Does Medication Hinder The Processing Of Traumas In Certain Therapies? (emdr, Somatic Experiencing)

[MarriedKoreanGuy]

Several months ago I tapered off Lexapro (5mg) entirely after being on it for four years, and I am soon starting my first Somatic Experiencing session. I've been meaning to get back on the Lexapro because I've realized after being off of it for several months, the benefits outweigh the negatives for me. Although off medication I am more in touch with my emotions, it is all much too overwhelming. I frequently fall into crying spells, hopelessness, obsessiveness, and rage, but... I have this lingering idea that during therapy that may be a good thing so I can have a full emotional release when processing trauma.

While I am on medication, I am frequently fatigued and "zombied out," but my indifference and contentment from being slightly anesthetized helps me to move along with day-to-day responsibilities. It makes me less obsessive and worrisome about my own actions, which unfortunately... has proven in the wrong circumstances to be a bad thing, because it makes me more uninhibited when I give in to the fits of rage and hostility. However, I do believe that the rage is not entirely a bad thing, because sometimes I'll break down and cry afterwards, and my lovely wife will support me and I'll end up crying, and opening up, shaking, all that jazz, and I'll eventually feel a little better afterwards (my poor wife...I know...).

So my question is this:

Can the anesthetizing properties of medication to get in the way of trauma processing during sessions which focus very much on the body-mind connection, such as EMDR, CranioSacral Therapy, Somatic Experiencing, and Trauma Releasing Exercise?

My plan is to get back on Lexapro, maybe 5-10mg, and combine it with one of the therapies above. From what I've learned about trauma and the human body, I don't believe SSRI's will ever help release any trauma. I mean, it just doesn't make sense from what I've learned in Peter Levine's research and teachings. But, I do believe that it takes the edge off, mentally, and helps tremendously with coping every day. But, when it comes to processing traumas during therapy, could the anesthetizing properties of medication be hindering the release?

What do you guys think?

 

[BuckarooBanzai]

Hello, and welcome to the forum!

I can only offer you anecdotal evidence.

I tried many many antidepressants, a couple of mood stabilizers, and sleep medications over a number of years. After some time, not only did I realize meds weren't working for me, but some actually triggered me, so I had to stop taking them.

After I stopped, that's when my real healing process began. I really took off and experienced dramatic improvements. I took more responsibility for my healing. Eventually, I came out of both PTSD and DID. Now, I have a residual Anxiety problem, but the other two diagnoses are no more.

Now, my mother, who has absolutely no insight into her issues, told me something along similar lines. When my father was diagnosed with incurable cancer, my mother started taking an antidepressant. She then stayed in bed and slept all day while we were up, getting up and staying up only after 11 PM, while we were all asleep. So, she was actively avoiding both us and life, living her days from 11 PM until about 7 AM. After Dad passed on to the next world, she continued the medication and this passive lifestyle. Then, one day, she was encouraged by a brother to quit the medication. She did, very slowly, and after she'd been totally off for a number of months she told me something remarkable. She said that, when Dad died, she had been unable to grieve and move on; suddenly, once the antidepressant was totally out of her system, she began to grieve for Dad and move through the traditional grieving steps. She is sure, she claims, that the medication prevented her from grieving and moving on.

Now, that's only anecdotal evidence, but I hope it helps.

Ben

 

[lostforgottensoul]

If Lexapro makes you "zombied out" after a week or so of being on it, Id advise to take another medication.

Personally SSRIs and SNRIs dont work for me. Im on a low dose of Seriquel XR (extended release) which is an anti-psycotic given in low doses for depression, bipolar, BPD, anxiety and others. Abilfy is its cousin being also an anti-psycotic. And i am able to do all the therapies needed and work and function and not feel "zombie-fied".

So you may need a different medication.

 

[VikVikViktorious]

No advice to give- just letting you know that I just started my weaning process off Zoloft and day 2 is so far so good. I will also be weighing the benefits vs the inevitable return of some unpleasant feelings.
It's definitely part of the journey.. Best of luck to you!

 

[Friday]

Can the anesthetizing properties of medication to get in the way of trauma processing during sessions which focus very much on the body-mind connection, such as EMDR, CranioSacral Therapy, Somatic Experiencing, and Trauma Releasing Exercise?

In my experience? Yes.

In my education / what I've been taught? Also, yes. Which is why about 3/4s of my psych classes underscored that if a client is on temporary* medication, therapy needs to be done in 2 rounds. 1st time ON medication, to allow the therapy to happen in the first place**, then peel meds off, & 2nd time OFF meds.

