What happens when you are traumatized?

 Most of the time your body routinely manages new information and experiences without you being aware of it. However, when something out of the ordinary occurs and you are traumatized by an overwhelming event (e.g. a car accident) or by being repeatedly subjected to distress (e.g. childhood neglect), your natural coping mechanism can become overloaded. This overloading can result in disturbing experiences remaining frozen in your brain or being “unprocessed”. Such unprocessed memories and feelings are stored in the limbic system of your brain in a “raw” and emotional form, rather than in a verbal “story” mode. The limbic system maintains traumatic memories in an isolated memory network that is associated with emotions and physical sensations and are disconnected from the

brain’s cortex where memories are stored in language form.  The limbic system’s storage of traumatic memories are repeatedly triggered when you experience events similar to the original trauma. Often the memory itself is long forgotten, but the painful feelings such as anxiety, panic, anger or despair are continually triggered in the present. Your ability to live in the present and learn from new experiences can therefore become inhibited.  EMDR helps create the connections between your brain’s memory networks, enabling your brain to process the traumatic memory in a very natural way.

What is an EMDR session like?

After a thorough assessment, you will be asked specific questions about a particular disturbing memory. In traditional EMDR, eye movements similar to those during REM sleep, will be recreated simply by asking you to watch the therapist’s finger moving backwards and forwards across your visual field. Sometimes, a bar of moving lights or headphones is used instead. The eye movements will last for a short while and then stop. You will then be asked to report back on the experiences you have had during each of these sets of eye movements. Experiences during a session may include changes in thoughts, images and feelings.

With repeated sets of eye movements, the memory changes in such a way that it loses its painful intensity and simply becomes a neutral memory of an event in the past. Other associated memories may also heal at the same time. This linking of related memories can lead to a dramatic and rapid improvement in many aspects of your life.

What can EMDR be used for?

In addition to its use for the treatment of Post-traumatic Stress Disorder, EMDR has been successfully used to treat:

• anxiety and panic attacks
• depression
• stress
• phobias
• sleep problems
• complicated grief
• addictions
• pain relief, phantom limb pain
• self-esteem and performance anxiety

Can anyone benefit from EMDR?

EMDR can accelerate therapy by resolving the impact of your past traumas and allowing you to live more fully in the present. It is not, however, appropriate for everyone. The process is rapid, and any disturbing experiences, if they occur at all, last for a comparatively short period of time. Nevertheless, you need to be aware of, and willing to experience, the strong feelings and disturbing thoughts, which sometimes occur during sessions.

How long does treatment take?

EMDR can be brief focused treatment or part of a longer psychotherapy program. EMDR sessions can be for 60 to 90 minutes.

Will I will remain in control and empowered?

During EMDR treatment, you will remain in control, fully alert and wide-awake. This is not a form of hypnosis and you can stop the process at any time. Throughout the session, the therapist will support and facilitate your own self-healing and intervene as little as possible. Reprocessing is usually experienced as something that happens spontaneously, and new connections and insights are felt to arise quite naturally from within. As a result, most people experience EMDR as being a natural and very empowering therapy.

What evidence is there that EMDR is a successful treatment?

EMDR is an innovative clinical treatment which has successfully helped over a million individuals. The validity and reliability of EMDR has been established by rigorous research. There are now nineteen controlled studies into EMDR making it the most thoroughly researched method used in the treatment of trauma, (Details on www.emdr–europe.org and www.emdr.org) and is recommended by the National Institute for Health and Clinical Excellence (NICE) as an effective treatment for PTSD.

Adapted from www.thetraumacentre.com

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Knipe, J. (2015). EMDR toolbox: Theory and treatment of complex PTSD and dissociation. New York: Springer Publishing Company, LLC.

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Manfield, P. (2010). Dyadic resourcing: Creating a foundation for processing trauma. United State of America: On-Demand Publishing, LLC.

Manfield, P. (2013). EMDR up close: Subtilties of trauma processing. United State of America: On-Demand Publishing, LLC.

Mosquera, D. & Gonzalez, A. (2014). Borderline personality disorder and EMDR therapy. Madrid, Pleyades, SA.: Dolores Mosquera Barral.

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Shapiro, F. & Forrest, M.S. (1997). New York: Basic Books.

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Shapiro, F., Kaslow, F.W., & Maxfield, L. (2007). The handbook of EMDR and family therapy processes. Hoboken, NJ: John Wiley & Sons.

