What You Should Know About EMDR

Have you ever heard of EMDR?

EMDR stands for Eye Movement Desensitization and Reprocessing. It’s a kind of psychotherapy that was developed in the 1980s by Francine Shapiro. Dr. Shapiro was walking outdoors in 1987

when she noticed that the distress she was feeling, related to upsetting memories, was lowered when she moved her eyes back and forth. She did further studies on this phenomenon, and eventually developed EMDR as the treatment it is today, as well as the Adaptive Information Processing model to explain how the treatment works. 

While EMDR is a newer treatment, it’s been shown to be incredibly effective in both research and in clinical settings. Many people experience a dramatic decrease in their distress level after EMDR therapy, and studies show it’s effective for many many mental health issues, including trauma, depression, anxiety, and OCD. 

How does it work?

The basic premise of EMDR is that our minds can heal wounds in the same way that our bodies can, but sometimes those wounds don’t heal correctly and cause pain long after the event in question. It’s almost like the painful memories and emotions get stuck. When this happens, we experience negative outcomes like trauma, anxiety, and other kinds of emotional and mental distress. Resolving these issues requires us to access and process these stuck memories and emotions, which happens through EMDR. 

EMDR offers a way to locate, access, and reprocess these stuck memories and emotions. The goal is to change the way the brain is storing these stuck memories so that they stop causing pain. EMDR treatment requires a clinician who is trained in EMDR, because the process of accessing and reprocessing traumatic memories is very sensitive. EMDR therapists have extensive training in the background of why EMDR works, and how to adapt it for different situations based on what the client needs.

What happens during an EMDR session? 

EMDR helps you to locate and reprocess traumatic memories, so it’s not something you can just jump into without preparation. EMDR has 8 phases, and each phase is essential, especially the phases where you work with your therapist to develop resources to help you during upsetting moments. 

• The 8 phases of EMDR are: 

• History & Treatment Planning

• Preparation

• Assessment

The first 3 phases are completed before reprocessing can begin. These phases are focused on understanding how EMDR can help the client based on their history, developing a treatment plan, building a rapport between the client and therapist, providing resources for the client to use in moments of distress, and deciding what event or memory to reprocess. 

• Desensitization

• Installation

• Body Scan

The next 3 phases are the reprocessing phases, where the client works with the therapist to access and reprocess the memory until they no longer feel distress around it. These phases include the bilateral stimulation that EMDR is famous for. Some clinicians will have you use eye movements, tapping, headphones, lights, buzzers, or tappers to direct the bilateral stimulation that allows you to access the memory networks that need reprocessing. 

• Closure

• Reevaluation

The final 2 phases help to build safety for the client as each session ends and begins. Each session will end with helping the client return to a calm state of mind, and each session will begin by checking back in to make sure that their distress level stays low around the reprocessed memory. 

Some of the phases go faster than others, and once you are ready to begin reprocessing, most of your EMDR sessions will be some combination of phases 3-8. 

What can EMDR help with?

EMDR was initially developed to help process trauma, and lessen the effects of PTSD, and it is an incredibly powerful way to treat trauma, including trauma from childhood or abuse. However, research has shown that EMDR can be helpful with a number of other mental health concerns, including: 

• Anxiety

• Depression

• Chronic Pain

• Dissociative Disorders

• Personality Disorders

• Addiction

• Eating Disorders

• Grief

• Self Esteem 

• OCD

EMDR is a treatment that can be used for children, teens, and adults. There are some situations where EMDR is not an appropriate treatment, so it’s important to check with an EMDR therapist to determine if it’s a good treatment choice for you. 

What are the benefits and drawbacks of EMDR?

One of the biggest benefits of EMDR is how effective it is as a treatment. Although it’s a newer treatment modality, there have been many studies conducted on EMDR that show it works. The data showed that EMDR was working for people before we even understood why it worked! Many organizations, including the World Health Organization, the American Psychological Association, and the US Department of Veterans Affairs recognize EMDR as an effective treatment for PTSD and other disorders.

Another major benefit of EMDR is that it doesn’t require a person to talk in detail about the distressing memories they have to reprocess them. EMDR does require you to focus on the memories, but you don’t have to put them into words. While focusing on the memories is definitely upsetting, it’s less intense than having to narrate or fully relive a traumatic memory. EMDR is also fully confined to the therapy session - you won’t have homework to do or be expected to process things on your own, everything will take place with your therapist, which can be appealing. 

