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EMDR from the inside

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. 

EMDR

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. 

Understanding Trauma

If youve made it this far in your life without sustaining some kind of trauma, then you are one of the lucky ones. Most of us are experiencing different kinds of trauma all along the timeline of our lives. Some of these are big traumas, some of them small. And whether they leave a lasting mark or scar is difficult to predict.

What is Trauma?

The word trauma is subjective based on experience, so Id like to take a moment to define it before we move on. Trauma is what occurs anytime we take on injury. This could be a physical injury: a bruise, a broken bone, a cut to the skin. Or it could be an emotional or metal injury that causes damage to the psyche: feelings of inadequacy, lack of safety, or an experience of hurt or pain.

Most of the time, a traumatic event leaves both physical and emotional wounds. For example a car accident may leave you with broken bones and a head injury, along with complex emotional scars from the fear, pain or loss that occurred. Likewise, a sexual assault leaves a complex array of physical and emotional wounds.

What is PTSD?

Post Traumatic Stress is what can occur after a physical or emotional injury. Postsimply means after, indicating that there is a stress associated in the wake of a traumatic event. Post Traumatic Stress Disorder, or PTSD, is a diagnosable condition based on set criteria outlined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)

You can see the full criteria here https://www.brainline.org/article/dsm-5-criteria-ptsd, though to summarise: a person experiences distress, upsetting memories or flashbacks, becomes unsettled or hyper-vigilant and has difficulty feeling positive about themselves or the world.  

In addition, the person experiences a sense of depersonalisation or derealisation: as if things are not real or are not happening to them. PTSD is longer term: being diagnosed only after six months post event, with symptoms occurring for months or even years.

Another way to look at PTSD

There is another way that we can look at PTSD that I find very helpful. It is the program that didnt get to run, and the dream that never happened. Lets look at these two concepts.

The dream that never happened.

Each night, as we sleep, we take our memories from the day and reprocess them into long term memory. This happens via the rapid eye movement of REM sleep (REM stands for Rapid Eye Movement, and is the deep, dreamless stage of sleep). REM takes the memories from our cortex and moves them to the limbic brain, where they reside as long term, less impactful memories.

Traumatic events do not integrate in this way. They remain closer to our minds: more impactful, as they refuse to go to the long term memory. This is what leads to the feeling of reliving the event, of life-like flashbacks, visual and auditory hallucinations or embodied experiences of the frightening memories. The events stay up close and intense, as if we are still right there with them.

The person loses the ability to seethat was then and this is now. During trauma, the cortex cant process complex language, so the person experiencing a flashback cant use the appropriate language to communicate whats going on to others.

The program that didnt get to run

Non-PTSD programs

As humans we create programsthat allow us to function with whatever is happening. These programs are created and are the best available at the time. For example, a six year old who suffers an abuse creates a program that helps them to cope and feel as safe as they can inside their environment.

Many years later that program is still running to keep them safe. However the program is out of date. The adult is still using a six year olds program to guard themselves against an environment that no longer exists. They may avoid powerful people, stay small, do what theyre told, never step out of line, even though it is no longer required of them. They are trying to stay safe and cope with life, using an outdated operating system.

They may still see themselves as badbecause when they are six, they were unable to understand that bad things can happen to anyone. They wouldve believed that they were bad and wrong, as that is the only thing that wouldve made sense then. As an adult, the old program needs to be re-integrated, or it will continue to run as them, their inherent belief about themselves

PTSD

We can think of PTSD as the program that didnt get to run. In the case of a traumatic event, the person may have created a program of panic, of paying attention, or of doing something. Then, as the event ended, that program did not get to complete.

And example is one of my clients, Kate, who was a paramedic for 13 years. Kate created a program of being highly functional, always paying attention, judging her performance harshly, and being emotionless during times of heavy emotion.

Later, two years after resigning, Kate was still trying to hide her grief, stay alert, and be capable. Kate had adopted a negative view of the world, was having difficulty feeling optimistic and held unconscious negative beliefs about herself within the traumatic memories.

Kate was exhausted, and all she longed to do was soften, let go of judgments about her performance as a paramedic and cry all the tears shed had to hold in over the years. Kates programs were out of date. She no longer needed them in her life. We had to integrate the program so she could let them go.

Case Study on EMDR

In order to integrate Kates outdated program we did a full day of intensive therapy called EMDR. In our next blog we will be sharing the Kates story in greater deta

Lessons from my four year old

Often, we look upward for advice and modelling. Yet If were open anyone can teach us a lesson. The less privileged man on the street, a neighbour we always thought of as simple, or in my case recently, my own child. 

