just files information away inappropriately or as is. When this happens, we end up using information to make decisions that is wrong. When this happens, we end up responding inappropriately like in the above examples. If we are operating at an optimal capacity, or if we feel supported in our life, our brain will process information during sleep very easily. It will file information properly in our sleep so that in the future, it makes decisions soundly.
When clients come into session 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.
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 clients 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 moment, what image comes to mind, what do you think about yourself, what do you feel and where do you notice it 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.
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. In therapy, we call this dual attention, where our current self stays in the present and our younger self-notices the past feelings and thoughts. 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 think of a positive thought about themselves when they think of the situation and do BLS so that the brain will then file that 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, then it is said that that 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 do “Google search” 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?
As cited the Trauma-informed workshop at Klinic in November 2015, 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, 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
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