* Temporary Meds = disorders like PTSD, situational Depression / Grief / Anxiety / etc. AKA the meds are a temporary stopgap only, a tool to be used to allow therapy that would otherwise be impossible, until better / more sustaining coping mechanisms can be learned. As opposed to disorders like Bipolar, Schizoaffective, MDD, GAD, etc. where medication is going to be a lifelong component to deal with a permanent chem imbalance or structural issue. When the meds are temporary, therapy HAS to happen twice, in order to be ethically sound.

** Not everyone needs meds to allow therapy to happen. For those that do, 2 rounds of therapy (on meds and off meds). For those that do not, 1 round of therapy.

 

[lostforgottensoul]

In my education / what I've been taught? Also, yes. Which is why about 3/4s of my psych classes underscored that if a client is on temporary* medication, therapy needs to be done in 2 rounds. 1st time ON medication, to allow the therapy to happen in the first place**, then peel meds off, & 2nd time OFF meds.

Is that for all therapy and all meds? Im just asking as I can do EMDR and other therapies now on 200mg Seriquel XR after it built up in my system.

I was also on Lexapro 20mg for a LONG time and also could do therapies after it had built up in my system.

For both, after I had gotten used to them, they never made me "zombie-like".

 

[MarriedKoreanGuy]

lostforgottensoul, even on those dosages of medications were you able to make significant progress in releasing trauma during those therapies? Also, thank you for your advice. I definitely will ask about other medications.

 

[MarriedKoreanGuy]

No advice to give- just letting you know that I just started my weaning process off Zoloft and...

Pleeeease go very, very, very slow. When I got off 5mg of Lexapro I didn't taper any lower nor go every other day. I just stopped, and it messed me up for a long time. It was rash, and stupid, but I was giving up hope and was trying ANYTHING to get better. Good luck and I hope it goes super smooth =].

 

[Friday]

Is that for all therapy and all meds? Im just asking as I can do EMDR and other therapies now on 200mg Seriquel XR after it built up in my system.

With the caveat that I am not a therapist, and underlining this is what I've been taught; my understanding is yes.

It ISNT that you can't do therapy on meds. It's that a second round of therapy is needed when a person comes off meds, because how a person's brain functions off med is different than on. To leave someone high and dry and just expect them to apply everything they learned to do on med, when off med? Is unethical. Especially as medications mask or alter symptoms. So a person may have minimal anxiety issues on meds, and be focusing most of their work on other areas....but anxiety becomes a huge problem off meds... And they haven't learned the skills to deal with anxiety, because the meds were helping. Ditto any other symptom, or expression, or coping mechanism.

That second round isn't necessary when it's a lifelong course of meds (say for bipolar disorder), nor if a person goes through therapy completely off-medication... Because in both cases? You're dealing with the baseline.

It's like learning how to walk with crutches? Is very different from learning how to walk without crutches. It's a different set of skills needed. Although similar. If you're doing physical therapy with someone from a car accident? First round of physical therapy is done using the crutches. Then a cane. Then 2 legs. You don't just quit after they've mastered crutches. You're not done, yet. There's still steps to take. But if someone is going to be in a wheelchair? Or doesn't need crutches? You don't do the progression from with tools to without tools. Because there is no change. The tools are either here to stay (chair) or they never had them to begin with (no crutches).

It's a hot button topic in schools & in ethics circles, because insurance only wants to pay "once". And every client wants to be done yesterday ;) But working with the brain is very much like working with any other body part. Just because a person with a serious back injury may need to learn to walk 3 different times? Doesn't mean that 2 of the times are extra and shouldn't be done or paid for. Or that the patient should somehow be able to intuit how to walk on 2 legs, if they've spent a year learning to walk on crutches.

 

[Crow]

My T took me off all psych meds before beginning SE. The meds hinder the completion circuitry. Took me over a year to stabilize without meds before we started intensive SE. Really happy I took this path.

 

[EveHarrington]

I think it can be an individual thing-----I mean I am trying to say that there are some people who really need medication in order to stabilize and stay functional so I'm not sure that becoming completely med free would be the way to go. I think that if you can stabilize without medication then it's worth giving it a shot. I have done some processing myself and I was off most medications by that point except for a few that I take as needed. :hug:

 

[lostforgottensoul]

@Friday, that makes a ton of sense, thanks!