 

The lesson came packaged up in a playground session, and the teacher was my four year old daughter, who completed the whole length of the monkey bars for the first time. 

 

She didn’t mean to teach me anything, rather she was simply being herself. Lining up behind her big sister, watching carefully as those seven year old arms swung that seven year old body easily from one bar to the next. My four year olds eyes were intent, her forehead burrowed as she prepared herself to follow. 

 

For the last year she had been attempting to make it to the other side. Shed been watching her older sister, cheering her on and trying, trying, trying, until this day, she finally got it. As I watched the whole thing from beginning to end; the concentration, the determination, and the completion of the goal, the lesson sunk in. 

 

You see, over the last year, my four year old didnt see someone doing better than her and give up. She didnt decide that the monkey bars were her sisters thing and not compete. She watched and she learned. She modelled and practiced and got better until she nailed it. 

 

That day, that made her my hero.

 

I sometimes look at other professionals in my game – ones who fill the big training rooms and charge the megabucks and command the highest paying high profile clients and I think, It’d take me forever to get to that point. 

 

In these moments I forget how far I have come. I run my own business, I have other therapists that work with me, I have my own premises with its own staff. I run regular training events in my area and even if theyre not huge, theyre always a success. 

 

That day, watching my daughter, it hit me. Next time, I might just model my youngest child. 

 

Ill see someone doing something I dont think I can do yet and Ill cheer for them.

 

Ill watch and Ill have a go.

 

Ill practice and remain focused and determined, progressing in increments when time allows (were not always at the park after all). 

 

Its not like her path across the monkey bars was completely easy. There were times that she let go and started again deliberately, because of some factor unseen to others. She didnt give herself a hard time, didn’t call herself a failure and walk away. She just knew she needed a rest, so she could get back up there and go again. 

 

Next time, Ill do that. 

 

What my daughter taught me that day is that we always have a choice. We can either use our observations of others to measure ourselves against, comparing and diminishing what we are capable of. Once weve made our measurement, we can believe well never make it to that level. We can decide were lesser than them. We can let ourselves be consumed with jealousy or feelings of unworthiness. We can give up and walk away.  

 

Or, we can use our observations of others to motivate us. We can learn from them, watching closely how they do it, with the assumption that were getting there too, someday. We can model their behaviour, cheering them on as we go, knowing that well all arrive eventually too, with effort. 

 

In sharing this story with you, I hope to inspire you to ask these powerful questions of yourself: How are you comparing yourself to others? How do you feel discouraged by the success of those around you? Can you be encouraged instead? Determined? Patient? How can you believe that with effort, and encouragement, you will get there too? 

 

Perhaps, we can be open to letting everyone be our hero. Watching closely and learning from even the most unexpected sources. Observing those who are great, and those who are still small. Watching for the lessons, the inspiration, and the motivation to get yourself across any gap. One day, if you just keep going, youll get there. Thats what my beautiful four year old taught me that day. 

 

My daughter, my hero.

It’s not always the season to be Jolly.

When someone takes their own life, the questions they leave behind are usually the same. Why did they do it? What were they thinking? Could I have stopped them?

Perhaps, you know the answers to these questions: Have sat inside your vehicle on a quiet night and thought the world will be better off without you in it. Maybe the thought of waking up to one more day of your private hell felt like too much.

Today, were going to explore why someone wants to take their life. Well talk about the three levels of suicidal ideation, and offer a place to go if you, or someone you love, is suicidal.

There are a few things to think about when it comes to suicide:

1. Its permanent

People end their lives for one simple reason. They lose sight of the fact that a feeling is temporary. If I asked you, Do all things change?you would likely answer yes, because upon examination, we all know this to be true.  Yet, in the moment of suicide, the person believes that their depression, hopelessness, despair, or frustration will never go away. They believe that there is no end to the hardship, that nothing will get better, ever. Completely overwhelmed by what they feel, by the unending nature of it, it makes sense to end their life.  

All things change. In buddhism, the term impermanence is used to describe the changing nature of all phenomena. It is a law: nothing is permanent. The downside of this law is that joy, love, sunshine and pleasure will inevitably pass. But its opposite, the flip side of the coin, is that sorrow, hate, darkness and pain will also pass.  When looked at this way, we can see that suicide is a permanent solution to a temporary problem.

2. Expectation isnt reality

Have you heard the saying: happiness = reality – expectations. If you havent, read it again and let it sink in. We all have so many ideas of perfection ingrained in us from relentless propaganda. Television shows, commercials and magazines painting pictures of the perfect family. They paint easily resolved disagreements and vomit inducing happy endings. Its all supposed to be so perfect isnt it? And now we have social media, where most people chose to share only the joys, but never the sorrow.

