EMDR: A Client and Therapist Perspective

EMDR has been used and researched for 25 years, and is considered a highly effective therapy for resolving trauma. Nevertheless, it remains somewhat mysterious and misunderstood. Written explanations can become jargon filled very quickly. Visual demonstrations of the process can raise concerns as it looks strange. In an effort to shed some light on the EMDR process, we offer a personal account of EMDR therapy and a discussion of some common questions about EMDR.

Mia:
My husband and I suffered the loss of our first son Nick when I was nine months pregnant and it shook us to the core. At the time, I told myself that I couldn’t go through something like that again and yet, I longed to have another child. When I found out I was pregnant with our second baby a few years later, I had mixed emotions. We were both elated about this new little life, but also fearful that we might have to say goodbye much too soon.

Painful Triggers
For years after baby Nick’s death, I experienced post-traumatic stress symptoms. Painful flashbacks of sights, sounds and emotions that brought me right back to the day we lost him at the hospital. Thinking about my future labour and delivery; seeing a specific blue stroller roll by; news reports about infant accidents and talk about difficult deliveries involving the umbilical cord all became powerful triggers. Flashbacks made my heart race and my breathing became shallow. I literally felt like someone had punched me in the stomach. I just wanted these knee-jerk reactions to subside.

As I approached the last trimester of pregnancy, worry and anxiety kept building up. The thought of going to the birthing unit became overwhelming. It got to the point where I had to look away when we drove by the hospital and I blocked myself from thinking about having to go back to deliver again. How will I react when I’m back in the maternity triage area? How will I survive labour? Will flashbacks be too much to bear? I wanted to avoid having an anxiety or panic attack and knew I needed to put a plan in place to build up my confidence.

Questions About EMDR
My therapist suggested I consider sessions with an EMDR therapist to compliment the work I was already doing with her. EMDR was to specifically address the trauma I experienced during childbirth. I knew the importance of being able to keep reasonably calm during labour – especially for the sake of our unborn child. Before deciding to give EMDR a try, I had a few questions and asked Dr. Alivia Maric to help give me some perspective.

• How does EMDR help?
• What are common reasons clients come for EMDR therapy?
• What can I expect during sessions?
• How long will it generally take?
• Traumatic memories seem too painful to have to go through, do I need to re-live them?
• What if I have multiple traumatic events to deal with?
• How can I prepare for the sessions?
• What is the success rate?

Dr. Alivia Maric:
Your experience highlights the fact that traumatic reactions can follow many overwhelming events, including sudden loss and difficult birth. Your questions about EMDR are understandable given that it is difficult to describe, and can seem “weird”. People wonder how watching a waving hand, or a row of lights moving back and forth, will help them feel better. Some people worry that EMDR is hypnosis – but it isn’t. EMDR is a rather complex therapy, involving several phases to help people focus on thoughts, feelings and images associated with a painful memory until the memory is no longer as painful or disturbing.

EMDR is helpful in two important ways. When people experience a traumatic event their nervous system goes on ‘high alert’, resulting in flashbacks, anxiety, and distressing memories that are triggered by reminders of the event. They begin to avoid people, places or things that trigger the distressing memories.

Also, traumatic experiences can “shatter assumptions”. For example, before the trauma you might think “I’m safe” or “I’m a good person” or “I’m in control”. But when tragedy and trauma occurs, it can shake you to our core, as you described, and those beliefs can change to “I’m in danger” or “I’m a bad person” or “I’m helpless and out of control” – even if those beliefs don’t make sense, and even after the danger is over (e.g., a person who has been in a car crash, or a soldier returning home from war can continue to feel unsafe or in danger). You may spend a lot of time trying to convince yourself of those previous beliefs, and loved ones may also try to convince you, but the negative beliefs remain, “frozen” in your system. EMDR helps to shift those beliefs to a more tolerable place such as “I’m safe now” or “I’m a good person even if bad things happen” or “I can control what I can control even in scary situations”.