Are you interested in EMDR? Our clinicians at Hope+Wellness offer EMDR therapy in our office and online. We serve the McLean, Great Falls, Falls Church, Arlington, Alexandria, and the greater Washington DC regions, as well as offering online services in DC, MD, VA, and all PSYPACT states. If you would like to talk to one of our therapists, please contact info@hope-wellness.com.

Listening to Your Intuition After Trauma

Trusting your intuition after something traumatic has happened to you can be extremely difficult. 

Oftentimes after trauma, we don’t trust ourselves at all. We feel a false sense of responsibility for what happened to us–like if only we had been on the lookout for warning signs, we could have prevented it. This sort of thinking can make us what is known as hypervigilant.

Okay, what is hypervigilance? And how does it impact our intuition? 

Hypervigilance is a state of extreme alertness, and often a symptom of PTSD. When you are hypervigilant it means you are constantly evaluating your environment for potential threats–and frequently responding to threats you perceive that may not really be there. In this state of extreme alertness, normal things that are not actual threats to your safety (physical, emotional, mental) are interpreted as threats, even if all they are is minor discomforts. 

This of course has a huge impact on your day to day experience. Experiencing this sort of endless hypervigilance can:

• heighten your anxiety

• make you feel physically more tense/sore/achy

• affect your sleeping habits

• affect your appetite 

So it is hard to live in a state of hypervigilance. It is basically like living, constantly in fight, flight or freeze mode. Recognizing that is an important beginning step as you heal: What you are doing takes so much strength, and even if others can’t see it, you deserve to have that acknowledged. Be kind to yourself through this process of healing, even if it doesn’t go as quickly as you would like it to. Anything you’re feeling is okay; whether you’re disheartened or frustrated or angry or sad. There is no wrong way to feel, but remember this is only temporary.

So, the first step to healing your relationship to your intuition after trauma is to promise to be gentle with yourself.

It will likely be a slow process, that will happen gradually as you work through what happened to you and do other healing work in therapy. Being hypervigilant will not disappear overnight, but you can begin to pay attention to your body's cues, to learn them and start to distinguish between fear and hypervigilance and your intuition or “gut feelings” again.

Getting in tune with your intuition again: 

Don’t rush it!  

After experiencing trauma there’s often an internal sense of “I should just get over it” or “it wasn’t that bad” or “I’m overreacting” or “I should be over it by now.” But none of these thoughts are true or helpful!  There is no timeline on healing, so there is no wrong amount of time for you to “get over” something. And it is always better to heal slowly than to sweep over something and leave the wound ignored or dealt with insufficiently. 

Change your goal.

The goal isn’t going to be figuring out what is fear and what is intuition at first. While eventually you want to be able to know when you’re being triggered so you can self soothe or get some support in the moment rather than react to every perceived threat (when there may not be one), to start that’s not realistic! It’s too many steps at once. 

Instead start by not focusing on whether your  feelings are rational or not or whether the danger you're feeling is "real" or "valid"–but noticing when those feelings pop up at all. It’s actually okay to protect yourself more than “necessary”–this is something many people struggle with. It is not your responsibility to live as though you haven’t experienced a trauma when you have. It’s just your job to notice your feelings thoughtfully and explore what they mean for you–and to keep yourself safe as you do so.  

The feelings you’re experiencing do have a real impact on you, so responding to that fear is perfectly normal. These extreme responses will come up more often than before but they will slow and settle as you heal. The point isn't to shut those reactions off but to learn to tune in and notice what you're feeling when you feel it

Notice what you’re feeling!

When instances like this(feeling triggered, responding to a perceived threat, etc.) come up, don’t try to shove your feelings away because they’re “irrational.” Instead, ask yourself: 

• What am I feeling?

• Where did this feeling come from?

• Was there something in my surroundings that triggered it?

• Where in my body do I feel this feeling?

Get familiar with your responses.

Eventually you will be able to distinguish between your intuition or “gut” telling you something, and your past trauma being triggered and putting you on high alert. Getting in tune with your emotional responses, and taking time to notice will help to facilitate this. 

Many people, even those who haven’t experienced something traumatic, struggle to tell the difference between their fear and their intuition. It takes time and practice to be able to recognize which one is speaking to you. A general rule of thumb is that if it is your intuition, it will provide a feeling of calm groundedness, whereas fear and hypervigilance feel emotionally charged, urgant, and focused on uncontrollable what if’s. 