The result is a cumulative expectation around how life, and the state of your mental health should be. You feel isolated and alone in your misery. But should doesnt matter, what matters is what IS. As a therapist, let me tell you: most people arent always happy. Far more likely is that each of us have complex relationships, ongoing financial trouble, work challenges, and disappointing personal characteristics. Most of us wish we were somehow better. Most of us feel just as sad as we do joyful. And, because we share a common illusion that were always supposed to be happy, we become isolated and depressed.

Its not an accident that were talking about suicide right now in the lead up to Christmas. Theres no greater time where our expectations are sky rocketing past reality. Were hoping for postcard interactions with our families, but in reality the people we say we love disappoint us, hurt us, or trigger our wounded inner child. We hurt them, or fall into patterns of people pleasing or walking on eggshells. We overspend, causing insane stress all in the name of meeting the societal expectation for presents. We also tend to evaluate our life more, comparing who we are to who we thought we would be.

We have to be ok with what is. Every morning, my house is so disheveled, it looks like its been burgled. Sure, Id love to have a perfect house. But I dont. Instead, I have a good family. After Ive worked all day on maintaining healthy relationships, I dont have the time to work on the house. In accepting what is, instead of wishing it were different, I can be at peace.

3. Pride equals hell on earth

Many who plan to take their lives exist in a private hell, where they believe that no one can truly understands what they are going through. Yet, for most men who report being suicidal, their last option is to break down and tell their loved ones what is happening for them. When asked why, most would tell you, Pride. To show emotion, to break down, is to do the worst thing of all: to be weak. Male suicide rates in Australia are staggering, and suicide is the leading cause of death for people between 15 and 45, with three times as many men than women taking their lives. (source: lifeline)

Unwilling to reach out to those around them, the person may feel like no one cares whether they live or die. They may become spiteful, angry, and convince themselves that the world is better off without them in it. If you find yourself thinking these kinds of things: theyre the biggest delusion of all. The world does want you in it: and your loved ones want nothing more than to help you.

The three levels

If you suspect someone is suicidal. Ask. If you can, find out where they are:

1. They are having fleeting thoughts about it. This is actually more normal than most people think: this is when someone is driving along and a semi trailer comes by and they think something like: I could swerve right out in front of it. Often, these thoughts are impulsive, and impulsive thoughts are driven by alcohol, substances, or extreme emotion.
2. The thoughts are beginning to take root. This is more likely to happen when youre sober, yet the thoughts are becoming stable. Its more than just at the height of emotion or when intoxicated. Theyre beginning to think about it as a real possibility.
3. They have a plan. A plan is when theyve put a strategy into place for how they intend to follow through. This stage requires immediate intervention.

What do you do?

This Christmas, be on the lookout for anyone who appears to be managing a low mood. The extra financial pressure, unrealistic expectations, childhood triggers, and excess alcohol consumption can cause the kind of impulsivity that leads to spontaneous suicide. Dont assume any one leaving an argument will be fine.

Tell your loved ones how valuable they are the you, especially if you suspect they are down. A person who has a plan may do anything to cover it up, and may not tell you: but small powerful words of love and acceptance can unknowingly change a persons mind.

If you think someone is in trouble, seek assistance through a helpline, your local hospital or trusted therapist. If things seem like theyre escalating, dont be afraid to call 000. Ambulance and police are experienced in handling such matters. If you are managing your own low mood, or find yourself having thoughts that take root, reach out to a professional.

Above all else, take good-will into your holiday season. You never know when your kindness could save a life.

The Suicide Callback Service 1300 659 467

The suicide call back service is an incredible way to get assistance. If you call their toll free number, they will ring you back, for 5 sessions free of charge, anytime of day or night.

Inner Child Healing

Becoming a loving parent to you inner child is an imperative step in becoming a fully grown and psychologically healthy adult. 

While everyone grows up to become an adult in a physical sense, many of us are still children in our minds. We act out from the unconscious and unaddressed programs we learnt in our past. 

In this post we will learn how to become the loving parent of these inner children. But first, we need to get clear on what, exactly, an inner child is. 

What is an Inner Child? 

When we were young, we had powerful developing brains. As things happened to us, good or bad, we learned to categorise our experience. When an event was particularly impactful, we filed it away as “how things are”. For example: if you had to cope in an unsafe environment your child brain may have concluded “the world is unsafe”. If a kid on the playground punched you in the belly after you asked them to play with you, you may have concluded “people don’t like me”. 

