Thursday, 29 August 2013

EMDR Therapy for PTSD

The Birth Trauma Association estimates that in the UK 10,000 women a year develop post traumatic stress disorder (PTSD) and up to 200,000 develop some symptoms of PTSD.  I am one of those women.  I will try to share my therapy here so others can find their own path to healing.

Prior to the first actual session of EMDR, I had one session where I recounted my intrapartum experiences in as full detail as possible.  There was another session which familiarized me with the techniques for desensitization and reprocessing.  One was visualization to help me calm myself through the day when I was in a stressful situation and the other was the eye tracking technique and then detailed documentation of one traumatic memory from the whole event including how the memory makes me feel and what is the opposite of that.

The first session of EMDR therapy began with the imagery of one of the most distressing memories of my birth experience.  During the preparation session on the previous visit I was familiarized with the techniques which would be used to desensitize my experiences I had been asked to relate a part of the  birth that was most distressing.

EMDR Tacas

An integral part of the therapy is a device with earphones which transmit alternating clicking and two vibrating finger disks on which a blinking light is set on each.  The focus is to hear the clicking which were tuned into the lights which flickered simultaneously in turn as the finger disks vibrated.  So three senses are being stimulated during the therapy.  As you recount or reflect on the memory or what you are feeling your eyes are to track the lights which blink alternately, thereby simulating REM eye movement.

My therapist reminded me about the details of the memory which made me well up.  I was instructed to focus on the memory while following the blinking lights.  It took me a few minutes to settle into this procedure but before long I adjusted to the process.  It could take longer to settle into this expectation but a well trained therapist will understand that and help you with the process.

The intention is to desensitize the memories.  After the lights stopped blinking I am asked about any sensations I am experiencing. I focused on a tightness in my chest and rapidly we work on reducing that sensation...and then reducing it more.

I am also asked to rate from 0 to 7 how upsetting I am finding the memory, with zero being not at all and 7 being very upsetting. The intention is to bring it to zero.

When I think I am at zero, am asked to articulate what I think of the memory now.  I recall the introduction of the movie the Devil's Backbone where the narrator describes a place where a tragic event occurred as charged with an energy that replays itself.  That it is like an insect trapped in amber. For me the memory will always be present to replay itself, but like an insect trapped it amber, it cannot harm me anymore.

The next blinking lights session is to capture that phrase and to concentrate on it:  It cannot harm me anymore.

The therapist asks me to find the earliest memory where I felt out of control. My trigger memory was indelibly linked to having no control and seeing the phrase 'it is out of  my control' had reduced me sobbing in the fetal position during the previous session.  My earliest childhood memory of panic and out of control was from about the age of three and for the first time this memory triggered tears.  We followed the same process as about to relieve the distress connected to this memory.  I had never found telling this story distressing - it was a burglary incident where my mother and I came home to discover someone had broken in and was still in the house - until today. One sensation was an incredible tightness and pain manifested in my forehead. However, the therapist explained that the reaction to both traumatic events was filed in the same place so opening one file exposed the other trauma which also benefits from desensitization. The goal once more is to make that memory harmless and to recall it in a way that it cannot hurt me anymore.

At this point I start to cry again because I realize that there has been so much hurt stored up for so long that I yearn to reach the place where none of the memories can hurt me anymore.

As the session progressed, other thoughts had entered my head like:  'when is this going to be over' and 'how longer before the hour is up'.  I also found that I wanted to leave and that my senses were becoming overloaded. I recalled video clips of hospital births and sexual violence which triggered panic attacks, and wanting to crawl out of my own skin, if necessary, to escape.   I only related these feelings after I told him that my back was starting to hurt due to an old injury.  He offered to work on it because it could be psychosomatic.  I was skeptical but after following the lights again, the back pain actually diminished.  There is hope yet for me.

For my own reflection, this experience reinforces what is known in birthing circles that the experiences of a woman during childbirth becomes emotionally charged and that the type of experience she has can affect her forever.  The role of oxytocin is instrumental in the formation of positive residual chemical markers, memories and emotions, on the brain when the experience of childbirth is positive.  On the other hand its presence during negative birthing experiences also lay down powerful negative emotions and memories connected with traumatic experiences.

Added:  for more academic detail regarding EMDR, this powerpoint may be helpful.

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