Worried About T's Suggestion Of Emdr & Hypnosis

[Toranoko]

Re: Hypnosis. There is something I should mention, though perhaps it really belongs somewhere else(?).

Self-Hypnosis induces the hypnotic state differently than Other-Hypnosis. Self-Hypnosis uses relaxation to enter the deeper state; when hypnotizing someone else I have to overload them. This has two implications with people like us: one, if your anxious (PTSD is an Anxiety Disorder) the prospect of being deliberately overloaded may very well be too much; two, you may, unbeknownst to you, already be in a more-or-less constant hypnotic state. (If you're constantly overloaded).

I did a self-hypnosis session where I actually placed a hypnotic block -- prevent myself from entering the hypnotic state other than on purpose. That did help, actually. Even had others notice the difference.

Re: inventing memories in Hypnosis. Yes, that's a possibility. We had a class specifically on that (and how to avoid it). "First, do no harm" and all that.

 

[Hashi]

Self-Hypnosis uses relaxation to enter the deeper state; when hypnotizing someone else I have to overload them.

That's interesting to hear it put like this, and it makes sense. I think for some of us - me, at least - even the deeper state of relaxation was too much for a long time. I've had extensive traumatic amnesia, and it would just have been too much to relax my defences in that way.

We didn't explore the incident, and things happened that carried a lot of weight. Maybe I need to talk to her more about that. She doesn't know the half yet about a lot of stuff. I don't know how to tell her.

Very much encouraging you to find a way to tell her. Write it down and hand it to her, write it down and read it out, start by telling her the smallest thing, start by telling her there is something more but you just can't say it yet... anything.

It sounds like your therapist is trying to work with what you've brought so far. If there's quite a bit more, I know how hard it is to go there - I really do - but maybe getting there is your aim before the other things? Personally, I think imagery and visualisation is one of the most powerful things we can do - if we can identify the best images to use. If we're going a bit off-track with the imagery, or haven't done enough processing before trying to change things, it isn't going to help much.

Sometimes trying things in therapy that weren't the biggest success opens the way to finding a much more effective approach. I wonder if your experience of trying the particular image you did has given you an understanding that you can go back and discuss? In which case, it will have been valuable for that reason.

 

[zaniara]

Re: Hypnosis. .. two, you may, unbeknownst to you, already be in a more-or-less constant hypnotic state. (If you're constantly overloaded).

I did a self-hypnosis session where I actually placed a hypnotic block -- prevent myself from entering the hypnotic state other than on purpose. That did help, actually..

I hope it's okay if I send you a private mail, because I have a question about this, but don't want to take it off topic.

@macca I've found EMDR very helpful, but it is very powerful as well. And it can be though to go through it, but if the therapist is skilled they can work i very safe ways. There is 'positive EMDR as well that can be used in order to build strengths and coping-abilities. Maybe you could start with that? Or just take it in your own time. Baby-steps can be very good. Maybe you need to talk a bit more and open up a bit more first? (Scary, I know.. )

 

[Lucycat]

I have successfully used EMDR. The idea of hypnosis scares the hell out of me - the fear of not being in control I think.

 

[macca]

Thanks to all of you. I'll have to work out how much I trust her I think, as well as ask her precisely how the process goes. I've decided I'm not going to rush into any decisions. I'm messed up enough already! And I'll have to let her know more stuff, whatever way I do it, so that I can process stuff properly and understand it before trying to change it. If I try to change it too soon, I guess it won't work. Thanks again for your answers, your input has helped me work out how to handle this I think.

 

[Abstract]

Macca, I wondered if she could rather use something in the present or recent past for the purposes she has in mind? I realise it may not be as intense but that seems like a good thing presently. If the aim is to help you manage the intense anger response that you are presently going into then it seems using childhood experiences that she doesn't know the details of are not necessary initially. Just a thought.

I think it can be tricky for the T to gage all the possible effects when they don't yet understand enough of your reality. That has been a constant problem for me in therapy.

 

[macca]

Abstract, that's a really good idea - I'll suggest that when I see her next :)

 

[Abstract]

Good luck! :)

 

[Deleted member 18510]

The concerns folks are posting about EMDR and hypnotherapy share an important element: the sense of safety and control. What is trauma/PTSD if not the experience of feeling out of control and unsafe?! So in EMDR therapy, it’s really crucial that a professionally trained therapist spends enough time in one of the initial phases (Phase 2) 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. 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. While EMDR therapy (any any efficacious treatment for trauma) does not go “digging” for buried memories, sometimes memory does become more clear, and related memories emerge which can then become targets of their own for EMDR processing. 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). Thorough knowledge of the biopsychosocial impact of trauma and PTSD are crucial for a therapist who uses EMDR or any psychotherapy when working with trauma survivors. Talking with your (trusted) therapist about all the "what-ifs" is essential so that you can feel assured that no matter what comes up, you'll be able to handle it in session, and in particular, after you leave the therapist's office.

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.

