My EMDR treatments for PTSD  included Cognitive Feedback Therapy, which focuses on the individual’s thought processes and how they affect behavior and beliefs. For example, it did not take much for my mind to swirl with negative thoughts when my husband traveled out of town for music gigs. I imagined him sprawled on the side of the road after being hit by a car. At night, I would wake and watch my husband’s chest for movement. In the dark, it was difficult to see if it was rising and falling, so I’d gently lay my hand on his chest, feeling for life. Or I’d snuggle close to him, waiting for him to exhale. These negative thoughts would lead to other negative thoughts or images: sometimes I’d see myself in a hospital bed struggling to breathe, with doctors hovering over me, sticking needles into my arms.

Like any successful project, cognitive therapy involves homework. My therapist instructed me to keep a log of events that triggered negative thoughts, sensations, and emotions. One day, I felt weak and feverish, as if I had the flu. Even though I did not have a fever, I thought something was wrong: I should go to the hospital, because I might have an infection. What if I need antibiotics? What if I don’t go to the hospital? I might die. As a nurse, it was easy for me to scoot down this irrational path. And since my spleen – an organ that destroys bacteria and is part of the immune system – had ruptured in the farmers’ Market accident, I couldn’t help but be anxious about dying from an overwhelming infection. But an uncountable number of people live productive and healthy lives without a spleen. By categorizing my thoughts into what my therapist labeled “faulty thinking patterns,” such as drawing conclusions or exaggerating the meaning of an event, then forming positive ways of thinking, I learned to halt the unraveling of irrational thoughts. I no longer keep a log, though I’m not completely free of negative thoughts and images. Instead, when they intrude on my sleep, or my daytime routine, I envision a huge stop sign. Sometimes I hold my hand up and say, “Stop!” And just like that, I’m unburdened by blackness, screams, and blood.

How exactly does EMDR work? Francis Shapiro, who discovered the treatment, explains it through the theory of the “Adaptive Information Processing Model.” The theory sounds metaphysical, but it’s not. The assumption is that all individuals have an information processing system, which takes our experiences and stores them in a section of our memories that is easily accessible. These experiences are connected to particular images, emotions, sensations, and beliefs.

Think of a computer. If you’re like me, you might have several folders filled with documents dotting your desktop, because you need the information to be readily available – at the click of the mouse. One of those folders might hold information that reminds you of something that evokes negative feelings. For instance, a folder has photos of your deceased parents. Every time you turn on the computer, you see the folder, and images of your parents fighting in front of you when you were a child return. You hear them screaming at one another, one of them saying, “I wish I never had children.” Each time you drag the folder into another one, so you won’t see it, the folder bounces back onto the desktop. Your computer is malfunctioning, so you need to take it to a computer geek.

Of course, we are not computers; we are human beings. Yet, our brains are very much like computers. In PTSD, the trauma – the negative images, emotions, and thoughts – are stuck in the easily accessible part of the brain. The processing system in our brains is working ineffectively, so each time something triggers memories of the trauma, like a car backfiring, you exhibit PTSD symptoms, such as panic. EMDR helps transfer the trauma and related images from your brain’s desktop into the part of the brain, or folder, that effectively processes the event.

When I speak to others about EMDR, they shirk from me, as if suspicious – maybe I’m looking to recruit them into a cult. But EMDR is not a cult at all, I promise.

There are 8 phases to EMDR: First, the therapist gathers background information about the client and discusses possible targets, or memories, on which the client may focus during treatment. In phase 2, the therapist ensures that the client is prepared to cope with potential distressing feelings. This may involve imagery or other stress reduction techniques. During phases 3 through 6, the EMDR procedure takes place. In phase 7, the client keeps a log noting any thoughts or emotions that arise. Finally, in phase 8, the client and therapist evaluate the progress made.

When I first learned about EMDR, I imagined walking out of the therapist’s office magically cured of all my PTSD symptoms. Maybe that’s what I wanted to hear when my original therapist told me about the treatment. But that’s not how EMDR works. EMDR is not a panacea – it assuages the anxiety related to the trauma, but does not necessarily eliminate PTSD symptoms all together. It wasn’t until I completed my first 90-minute session with the therapist when I learned that she could not give me an answer as to how long it would take before I noticed a reduction in anxiety.

Some people experience reduced symptoms of PTSD after a few sessions, but those who have suffered multiple traumas, or a complex history may require prolonged treatment. Once the therapist explained this to me, it made sense that I did not leave even the fifth or sixth session feeling marked relief. I grew up in a household where I endured both physical and emotional abuse. The emotional abuse continued into my twenties and early thirties when I became involved with men who treated me poorly.

As I shared my history with the therapist, I realized, for the first time, that other traumas I had experienced made my treatment complex: I was in a car accident with my father when I was ten, and another one with my step-mother when I was eleven. I nearly  drowned in the Colorado River when I was fifteen, and rammed into a tree while backcountry skiing when I was thirty. I completed twice-a-month EMDR treatments a year after my first session. Six years later, I returned for what I call a “tune up.”

For more information on EMDR, click on the video below:

https://www.emdr.com/client-session.html

Eye Movement Desensitization Reprocessing, or EMDR, was first discovered in 1987 by Psychologist Francis Shapiro.  One day, she felt anxious by negative thoughts, so went for a walk in the woods. Sure, you might say, sounds like a great way to shed some stress – walk it off. But as she moved her eyes from right to left, taking in nature’s greens, yellows, and browns, she noticed that her level of anxiety decreased. She tried a similar eye movement process with her clients, and it worked. They, too, experienced a reduction in anxiety. That’s how EMDR was born. Initially used to treat individuals with PTSD and other anxiety disorders, it is now used to treat other conditions like depression, schizophrenia and eating disorders.

