The effects of trauma are among the most difficult issues to deal with in the field of mental health. Trauma has a way of burrowing deep inside the psyche of a person that simply identifying it so that it could be treated is already a massive challenge. This is why there are so many innovative approaches in psychotherapy today, much like the EMDR, or eye movement desensitization and reprocessing therapy program, that are being used to deal with the deep-seated mental health issues plaguing the modern world.
The most common form of psychotherapy is talk therapy. This is the method where a therapist will engage a patient in a dialogue intended to bring out their issues, help the patient sift through the issues and process them, and then reach a resolution to them later on. This process might sound simple, but in reality, it is the farthest thing from being simple, particularly with the myriad ways in which mental issues could affect the way a person thinks and acts.
EMDR therapy does not require much talking to be done between the patient and the therapist. Instead, EMDR therapy attempts to change the thoughts, emotions, or behavior that arise due to some distressing event that proved to be traumatic to the patient in the past. This is done by exposing the patient to a stimulus while they are asked to focus on the traumatic memory. The stimulus is typically bilateral stimulation to induce eye movements, through a series of flashing lights, as this is believed to significantly reduce the jarring impact the traumatic memory has on the patient.
Although relatively new compared to some of the more popular therapeutic techniques, such as the widely-used talk therapy, EMDR is showing very promising results. Patients have been known to overcome the barriers and hindrances caused by trauma enough to engage in efforts to help them achieve a full recovery from their trauma. The most common application of EMDR today has been to help process the damaging effects of post-traumatic stress disorder (PTSD) on people who have it.
The nature of trauma is such that it actually makes treatment anywhere between immensely difficult to near impossible. This is because there are cases wherein the traumatic event is so severe that the patient makes every attempt to avoid even the mention of it. In turn, this practically prevents therapy. Sometimes, the patients simply shut down and withdraw into themselves even further, making any attempts at communication with them futile and frustrating.
In most cases, this can’t be helped. The mind is normally equipped to deal with increasingly stressful situations that the person is exposed to. This is why the human brain has a mechanism that triggers a fight-or-flight response, so that the person operates on instinct more and on intellect less, in an effort to increase the person’s chances of survival.
The brain, however, is also designed to optimally absorb, retain, and process information every single moment that a person is awake, and sometimes even during periods of sleep. This constant absorption of information is actually a key factor as to why trauma is so damaging. As the brain does not get to select what kind of information it absorbs, it will take in every detail of whatever the person experiences, even the ones that become traumatic.
The problem then lies in the other two actions the brain does to the information: retention and processing. The traumatic information, usually in the form of a vivid memory, is stored but is not processed properly, as it may be too horrible or frightful to the person’s mind. As it is not processed properly, it could form a loop that keeps on bringing back the horrible memory. This is why PTSD is so damaging. Adler Health has different trauma treatment programs for anyone suffering from mental health disorders.
In 1987, American psychologist and educator Francine Shapiro had an experience while walking through a park where a chance observation that moving her eyes from side to side appeared to reduce the disturbance of negative thoughts and memories. The experience inspired her to examine the experience in greater detail, the result of which was the development of EMDR as a form of psychotherapy that could work well in processing trauma and other disturbing experiences.
The entire premise of EMDR relies heavily on another theory also developed by Shapiro, the adaptive information processing (AIP) model. This model suggests that the inability of the brain to properly process traumatic memories is due to the fact that a sudden disconnect happens inside the brain when exposed to significantly traumatic or damaging events.
The way that memory works are that it associates information from the past with the body’s senses, as a person is only able to absorb information through sensory input. Health memories are those that the brain properly connects to a person’s senses. Shapiro’s AIP model looks at trauma as the time when the brain fails to connect the memory to the senses, perhaps due to the fact that the information entailed in the memory could be too much for the brain to handle.
