As I made my way up to the rambling building by the sea in my hometown of Saint John, N.B., I tried to look surly. In reality, I was petrified. It was my first day back in therapy in a couple of years, and though I knew I needed it, it was the last thing I wanted to do.
Surly is probably how I could best be described in those days, at least from the outside. Somehow, feelings of anger and agitation had taken me over. Opening up to others had become hard, and trusting them next to impossible. Being in crowded public spaces would sometimes bring on a panic attack. I couldn’t feel the beauty in life. Childhood trauma, various instances of physical and emotional abuse, sexual assault and one whopping infidelity took over the stories I told myself and made it difficult for me to function for years. It became clear to me that I needed help managing the narratives that had hijacked my brain, because I could barely recognize myself anymore.
By a stroke of total luck, I wound up in the office of a therapist who practiced EMDR, which stands for eye movement desensitization and reprocessing. When I walked into the office, I was hoping to receive CBT, or cognitive behavioural therapy. After talking to me for ten minutes, the therapist told me sometimes it’s not about labouring to change our thoughts, but about letting the brain’s natural functions heal us. She had a technique, she said, that would clear these feelings out and put them in the right place.
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What Is EMDR?
EMDR was invented in 1987 by American psychologist Dr. Francine Shapiro. One day as she was walking in the park, she noticed her eyes were moving rapidly back and forth as she thought about something that was bothering her. At the end of the walk, she realized the troublesome thoughts were gone. She found this technique helped others, too. In the early days, EMDR was used to help both veterans and survivors of sexual assault, and today clinicians use it to treat people who have witnessed murders, survived sexual assault and family violence, and who deal with other psychological issues such as anger, grief, depression, chronic pain, addictions and attachment wounds. Some therapists have also used it to help people with psychosis process delusional thoughts or manage feelings related to phantom limb syndrome, and it’s also used in relationship counselling.
EMDR is the opposite of a lot of other therapies: There’s very little talking, and almost no verbal processing. It works to treat people suffering from traumatic memories that were stored in the wrong place, and because they’re left unprocessed, these memories and our reactions to them start to dominate our lives. While this is happening, our limbic system holds on to the emotions, turning them over and scanning for more danger. EMDR moves the material to the forebrain, where the memory will stay, but without the brutal emotions or the related negative thoughts and beliefs. It just becomes, at that point, a part of our wider story, and not our defining story.
Nancy Cusack, another EMDR practitioner in Saint John, explains that the process uses bilateral stimulation to mimic REM sleep, but while the client is awake. During REM, the eyes move back and forth quickly as the brain processes information from the day. When someone has a traumatic experience, the processing system can be interrupted, and information can become “stuck.” This can cause a number of symptoms, including those of post-traumatic stress disorder (PTSD).
The bilateral stimulation used in EMDR comes in the form of sensation on both sides of the body: either knee tapping, noise being heard by both ears through a set of headphones, or the eyes moving back and forth. This helps to process that information and eliminate symptoms of trauma.
“EMDR works quickly because the brain knows how to process information, however it can be injured from a traumatic incident. Old language such as post traumatic stress disorder is now often referred to as post traumatic stress injury—not a disorder but an injury that can happen in the brain after an incident.”
“When an incident is desensitized and reprocessed with EMDR therapy, emotions, negative beliefs, images from the incident and physical sensations in the body get processed. Channels in the brain free up and are able to access the memories, and feelings of joy that are often blocked after trauma,” Cusack says. Symptoms of post-trauma, she says, can be eliminated in three to five sessions.
How EMDR works
Here’s how the session works: You sit in a chair. The therapist makes sure you’re comfortable. Then, you pull up a target: a traumatic experience, or a painful past memory you want to work through. You rate this memory, how much it disturbs you in the body, on a numeric scale. You identify how it makes you feel, and you read a series of statements about the thoughts it left you with. These thoughts include statements like “I cannot trust anyone,” “I cannot be trusted,” “I don’t deserve love” and other disturbing and dejected feelings. As in other therapies, there is potential for triggering moments of upset as you feel your way through these experiences again.
But it’s brief. The session starts in earnest then, and it feels underwhelming. But then, something remarkable can happen. As I said, when I went in to my therapist’s office, I didn’t trust anyone, and I didn’t want to trust her, either. But I felt I had no choice, and that I had nothing to lose. So I made the leap to trust her entirely. The first incident we worked through was my former partner’s betrayal.
As I focused on the memory, the therapist tapped on my knees. She walked me through: What are you feeling now? What’s happening for you now? I would tell her: anger, sadness, worthlessness. I cried. Just sit with it, she would say, and check in again in a few minutes. Eventually, when she asked me what I noticed, my brain came back as though from far away and I said, spacily, “nothing.” There was warm sunlight in the room, corny classic rock tunes playing, and nothing else.
It worked so quickly and easily that I felt almost hoodwinked. Was I tricked? Lulled into a feeling that would go away when I left her office? But no. I came out into the early summer sun and felt only joy and peace, the peace of a child with no worries. It was a long ago feeling, something I hadn’t experienced in the whole of my adult life. I walked out to an open field near the building and sat watching the sea for probably an hour.