Before beginning to focus on the painful memories, the therapist will ensure that you have strategies to help manage painful feelings and memories that might come up during sessions. The goal is not to overwhelm you again, but to help you face the painful memories in small amounts, at a pace that is tolerable. Following the waving hand (or moving lights) with your eyes seems to provide some distraction while you think about the painful memory. In some way we don’t yet fully understand, those frozen beliefs and intense memories begin to fade and move into the past. EMDR doesn’t erase memories, but it can make the memories easier to bear. It doesn’t make you feel like the trauma and loss is okay – it will always be sad – but the triggers will become less powerful.

How long it takes to notice positive changes varies, depending on a number of factors including how many traumas a person has experienced. Generally, the more traumas experienced, the longer therapy can take. Together, you and the therapist decide together which experiences to focus on, and in what order, so that therapy is tolerable. (Some people decide not to focus on past traumas, and only focus on the most troubling experiences they currently face.) Many people will begin to experience some relief in four to six sessions.

In terms of preparation, it’s useful to have skills (e.g., abdominal breathing, progressive muscle relaxation) that help cope with difficult feelings. The therapist will teach you such skills and ensure you are practicing them successfully before beginning to focus on painful memories.

Over the past 25 years that EMDR has been used and researched, its effectiveness in treating trauma has been well established. EMDR is also being used effectively with other difficulties such as addictions, eating disorders, anxiety, panic, depression, grief, and performance anxiety (such as public speaking and athletic performance) with good results. Many people have benefited from EMDR.

Mia:
My Experience with EMDR Therapy
As a result of the information I was given about EMDR, I thought it would be worth a try. At my first appointment, I spotted a machine with a row of lights across it, which made me curious as I had never seen one before. The therapist asked what I knew about EMDR and explained the process. I learned that some therapists used lights or finger waving and others use tapping. We were then able to start addressing specific triggers and explore the post-traumatic symptoms.

The EMDR session was difficult at first and it was challenging to stay focused. Memories came flooding back and having to follow the pattern of lights seemed awkward and unnatural. No wonder people describe EMDR therapy as being “weird”! After the third session however, I became more comfortable. More importantly, I noticed a difference in my anxiety level. In a controlled way and on my terms, I was able to face my fears. Little by little my physical reactions and emotions subsided and past triggers didn’t take me by surprise as they used to. After the sixth session, I was able to visualize the upcoming birth and was able to tolerate the anxiety. The worry was still there, but I felt more confident and hopeful.

EMDR Put to the Test
At an ultrasound appointment a couple of weeks before our due date, the Perinatologist gently told me I needed to go for an early induction as there were signs that our baby was at risk. My initial reaction was to go into panic mode. “What if…”questions raced through my mind and yet, I was able to stay level-headed when we arrived at the hospital.

I feel fortunate to have gone through EMDR therapy beforehand because things turned scary shortly after labour progressed. The machine monitoring the baby’s heartbeat started beeping incessantly and all of a sudden I was swarmed by a team of nurses. “Your baby is in fetal distress, we’re prepping you for surgery,” the doctor on duty explained amidst the commotion. She happened to be the same doctor who delivered my first son and knew our situation. “Just breathe…” I repeated to myself between prayers. Before I knew it, I was whisked in for an emergency c-section.

Thankfully, our baby arrived safely despite having a knot in his umbilical cord. We now have a happy, healthy toddler in our arms. I shudder to think what it would have been like had I not gone through EMDR therapy to help get me through the second risky birth experience. Looking back, I was able to stay focused and relatively calm which surprised me as I was awake the entire time. I feel that this type of therapy has been effective in dealing with my past trauma and recommend EMDR to others.

Dr. Maric:
Thank you for sharing your very moving story, and your description of your post-trauma reaction. I’m glad to hear that EMDR was helpful for you.