Excerpt from Finding the Energy to Heal

INTRODUCING EMDR

On a golden fall afternoon as sunlight filtered through the trees and spilled into my office, Sam's eyes followed my fingers as they moved rapidly in front of his face. He had started this set by focusing on an image of a recent episode of chest pains. After about 40 side-to-side eye movements, I asked him, "What did you experience?"

He told me, "I thought about the earthquake we had a few years ago and how scary it was for me and my wife and kids. Then for some reason I thought about my father. I saw him standing in the doorway of my bedroom. He was looking at me with such an odd mixture of love and, I don't know, disdain. And I remember right after that, he had his first heart attack. He was gone so much of the time--I never knew what he was really thinking. He really didn't see me and who I am at all. It was so sad, how we all missed each other. I don't want to do that with my family. I want to learn how to take better care of myself than he did. That's why I'm here."

What on earth could be intriguing about a therapy approach that involves shifting your eyes rapidly back and forth from side to side while following someone's moving fingers? How can what seems like such a ridiculously simple method make the claim of resolving a challenging condition like PTSD (post-traumatic stress disorder) in only a few sessions? Had the therapy world gone mad again? These were some of the questions that plagued me when friends and colleagues first started telling me about this radical new approach to the treatment of trauma. In California, we're used to revolutionary new therapies. Here we go again, I thought.

I paid no serious attention to EMDR (Eye Movement Desensitization and Reprocessing) until one of my close therapist friends shared with me her own extraordinary EMDR healing experiences from childhood abuse. Because I had the deepest respect for her, I could no longer dismiss EMDR without finding out more about it.

Two months later, in the spring of 1989, I was sitting with a group of therapists in Palo Alto in what was then called an EMD training workshop.  I listened as Francine Shapiro, originator of the model, explained the principles and steps involved. I watched videotaped examples, including one of my friend. Later, I practiced the techniques in a small group. Although some people in the room reported very powerful experiences, mine was uneventful.

Some months later, remaining skeptical, I invited Dr. Shapiro to present her workshop to the membership of the Northern California Society of Clinical Hypnosis Society, where I was president.  If only a few clients were reached who otherwise would not be helped, learning about EMDR seemed worthwhile. I used EMDR on an experimental basis after that with a handful of clients and found myself filled with more questions than answers. There were a few cases where fear-based symptoms were resolved. Some problems remained unchanged. Other clients remarked that it seemed to induce a state of inner focus that was similar to hypnosis, but they preferred hypnosis because it was more familiar and comfortable. Still others did not like the arrangement of holding their heads still and following my fingers from side to side. They found EMDR "too mechanical." Furthermore, my arm grew tired (a common complaint!) and I grew more reluctant to use EMDR.

I decided to place EMDR on a mental back shelf for a while. Nonetheless, I kept reading and hearing about the astonishing results that others were having with this method.  I explained my lack of resonance with EMDR to myself in several ways.  I was so successful with hypnosis that learning a new technique seemed like a waste of valuable time. This was especially true since I was getting ready to write a book on the uses of hypnosis in the treatment of trauma and dissociation. I also worried that there were too few safeguards in the model. I had heard reports that EMDR moved clients so quickly into and through traumatic memories that they were flooded with reactions, sometimes retraumatized. And, I had always resisted jumping on the bandwagon when a "too good to be true" technique came along. There was, however, one major problem with all of these objections. I could not argue with or explain away the dramatic results that were being published.

Finally, in the middle of writing my first book, Healing the Divided Self, I took myself to task. How could I put myself out as an expert in the field of trauma when I did not actually know how to use a technique that so many clinicians who treated trauma were finding to be invaluable? I decided to take the Level I EMDR training over again. I was glad to see that more attention had been given to ways of helping clients achieve feelings of safety while exploring powerful moments that had been so dangerously unsafe for them. Additional flexibility in the protocols seemed to allow more healing possibilities for greater numbers of clients. I began using EMDR with more confidence. After completing the Level II EMDR training, where I learned about many exciting and creative new ways of using EMDR beyond the basics, somehow the method clicked for me. As my confidence grew, so did successful outcomes with my clients.

At this point in my professional journey, I use EMDR to treat many PTSD symptoms my clients present. It is becoming a primary approach I use to resolve health symptoms. And, sometimes, I interweave EMDR with hypnosis, ego-state therapy, and somatic approaches in ways that you will read about in the last section of this book.

The Birth of EMDR

EMDR originated from a serendipitous discovery in 1987 by Francine Shapiro, then a graduate student in psychology in Palo Alto, California. She noticed that certain disturbing thoughts lost their negative charge immediately following a series of diagonal eye movements she made spontaneously while walking, lost in thought, through a park. Later, she experimented with lateral eye movements and found that they helped to resolve post-traumatic symptoms in a group of Vietnam veterans as well as in a group of women who had been sexually assaulted.

