Archive for the ‘Trauma Therapy’ Category

When Is It Time To Consider EMDR?

Thursday, January 31st, 2019

The field of psychotherapy has advanced a great deal in the past  20 years. Since Freudian time, therapy was commonly referred to as “talk therapy”. Over the years, however, many different forms of therapy have evolved including psychoanalysis and psychodynamic therapy, and later, cognitive behavioral therapy and supportive therapy.

Most of these therapies consisted of a patient doing the talking and therapist mostly listening whiles interjecting every so often, and in the case of psychoanalysis – making interpretations. In other therapies like Cognitive Behavioral Therapy (CBT), the therapist was more active and directive with their patients.

Over the past 20 years, other types of therapies been developed which include EMDR, Somatic Experiences (SE), Sensory Motor Integration, and many others. What makes these therapies different from the ones previously mentioned is that the principles of these therapies are grounded in developing an understanding of the brain and the nervous systems, as well as making a connection between mind and body.

For this reason, these therapies are sometimes referred to as “mind-body therapies”.

EMDR, in particular, is a therapy based on an assumption that all traumatic events get stored in a fragmented form in both the brain and nervous system. At the time of the incident, our minds are capable of assimilating only certain parts of the incident usually in an incomplete form.

Some parts of traumatic events are stored in the right hemisphere of the mind while others are stored in the left. During EMDR treatment both hemispheres are stimulated in order to bring all the pieces together to create a coherent and complete experience and understanding of the event. In subsequent sets of stimulation, the memories of the event lose their emotional charge and become neutral rather than dormant in our system which allows them to be triggered again and again.

Many patients seek EMDR treatment after being in traditional therapies for many years while still experiencing the same triggers and reactions to events. These triggers are occurring because in some way they are reminding the patient of the original traumatic incident.

For example, a young female patient who was assaulted by a man in a blue jacket at age 10, may become panicked every time she sees a man in a blue jacket. However, she did not know why this was triggering panic until she received EMDR treatments which targeted her seeing man wearing a blue jacket. From there, a memory rose up connecting the two pieces. After this was discovered, treatment was able to ensure that men wearing blue jackets were no longer a trigger for her.

While EMDR therapy is not for everyone it is worth exploring as it can often facilitate relief from troubling symptoms.

What is Trauma?

Monday, January 28th, 2019

Today, there are a number of different trauma therapies available to patients, as well as trauma therapists to administer this therapy. This is important because trauma is one of the most common reasons people seek therapy.

In the trauma field, there are two types of trauma that exist – “Big T trauma” and “Little T Trauma”.

Big T Trauma most commonly refers to a traumatic event or events in which a person’s physical survival is threatened. These events are usually life and death situations, or ones where there is an extreme physical or psychological abuse involved. Some common examples of Big T Traumas include muggings, car accidents, other types of accidents, sexual assaults, experiences while under anesthesia, or the loss of a loved one.

Often after experiencing Big T trauma, people will develop symptoms such as Post Traumatic Stress Disorder (PTSD), panic attacks, anxiety, depression among others. These traumas will also cause a person to develop beliefs about oneself such as “ I am not safe”, “I am powerless”, or even “ I am a bad person”.

Little T Traumas are more common and typically things that everyone has encountered.  Such traumas can include failures, disappointments with someone they consider important, painful breakups or work-related stresses like getting fired. While these traumas are not threatening to a person’s survival in the physical sense, they are capable of having long-lasting effects on a person’s self-esteem and emotional well being.

While a person can typically “get over” such traumas, these events are still capable of informing our view of the world and ourselves – usually in negative, maladaptive ways.

Post Little T Traumas, symptoms like anxiety and depression maybe be experienced. Usually, however, they will be shorter lasting and less severe.  It can also become normal to experience negative self-referencing beliefs such as “There is something wrong with me” or “I am a failure”.

Whether you experience a Big T or Little T Trauma, it is advisable to deal with these issues with a trained therapist in individual counseling so they do not impact your daily life.

What Is EMDR?

Tuesday, June 19th, 2018

EMDR, or Eye Movement Desensitization and Reprocessing, is a treatment modality that was developed in 1987 by a clinical psychologist, Francine Shapiro. It is used as a salient and effective method for working through patients who have experienced a trauma.

The basic premise of EMDR is that most psychological disorders or symptoms are based on earlier life experiences. Painful experiences often become “frozen” in brain neuro networks, which sets in motion a pattern of feelings, behaviors and cognitions. These create which predictable, rigid responses to triggers which which may be reminiscent of the original traumatic event.

EMDR treatment is designed to rapidly metabolize (reprocess and functionally organize) dysfunctional residue from the past traumatic experiences and even turn these experiences into something useful. With EMDR painful experiences undergo a change in form and meaning.

In cases of Post Traumatic Stress Disorder (PTSD), panic disorder, some forms of depression and other psychological illnesses or syndromes, pathology is viewed as result of, or impacted by earlier experiences that are held in the nervous system in a state specific form. Painful experiences are reprocessed using an 8 step protocol administered by a trained clinician. During reprocessing, the memory system is stimulated and the painful incident is experienced in a way that provides additional insight and feelings that are enhancing rather than harmful to the person. The goal of EMDR is to “free” a person from being triggered by the earlier traumatic incident.

How Trauma Leads to Depression and Anxiety

Tuesday, August 25th, 2015

A few years ago years ago after the Oklahoma City bombing, Hurricane Katrina and Sandy, I contributed to an article for discussing Trauma, Post Traumatic Stress and its impact on Mental Health. This week I wrote an update to this article mentioning more recent events in the past 2-3 years, such as the Boston Marathon shootings in which three people were killed and hundreds injured, murder of a teacher outside a preschool by her husband on March 11, 2014. Not to mention unspeakable executions by ISIS. In doing research for this article, I was shocked about how many violent acts of random violence have occurred in the past two years in schools and colleges all over the country.

Actually this week a patient of mine in marriage counseling, came to the session and announced that she is not really here, there was a “crazy” incident that occurred at her workplace that day. To be sure, she works in a state of the art security building in Midtown Manhattan. Apparently a coworker’s husband was able to get past security and entered their office with a knife. He suspected that his wife was having an affair with a co-worker and intended obviously to use the knife on both of them. He first went after the male and basically was eventually wrestled down by other men in the office who were able to get the knife from him. Security was called and he was luckily arrested. My patient was in a state of shock and was able to talk a little about her fear and what would have happened if he had a gun….

I think that being a New Yorker and having lived through 9/11 has forever changed our nervous systems. Many of us are more on guard and are looking for potential dangerous people or elements in our environment. Fortunately nothing of this magnitude has happened in this city or country since but oftentimes, we all think it will, may be happen again and it certainly has in other parts of the world.

What makes trauma what it is, is the element of it being completely unexpected and out of nowhere. It shakes our basic assumptions about our lives, order and predictability and makes us different. There is a sense of loss that occurs which leads to depression as underlying issues in depression are often loss, disappointment and helplessness. All these feelings are experienced in trauma as the shock lifts. Another related feeling is that of fear, a pervasive fear of this or something like this happening again and the need to be worried and hyper vigilant all the time. There is a sense of life not being safe.

These feelings are common and normal after traumatic experience. However, if they persist, one should seek professional help. Psychotherapy such as EMDR ( Eye Movement Desensitization Reprocessing) is especially effective in clearing trauma so we do not have to live in the grip of sadness and fear.

Children may also experience these symptoms. There are therapists who specialize in treating children after trauma and they use same approaches, such as EMDR. It is important for parents to become educated about this and take an