Thread: starting EMDR
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Old Nov 20, 2013, 07:15 PM
pattijane pattijane is offline
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Member Since: Sep 2007
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I am concerned about Hezaa82 getting EMDR therapy via Skype, but more than that, by a newly trained therapist.

One of the initial phases (Phase 2) in EMDR involves preparing for memory processing or desensitization (memory processing or desensitization - phases 3-6 - is often what is referred to as "EMDR" which is actually an 8-phase method of psychotherapy). In this phase resources are "front-loaded" so that you have a "floor" or "container" to help with processing the really hard stuff, as well as creating strategies if you're triggered in everyday life. In Phase 2 you learn a lot of great coping strategies and self-soothing techniques which you can use during EMDR processing or anytime you feel the need. There is a special EMDR protocol for dissociative disorders and complex PTSD. The treatment of trauma and dissociation with EMDR (or any therapy) requires special/extra training. Be absolutely certain the therapist has specialized training in DD, as well as advanced training in EMDR therapy. Neither EMDR nor any psychotherapy should go digging for memories. Memories are gone - may be buried/held in different parts - for good reasons. It's really a brilliant protection. Always talk with your therapist at the beginning of your work about what you already know is grounding.

In phase 2 you learn how to access a “Safe or Calm Place” which you can use at ANY TIME during EMDR processing (or on your own) if it feels scary, or too emotional, too intense. One of the key assets of EMDR is that YOU, the client, are in control NOW, even though you weren’t in the past, during traumatic events. You NEVER need re-live an experience or go into great detail, ever! You NEVER need to go through the entire memory. YOU can decide to keep the lights (or the alternating sounds and/or tactile pulsars, or the waving hand, or any method of bilateral stimulation that feels okay to you and your parts) going, or stop them, whichever helps titrate – measure and adjust the balance or “dose“ of the processing. During EMDR processing there are regular “breaks” and you can control when and how many but the therapist should be stopping the bilateral stimulation every 25-50 passes of the lights to ask you to take a deep breath and say just a bit of what you’re noticing, anything different, any changes. (The stimulation should not be kept on continuously, because there are specific procedures that need to be followed to process the memory). The breaks help keep a “foot in the present” while you’re processing the past. Again, and I can’t say this enough, YOU ARE IN CHARGE so YOU can make the process tolerable. And your therapist should be experienced in the EMDR techniques that help make it the gentlest and safest way to detoxify bad life experiences and build resources. Your therapist should also be using a variety of techniques to make painful processing less painful, like suggesting you turn the scene in your mind to black and white, lower the volume, or, erect a bullet-proof glass wall between you and the painful scene, or, imagine the abuser speaking in a Donald Duck voice... and so forth. There are a lot of these kinds of "interventions" that ease the processing. They are called "cognitive interweaves" that your therapist can use, and that also can help bring your adult self's perspective into the work (or even an imaginary Adult Perspective). Such interweaves are based around issues of Safety, Responsibility, and Choice. So therapist questions like "are you safe now?" or "who was responsible? and "do you have more choices now?" are all very helpful in moving the processing along.

Grounding exercises are essential. You can use some of the techniques in Dr. Shapiro's new book "Getting Past Your Past: Take Control of Your Life with Self-Help Techniques from EMDR." Dr. Shapiro is the founder/creator of EMDR but all the proceeds from the book go to two charities: the EMDR Humanitarian Assistance Program and the EMDR Research Foundation). The book is an easy read, helps you understand what's "pushing" your feelings and behavior, helps you connect the dots from past experiences to current life. Also gives lots of really helpful ways that are used during EMDR therapy to calm disturbing thoughts and feelings.

For DID, as with any complex PTSD/trauma, the "front-loading" of resources, and a phased treatment plan is essential. Please read the 2011 revision of International Society for the Study of Trauma and Dissociation (ISSTD) guidelines for treating adults with dissociative disorders available for free public download.
Also good to read:
"Amongst Ourselves: A Self-Help Guide to Living with Dissociative Identity Disorder" by Tracy Alderman
"Healing the Heart of Trauma and Dissociation with EMDR and Ego State Therapy" by Carol Forgash
There are other kinds of Resource Development strategies that can be used depending on the skill level and experience of your therapist (Google "Resource development and installation" and find articles by Janina Fisher, Debbie Korn, and/or Andrew Leeds, ask about John Omaha's AMST - Affect Management Skills Training, or the Imaginal Nurturing protocol).

I'm a therapist who uses EMDR as my primary psychotherapy treatment and I've also personally had EMDR for anxiety, panic, grief, and “small t” trauma. As a client, EMDR worked extremely well and also really fast. As an EMDR therapist, and in my role as a facilitator who trains other therapists in EMDR (certified by the EMDR International Association and trained by the EMDR Institute, both of which I strongly recommend in an EMDR therapist) I have used EMDR successfully with panic disorders, PTSD, anxiety, depression, grief, body image, phobias, distressing memories, and bad dreams, DID, and many other problems. It's a very gentle method with no significant "down-side" so that in the hands of a professional EMDR therapist, there should be no freak-outs or worsening of day-to-day functioning.

In addition to my therapy practice, I roam the web looking for EMDR discussions, try to answer questions about it posted by clients/patients, and respond to the critics out there. It's not a cure-all therapy, however, it really is an extraordinary psychotherapy and its results last. In the hands of a really experienced EMDR therapist, it's the most gentle way of working through disturbing experiences.
Thanks for this!
Asiablue