EMDR works by engaging the senses, particularly that of sight, along with some guided instructions from the therapist. This helps the patient go over the traumatic memory once more without having to experience a sudden “disconnect” brought on by the brain trying to not go through the experience again.
The bilateral stimulation removes the focus the brain might have on the jarring aspects of the memory by “distracting” it with additional information. Therefore, the patient could process the information that comes with the traumatic memory, and in so doing, heal from it. This gives the patient the ability to remember what happened and understand it better, as they are no longer experiencing the horrible things that go with the memory.
There are many people who went through significantly terrible events in their lives and experienced things no one should have to go through. The most common examples of this are the combat veterans who have seen the horrors of war, members of law enforcement who have seen horrendous crimes, and everyday people who have either been victims of abuse or survived a harrowing accident.
The things these people have seen heard and felt have proven to be too much for their brains to process, resulting in trauma that is so damaging that it changed their perception and behavior to a certain extent.
To add to the problem, most people do their best to just bury the memory, as it is simply too much for them to handle, let alone confront. What most don’t realize is that even if they do their best to bury the trauma and try to forget it, it would still affect them by instilling intense fear, great resentment, and even inexplicable anger in them when exposed to something that could be related to their trauma.
Combat veterans sometimes bring with them the intense urge to hurt and even kill others they perceive as “enemies”. This is in the same manner, that a person who developed an intense fear of flying will choose to travel in every other way except in an airplane, regardless of the time and cost.
The first step in any kind of therapy intended to treat mental health issues is to get to the core memory associated with the trauma so that it could be dealt with and processed. People who experienced trauma will do everything they could to not go back to the memory as it is simply too much for them. EMDR helps with this by removing the elements that inspire the avoidance behavior. This is mainly by distracting the person with visual stimulation so that they could go back to the memory to process it and get over the cycle of damage that it has caused them.
EMDR therapy entails the same amount of preparation and consideration that all therapists take whenever they take on a patient for treatment. Although the methods may be a bit different as the methods vary greatly from traditional talk therapy, the treatment still requires the following:
- A thorough examination of the patient
- An assessment of the issues that need to be addressed for therapy
- The determination of a suited form of therapy for the patient
Much like how a physician builds a patient’s medical history for future reference and determination of treatment, a therapist also essentially needs to study the history of the patient to get a better idea of what issues might exist, which ones need attention and treatment, and what treatment might be the best for the case. This is also the time when the therapist gets to know more details about the patient to see if there are any existing conditions that might be making the problem worse, including surrounding factors are social circles, family, and living environment.
In many cases, the patient’s history could necessarily include their childhood, as the cause of the problem might not just be one significant event, but the accumulated effect of a series of events, with each event making the next one even worse. It is not uncommon for people to develop trauma from the compounded effect of more than one event, and this could even make the case more complex as more factors now play in that the therapist needs to look at as well.
Unlike most depictions in popular media, therapists do not go to the extent of pushing patients to their limits just to achieve a breakthrough. This could simply make matters worse as pushing the patient could damage their already-fragile mental state. This is why there is a need for the therapist to build a patient’s history, as this could reveal vital information that the patient might not divulge on their own.
By determining the patient’s threshold, the therapist could figure out where to drive the therapy, what other methods they could also include, and how much therapy would be tolerable for the patient, given that they might already be on an unstable footing with their mental health. During this assessment, the therapist could check if the patient has the necessary ways of handling emotional distress. Should there be a need to teach them additional ways of coping with having to face their trauma, the therapist may also teach them stress reduction techniques that they could employ during sessions.
Once a suitable patient history and case study have been built and assessed, the treatment with EMDR may proceed. Therapists also need to be aware and mindful of any kind of self-sabotaging things the patient might do during therapy. Most people with mental health issues have worsened to the point that many believe they do not deserve treatment, or that any kind of treatment is wasted on them as they are “incurable”.