Sometimes, these are called defining moments, and they can be good or bad. Jim Carey, for example, talks frequently about receiving a bike when he was quite young and poor, the day after praying for one. That moment he saw the bike, he concluded that the world would give him anything he wants. This shows the power of the “how things are” beliefs we create as a child. Jim Carey is now one of the most successful men in the world (and reportedly, extremely happy). 

Unfortunately, most of us did not have the Jim Carey experience. Later in this post, I’ll offer an exercise of how to uncover your defining moments, and sadly, for most of us, they’re pretty negative beliefs. Many of us did not receive the kind of love, support or nourishment we needed to grow up healthy and complete. Many of us were physically or emotionally abused or neglected. 

To make it through each experience as a child, we created what I like to call a “program”. We could only create that program with the resources we had at the time. As young children, those resources weren’t very good. 

A program includes our new beliefs about how things are, and also our damaging beliefs of how we are (I am bad, I am wrong, I am worthless, I am unlovable). Then, it creates an operating system to carry us through those new beliefs.  This system, or program, may include a variety of mechanisms, like striking out at people first, or isolating from social situations, or becoming a people pleaser. We pick a program that works for us at the time, using the best resources available to us, and we lock it in. 

How Your Inner Child plays out as an adult 

As humans, our tendency is to only accept information that aligns with our existing beliefs. Therefore, as we grow into adulthood, we are unlikely to change the powerful defining moments we learned as kids. We will act out from these wounds as long as they remain untended to. 

This is best demonstrated using an example: so let’s continue with our inner child that was punched in the belly at four years old, and let’s call him Jim. Jim is now 39 and has become a successful business man. He’s secretly a little depressed, but mostly, he thinks life has worked out for him. He’s just been invited to a party and his hands are sweating as he enters the room. His feels sick, and he can’t understand why this is so hard for him. 

Jim has always hated parties, though he’s not sure why. His heart is racing and he wishes he’d just stayed home with a movie. Problem is, Jim is incredibly lonely, He’s been single since his last break up, over six years ago, and all he wants is a companion. He’s afraid he’s running out of time to become a father. Jim finds his friends and relaxes little. He smashes a shot and a beer and starts to calm down.

Jim has no idea that he is acting out a program that is thirty five years old. Since he hasn’t done any investigation into his childhood defining moments, he has barely thought about being punched in the belly. If Jim sat down quietly and did an inner child exercise, he would most likely remember the event clearly. Jim might even cry when he realises how much that punch hurt, not for the physical injury, but for the lasting scar in his heart. For Jim to realise his dream of being a loving partner and father, he will need to update his program to an adult version. 

Creating a New Program

So how does Jim make the unconscious conscious? How does he update this belief he learned as a child that people don’t like him? The first step is the become aware of the inner children that are unconsciously running your adult life. There are a few ways to do this.

  1. Sit quietly in a safe place where you wont be interrupted. Grab a journal and a pen and draw a line down the middle of the page.  In the lefthand column, write down every significant childhood memory you have, from the earliest time you can remember. Trust that you know which ones want to be addressed. Then, go through and write the belief and program (if you can identify one) that came out of that event in the righthand column. 
  1. Sit or lie quietly and close your eyes. Visualise yourself as a child, if you can, focussing on times that were difficult for you. What was your experience like? Do you feel any emotion arising? Can you feel what emotions or beliefs are tied to this memory? 
  1. If there are strong emotions tied to your childhood memories, you may want to seek the help of a trained therapist, coach or psychologist to explore your childhood memories with. They will guide you to explore what beliefs you learned as a child. 

Parenting your Inner Child 

Looking into your past in this way allows you to make contact with your inner child, or children. You may be able to specifically visualise, or feel, the different versions of yourself that are still present, running the show. You can ask, is there a child in me that was teased, beaten, neglected or assaulted that is still running the old program that it used to survive? Once you have found him or her, you can begin to be a loving parent to those children. 

Parenting you Inner child means that you are attentive to their needs. You are aware enough to notice when they are hurt, or throwing a tantrum, or stamping their feet to be heard. You might be at a party, like Jim, and be conscious enough to acknowledge (when one is looking) that there is a scared little boy inside, longing to be accepted, and that it is HIM running the show. 

When this happens, you can quietly acknowledge that version of you. You can give the child what he or she needs: whether it is love, attention, safety, or care. When you are there for your inner child, it’s like you put them to rest. Now the adult you can take the driver’s seat, which is far safer, and more appropriate than letting a kid run the show.