EMDR

Last one 'til after Passover.

Eye Movement Desensitization and Reprocessing

I used to think a more apt description would have been, Rapid Eye Movement Desensitization Reprocessing, but R-E-M-D-R just doesn't cut it, and the procedure isn't necessarily rapid, to tell the truth.

Years ago I heard of this woman, Francine Shapiro. This is the late eighties, I think 1987.

Legend has it that Francine got tired of whatever it was that was dragging her down; maybe the est* movement disappointed. So she plopped herself down on a concrete bench to watch the Pacific waves crash into the sand. Some of the crazier sounding innovations start in California, and then come to find, they're not so crazy.

She's chilling, trancing out as anyone of us might. The waves get boring, and she's thinking about some terrible thing that has happened to her.

Keep in mind there are probably better legends about Francine, this is just the one I heard.

Anyway, my version has her sitting back on a concrete bench (not far from the concession stand), relaxing. She randomly stretches out her right arm, points her index finger up and to the right, and slowly follows her finger with her eyes as she waves first to the right, then to the left. She does this several times, watches her finger as it waves left and right, all the while focusing on something in her mind's eye, something annoying, an annoying snapshot picture, one of her traumas associated with all sorts of negative emotion.

And voila! All of the negative emotion associated with the snapshot dissipates. Gone.

Francine's theory is that eye movement somehow has a desensitizing effect on the affect associated with trauma. She has determined, with her single case design, that we don't need to delete our memories, zap them with lasers. We need to delete the affect, the negative emotion associated with it.

We already know that flooding, revisiting traumatic memories over and over again, desensitizes. It worked for Viet Nam veterans. Why wouldn't EMDR work then, in much the same way, for everyone else? EMDR makes clinical sense.

I had to learn it.

So FD found his conference and I found mine with the official EMDR training gurus, and together we took a trip west, years and years ago. It never rains in San Diego, you know, but for us, it rained. They told us, This is the first rain we've had for as long as anyone can remember. All weekend long, it rained.

Anyway, there's much to learn about EMDR. It's not as simple as it looks (I may demonstrate one day) and I recommend that you don't just go waving your finger in front of your face, like Francine Shapiro allegedly did, if she even did. You could get dizzy or sick, or unstable. Just don't do this yourself. Go to a trained professional. The therapist I refer to on my side-bar has certification, but we do hope she doesn't do this particular procedure virtually.

If you're going into the biz, maybe get some officious training yourself.

The training is initially didactic. First you learn the theory and the many, many reasons not to use EMDR with certain people. You learn the particulars of how to do it effectively. You learn what to do before you do it, and what to do afterward to debrief the patient.

Then you get to practice on another trainee. To get a feel for the work, you find a partner and perform, or execute the procedure on one another. You give it and you receive it, EMDR. As the subject you have to think of something or another, some memory that is disturbing, one you can pinpoint. A snapshot.

This is supervised, of course, and at the very end of the conference you get a cool certificate.

So during the training, a trainee receives the treatment, or what we might call a very brief, condensed treatment for a traumatic event, one's own personal PTSD. That's how it worked way back when at least, in San Diego.

Most of us have experienced some sort of trauma, and if you read earlier posts, you might know that the worst thing that ever happened to my family of origin might have been an episode out of Without a Trace. I've never watched Without a Trace (a person has to protect oneself) but I imagine the show is about people disappearing.

In my junior year in high school, that's what happened to my older brother, just twenty. He disappeared. A medical student on campus downtown, he had a medical condition. So when he didn't return one night his concerned roommate called my mother and told her. She panicked, like any mother would, but remained outwardly calm. We're stoics in my family, some of us better at it than others, and it is amazing the degree to which parents can control their emotions to protect their children when they feel they must.

Except I wasn't exactly a child.

When the body washed up at Oak Street beach in late February, nearly two months later, we were devastated, of course. It took me years to even drive by that beach. What you picture, if you're me, is a person drowning, fully dressed as you saw him last, and that person is your brother.

Fix THAT, Francine.

Anyway, when it was my turn to describe a trauma, it didn't take long to think one up, although it wasn't something I especially wanted to do, repeat my construction of a reality that had happened so many years ago. I could see the supervisor worry about complications, melt-downs, that sort of thing.

But tick tock, we did the procedure. And hickory dock, it worked. I was totally shocked, but the affect, the emotion, the shock, the fear, the sadness associated with that construction, all dissipated. The event lost its power. Remember, I had had previous therapy, group therapy, and there's nothing more powerful than a good group therapy. Except maybe, decent exposure therapy, like EMDR.

So that was powerful, what happened to me in San Diego, and as a result, I still use the procedure today in my practice. I find it useful to the degree that the research predicts its usefulness, fifty percent of the time.

I think at some point, as we age, distress over trauma comes back with the usual suspects, the triggers. Like for me, all I have to do is see a drowning on television (and for some reason these are very popular) and I'm out of the room, although I'll see how far I can go with it. So these therapies might need reinforcement over the years. There's no magic bullet for trauma, not yet.

But not everybody needs therapy. (Did I say that?) As we age, the snapshot can lose its power naturally, with or without EMDR. What once triggered negative emotion isn't necessarily going to do that, because over the years we've naturally desensitized. What EMDR does in hours, age accomplishes over the years.

Depending upon different variables. Everyone is different. Our histories, I feel, round us out in perspective, determine who we are, the stuff we're made of, how we will cope with our package and how we will approach others with theirs. For some, history demands an intellectual philosophical quest, a search for meaning, the gestalt of it all. But ask a Holocaust survivor and you might not get much of an answer about anything trauma related. Even thinking of revisiting is out of the question. It's that painful.

And they would tell you they had plenty of exposure therapy.

For those who remember even better than before as they age, who "telescope", who remember things they had forgotten altogether in later years, it is likely that the membrane of their hippocampus is thinning out with age; memories are more accessible to the cerebral cortex, that place we think. That surely makes us vulnerable to emotion and philosophizing about it.

For some of us, talking about memories dismisses their impact nicely, quickly. The envelope full of sensory data is sent back to the proper file in the brain, back to storage. For others, talking is unthinkable.

As for me, hand me that remote, if you don't mind. Gimme a little control, here. Happy holidays, whatever you celebrate.**

therapydoc

I know, I know, it's a lot of intimacy. So in your comments, if you don't mind, try to talk about you or your thoughts on the subject, not me. Much obliged.

*Erhard Seminar Training, est is Latin for "it is"



**If you live in Chicago you'll celebrate a little decent weather.