As I’ve mentioned about Phase 2, during EMDR therapy you learn coping strategies and self-soothing techniques that 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. While learning about this resource uses guided imagery, it's imagery that you, the client, supplies, and is tailored to fit your needs very specifically. It can be a place of comfort, or courage, or strength, if it's hard to imagine a safe or calm place. 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) 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 passes of the lights to ask you to take a deep breath and ask you to say just a bit of what you’re noticing. (The stimulation should not be kept on continuously, because there are specific procedures that need to be followed to process the memory). 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 your therapist should be experienced in the EMDR techniques that help 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 should be using 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, or, imagine the abuser speaking in a Donald Duck voice… 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.

I’m a therapist 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, both of which I strongly recommend in an EMDR therapist) I have used EMDR successfully with panic disorders, single incident trauma and complex/chronic PTSD, anxiety, depression, grief, body image, phobias, distressing memories, birth trauma, bad dreams and more…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.

 

[Hashi]

,

In the hands of a really experienced EMDR therapist, it’s the most gentle way of working through disturbing experiences.

Not for everyone. Maybe for many people, but I don't think you can make a blanket statement like this. Essentially, you're saying EMDR is a perfect therapy and if anything goes wrong it's because the therapist wasn't practising it well enough. I find that a surprising viewpoint. People are so different, their experiences of trauma are so different, their experiences of life post-trauma are so different... how can anyone say that one therapy is always right, or even always OK?

EMDR isn't OK for me and that's not because of the therapist or my grounding and safety skills, but because of the therapy itself. It's right for some people, and it isn't right for others. Your statement needs to be qualified.

It's particularly the issue of amnesia and new memories that concern me with EMDR, and I think you gloss over that very unrealistically.

You NEVER need re-live an experience or go into great detail, ever!

If you're going to do things that affect your brain this can't be guaranteed, sorry. It's not even fully understood how EMDR works. You have talked a lot about control, but EMDR is inherently letting go of some control by allowing something to affect your brain. The therapist and client can control what happens in the session but that doesn't mean they can control what happens inside the brain.

In many or even most cases it might be OK. In other cases it might not. You might re-live an experience by getting a new memory or flashback outside the session (perhaps even in the session). The safety you're talking about is reactive - going to a safe place or grounding because something distressing (or retraumatising) has already happened, or begun to happen. It doesn't stop something from happening in the first place. So what you're saying is a promise that you aren't in a position to make.

You talk about the importance of pacing and dosing. How can you pace new memories that come up involuntarily?

Safety and avoiding overwhelm is always an issue with trauma and PTSD, but there's an additional element with amnesia because of the importance of the amnesia as a protective mechanism. Even with the best safety and grounding skills, it's necessary to be protected from some memories until other things have been sufficiently processed and assimilated. As I said before, I feel EMDR carries the risk of interfering with the way the subconscious manages that. (There are other ways to process which work with that, and don't risk disrupting it.)

What you say doesn't allow for a single difficulty, let alone a serious issue, as long as the therapist is as you describe. What if the therapist has a flaw? A bad day? Misses a cue? At what point is an experienced therapist "really experienced" enough and how do you know?

This is another issue with amnesia - the client themselves may not even know what all their experiences have been, so has no way to assess how appropriate the therapist's experience is for them.

There are some traumas that it's less likely a therapist will have previous experience of treating, and those traumas can have different implications from other types of trauma. You ask:

What is trauma/PTSD if not the experience of feeling out of control and unsafe?!

It can also be horror, and I think it's horror above all that I personally would be concerned about treating with EMDR. I do other types of therapy that have the same effect as EMDR - putting what happened into the past, de-activating it etc - but for various reasons I would not use the same approach towards the horror aspects as towards the other ones.

I also question your emphasis on how gentle EMDR is. Reading posts here, a number of people seem to find it effective but don't describe it as the gentle (or continuously safe) experience that you present.

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.

I'm aware of this, because I see you from time to time posting almost exactly the same thing in various threads here, both under your current user name and when you had your previous one. I have previously replied and questioned some of the things you said, including how they contradicted the site administrator's own article on EMDR, but you didn't follow through in responding. I find it frustrating that your only participation in this community is to drop in occasionally to promote the therapy that you practise. I think your post should be read in that context.

 

[Deleted member 1860]

I agree with @Hashi in that EMDR isn't necessarily the most gentle way to process traumatic memories. Stop me if I'm wrong, but isn't everything talked about in the first person? ie my, me, mine? That in itself can cause one to relive the trauma. I attended a trauma center where they essentially separated you from the trauma by a degree or so by saying that the trauma happened to "little me". It wasn't a lie. I'm not that person anymore. None of us are the person who was traumatized. It helped to move the mind from emotional thinking into the wise mind.

 

[Powder]

I am thinking of heading into the direction of EMDR with the light thing. Three things that my T has on hand as "positive resources" are aromatic oils, rocks to hold and smooth of differing textures, and a beanie baby to hold and toy with almost like a stress ball.

She also recommends cold or hot beverages to sip or hold.

What other means do people find useful in complex PTSD with EMDR (to manage dissociation)?

Is she offering enough, or should I also come up with more on my own?