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Shapiro, R. (2009). EMDR solutions II: For depression, Eating disorders, performance, and more. New York: W.W. Norton & Co., Inc.

https://naturalprocessing.org

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Two types of parts:

Major parts of personality: are focused on dealing with daily life and avoiding traumatic memories

Smaller parts: are stuck in past trauma experience and focused on defense against threat. They are highly emotional, limited in thinking and perception, not oriented in the present, and feel overwhelmed. These parts may repeat behaviors that are protective during the threat. They feel like running away, (though safe in the here and now,) and freeze in fear or completely collapse.

EXERCISE

Getting to know your parts is like becoming acquainted with neighbors in your community. Spend time with them. Ask questions. Seek to understand the neighbor’s/part’s relationships with each other. In becoming part of a neighborhood it is not helpful to be judgmental or rejecting. That is not neighborly. The same applies to your parts. Understand that each part is the way he/she is for a reason. Just as some neighbors are easier to get along with, some parts are easier to accept, however they all have value and purpose. Develop a way to treat each part with compassion, to notice the suffering with a desire to help. Treat them with respect. The idea is not to make the parts go away, but rather, to decrease the pain. This exercise may take time to complete, in fact it may never be totally complete. In the same way you may never get to know all your neighbors at the same level of intimacy, you may get to know some parts better than others. Take time with each part, just as you would cultivating a friendship. Care about them; they are you.

In a journal use separate pages to depict each part.

1. Draw the part. Represent the part’s age and gender in the drawing. Include body posture and/or facial expressions. Can use symbols to do so such as an exploding volcano head for an angry part. Some parts may be underdeveloped and not have all these features.
2. Write with words or depict with pictures each part’s thoughts, needs, wishes, preferences, roles (including introjects, personalities, emotions (including numbing), values/agendas (such as protect the child, or don’t let anyone take advantage of you), or behaviors (such as procrastination)
3. Indicate how these parts can be triggered, if you know.
4. Write with words or depict with pictures each part’s body sensations, other relevant sensations such as images, scents, sounds, tactile.
5. Indicate, preferably with pictures, where the part lives, )e.g. Huddled in the corner. A house with many rooms. A room separated from the other parts.) These images are helpful because they can be change therapeutically to increase inner safety and communication, for example installing intercoms in the house for a part separated from the others, or giving a warm blanket or stuffed toy to a child part huddled in the corner.
6. Memories of each part depicted in symbols and pictures.
7. Some of these parts might be incomplete, or internalizations of someone else (e.g. a grandmother who criticized or a mother who experienced shame when abused.)

It may be helpful to ask the part questions by writing them with your dominant hand then having the part answer with the nondominant hand.

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Parts Work – A compassionate, relational approach

Once when I was planning on going to an EMDR workshop over the weekend and I was amped about it my organizer part took over. I used my excitement energy to dedicate long hours to tying up loose ends at work and home in order to free myself to have complete focus on the workshop when I got there. After about four days of this fervent productiveness I was walking into my office and noticed a heaviness in my heart.  I knew that my body was telling me of a sadness within, but I knew enough to not ask myself why I was sad. Instead, I went into my office, settled comfortably into my chair and asked my parts who was sad (with my eyes closed to activate the areas of my brain responsible for self-awareness – the mohawk line along the top of the brain). I was surprised to hear from a part that I was not acquainted with, a little old lady decades older than my present age. I asked her why she was said and she said that she was tired and just wanted to rest. Then, I asked if any other parts wanted to pipe in on this and waited in an active listening state a few minutes until a very young infant part said she was tired of being “dragged around” and just wanted to rest as well. Being at work and limited in my opportunity for resting I told them that I had twenty minutes before my next client and that I could spend that time deep breathing and meditating. I asked them with compassionate caring if that would be enough. They both said, “yes” aware that I had every intention of doing more if they needed me to because they are parts of me. The heavy heart was gone completely after allocating that time to care for my parts. Upon reflection, I realized that parts, like children, need to be seen and heard. Sometimes connecting in a compassionate, caring way is half the solution when parts are conflicted, as it was in this case. As a result of this experience I thought about how to share what I learned with clients.