When you cut your finger, cells race to the site and clump together to stop the bleeding. Your body’s nutrients then heal the wound. If it continues to get irritated, it will become inflamed and may open up again. Once the source of irritation is removed, the wound can finally heal. PTSD symptoms are like festering wounds; the goal of EMDR is to remove what is blocking those wounds from healing.

Here’s how EMDR works: The client recalls a vivid image from the trauma experienced, such as a lying on the pavement after being hit by a car while thinking about a negative belief about the self, such as “I’m going to die.” The client notes the visceral sensations and emotions she is experiencing like a tight chest, shortness of breath and increased fear. She then thinks of a positive image like taking a warm bath, then a thought: “I’m safe.” Following this, the client conjures the negative thoughts and images while undergoing 15-20 seconds of bilateral stimulation: lateral eye movements, where the client follows the back and forth movement of the therapist’s fingers. Even though lateral eye movements are the most common form of stimulation, other stimuli may be just as effective, such as tapping or tones. The therapist who treated me used walkie-talkie like devices that vibrated beneath the backs of my thighs.

The same bilateral stimulation is then used while the client focuses on the positive images and thoughts. Over time, these will become embedded in the client’s memory, blocking the negative images and thoughts – the wounds. Eventually, PTSD symptoms will lessen when exposed to sounds, smells, or sights reminiscent of a trauma or threat.

EMDR is different from exposure therapy, which involves prolonged exposure to a stimulus that triggers thoughts, emotions, and sensations about the traumatic event. Some therapists believe that prolonged exposure is necessary to produce effective treatment outcomes. But others believe that this type of therapy will cause fearful memories to outweigh the joyful ones in people who have experienced extreme trauma, then encounter a particularly stressful situation in the future.

http://www.emdr.com

How do you predict who will suffer from PTSD after a traumatic event and who will not? Most people who experience a traumatic event actually do not suffer from PTSD: about 56% of people will experience a traumatic event in their lifetime, but only 8% will develop PTSD.

Research studies show that individuals with a variant of two genes – TPH1 and TPH2 – are more likely to develop symptoms. These genes, which control levels of serotonin – a chemical in the nervous system that regulates mood, sleep, and alertness – are altered in PTSD sufferers.

Genetics aside, other factors increase the risk for PTSD:

Having experienced other trauma earlier in life, including childhood abuse or neglect.

Having other mental health problems, such as anxiety or depression Lacking a good support system of family and friends Having biological (blood) relatives with mental health problems, including PTSD or depression.

Gender: Because there is more societal pressure on females to take care of others, we are twice as likely than men to suffer from anxiety disorders, such as PTSD.

Personality: People who are worriers, and cannot tolerate unpredictability. These traits may have a biological basis. It’s possible that the amygdala, the part of the brain that controls emotion, is oversensitive in worriers.

Have you been diagnosed with PTSD? If so, it may come as a relief to know that you can blame your symptoms on factors beyond your control.

http://www.ncbi.nlm.nih.gov/books/NBK49142

http://www.mayoclinic.org/diseases-conditions/post-traumatic-stress-disorder/basics/risk-factors/con-20022540

http://www.nimh.nih.gov/statistics/1AD_PTSD_ADULT.shtml

http://newsroom.ucla.edu/releases/ucla-study-identifies-first-genes-231248

http://psychnews.psychiatryonline.org/newsArticle.aspx?articleid=1130400

When exposed to danger, it’s natural to be afraid. Our bodies are triggered to make a split-second decision to either face the danger, or run from it: the “flight-or-fight” response. This is a healthy reaction. But in those with PTSD, they continue to be afraid and feel stressed long after the danger has passed – in my case, the speeding car at the Santa Monica Farmers’ Market. Symptoms, like avoiding places that trigger memories of the event, nightmares, depression, and hyper-vigilance – heightened awareness of your surroundings – may interfere with day-to-day-life. In hyper-vigilance, there is a perpetual scanning of the environment for sights, sounds, smells, or anything that is a reminder of threat or trauma. Just because you have been in a car accident, for instance, doesn’t mean you’ll be hyper-vigilant only for screeching brakes or beeping horns.

A month after my psychologist told me I had PTSD, I called her, wondering if I should go to the emergency room because my toe was red – I thought I had a life-threatening infection (I’m a nurse, and sometimes nurses know too much). I wouldn’t sleep in my bedroom on the third floor of my apartment because I was afraid of dying in a fire (I worked as a burn nurse years ago).

Months later, when shopping at an outside market with my father, I suddenly felt short of breath and couldn’t swallow. I told him he needed to drive me to the emergency room because I thought I was having a heart attack. I was a physically fit, non-smoking, lover-of-veggies thirty seven year old. I was not at risk for a heart attack. I called 911 three more times in the next few months, because I thought I was having allergic reaction: first to chocolate, then shellfish, then a bug bite. Miraculously, each time the EMT’s arrived, my rapid pulse slowed and my quivering body relaxed. I was suffering from panic attacks.

Before the accident, I had been known for my calm demeanor, and my no-worry attitude in my family. When working in the neonatal intensive care unit, I had been known for my in-control, I-can-handle-this disposition, even when a baby’s heart rate plummeted to near zero. After the accident, I felt as if there was a circuit breaker inside my brain that tripped at random moments, sending sparks into my nervous system. I didn’t know exactly where the breaker was located, or how to stop it from tripping. I reasoned that my brain had been re-wired. My reasoning was accurate – recently, I learned that researchers have found differences in the structure and circuitry of the brain between those with PTSD and those without it.

http://www.ptsd.va.gov/professional/treatment/overview/clinicians-guide-to-medications-for-ptsd.asp