I have never been one to leave anything unresolved. I also want things better for others. So in the middle of the chaos of my mental issues, I have been mulling over contacting my previous therapist. She is a very nice lady, I just think things went very VERY VERY wrong with my EMDR process.
So I did it. I bit the bullet last night, and emailed her, though terrified that I represented myself as a crass and insane witchy woman, after I hit send
Some of the points I made were specific to my treatment and my understanding of EMDR based on how I have seen it on Youtube, and EMDR.com. I also expressed my fears of the whole process, and of anyone I love doing it. Rightfully, so I believe.
She and I shared a couple of very nice emails last night and she expressed gratitude for the feedback, and plans to study up on some of the procedure as well as implement some administrative policies to let patients know what might happen. I have always joked about being Heavenly Fathers guinea pig, why not someone else’s too. Seriously though, without sounding too much like a martyr, I am grateful that it happened me rather than someone who did not have a strong support group at home to help deal with it. It has made my life hell, but if good comes of it in helping others, and if I can heal from it, then all will be fine.
So if you are considering EMDR what should you know?
First it is not all rainbows and puppies. It can go seriously wrong, and even if it does not go wrong, processing is not easy. I was able to process one event through. My kindergarden teacher was awful to me. I do not know if you would call her abusive or not, you can be the judge of that. She would make me clean up my vomit. She would sit me in the corner table alone for being upset wanting to be in the third grade with my sister, throwing a third grade Math book at me and telling me, “If you want to be in the third grade so bad, teach yourself”. All of this is while the rest of the class was coloring BIG Dalmations and getting bright red fire hats for fire safety week. The worst thing though, was the day that my best friend tried teaching me a magic trick with her shoes. She could tie a bow with both shoes, pull one string and the bow would untie. My friend had me try it on her shoes. I was not as magic as she was, I created a knot. The teacher angrily made me put on my friend’s shoes with were several sizes too small, they were still knotted. I had to walk around in them. She told me, “If — were to tell you to jump off a bridge YOU probably would”. After walking around for a while, I tripped on the side walk. I did not understand why no one helped me, no other teachers. Any way, she took me to the room and made me sit on the carpet and wrapped the shoes around my neck. Through EMDR, I can see this like a movie, I do not have near the anxiety I did with it. I have more now than right after reprocessing it, I do not know if that is because this is around the same time period/age as my rape or what.
What I was getting at if you are seriously considering EMDR, make sure your therapist is properly trained. Ask all kinds of questions before you ever have one session. Things that happened to me that I was unprepared for:
1. The things that happened to me were a possible disassociation. We are working to re-integrate my core being again.
2. Traumas and Flashbacks that you had no idea existed can throw your life, and the life of all those that you love into complete and utter chaos. These do no only come up during session.
3. You think you are crazy.
4. Severe splitting headaches after intense sessions, these can last for a week. I have migraines. This was not a migraine this was in the back of my head and I asked my therapist, and she said it was from the therapy.
5. Getting stuck in fight or flight, and panic mode.
I wish I would have done more research before I would have went so I would have known what questions to ask. I have now researched, I went to the EMDR Institute website and I have copied and commited on how the process is supposed to go. I hope this will help anyone considering EMDR and therapist practicing it.
There needs to be an extensive intake history done. This is for you and for the therapist to get to know you and what problems are weighing on you. According to the EMDR Institute this should take 1-2 sessions before any EMDR is done.
According to the Institute: History and Treatment Planning: Generally takes 1-2 sessions at the beginning of therapy, and can continue throughout the therapy, especially if new problems are revealed. In the first phase of EMDR treatment, the therapist takes a thorough history of the client and develops a treatment plan. This phase will include a discussion of the specific problem that has brought him into therapy, his behaviors stemming from that problem, and his symptoms. With this information, the therapist will develop a treatment plan that defines the specific targets on which to use EMDR. These targets include the event(s) from the past that created the problem, the present situations that cause distress, and the key skills or behaviors the client needs to learn for his future well-being. One of the unusual features of EMDR is that the person seeking treatment does not have to discuss any of his disturbing memories in detail. So while some individuals are comfortable, and even prefer, giving specifics, other people may present more of a general picture or outline. When the therapist asks, for example, “What event do you remember that made you feel worthless and useless?” the person may say, “It was something my brother did to me.” That is all the information the therapist needs to identify and target the event with EMDR.
I had EMDR my first time seeing my therapist.
There also needs to be a preparation phase. I think this is one of the big disconnects for what happened to me, because we had EMDR that first session, there was the assumption that I was prepared with that coping skills I needed. This phase is also key in developing trust. I think not only trust in your clinician, but in the process. With it being left out, and something major comes up, you have no idea how to deal with it. You are not “prepared”. I had no idea how to take care of myself when these traumas surfaced.
