Living with PTSD
Post-traumatic stress disorder (PTSD) can strike when someone least expects it. Perhaps an aggressive driver makes someone feel threatened, or a noise or smell triggers a traumatic memory and triggers an excessive reaction that is difficult to control.
Trauma changes your brain, but there are treatments to help. An intriguing option is EMDR, an evidence-based therapy that helps you process traumatic memories and learn to cope in a healthy way.
What is PTSD?
PTSD affects nearly 7 percent of the U.S. population, according to the National Institute of Mental Health. From flashbacks and hypervigilance to difficulty concentrating and sleeping, symptoms of this surprisingly common condition can drastically change your daily life.
And while the condition itself isn’t always permanent, researchers suggest it could change the way your brain functions forever.
PTSD is “a type of anxiety disorder that develops after a person has experienced or witnessed an intense event that causes anxiety,” explains Janet Civitelli, PhD, a licensed psychologist and certified career coach in Austin, Texas.
While PTSD is often associated with combat, Civitelli explains that many experiences can trigger this “fight or flight” response to trauma, including bullying, abuse, medical treatments, and natural disasters.
People can also develop PTSD from recurring minor trauma. “We now have evidence that repeated exposure to minor traumas can cause more emotional damage than exposure to a single major trauma,” said clinical social worker Annie Miller, who specializes in trauma and sleep-disorder therapy.
Whether you experience an accumulation of non-life-threatening incidents or a single tragic event, you experience trauma and develop the potential for PTSD when your stress exceeds your brain’s processing limits, says board-certified and EMDR-trained therapist Kevin Faust, who practices at Akahai Emotional Wellness in Hawaii.
What is EMDR?
Eye Movement Desensitization and Reprocessing (EMDR) is a highly complex, structured form of therapy delivered by trained mental health professionals.
EMDR uses rhythmic bilateral actions (using both sides of the body) to help people reprocess stuck memories, according to Indiana-based graduate counselor Brittany A. Johnson, who is certified in EMDR and currently training. to become an EMDR educator.
Research on the therapy is promising and it is one of the approaches the American Psychological Association (APA) is proposing for treating PTSD. (Here’s the APA’s full list of PTSD therapies.)
EMDR therapy sessions involve focusing on a traumatic event from the past while performing back and forth actions designed to activate both sides of the brain and keep you “safe and grounded in the present,” Miller said. For example, you may trace your therapist’s hands back and forth across your vision, thinking about a traumatic event.
While sideways eye movements are a hallmark of EMDR, she says, the bilateral stimulations can be visual, auditory, or tactile. The idea is that focusing on the stimulation while reliving an event can help you reprocess the memory without getting lost in a flood of negative emotions.
How EMDR works
The therapy is credited to research first begun in the late 1980s by psychologist Francine Shapiro; Remarkably, she got the idea during a walk in the woods where she found that flashing her eyes back and forth through the trees helped relieve the fear she was feeling at the moment. After successfully trying it on patients, she developed the theory behind EMDR. The approach took time to gain acceptance, but a comprehensive 2018 review of research on EMDR – published in the journal Limits in Psychology—found that EMDR can not only help diagnose PTSD but also reduce symptoms such as anxiety and fear.
The basis of EMDR is a theory called adaptive information processing (AIP), which theorizes that mental disorders can occur when a traumatizing experience is insufficiently or incorrectly processed by the brain, according to another report published in Limits in Psychology.
“Dr. Shapiro’s research led her to work with ‘bilateral stimulation’, or rhythmic stimulation of both sides of the body,” Faust says. “It is thought that stimulating both sides of the body stimulates both sides of the brain, moving that stuck psychological trauma from the emotional part of the brain to the logical part, processing it and storing it appropriately. “
Miller says stress and trauma can overwhelm your brain’s ability to heal. EMDR can help by allowing you to reprocess those events and wrap them up at a later time.
Rewinding the clock and releasing “captured memories,” as Johnson describes it, through quick eye movements and hand tapping might sound a bit fantastic. But the research seems to support practitioners’ claims.
Numerous studies have shown that EMDR therapy is particularly helpful in reducing PTSD symptoms. Research published in the International stress management magazine also suggested that the effects of EMDR persist for several months after people stop taking therapy.
The 8 Phases of EMDR Therapy
If you are interested in taking EMDR therapy, it is important to have clear expectations. A single session is not enough to relieve PTSD symptoms or teach you all the regulation methods you need.
“EMDR happens in eight stages, and while some clients and clinicians can complete the stages quickly, for some things there are multiple sessions for each stage,” Johnson explains. She says an EMDR-trained therapist will explain how many sessions you need at the beginning of the process.
Johnson says the basic focus of each EMDR therapy phase is divided in the following ways:
- Phase 1 and 2: Reviewing your mental health history and developing a treatment plan.
- Phase 3 and 4: Identifying, processing and desensitizing specific memories using bilateral stimulation.
- Phase 5 and 6: “Installation” (inserting or amplifying positive thoughts) and “body scan” (observing your thoughts, feelings, and actions, then identifying the remaining negative reactions).
- Phase 7 and 8: Close, evaluate progress and identify future goals.
What it’s like to go to an EMDR therapy session
An EMDR session lasts on average between 60 and 90 minutes. Your session will vary depending on how far you have progressed through the EMDR stages.
Once you’ve reviewed your mental health history and created a treatment goal and plan with your therapist, “expect your therapist to let you talk for just a few seconds between each set.” [of bilateral stimulation]Johnson says. The goal is to keep a continuous flow through the recall and processing.
EMDR-trained therapists emphasize that you can expect warm-up activities and careful handling of your traumatic memories and negative emotions.
Traumatic experiences are relived in bursts of 20 to 30 seconds while simultaneously performing bilateral stimulation. You may be asked to follow your therapist’s hand with your eyes quickly back and forth or listen for taps, vibrating buzzers, or tones. Your therapist will guide you through the entire process.
“The goal of an EMDR therapy session is to make you think about the memory or event, but not get stuck in it,” Miller says. “You can learn how to let go of painful emotions more easily.”
How do you find an EMDR trained therapist?
To find a therapist trained in EMDR, visit the EMDR International Association or ask for a referral from your doctor or a local clinic.
“If you plan on using health insurance to pay for EMDR therapy, I recommend calling the phone number on the back of your insurance card and asking which mental health therapists in your area are ‘in the network’ Faust says. Once you have a list, you can visit their websites to check for EMDR certification.
Can EMDR treat other problems?
While research isn’t as clear-cut about EMDR’s success in treating other mental health conditions, researchers are exploring EMDR’s potential in managing: