PTSD & EMDR Info
Hi there Kay,
Having intently read your postings I would like to extend an open hand to you as others have already done and offer you support the best I know how. I felt touched when I saw your strength and endurance after all of these years. You're a fighter that's for sure, but even the strongest of us can always use strength and love from others.
I have some news I'm hoping will be helpful for you. In previous conversations with Kerrie-Anne and Anthony you mentioned you were having treatment about EMDR. I think it is extremely important that you know as much as you can about any proposed therapeutic technique your therapist may want to use with you and that you feel comfortable with and confident in your therapist. Open communication is the most important thing for treatment to be effective.
Well I've done a little research for your and found a great article by Susan McCabe. It says that EMDR has most consistently been used for treating PTSD. Nurses in the article state that “traumatic events†(producing PTSD) “upset the balance of the brain’s information-processing center [which] prevents the information from proceeding to an adaptive resolution, and perceptions of the trauma incident are locked into the nervous system†(McCabe 2004). In other words PTSD has produced an ‘alert switch’ which has been left on ‘stop’ not can’t allowing the person to understand or interpret the traumatic event/memory and move on from that event/s. Rather they are re-experiencing the event/s constantly in their mind and body, hence current symptoms such as nightmares, flashbacks, exaggerated startled responses, poor sleeping patterns, avoidance behaviours etc.
Commonly Available Treatments for PTSD
Cognitive Behavioural Therapy (CBT)
Core Aspect of Therapy - Working with cognitions to change emotions, thoughts, and behavriours
Level of Evidence on Efficacy - High
Level of Acceptance - High
Psycho/pharma-cotherapy
Core Aspect of Therapy - Medications targeted at discrete symptoms clusters
Level of Evidence on Efficacy - High
Level of Acceptance - High
EMDR
Core Aspect of Therapy - Eye movements, hand taps, sounds to create an alteration in distress level of intrusive memories
Level of Evidence on Efficacy - Low to moderate
Level of Acceptance - Moderate
Group Therapy
Core Aspect of Therapy - Using group factors of cohesion, safety, universality, and problem solving to reduce symptoms through shared experiences
Level of Evidence on Efficacy - High
Level of Acceptance - Moderate
Individual Therapy
Core Aspect of Therapy - Focus on emotional conflicts caused by traumatic event, often as they relate to earlier life experiences
Level of Evidence on Efficacy - Moderate
Level of Acceptance - High
Reference: Adapted from National Centre for Post-Traumatic Stress Disorder, 2004, cited in McCabe 2004.
Although this information suggests EMDR as having a low to moderate level of evidence on efficacy my supervising psychologist specialises in treating clients with PTSD using this method and she has had an extremely high success rate with clients in many situations including war related incidents, sexual dysfunction, rape, phobias, police etc. Other research indicates EMDR can be used with problems such as addictions, pain management, panic disorder, dental fears, childhood trauma, body dysmorphic disorder, fear of public speaking, eating disorders, morbid jealousy, chronic pain, depression and anxiety (McCabe 2004).
Success Rate of EMDR
Research indicates limited data indicating negative effects from EMDR therapy, leading to a general acceptance on its overall safe treatment.
Therapist Training for EMDR
Supports of EMDR contend it should be undertaken only by licensed mental health providers who have been adequately trained in its use. To date, more than 20,000 mental health professionals have been formally trained.
EMDR: What Is It?
“A patient is troubled by intrusive and disturbing memories of past traumatic events and is feeling a significant level of distress. He/she seeks help from a therapist, who quickly moves a finger back and forth in front of the patient’s face, all the while asking him to hold traumatic images and memories in mind, and then asking the patient to shift associated memories to positive thoughts. After this activity, the patient self-rates his/her level of distress, and treatment is continued until significant improvement is noted†(McCabe 2004). That is the core of EMDR treatment.
EMDR is perhaps best described as the intentional induction of rapid, rhythmic saccadic eye movement in order to assist an individual to desensitize linkages between experienced events and emotionally loaded memories (Blore, 1996). The aim is to make individuals so accustomed to the traumatic memories that they lose their distress-inducing capacity (EMDR, 2002, cited in McCabe 2004).
The Dentist
I like to think of treatment for PTSD using the metaphor of a dentist treating a patient with a hole in their tooth. The dentist could easily just put a filling over the tooth, however the problem underneath which caused the hole in the first place is still trapped there. Instead, for the best result, the dentist uses the wide variety of tools such as the drill to give it a very through clean making sure they get all of the plaque before filling it in. It could hurt like crazy while the cleaning process is occurring but both the patient and dentist know the pain in the long run will be worth it because the hole won’t spread and create more problems. Once the cleaning process is done the filling can be put in place.
This is similar to the process of treating trauma. EMDR and indeed any treatment process can be difficult and possibly painful because you are digging through the layers of trauma (plaque) that may have become comfortable revealing personal feelings of vulnerability, hurt, fear and pain. Instead of digging with a drill, therapists operate by waving their fingers from side to side to help you process your event/s. If you can find the right therapy for you, the process of cleaning, although difficult, will be helpful for you in the long run. Once you have gone through this cleaning process healing can begin.
Be mindful though, therapy is not a cure, particularly for PTSD. Therapy is designed to assist you in managing your symptoms. Unfortunately the expectation of “getting things completely back to normal†to before the traumatic event took place is unrealistic, rather we must grasp the concept that any event (positive, neutral or negative) will change us (PTSD or no PTSD) and we don’t go back once we have learnt something. We can move forward though and this brings me hope. Engaging in the right therapy for you is one way of moving forward.
In Conclusion
My apologies for the length of this post but I hope this leaves you with a little more knowledge and comfort knowing that wonderful techniques such as EMDR are being used daily with good success rates all over the world. So to sum up discussed in this short essay as it has turned out to be, topics touched upon were;
What is PTSD, the affects of PTSD, treatment methods for PTSD, types of PTSD treated with EMDR, safety of EMDR, Therapist training and the cleaning process.
I do not profess to be an expert on this topic however I believe this research to be consistent with various sources including PTSD specialist Leah Giarratano’s (2004) text “Clinical skills for Managing PTSDâ€.
References
Giarratano, L (2004) Clinical Skills for Managing PTSD: Proven practical techniques for treating posttraumatic stress disorder. Talomin Books Pty Ltd: Mascot, Australia.
McCabe, S. EMDR: Implication of the Use of Reprocessing Therapy in Nursing Practice. Journal: Perspectives in Psychiatric Care; July-September 2004; 40, 3; Academic Research Library pg 104.
I hope I have produced something useful for you and to encourage a little reflection and discussion with you (and anyone else who wishes to participate), what (if anything) has been most helpful for you? Has it evoked some kind of connection of previous information you had on any of these topics? If you are interest in further information please just ask questions. This is how we learn. I can contact my supervisor and I’m sure she would be able to help us.
I'll be interested to hear your comments.....
Hi there Kay,
Having intently read your postings I would like to extend an open hand to you as others have already done and offer you support the best I know how. I felt touched when I saw your strength and endurance after all of these years. You're a fighter that's for sure, but even the strongest of us can always use strength and love from others.
I have some news I'm hoping will be helpful for you. In previous conversations with Kerrie-Anne and Anthony you mentioned you were having treatment about EMDR. I think it is extremely important that you know as much as you can about any proposed therapeutic technique your therapist may want to use with you and that you feel comfortable with and confident in your therapist. Open communication is the most important thing for treatment to be effective.
Well I've done a little research for your and found a great article by Susan McCabe. It says that EMDR has most consistently been used for treating PTSD. Nurses in the article state that “traumatic events†(producing PTSD) “upset the balance of the brain’s information-processing center [which] prevents the information from proceeding to an adaptive resolution, and perceptions of the trauma incident are locked into the nervous system†(McCabe 2004). In other words PTSD has produced an ‘alert switch’ which has been left on ‘stop’ not can’t allowing the person to understand or interpret the traumatic event/memory and move on from that event/s. Rather they are re-experiencing the event/s constantly in their mind and body, hence current symptoms such as nightmares, flashbacks, exaggerated startled responses, poor sleeping patterns, avoidance behaviours etc.
Commonly Available Treatments for PTSD
Cognitive Behavioural Therapy (CBT)
Core Aspect of Therapy - Working with cognitions to change emotions, thoughts, and behavriours
Level of Evidence on Efficacy - High
Level of Acceptance - High
Psycho/pharma-cotherapy
Core Aspect of Therapy - Medications targeted at discrete symptoms clusters
Level of Evidence on Efficacy - High
Level of Acceptance - High
EMDR
Core Aspect of Therapy - Eye movements, hand taps, sounds to create an alteration in distress level of intrusive memories
Level of Evidence on Efficacy - Low to moderate
Level of Acceptance - Moderate
Group Therapy
Core Aspect of Therapy - Using group factors of cohesion, safety, universality, and problem solving to reduce symptoms through shared experiences
Level of Evidence on Efficacy - High
Level of Acceptance - Moderate
Individual Therapy
Core Aspect of Therapy - Focus on emotional conflicts caused by traumatic event, often as they relate to earlier life experiences
Level of Evidence on Efficacy - Moderate
Level of Acceptance - High
Reference: Adapted from National Centre for Post-Traumatic Stress Disorder, 2004, cited in McCabe 2004.
