This case study is a follow-up to our article on Post Traumatic Stress Disorder (PTSD), and will be used to demonstrate the highly effective technique of Eye Movement Desensitisation and Reprocessing (EMDR)
EMDR is a therapy that assists in the processing of traumatic memories using rapid eye movement. During the therapy the client attends to emotionally disturbing material in brief sequential doses while simultaneously focusing on a rapidly moving stimulus, in this case the therapist’s finger moving in front of the patient’s eyes.
How it works
When we sleep, short term memories are processed into long term memory through the rapid eye movement of REM sleep. Traumatic memories often skip this step, staying in short term memory. During EMDR impactful memories and psychological distress associated to the event is eliminated, and negative beliefs are reformulated into positive ones.
The most effective way to understand how EMDR works, and why it might be the right form of therapy for you, is to understand by example. If you haven’t read our last post on PTSD https://wordpress.com/post/therapyandtrainingdotcomdotau.wordpress.com/106, you might want to go back and read that now.
To explore EMDR by example, we will use Kate as our case study. Kate is a real person who came to me for a full day intensive EMDR session last year. When we discussed using her as the case study for this article, she decided she wanted to write about it herself. The following is Kate’s account of the process:
Kate the Paramedic
I came to see Jenny with many undiagnosed symptoms of PTSD. I had been a first responder for 13 years, and had resigned 2 years prior to our session. I had decided to resign due to a sudden onset of physical tension and anxiety about 12 years into my career. I’d been to a run of awful calls and somehow my body wasn’t recovering. It took 6 months of dealing with this new anxiety (I’d never experienced anything like it) to resign. The tension and anxiety continued for another 18 months after I left.
I had been mostly anxiety free when I came to see Jenny. I was unmedicated, had received very little therapy and had used meditation, yoga, coaching and personal development work to heal. While this was working beautifully (and I was very proud of myself), I felt that there was some kind of “misfiring” occurring in my mind. It’s hard to describe, but it was like something was a little “off” and needed fixing. After hearing repeatedly that EMDR had helped others when nothing else worked, I wanted to give it a try.
Even though I was anxiety free, my system was fragile. I avoided TV, I never watched the news, and I struggled to hear about any form of death, violence or tragedy. I became highly triggered when I went to any of the areas where I used to work and I felt stressed if I talked to old coworkers.
I didn’t suffer from textbook nightmares or flashbacks, but I would get extremely disturbing memories that felt like they bombarded and overtook my mind. When I would remember one memory, the whole line-up of 13 years of them would play like a movie reel.
I was tired of carrying this burden. I still identified as a happy person, yet I struggled to feel the old “easy going” nature I used to have. Over the last two years I’d felt an increasing sense despair and hopelessness about the world. I wanted to stop having to avoid potential triggers all the time, and I longed to feel normal again.
Jenny asked me to come in with three main memories in mind: the most recent, the first, and the worst. We chatted for a while to get comfortable, then sat opposite one another in a chair. We began with the worst memory. Jenny asked me to bring to mind the most impactful moment of that memory and to screenshot it, or lock it in.
I had been avoiding this memory, and as I brought it to mind I began to sob, shake, and tense. There was so much emotion, grief and horror there. Jenny coached me to breathe, and let me know we would take our time. She asked me rate the level of disturbance, and I immediately gave it the highest number.
Then, Jenny asked me what the negative belief I held about myself in that moment was. I was confused, what did this horrible moment have to do with me? I couldn’t come up with anything: I was so inside the memory. Jenny gave me a piece of paper with a list of beliefs. I read down the list thinking: I don’t know what these have to do with that woman dying, but ok. And then one line jumped out at me
I am inadequate.
“Holy shit. I think that’s it,” I told her. Something inside me broke open, as I realised I didn’t think I had done a good enough job that day. I secretly thought that being so horrified on that call made me an inadequate paramedic, an inadequate person. If I were better, I wouldn’t have been so disturbed.
Each negative belief has an opposing positive belief, and in that case it was I am adequate. I did a good job. Jenny asked me to rate how true I felt that was. I gave it a low score. Then she asked me to hold the belief together with the memory, and to look at the index finger she was holding out in front of my eyes. She moved it back and forth, and I simply followed.
She stopped, and asked me to recall the memory again. It was somehow less. We kept doing this over and over. Each time we repeated the eye movement, the memory lessoned, change, lowered, and the emotion around it changed too. Eventually, it was like the woman in my memory was a friend: she wanted me to know she thought I did a good job, that I was not just adequate but excellent, that I had honoured her. She wanted to say thank you to me.
We kept going: back and forth, back and forth, until eventually I realised that the woman was me. I was the one who wanted me to know I was excellent. I wanted to say thank you to myself for the good work I had done.
We went through so many memories that day, all of which had their own negative beliefs. They were somewhat similar: Feelings of inadequacy, incompetency, or weakness. Ridiculous beliefs that I could have done better. And each time, without fail, we transformed them into the truth.
I had been an amazing paramedic. I had done the very best I could. I was a good person. At times I cried or laughed with the realisation of it. It was like angelic lightbulbs were going off everywhere. And with each one, a release from the secret burdens I’d been carrying. All those years I’d had these shameful secrets hiding away in my unconscious mind where I couldn’t find them.
That was the trauma.
There was magic in the eye movement: the memories themselves becoming further away, more distant and hazy. Each of those memories faded away into something that still existed, but didn’t hold me so tight. I still remember all the things I’ve done, so nothing has been taken away. If anything EMDR gave me back my truth.
Still, many months later, the disturbance is gone. And still, many months later I know my truth: I did a great job, and I’m a good person.
Like Kate, most people do not understand that they have formed negative beliefs about themselves through their trauma. EMDR was created to reprocess not just the memory itself, but also the negative beliefs associated with the memory.
Through multiple studies, EMDR has seen incredible results.A study funded by Kaiser Permanente found that 100% of single-trauma victims and 77% of multiple trauma victims no longer were diagnosed with PTSD after only six 50-minute sessions. In another study, 77% of combat veterans were free of PTSD in 12 sessions. (SOURCE EMDR Institute: http://www.emdr.com/)
Each of us have sustained countless trauma’s in our lives, and in each one we formed beliefs about ourselves. Given how effective the results of EMDR are in treating “big trauma,” imagine what it can do for all the events in our lives, from our childhood and our youth, that led to our low self-worth, unlovability, insecurities and fears.
EMDR is for anyone who has formed a negative belief about who they are. And that, my friends, is everyone.