1. If you notice that you are upset, find a quiet place and do a body scan. Close your eyes and bring your awareness, starting from the top of your head and working downward to your toes. If you notice any tightness, tension or unusual sensation, stop and focus on that sensation in your body and ask which of your parts needs attention, “Who of you needs my attention right now?” Then wait with patient compassion as you would a child who was struggling for words to tell you about a problem he/she was having. Just be there for a while.
2. An image of your part may appear or just the emotion. If it’s just the emotion, validate it, “I hear the trouble that you are having. That’s really hard.” Ask who it is that is having the difficulty.
3. Ask what the part needs from you after the part(s) lets you know what the difficulty is about. Ask what you can do to help with reassurance that you are there for him/her, “How can I help?” If the part doesn’t know, make suggestions, starting with the least interfering with your life at present and incrementally to the most you can possibly do with the attitude that you will do whatever it takes because you care. Negotiate when necessary. The parts that are not angry will not want to disrupt your life any more than necessary. The angry parts may need gentle boundaries with assurance that you care because he/she is part of you.
4. Do what you said you would do and check in afterward to see if everyone is okay. If not, repeat the process.
5. At first you may feel a bit overwhelmed giving your parts all the attention they need. But giving them what they need helps integrate them.

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Parts – Developing a Core Self

What is a core self?

In the center of the inner system there is something that is different in nature from the parts. This is the place from which we can observe our parts. It is the subtle center of ourselves. The core of our being. When we are in the Self we can see ourselves and others through the kind eyes of nonjudgement, a loving bemused observer, very present to our own inner state, and to other people we encounter. In this state we are aware of our wholeness.  In this state we are either passive witnesses or active doers, whichever is called for, and in this state we seem to know clearly what it is we are to do. We are able to observe the parts and not be taken over by them.

Self is both an individual and a state of consciousness.

Characteristics of the Self include:

Functions of the Self: The ability to step back from the feelings of parts and get some distance from the engulfing emotions. Helps parts transform into their natural function. The conductor of the orchestra of parts. The main menu of computer software of parts. When caught up in a part or parts, you can reset in the Self (sometimes the reset is a timeout, sometimes going to sleep.)

How to get into Self:

Meditation practices and spiritual traditions can help.

Meditations:

Receiving Guidance (Holmes, Holmes, 2007) (To be done after a generic meditation)

• You may notice somewhere a special place that seems made just for you where you can sit and relax even more deeply….If you like, you may approach this place and sit down or lie down…..You feel comfortable but alert, knowing that here is a place where you can invite your source of guidance to be present…
• You gradually become aware of a source of guidance; you sense a wise and loving presence… the guide could appear in many ways; simply as a feeling that you should have, as a figure, a voice, or a light. Whatever the form, you should feel safe, cared for and loved in its presence….
• Allow your sense of this presence to clarify…. You have a feeling of being deeply understood and cared for….Become aware of how you can communicate with this source of guidance…..Make contact with it…..Perhaps it has a name?…. Let the source know you would like its guidance….Perhaps you have a question?…Do whatever you need to do in this place of peace and healing.

Getting into Self (Holmes, Holmes, 2007)

• At moments during the day, when you think of it, stop what you are doing for a minute, take three deep breaths and return to awareness, to Self. Some routine events can be signals for moving back from the parts toward the Self. For instance, Thich Nhat Hahn suggests that when the [phone rings you breathe three times before answering it. You can turn many routine events into opportunities to remember Self, such as getting into the car, turning the ignition key, stopping at a red light, or unlocking the front door. These can also be signals to stop, take a moment and step back into Self.

The Core Self Meditation (DNMS) (Schmidt, 2009)

• Think of a peak spiritual experience… maybe during meditation, prayer, yoga… maybe a time out in nature…a time when you experienced the characteristics/qualities of Self.
• In a very gentle, slow, and soothing voice, say: (Think about the above named special transcendent experience.) Close your eyes (if that’s comfortable) and take a deep breath. Now get in touch with the center of your being…..that place that is within you that is quiet…peaceful…and still. And in this place…it is possible that you will connect to your core self. Your core Self has been with you from the beginning…it’s the essence of who you are…your core of goodness. Pure…resilient…and whole. And your body knows exactly how to connect you. Notice as you connect to your core Self. Notice that good feeling. Let it get as strong as it wants to. Notice when it’s strengthened all the way. Once fully strengthened, do you have a mental picture of this core self, perhaps one of light or energy?

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Summers, R. F. & Barber, J.P. (2012). Psychodynamic therapy: A guide to evidence-based practice. New York: The Guilford Press.