5. EMDR and Desensitizing Memory
Certain forms of therapy work by helping individuals to remember difficult
experiences safely and to learn to relate to those memories in ways that no
longer cause pain in the present. By going through controlled exposure and
reexposure, they learn not to associate negative emotions with objects or
memories that they fear. Through working with a therapist to do this in a safe
manner, they gradually become able to bring to mind an object, person, or event
so that it no longer fills them with dread. They become free.
Danielle Schiller, PhD, assistant professor of neuroscience and psychiatry at
Mount Sinai, has found through her research that “If you present a negative
memory over and over again, without anything bad happening, it is possible for
most people to overcome their fear. You will still know what happened, and the
information will be available to you,” says Schiller. “But the emotion will be
gone.” For instance, it may become possible to be around a parent who
humiliated or harmed you, and over time, no longer experience waves of panic
and anxiety. The fear is no longer there.
By helping to uncouple fear from what is remembered, it may indeed be
possible to untether ourselves from our most painful emotional memories.
EMDR, or Eye Movement Desensitization and Reprocessing, is a potent form
of psychotherapy that helps with this process. EMDR therapy was developed by
Francine Shapiro, PhD, senior research fellow at the Mental Research Institute in
Palo Alto, California, in 1990. Shapiro noticed that if an individual shifted his
gaze back and forth quickly, as we do in the deepest stages of our REM, or rapid
eye movement sleep, while thinking about painful past experiences, the emotions
and stress reactions associated with those memories would dissipate.
As a psychologist, Shapiro realized that “many patients might come in to see a
physician or psychiatrist complaining of anxiety, but if the patient wasn’t
reporting PTSD or major trauma, the clinician or therapist might never know
about their early history of adversity.” This seemed to Shapiro to be a very big
miss. Like Ruth Lanius, Shapiro found that “adverse experiences cause many of
the same symptoms of PTSD—but lead to an even wider range of emotional and
physical symptoms than major trauma. Yet if patients don’t talk about them, and
they don’t fit into the PTSD category, psychiatrists don’t know, and so they treat
those symptoms as anxiety and prescribe medication.”
But medication doesn’t help us to revise how we respond to our memories; it
masks the anxiety that has shadowed us into the present.
To Shapiro, therapists needed to look “more closely at the kinds of ubiquitous
adverse experiences that most people have had, the smaller traumas” and how
these unprocessed memories might be “behind many of the disorders we see.”
For instance, says Shapiro, if we read the following list of negative beliefs and
find that any of these statements give us an uncomfortable feeling in our body,
or cause our breath to quicken, shorten, or catch, we probably have unprocessed
emotions from earlier life events. Some of the negative beliefs we might be
carrying around include these:
I don’t deserve love.
I am terrible.
I am a bad person.
I am inadequate.
I am not good enough.
I am ugly (my body is hateful).
I do not deserve . . .
I am stupid (not smart enough).
I am a disappointment.
I deserve to die.
I deserve to be miserable.
I am different (don’t belong).
I should have done something.
I did something wrong.
I should have known better.
Shapiro found that she could help patients to safely tap into their negative
emotions and reprocess early memories associated with their negative,
emotionally damaging beliefs by working with the body’s natural process of
rapid eye movement.
Here’s how this reprocessing works: in an EMDR therapy session, a patient is
helped to cue into painful emotions. As those emotions lead them to recall
specific difficult experiences, and deep-seated feelings about those memories
arise, they are asked to shift their gaze back and forth rapidly, often by following
a pattern of lights that move from right to left, right to left, in a movement that
simulates REM sleep. The therapist guides the client’s focus of attention.
Or, individuals can hold a small wand in each hand that pulses intermittently
from right to left. Other methods include listening to bilateral tones, or bilateral
tapping, or simply having a therapist hold up two fingers and asking a patient to
shift their gaze from side to side. The therapist uses structured procedures to
make sure the client focuses on and processes everything that needs to be
addressed.