Shapiro began to test the technique with other types of trauma.  Her impressive results, which claimed to clear trauma-related thoughts, beliefs, fears, and somatic reactions, were replicated by other researchers, including the distinguished behavioral therapist, Joseph Wolpe.2 As the body of empirical clinical results expanded, findings were used to construct specialized training protocols for various types of post-traumatic issues, including depression, phobias, grief, anxiety, and substance abuse.

EMDR continues to evolve. Ongoing testing of the EMDR approach in recent traumatic situations, such as the war in Kosovo, the Oklahoma City bombing, and the Littleton shootings, adds valuable data. As more therapists worldwide use EMDR with diverse clients and clinical problems, their feedback and findings are being used to strengthen, expand, and deepen this model.

Eye movements, of course, have been used since ancient times in various healing practices, such as yoga, Reichian therapy, and hypnosis.  But EMDR is more than just a set of eye movements, which can appear deceptively simple. The complexities of EMDR include many dimensions, such as the accurate targeting of symptoms, precise phrasing and promotion of desirable beliefs about self, skillful introduction of interweaves, appropriate pacing of processing, and other competencies. These powerful ingredients can only come together in the hands of competent therapists who have completed at least Levels I and II of the EMDR training program.

In addition, EMDR offers a different view of how symptoms are created. Shapiro's theory emphasizes that the way we store disturbing, unprocessed early experiences, and link them unconsciously to subsequent events through complex information pathways, contributes to many of our difficulties. The key to healing and resolution of many symptoms we develop, from the EMDR perspective, is the reprocessing, or recofiguration of these original and linked experiences so that they promote healthy responses.

Much of what EMDR offers to clients resonates with many other types of effective psychotherapy.  In addition, EMDR offers a different view of how symptoms are created. Shapiro's theory emphasizes that the way we store disturbing, unprocessed early experiences, and link them unconsciously to subsequent events through complex information pathways, contributes to many of our difficulties.  The key to healing and resolution of many symptoms we develop, from the EMDR perspective, is the reprocessing or reconfiguration of these original and linked experiences so that they promote healthy responses.

What Happens in EMDR?

The brief description of Sam at the beginning of this chapter gives you only a glimpse of what happens during an EMDR session. When I work with health issues, before introducing EMDR, I interview my clients about the history of the health problem they want to resolve. I try to gain a thorough understanding of each person’s life in general and other therapy experiences. I also make sure clients have received appropriate medical attention. We then identify specific mindbody symptoms (e.g., insomnia, muscular pain, dizziness, or tinnitis), prioritize our list in order of their importance, and select one to target for change first.

If we choose EMDR as a method, I test the techniques with a positive target image. This image represents a recent time free from the health symptom s we will be working on.  An example of this kind of positive target is the conflict-free image, described in Chapter 1.

The goal here is to find an image that evokes only positive feelings that can be sustained or even strengthened and expanded over several EMDR sets, which usually consist of 20-50 lateral or side-to-side eye movements. These movements are created when clients follow my fingers, as Sam did at the beginning of this chapter. My fingers and hands3 make lateral sweeps a comfortable distance in front of their faces, as they hold their heads still. We install or put into place, a conflict-free image or other positive target image using these sets. Clients notice their inner experiences and tell me what happens during and after the time that their eyes were moving.

Usually, several important inner resources surface spontaneously when we associate to eye movements. Resources may be additional images, memories, thoughts, symbols, or body sensations. We also experiment with the speed, angle, and number of eye movements to make sure they are a "good fit" during this phase. If we are not able to install a positive target image of a time when the health symptom was absent, I introduce other types of strengthening experiences. If the strengthening phase is successful, we then find and explore a clinical target image connected to the symptom.  (I do not use the term negative target image because of its pejorative connotations).

With Susan, a 39-year-old lawyer who has high blood pressure, for example, the clinical target (i.e., what we want to change) is a recent episode of dizziness. I help her to form an image of that episode. I ask her to describe the thoughts, feelings, mental pictures, and somatic reactions that seem to appear when she focuses on the image. We rate on a scale from zero to ten how distressing the image is now to her. This rating, called SUDs (subjective units of disturbance scale), can be taken at different times to measure progress and to determine how much of the symptom still has not resolved.

Susan is also asked to notice what negative thoughts and beliefs about herself accompany the target image. She says,"When I feel that dizzy feeling, I am helpless.  I’m afraid I'm going to die young just like my grandmother did.”  Next we formulate a positive statement of what Susan wants to believe about herself, called a positive cognition:"I am capable of learning many ways to manage this problem."

We then begin reprocessing the image connected to dizziness.  To accomplish this, Susan moves her eyes to follow my fingers and then tells me what she notices. After the first set of eye movements, Susan says that her body feels as if it is leaning to the left. Next she begins to feel slightly more dizzy, and then remembers a fall that she sustained while she was skiing in the Sierra Mountains a few years before. I simply ask her to stay with each of those associations as a new target, and we start the next set of eye movements.