Quoting the Institute: Preparation: For most clients this will take only 1-4 sessions. For others, with a very traumatized background, or with certain diagnoses, a longer time may be necessary. Basically, your clinician will teach you some specific techniques so you can rapidly deal with any emotional disturbance that may arise. If you can do that, you are generally able to proceed to the next phase. One of the primary goals of the preparation phase is to establish a relationship of trust between the client and the therapist. While the person does not have to go into great detail about his disturbing memories, if the EMDR client does not trust his clinician, he may not accurately report what he feels and what changes he is (or isn’t) experiencing during the eye movements. If he just wants to please the clinician and says he feels better when he doesn’t, no therapy in the world will resolve his trauma. In any form of therapy it is best to look at the clinician as a facilitator, or guide, who needs to hear of any hurt, need, or disappointments in order to help achieve the common goal. EMDR is a great deal more than just eye movements, and the clinician needs to know when to employ any of the needed procedures to keep the processing going. During the Preparation Phase, the clinician will explain the theory of EMDR, how it is done, and what the person can expect during and after treatment. Finally, the clinician will teach the client a variety of relaxation techniques for calming himself in the face of any emotional disturbance that may arise during or after a session. Learning these tools is an important aid for anyone. The happiest people on the planet have ways of relaxing themselves and decompressing from life’s inevitable, and often unsuspected, stress. One goal of EMDR therapy is to make sure that the client can take care of himself.
The third phase that the Institute recommends is the Assessment. Assessment: Used to access each target in a controlled and standardized way so it can be effectively processed. Processing does not mean talking about it. See the Reprocessing sections below. The clinician identifies the aspects of the target to be processed. The first step is for the person to select a specific picture or scene from the target event (which was identified during Phase One) that best represents the memory. Then he chooses a statement that expresses a negative self-belief associated with the event. Even if he intellectually knows that the statement is false, it is important that he focus on it. These negative beliefs are actually verbalizations of the disturbing emotions that still exist. Common negative cognitions include statements such as “I am helpless,” ” I am worthless,” ” I am unlovable,” ” I am dirty,” ” I am bad,” etc. The client then picks a positive self-statement that he would rather believe. This statement should incorporate an internal sense of control such as “I am worthwhile/ lovable/ a good person/ in control” or “I can succeed.” Sometimes, when the primary emotion is fear, such as in the aftermath of a natural disaster, the negative cognition can be, “I am in danger” and the positive cognition can be, “I am safe now.” “I am in danger” can be considered a negative cognition, because the fear is inappropriate — it is locked in the nervous system, but the danger is actually past. The positive cognition should reflect what is actually appropriate in the present. At this point, the therapist will ask the person to estimate how true he feels his positive belief is using the 1-to-7 Validity of Cognition (VOC) scale. “1” equals “completely false,” and ” 7″ equals “completely true.” It is important to give a score that reflects how the person “feels,” not ” thinks.” We may logically ” know” that something is wrong, but we are most driven by how it ” feels.” Also, during the Assessment Phase, the person identifies the negative emotions (fear, anger) and physical sensations (tightness in the stomach, cold hands) he associates with the target. The client also rates the disturbance using the 0 (no disturbance)-to-10 (the worst feeling you’ve ever had) Subjective Units of Disturbance (SUD) scale..
We did something similiar during the EMDR session but not without EMDR, we did not do a rating scale. I do not quite understand the Assessment as related to my sessions.
Reprocessing as described by the Institute: For a single trauma reprocessing is generally accomplished within 3 sessions. If it takes longer, you should see some improvement within that amount of time.
Phases One through Three lay the groundwork for the comprehensive treatment and reprocessing of the specific targeted events. Although the eye movements (or taps, or tones) are used during the following three phases, they are only one component of a complex therapy. The use of the step-by-step eight-phase approach allows the experienced, trained EMDR clinician to maximize the treatment effects for the client in a logical and standardized fashion. It also allows both the client and the clinician to monitor the progress during every treatment session.
We jumped right into reprocessing on day one. When I initially went in I went in because I wanted to deal with the anxiety and depression that I had from the adoption fraud from 2007, but I was told to put that in a box and we would deal with it later. Later never came, but I was taken back to my conception, literally. That was my last session. Conception through age 6.
Desensitization: This phase focuses on the client’s disturbing emotions and sensations as they are measured by the SUDs rating. This phase deals with all of the person’s responses (including other memories, insights and associations that may arise) as the targeted event changes and its disturbing elements are resolved. This phase gives the opportunity to identify and resolve similar events that may have occurred and are associated with the target. That way, a client can actually surpass her initial goals and heal beyond her expectations. During desensitization, the therapist leads the person in sets of eye movement (or other forms of stimulation) with appropriate shifts and changes of focus until his SUD-scale levels are reduced to zero (or 1 or 2 if this is more appropriate). Starting with the main target, the different associations to the memory are followed. For instance, a person may start with a horrific event and soon have other associations to it. The clinician will guide the client to a complete resolution of the target. Examples of sessions and a three-session transcript of a complete treatment can be found in F. Shapiro & M.S. Forrest (2004) EMDR. New York: BasicBooks. http://www.perseusbooksgroup.com/perseus-cgi-bin/display/0-465-04301-1.
