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Emdr When On Meds

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Deleted member 19804

I've recently started EMDR treatment and I'm having quite a hard time with it already. Not that much during the sessions themselves, but it's the aftermath that's pretty tough on me. This week I cancelled one of my appointments because the symptoms got too much for me, after which my therapist suggested we in fact should intensify the treatment. So instead of once a week, we'll be doing EMDR twice a week.

I've been on antidepressants (sertralin) for almost 2 years now and I'm already on the maximum dosage. And yet the symptoms get more agressive and more frequent after every EMDR session, which has recently caused me to cancel a therapy session because I thought I couldn't take anymore. It luckily isn't by far as bad as it was before I got medication, but that seems to be only a matter of time and I cannot go back to that place. I almost lost my mind with fear back then.

Anyway, I was wondering if anyone else has done EMDR while on anti-anxiety meds or antidepressants of some sort for your PTSD? And have you experienced a similar thing with the meds being significantly less able to compensate for the symptoms than they were before the therapy started? Also, how do/did you go on when things start to get better? Do you decrease your meds when the EMDR seems to work well?
 
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Anyway, I was wondering if anyone else has done EMDR while on anti-anxiety meds or antidepressants of some sort for your PTSD?

Hi Snowwhite. I was on prozac for depression. The sessions were tough at first. Nobodies fault. I had come to find that there was hidden traumas. The T said with my reaction we needed to go back and do more front loading. Because my traumas were multiple more preparation was necessary.

I also added an anti anxiety drug called prazosin and it helped my sleep. Poor sleep increases the PTSD symptoms drastically for me. I have not finished my EMDR. I started two years ago. I have other trauma challenges that come up weekly also so not every session is EMDR.

I wish I could afford two times a week. You can use the second appointment to digest what was processed and deal with any stuck body memories. I have not decreased medication because I am not done yet. I have only increased a little on prazosin for the nightmares and anxiety.

I do want to say the quality of life for me is better and the symptoms are less frequent. Try to hold on to the fact it took time and trauma to get to this point and is going to take therapy and time to get to the other side. Best wishes on your journey to healing!

tb
 
Dear TB, thank you for sharing that with me. I'm glad things are getting better for you. And it's good to know it does get better. I love how you say that it took time and trauma for me to get to this point and that it therefore will take time and therapy to get back out. Really well put.


I can't afford 2 sessions either, but as a student in The Netherlands I can luckily make a loan safely and fairly easily with low interest. I figure the chance for a speedy recovery outweighs the debt I get into. I hate being weighed down like this.
 
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@Snowwhite I wish I could get a loan. I am almost caught up with all medical debt from this year.You will get through this! My opinion about the loan is it will secure a better future for yourself. I think a whole lot more forward motion can happen when therapy is doubled and it will go faster! Just take care of yourself after EMDR its like having an outpatient operation. You need recovery time! Take good care of yourself. Take the time to heal.
 
I'm a psychologist who uses EMDR as my primary treatment psychotherapy and I've also personally had EMDR therapy 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 Assoc. and trained by the EMDR Institute) I have used EMDR successfully with panic disorders, childhood sexual/physical/emotional abuse and neglect, single incident trauma and complex/chronic PTSD, anxiety, depression, grief, body image, phobias, distressing memories, bad dreams and more...

To understand more about EMDR therapy, it's really crucial that the therapist spends enough time in one of the initial phases (Phase 2) in EMDR that involves preparing for memory processing or desensitization (memory processing or desensitization - phases 3-6 - is often referred to as "EMDR" which is actually an 8-phase psychotherapy). In this phase resources are "front-loaded" so that you have a "floor" or "container" to help with processing the really hard stuff. 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. 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. So if you start feeling overwhelmed or that it's too intense, you can ground yourself (with your therapist's help in session, and on your own between sessions) and feel safe enough to continue the work. In my practice, after the Phase 2 work lets us know that my patient is safe enough and able to cope with any emotion and/or physical sensation both during and between EMDR processing sessions, I often suggest we try a much less intense memory first if there is one that happened BEFORE the trauma(s). If there isn't one, then I suggest we start developmentally with the least disturbing memory and work our way "up" to the most disturbing event(s).

Grounding exercises are indispensable in everyday life, and really essential in stressful times. Anyone 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). Anyway, the book is terrific. It's 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 teaches readers lots of helpful techniques that can be used immediately and that are also used during EMDR therapy to calm disturbing thoughts and feelings.

One of the key assets of EMDR is that YOU, the client, are in control NOW, even though you likely were not during past 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 hand/knee tapping - all forms of bilateral stimulation that should be decided by the client for the client's comfort) 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 or so passes of the lights to ask you to take a deep breath and to say just a bit of what you’re noticing. 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 having a therapist who is experienced in the EMDR techniques helps make it the gentlest and safest way to neutralize bad life experiences and build resources.

Pacing and dosing are critically important. So if you ever feel that EMDR processing is too intense then it might be time to go back over all the resources that should be used both IN session and BETWEEN sessions. Your therapist can use 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, 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.

So bottom line, with or without meds (that can certainly be helpful), I hope you're doing LOTS of Phase 2 work to help the processing of target memories go more smoothly and with less intensity!

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.
 
TB, thank you again for your kind message. I'm really sorry you can't get the financial aid to get all of the medical care you need. I wish you the best on your journey to recovery.

I'm trying to take good care of myself, but it's hard. I feel like I depend on other people's support to keep myself on the right path, but the people that matter the most to me, I'm too afraid to even tell I have PTSD.

My therapist is on a holiday now. My next appointment will be in the beginning of November. I really hope the extra sessions will do more good than harm.
 
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Snowwhite, you are doing a brave and important thing going to therapy.

It does seem like you and your therapist might want to slow down a little if the between-session time is so difficult. As Dr.Patti suggested, there are internal resources your therapist can help you build up that will make you stronger and that will give you self care and ramp-down strategies to use between sessions when you're having a hard time.

I'm in the US but I would guess that it is TOTALLY OK to call your therapist between sessions if you are having a hard time. I have done that on multiple occasions. Your therapist can give you assistance on the phone, or might be able to see you, to help you get through the tough times.

I hope you are able to confide in one or two of those people close to you someday. I am a supporter as well as sometimes a sufferer, and it is not easy to share the burden, but I am glad I know why my boyfriend behaves the way he does. If one of the people close to you also knows about self care strategies and can support you through tough moments or remind you about the things that might help, that could add to your strength. I know it is difficult and risky to confide in someone, though.
 
@LizardViolet : thank you for your reply. I think you might be right that it would be better for me to slow things down. But it also confuses me: why would my T suggest we intensify the treatment if one session a week is already so hard on me? Perhaps there's a chance I'll get through it sooner, but at what cost?

I like the idea to keep in close contact with my T. I'll definitely bring that up in the next session. I'm just so scared of the consequences when we start again.. I haven't been there for a few weeks and I still feel the 'damage' EMDR has done to the place where I had everything locked up. I know I have to process it all, but it's so extremely scary and tiring :(
 
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EMDR has exposure threapy component. If you feel uncomfortable, defer or cancel your sessions and restart when you feel better or ready.

Please DO remember that exposure threapy may be very painful to certain people and may make people feeling suicidal.

Worse, fear extinction mechanism in your brain may be malfunctioned and continue EMDR only aggrevate fear,
since EMDR rely on your brain to work.
 
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