If you’re looking for more support as you heal your relationship to your intuition after experiencing a trauma, one of our therapists can help support you. Contact us today!

What are Coping Skills and Why Do I Have Them?

What are Coping Skills and Why Do I Have Them?

Have you ever heard the term “coping skills” and wondered what that means? Coping skills are pretty popular these days as a buzzword on social media and health websites. There are lots of great tips out there on how to use coping skills, but it’s harder to find information out there about what coping skills are and why we develop them in the first place.

Coping skills are strategies or tools that you can use to manage stressful or distressing situations. Coping skills let you decrease your level of stress and handle difficult emotions in a way that maintains your sense of internal order. 

Most of us have coping skills in one way or another - getting through life is hard, and we all need ways to support our journey.

Coping skills or strategies are a way to manage stress both in the moment and long-term. Stress can cause all kinds of negative problems, like irritability, heart problems, and sleep disturbances. 

Coping skills offer options for getting through moments of distress until you can find a safe place to process what’s going on. It’s not always feasible to feel and process everything you need to in the moment, especially when emotions are heightened. Coping strategies let you get through the moment until you’re able to find a safe place, like a therapy session, to unpack the situation. 

Coping skills come in two basic forms, problem-based and emotion-based. Some people also conceptualize coping skills as being short term, to get you through the moment, or long-term, to help maintain balance in your life. 

As the name suggests, problem-based coping skills come up when there’s a problem or situation that you need to deal with. Problem-based coping skills can also be useful for long-term coping. For example, if you find yourself chronically tired, a problem-based coping skill would be to develop a nighttime routine that works for you. It may take time to implement, but establishing the habit of getting a good night’s sleep can help prevent future stresses from overwhelming you. Emotion-based coping skills allow you to take care of your feelings when things are out of your control or when you’re overwhelmed in the moment. 

Someone who grows up in an emotionally abusive home would probably rely more on emotion-based coping strategies. Since the person being abused has no control over the abuse, emotion based coping skills can help them deal with the abuse until they can escape it. However, problem-based coping skills may be helpful to them when they are at an age where they can leave the abusive home. 

Here are some common coping strategies that people use to deal with tough situations: 

• Negative self talk

• Catastrophizing or other cognitive distortions

• Worrying

• Escaping through books, media, and imagination

• Self-soothing with alcohol, drugs, food, sex, etc.

• Compulsive behaviors like shopping or gambling

• Numbing out with alcohol or drugs

• Getting too much or too little sleep

• Self-harm

• Reckless behaviors, like driving too fast

While all of these coping skills can provide relief in the moment, these are not all supportive habits in the long term. Sometimes, the coping skills we use to protect ourselves get out of control. This can happen when folks rely on things like substances to cope, for example. 

Lots of times, people refer to certain coping skills as ‘healthy’ or “unhealthy”, although more helpful terms might be supportive or unsupportive.

Many of us developed coping strategies to get through hard times, like trauma or mental illness. Those coping skills allowed you to survive. It’s okay if you had to use coping skills that aren’t supportive long-term. Whatever coping skills you’ve had to use in the past, they’ve allowed you to keep going to where you are today. There’s nothing to be ashamed of! 

Although the coping strategies you’ve used up until now  might not be ideal for you currently, you are don’t have to view them as unhealthy. You can instead decide that you’re looking for coping strategies that are supportive of where you are right now, instead of relying on ones that have gotten you to this point so far. You can even go so far as to thank your old coping skills for helping you stay alive until now. If you’re looking to find some new coping skills that are more supportive of where you are now, you have options. 

It can be helpful to have a list of coping skills ready to go for a time when you’re feeling distressed or overwhelmed. When you’re in the moment, it can be hard to think clearly, especially when you’re upset. Having a list handy helps take away the need to come up with ways to support yourself, so you can just jump right in to using your coping strategies. 

Here are some coping strategies that you may find more supportive long-term:

• Progressive muscle relaxation

• Grounding techniques

• Breathwork

• Meditation or mindfulness practice

• Taking a bath

• Spending time outside 

• Cooking or baking

• Being creative

• Gardening

• Gentle physical movement

• Playing with a pet

• Listening to music

• Drinking a warm beverage

• Reading 

• Setting boundaries

• Going to therapy

If you’re looking for more support as you explore your coping skills and establish new ones, a therapist can help suggest skills that fit your needs. Unpacking your history of coping skills with a therapist can be a helpful way to identify what’s working and what isn’t!