“We all have an information processing center in the brain that is geared to
take in experience and bring it to resolution. We take our present experience,
relate it to all of our past memories and events in our life, process this
information, and make new conclusions,” says Shapiro. Those conclusions often
evoke intense feelings. “With EMDR, we are looking at the early memories that
might be causing those feelings, the current situations that trigger those feelings,
what kind of symptoms a patient has, and what’s needed for the future for an
individual to go forward in a healthier way.”
EMDR therapy appears to link into the same neurological processes that take
place in REM sleep and clean up the brain. The repetitive redirecting of attention
in EMDR induces a neurobiological state similar to that in REM sleep, and this
process—both in sleep and EMDR—supports the brain integration that is
dysregulated during adversity and Chronic Unpredictable Toxic Stress. This
integration can, in turn, lead to a reduction in the episodic memories of traumatic
events that we store in the hippocampus, and downshift the amygdala’s alert
state.
Other studies have shown that EMDR increases the volume of the
hippocampus, which tends to be smaller in individuals who suffered early
adversity and trauma.
By inducing a similar processing experience to REM sleep in a safe
therapeutic setting through EMDR therapy, “we are jump-starting that process so
that we can finally move to resolution, so that negative emotions are no longer
there,” Shapiro explains. Painful memories of adversity “are like little dream
scenes that we don’t want around anymore. Because they are stored in an
unprocessed form, they retain an emotional charge. So they just remain that way
and no amount of passing years changes them at all.” But once we’ve “processed
the old memory, it lessens an individual’s level of day-to-day distress.”
There is, Shapiro underscores, such “a massive amount of suffering out there,
a pervasiveness of pain. It transmits from one generation to the next. And yet
here we have a very effective tool to help reset the brain.”
This process can work even when our memories are so old or so buried that
they exist outside of our conscious awareness.
Priscilla, who nearly died when she was a child, suffered from debilitating
panic attacks, and was diagnosed with the heart condition mitral valve prolapse,
decided to try EMDR therapy to deal with feelings that she hadn’t been able to
resolve despite trying a wide range of other modalities, including fifteen years of
talk therapy. With EMDR, she says, “I was able to bring up memories without
having to summon them. I began to understand that my nervous system was an
entity unto itself, one that could be activated, and could also be calmed down.
My nervous system was simply doing what nervous systems do; it was
overactivated. But most things I was trying weren’t really getting to the heart of
that problem.”
Priscilla’s therapist, Gina Colelli, had studied with Francine Shapiro, and had
worked with first responders and survivors of the terrorist attack on 9/11. She
had “a reputation for helping people who had hit a wall with traditional
psychotherapy.”
Priscilla was able to tap into her emotions, bring up memories of her past
when her parents had abandoned her—and recall childhood panic attacks that
she had not remembered. And as she did, she says, “I allowed those difficult
feelings to pass through me until I began to feel better—alive and resilient. I was
ready to leave the pain of my family behind.” EMDR helped her to “see the
lightness that was inside of me. And I could go out into the world radiating that
light.”
In the process, Priscilla came to realize that “I didn’t hate my mother. I
accepted her as she was. I realized that there was nothing to forgive, she was just
who she was, doing the best she could do at the time.” The timing for letting go
of her anger and resentment toward her mother couldn’t have been better—that
year, Priscilla’s mom deteriorated from Alzheimer’s, and Priscilla was able to
spend that last year of her life finding ways to connect with her before she
passed away.
According to Colelli, “When we clear the nervous system, the language,
emotions, and behavior that accompany them move from a subjective to an
objective experience.” In other words, we can observe what is happening—but
we don’t feel the same painful emotions. We can move on to the possibility of
the full life we can have right here, right now.
EMDR may provide a way to reexperience the feelings that accompany an
early Adverse Childhood Experiences memory, and intervene, to reconsolidate
that memory in a way that detaches it from the overwhelming fear that we felt at
the time.
Today, Shapiro’s EMDR therapy has been endorsed by the World Health
Organization as one of only two forms of psychotherapy for the treatment of
trauma in children and adults in natural disasters and war settings.
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