In this way, Susan moves organically through the internal links she might have to the dizziness that accompanies a rise in her blood pressure. Periodically, we test to see whether the symptom target has become less distressing for her (i.e., whether the SUDS rating has dropped) and whether Susan is moving closer to the positive beliefs she wants to have.

At the beginning of sessions that will follow this one, we will check to see whether there have been any shifts in Susan's symptoms of dizziness or in any other symptoms. Tracking changes that occur between sessions is extremely important. With any healing technique involving the unconscious, which includes all of those featured in this book and many others besides, the changes may not be predictable ones. What is most important here is that the shifts continue in a positive direction through any channel that we use to process information. In accord with principles of energy medicine, healing can take place only if the flow of energy is kept moving.

How Does EMDR Achieve Change?

Although there is no simple answer to this complex question, Shapiro has developed the Accelerated Informational Processing theory4 to explain the treatment results she and others have obtained with EMDR. To understand this theory, you must first understand the impact of traumas5 since EMDR was initially developed to resolve posttraumatic stress symptoms.

When a traumatic experience of any type takes place, it overwhelms temporarily, or even permanently, our usual ways of coping. The traumatic events, and our unique responses to them, are stored in what we can think of as memory networks.6  These can become frozen in time due to the psychological mechanism of dissociation as well as from the action of protective body/neurological responses.7 When any element of the trauma is triggered, the entire traumatic reaction, or some part of it, may recur again and again.

This explains why people who have had a traumatic accident, loss, or illness, or who have witnessed or experienced some other type of trauma such as abuse or violence may have recurring sensory

flashbacks, thoughts, beliefs, or dreams. Posttraumatic reactions remain connected to the traumatic events even though we are not consciously aware of them while the reactions are taking place. Since the traumatic reactions cannot be fully processed due to blocked or frozen mindbody pathways, the traumatic reaction can remain pretty much the same in intensity and quality. This can be the case even though many years may have passed and many intervening healing events may have taken place. EMDR therapy seems to help traumatized people reenter frozen memory and informational pathways, reprocess past memories as well as recent related events, and prepare for situations that may occur in the future. Because past, present, and future are connected in our information systems in many complex ways, positive changes spread or generalize throughout the system so that benefits are maximized in a short time period.

A good example of this can be found in the case of Jim, who was plagued with irrational worries that his health might collapse after a minor car accident. As it turned out, Jim was reexperiencing reactions to a far more traumatic collision that took place when he was four or five years old. In the earlier accident, his mother had lost control of the car when she turned around to discipline him as he moved around in the back seat. Since this was before the days of seatbelts, when the car hit a telephone pole, Jim flew into the windshield. As he lay bloody and terrified, his mother blamed him for the collision.

The terror and guilt he felt then, which had remained frozen in his memory networks, were reawakened by this minor car accident some 50 years later. Once Jim became aware of this link between the present and past, he was able to reprocess the previous and current car accidents, by adding new understanding to fully resolve his worries about his health.

The eye movements used in EMDR are believed to impact two different types of networks, which facilitate multifaceted reprocessing. First, they seem to stimulate the memory network where the trauma is stored. The eye movements may also activate the informational networks that can restore a traumatized person's ability to process an event fully. When both networks operate simultaneously during the eye movement sets, it appears that the traumatic information is rapidly processed.  Traumatic reactions such as fear, panic, despair, and grief are replaced by more positive ones that emerge from a new place of balance and completion.

Along with other therapists who use EMDR,8 I believe that the eye movements operate similarly to the rapid eye movements (REM) that occur during our sleep cycles when we dream. One biological function of REM sleep appears to be clearing away the stimuli that have triggered anxiety and stress during a day of living so that we can awaken with a "clean slate" the next morning, ready to move on to new life experiences. The eye movements of EMDR seem to mimic this function by clearing the stressful debris from our psychological selves so that we can "awaken" to take in new information that will help us go on to new life experiences. Since the eye movements move from right to left and left to right, they may also help to stimulate both hemispheres of the brain to promote a "whole brain" approach to healing.

When the trauma appears to be an isolated incident, the traumatic symptom can be cleared within one or two sessions. But when multiple traumatic events contribute to a health problem, such as physical, sexual, emotional abuse, parental neglect, or severe illness, accident, injury, or other health-related trauma that result in chronic impairment to health and well-being, the time to heal can be longer.

Resolving Health Symptoms with EMDR

The remaining chapters in this section include stories of the rapid healing of health symptoms as well as more complex treatment that took place over months and even years. You will see how some health symptoms can be linked to long forgotten traumatic experiences. Once these links surface and are reprocessed, many of the health symptoms completely dissipate. Other stories show how positive resources installed through EMDR eye movement sets seem to free up what we might think of as healing pathways, previously blocked because of stress. A third type of healing seems to take place with people diagnosed with purely organic disorders, such as diabetes, cancer, and head injuries. When these clients complete emotional and psychological healing using EMDR, their health can begin to show sometimes dramatic improvement.

Want to read more? Click here for Chapter One

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