Although this information suggests EMDR as having a low to moderate level of evidence on efficacy my supervising psychologist specialises in treating clients with PTSD using this method and she has had an extremely high success rate with clients in many situations including war related incidents, sexual dysfunction, rape, phobias, police etc. Other research indicates EMDR can be used with problems such as addictions, pain management, panic disorder, dental fears, childhood trauma, body dysmorphic disorder, fear of public speaking, eating disorders, morbid jealousy, chronic pain, depression and anxiety (McCabe 2004).
Success Rate of EMDR
Research indicates limited data indicating negative effects from EMDR therapy, leading to a general acceptance on its overall safe treatment.
Therapist Training for EMDR
Supports of EMDR contend it should be undertaken only by licensed mental health providers who have been adequately trained in its use. To date, more than 20,000 mental health professionals have been formally trained.
EMDR: What Is It?
“A patient is troubled by intrusive and disturbing memories of past traumatic events and is feeling a significant level of distress. He/she seeks help from a therapist, who quickly moves a finger back and forth in front of the patient’s face, all the while asking him to hold traumatic images and memories in mind, and then asking the patient to shift associated memories to positive thoughts. After this activity, the patient self-rates his/her level of distress, and treatment is continued until significant improvement is noted†(McCabe 2004). That is the core of EMDR treatment.
EMDR is perhaps best described as the intentional induction of rapid, rhythmic saccadic eye movement in order to assist an individual to desensitize linkages between experienced events and emotionally loaded memories (Blore, 1996). The aim is to make individuals so accustomed to the traumatic memories that they lose their distress-inducing capacity (EMDR, 2002, cited in McCabe 2004).
The Dentist
I like to think of treatment for PTSD using the metaphor of a dentist treating a patient with a hole in their tooth. The dentist could easily just put a filling over the tooth, however the problem underneath which caused the hole in the first place is still trapped there. Instead, for the best result, the dentist uses the wide variety of tools such as the drill to give it a very through clean making sure they get all of the plaque before filling it in. It could hurt like crazy while the cleaning process is occurring but both the patient and dentist know the pain in the long run will be worth it because the hole won’t spread and create more problems. Once the cleaning process is done the filling can be put in place.
This is similar to the process of treating trauma. EMDR and indeed any treatment process can be difficult and possibly painful because you are digging through the layers of trauma (plaque) that may have become comfortable revealing personal feelings of vulnerability, hurt, fear and pain. Instead of digging with a drill, therapists operate by waving their fingers from side to side to help you process your event/s. If you can find the right therapy for you, the process of cleaning, although difficult, will be helpful for you in the long run. Once you have gone through this cleaning process healing can begin.
Be mindful though, therapy is not a cure, particularly for PTSD. Therapy is designed to assist you in managing your symptoms. Unfortunately the expectation of “getting things completely back to normal†to before the traumatic event took place is unrealistic, rather we must grasp the concept that any event (positive, neutral or negative) will change us (PTSD or no PTSD) and we don’t go back once we have learnt something. We can move forward though and this brings me hope. Engaging in the right therapy for you is one way of moving forward.
In Conclusion
My apologies for the length of this post but I hope this leaves you with a little more knowledge and comfort knowing that wonderful techniques such as EMDR are being used daily with good success rates all over the world. So to sum up discussed in this short essay as it has turned out to be, topics touched upon were;
What is PTSD, the affects of PTSD, treatment methods for PTSD, types of PTSD treated with EMDR, safety of EMDR, Therapist training and the cleaning process.
I do not profess to be an expert on this topic however I believe this research to be consistent with various sources including PTSD specialist Leah Giarratano’s (2004) text “Clinical skills for Managing PTSDâ€.
References
Giarratano, L (2004) Clinical Skills for Managing PTSD: Proven practical techniques for treating posttraumatic stress disorder. Talomin Books Pty Ltd: Mascot, Australia.
McCabe, S. EMDR: Implication of the Use of Reprocessing Therapy in Nursing Practice. Journal: Perspectives in Psychiatric Care; July-September 2004; 40, 3; Academic Research Library pg 104.
I hope I have produced something useful for you and to encourage a little reflection and discussion with you (and anyone else who wishes to participate), what (if anything) has been most helpful for you? Has it evoked some kind of connection of previous information you had on any of these topics? If you are interest in further information please just ask questions. This is how we learn. I can contact my supervisor and I’m sure she would be able to help us.
I'll be interested to hear your comments.....