I’m not the only person to have felt this. Several studies have shown EMDR to be a quicker, more effective treatment for trauma than trauma-focused CBT. One study conducted by Kaiser Permanente found 100% of single-trauma patients and 77% of multiple-trauma patients no longer had PTSD after a mean of six 50-minute sessions. Cusack says millions of people worldwide have used it to recover, and the American Psychological Association and the World Health Organization now recommend it, too.
Dr. Dell Ducharme was sold on EMDR quickly, too. Winnipeg-based Ducharme is now president of EMDR Canada, a national nonprofit whose goal is sharing information on EMDR and connecting patients with clinicians. He found it, he says, “by accident.” He was already working as a clinical psychologist at the time. One patient he saw had lived through a serious accident and was having up to 30 flashbacks per minute. Slowly, Ducharme was helping the patient to decrease the flashbacks to 20 per minute. The next time he saw them, they were smiling hugely and said the flashbacks were gone. It turned out they had actually been to see someone for EMDR, and that person banished their flashbacks within two days of treatment.
Later that week, when Ducharme got home, he saw a poster at the hospital where he worked advertising an EMDR training at Winnipeg’s Aulneau Centre. He registered. “During the first day of training, I was quite skeptical,” he says. “It made little to no intuitive sense given my training and clinical experience.” As part of the training, the clinicians-in-training had a chance to practice on one another. He knew his partner from years back, and they reconnected by wondering how they might have better spent their registration money. They made the best of it, though, and while there, Ducharme started working through a phobia of his own: He had started feeling aversion to the phone, which was morphing into a fear of the doorbell.
Within 20 minutes of inexpert finger movement on the part of his friend, Ducharme heard a telephone ring. Not just any telephone: a random telephone in the kitchen of the building where the training was happening. “Without a blink, I quickly went to the phone and answered it.” This kind of speed is typical of the EMDR process. Regardless of the issue, and of the severity of the injury, most people Ducharme works with feel some emotional relief by the end of their first session, which improves in subsequent sessions.
Not only is it fast, but the issues being brought up in therapy don’t need to be revealed completely. Patients can just say it was “something that happened with my partner,” if they don’t feel comfortable sharing details. Ducharme says this is common when female survivors of sexual assault see male practitioners, or for children who have been through terrible things and don’t have the words for it.
“To date,” he says, “I have had equal success addressing significant trauma with or without knowing the trauma or the details of it.”
That said, it’s not the best mode of treatment for everyone. Ducharme says those in the early stages of pregnancy or who are experiencing other hormonal changes, or people experiencing psychosis, mania or who are strongly under the influence may find clinicians are reluctant to provide EMDR. Folks prone to seizures should be warned that sometimes bilateral brain stimulation can trigger them, and folks who are highly dissociative or who have high emotions should work with highly skilled practitioners.
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Rewiring the brain
Ken Genlik, who also practices EMDR in Winnipeg, sees many women who have been through traumatic breakups and infidelity. He says they often “feel like they’re never going to be loved, they’re never going to be enough for anyone, they’ll never have a healthy relationship. They feel like they’re not deserving.” These feelings then develop “bodily anchors,” so if someone doesn’t feel good enough, they might have pain between the shoulders, or a pain in their side if they’ve been angry. Combine it with early childhood experiences, he says, and people’s nervous systems can feel like they’re “on fire.” This is exactly what happened to me. I felt like being happy was out of reach for me, and I was in constant physical pain.
When we experience trauma, Genlik explains, our brains start to work in overdrive. We don’t feel safe, our brain starts scanning for more danger, and the frontal lobe becomes unable to do its job. We may have flashbacks, or feel like we’re reliving the experience. The eye movements and tapping help the brain to be better able to communicate. Eventually, through therapy, the brain’s natural methods of recovery are restored, and communication between the amygdala, the hippocampus and the prefrontal cortex is balanced again. Those fight, flight or freeze responses melt away and stop unduly influencing our lives.
“By changing the communication, we change whole brain states, producing calmer brain waves, and [patients] start to feel regulated,” he explains. With treatment, people can start to believe they’re worthy, that they deserve a good life, and that they can take care of their fear of abandonment within a few hours. Genlik says he’s been noticing an uptick in the number of people openly talking about trauma, especially the harms of narcissistic abuse, neglect, abandonment, sexual assault and other painful experiences. He has hope more people will seek it out in the future.
Of course, the costs for therapy are prohibitive for many people. Genlik says many EMDR practitioners across the country work to make their services available, though, regardless of a patient’s income. Some therapists offer a sliding scale, and some do pro bono work. Genlik says many of his former clients have gone on to heal and do well in business, and some of them send cheques each year to cover the cost of pro bono appointments. Also, those doing practicums or EMDR training in hospitals and universities will also often offer pro bono or sliding-scale work to complete their training requirements. Genlik says many therapists in the community feel a responsibility to help others.
“The goal is to help patients to fall in love with themselves and who they are, so that their light can shine out.” Genlik says, once a traumatic event has happened in your life, the sooner you go to therapy the better. That feeling of hypervigilance, or of inadequacy, is not something you should have to live with.
As for me, when I think of the things I’ve worked through in therapy, they feel like they happened to someone else. They’re completely refiled: I have to sift for them, reach for them and dig them out of my memories. They hold almost no weight, and they don’t bother me at all. I know now, both emotionally and intellectually, that other people’s shitty actions are just that: someone else’s choice, something that happened. Self love doesn’t come easily, but it’s been improving with time. In the meantime, I can say I’m finally free.