These perceptions often drive a patient to do things that would prove their point and render the treatment ineffective. Many of them even do it subconsciously, and when confronted about it, will deny any knowledge of having done anything to sabotage the treatment or prevent the achievement of the goals set for the sessions.
Therapists will also require the patients to keep their own personal log of the treatment as it happens. This is intended to help the patient appreciate whatever progress they are making in the treatment, and also to practice the stress-management skills they learned before the actual treatment. The logs also document what occurs in the patient’s life outside of treatment, as this offers insight into any notable changes that might arise from the treatment itself, whether it is for the better or for the worse.
The logging activity also encourages the patient to have better engagement and commitment to the treatment, as the motivation of the patient to recover plays a large part in how long the treatment could run. The more engaged they are in it, the greater the chances of a full recovery, as compared to those who might be dragging their feet and are only half-hearted about the entire treatment.
With any form of therapy, any milestone achieved is reason enough for a measure of celebration, as mental health issues are never easy to treat. The therapist will periodically go over the documentation and results of the sessions done and give the patient a good idea of how much progress, or lack thereof, has happened over the course of the treatment.
Despite what most might think, the lack of progress is also an important bit of information during treatment. It tells the therapist that there is a need for further assessment to see if anything important was missed, if the patient is putting in the necessary participation, or if anything else is amiss in the treatment.
While EMDR is currently known for being an exceedingly effective psychotherapy approach to dealing with PTSD, it is also being increasingly used by our therapists in our mental health treatment center in Orange County, CA to also deal with other mental health issues that require the particular nuance of this method.
Much like the response a person might have to the fear and aversion created by PTSD, there are also many people who are so overwhelmed by aspects of anxiety that they are unable to confront their issues, let alone deal with them.
Certain anxieties tend to completely preoccupy the waking mind of people who have it that they could not even begin to describe the origin and extent of their issues. In this state, therapists could use EMDR to “stabilize” the mental health of a person enough to be able to determine the extent of the anxiety disorder and find a suitable way to approach it.
The aspects of anxiety that therapists typically use EMDR to deal with include:
- Generalized anxiety disorder
- Panic disorder
- Specific fears
- Social anxiety
Depression causes a person to stop functioning properly by removing their will to do anything at all. It could be so bad that people consider suicide as a much better option to feeling the gnawing emptiness and uselessness they attribute their lives. The difficulty in getting someone with depression to get depression treatment is in convincing them that there is still enough value in their lives for them to get well. EMDR allows enough distraction from the sense of worthlessness to make patients see what the therapist is pointing out to them.
Depressive disorders include:
- Major depressive disorder
- Persistent depressive disorder
- Illness-related depression
Feeling completely detached from most things in life is not only immensely disturbing but also highly confusing for those who feel it. Dissociative disorders remove any sense of belonging or association from people, giving them an intense sensation of alienation and an inability to relate to anything or anyone around them. This creates intense confusion and frustration in people who have this condition because regardless of any fact they come across, they simply cannot comprehend the essence of relations with others, as they are unable to relate with anyone.
Dissociative disorders include:
- Dissociative identity disorder
- Depersonalization/Dereakuzatuib disorder
Obsessive-compulsive disorder (OCD) might be humorous to some, but to the people who have this condition, their ability to control their lives has been completely removed from them. People who have OCD cannot fight the urge to give in to their obsessions or compulsions and have to act them out, even if it is completely against their will. These people suffer from immense emotional and psychological breakdowns if they are unable to perform the ritualistic actions that their condition dictates them to do.
- Severe obsessions or compulsions
- Body dysmorphic disorder
- Hoarding disorder
Mental health issues are among the most difficult conditions to deal with not only because of the circumstances involved in it but also because most who have these issues barely know that they do have them. Those that do know that they have issues, could be completely unwilling to deal with them for one reason or another. This is where our expertise comes in, as Adler Health has been helping people with mental health issues for quite some time now, and we are more than willing to help you with whatever you are dealing with. Come talk to us now.