My target, that I wanted to discuss was the adoption fraud, that I had been told to put in a box. It was after sessions that my traumatic memories would surface. The situation with my teacher and then my rape. She did help me desensitize to the teacher, but because of how everytime I went I kept remembering something traumatic, and I did not have any coping skills for it, I decided that traditional therapy was better for me. In my “memory” I had a wonderul childhood, I did not see a reason to have it marred my these horrible memories, even if I could reprocess, I could never forget them once they were remembered. Neither could my family.
Installation: The goal is to concentrate on and increase the strength of the positive belief that the person has identified to replace his original negative belief. For example, the client might begin with a mental image of being beaten up by his father and a negative belief of “I am powerless.” During the Desensitization Phase he will have reprocessed the terror of that childhood event and fully realized that as an adult he now has strength and choices he didn’t have when he was young. During this fifth phase of treatment, his positive cognition, “I am now in control,” will be strengthened and installed. How deeply the person believes his positive cognition is then measured using the Validity of Cognition (VOC) scale. The goal is for the person to accept the full truth of his positive self-statement at a level of 7 (completely true). Fortunately, just as EMDR cannot make anyone shed appropriate negative feelings, it cannot make the person believe anything positive that is not appropriate either. So if the person is aware that he actually needs to learn some new skill, such as self-defense training, in order to be truly in control of the situation, the validity of his positive belief will rise only to the corresponding level, such as a 5 or 6 on the VOC scale..
In the case with the school teacher, I can see this worked. Though it was not a validity scale. The trigger that had initially made me flashback or remember this teacher was my desire to plant a garden this year. I was sitting at Lowes, and I looked at the plants, and lost it. I ended up in the car bawling, wondering why I thought I would fail at everything I did. I sat there and ask myself that question and saw her and heard her in my mind. In the Desensitization phase I was able to realize that I was not a failure at everything, and that gave me the courage to buy plants that day after the session.
Body scan: After the positive cognition has been strengthened and installed, the therapist will ask the person to bring the original target event to mind and see if he notices any residual tension in his body. If so, these physical sensations are then targeted for reprocessing. Evaluations of thousands of EMDR sessions indicate that there is a physical response to unresolved thoughts. This finding has been supported by independent studies of memory indicating that when a person is negatively affected by trauma, information about the traumatic event is stored in motoric (or body systems) memory, rather than narrative memory, and retains the negative emotions and physical sensations of the original event. When that information is processed, however, it can then move to narrative (or verbalizable) memory and the body sensations and negative feelings associated with it disappear. Therefore, an EMDR session is not considered successful until the client can bring up the original target without feeling any body tension. Positive self-beliefs are important, but they have to be believed on more than just an intellectual level.
We did not do this the day processed the memory. The next session, if I recall correctly she did ask me how I felt about the teacher.
Closure: Ends every treatment session The Closure ensures that the person leaves at the end of each session feeling better than at the beginning. If the processing of the traumatic target event is not complete in a single session, the therapist will assist the person in using a variety of self-calming techniques in order to regain a sense of equilibrium. Throughout the EMDR session, the client has been in control (for instance, he is instructed that it is okay to raise his hand in the “stop” gesture at anytime) and it is important that the client continue to feel in control outside the therapist’s office. He is also briefed on what to expect between sessions (some processing may continue, some new material may arise), how to use a journal to record these experiences, and which techniques he might use on his own to help him feel more calm..
For me when processing, I felt like the little kindergarden girl. I was bawling and my nose was running. I did not know that I could raise my hand or even wipe my nose until and tissue was finally put in my lap. My Mother said that it was in that session that she first saw “little Hope” come out. She has surfaced many times since.
Reevaluation: Opens every new session At the beginning of subsequent sessions, the therapist checks to make sure that the positive results (low SUDs, high VOC, no body tension) have been maintained, identifies any new areas that need treatment, and continues reprocessing the additional targets. The Reevaluation Phase guides the clinician through the treatment plans that are needed in order to deal with the client’s problems. As with any form of good therapy, the Reevaluation Phase is vital in order to determine the success of the treatment over time. Although clients may feel relief almost immediately with EMDR, it is as important to complete the eight phases of treatment, as it is to complete an entire course of treatment with antibiotics..
As I mentioned before she reevaluated the teacher experience in my last session.
I want to reiterate, my EMDR therapist was a very caring lady. She does alot to help people, especially our soldiers, and has practiced to the “best of her understanding”. The tools she has can either help or destroy lives. I know she did not intially fail to prepare me. She has expressed great concern in my well being. She has also committed to refresh her skills and study. We all make mistakes some are just harder and have more consequences than others.
My part is to pick up the pieces of my life, and help educate others.