EMDR and Headaches

On Friday and Saturday, May 1 -2, I spent  a total of about 14 hours learning to  treat headaches, specifically migraines, using a combination of EMDR techniques and simple, but effective, manual compressions of the head. I won’t go into detail here because it would bore you unless you are an EMDR provider 🙂

A fairly quick search  did not yield any videos of the process, but I suspect that there will be some cropping up as time goes on and the therapy gains support.

Dr. Stephen Marcus is the main researcher, writer, and presenter of the EMDR process for treating headaches. His work is well-researched, but is new enough that there have not been reams of literature yet to document its efficacy. I will tell you that my own observation and personal experience, both receiving and administering the treatment, was pretty impressive.

What I really like about the treatment is that no medication is necessary.  Now, that doesn’t mean we advise a patient to stop taking precribed meds. It simply means we have learned a treatment that is effective without medication, in the same way that EMDR itself is effective without medication. EMDR has been around since the early 1980’s, and literally hundreds of studies support its efficacy.

The only down side of the weekend was my poor, aching back.  I’m thankful for the pain meds that made it possible for me to sit through the two days; and part of the time, with Dr. Marcus’ approval, I stood in the back of the room to give myself some relief.  Tomorrow I’m having an MRI to evaluate for a herniated disc.  I’ll be very relieved to  know exactly what’s wrong back there, and from what I understand, a herniated disc isn’t the horror these days that it used to be. Non-surgical interventions are pretty effective.

So that was my weekend.  This blog should be back to normal tomorrow, when I’ll continue posting  in the book of Galatians, and getting back to my Friday Counseling Issues.

EMDR and Sexual Assault, continued

One of the saddest things to me, especially when it happens in Christian circles, is that victims of sexual assault are told to just be quiet, not say anything, especially don’t get the police involved because that would hurt the testimony of the church, and bring shame to the name of Christ.  Where is the concern and compassion for the victim? In my opinion, the real shame here is hiding the truth until it is found, often many years later, and paints ALL of Christianity with a very black brush.

Sexual assault is, in my mind, the most personal crime there is.  It is invasive at every level:  Physically, emotionally, mentally, and spiritually.  The victim is made to feel like the criminal (“What were you wearing?  Was it short/tight/revealing? Were you flirting? Why were you in a situation that could lead to rape? Did you scream?  Did you fight back?  We don’t see any marks or bruises, no buttons ripped off your blouse. Are you sure you’re not just trying to pay him back for dumping you?”) and sometimes the police interrogation and legal process are excruciatingly painful for the victim, while the perpetrator is seen as something of a hero.  Go figure.  I’ll surely never understand it.

So. Our miserable rape or other sexual assault victim has trauma at every level, and has very little help from friends, family, church, or society.  I’m working with a woman who was first molested as a little girl, by her sister’s husband. She was not helped in any way. The attitude was pretty much “just suck it up now and get on with your life. Don’t talk about it any more and eventually you’ll forget it.”

Wrong, so wrong. Her greatest need was to tell what happened over and over; to tell it to someone who was not judging her or accusing her.  So we’re doing that now, using EMDR, and she’s amazed at how much  of what happened is coming up as she retells the story.

One of the reasons EMDR is useful is that the client is in a very relaxed mode while “seeing” the incident mentally. My favorite tool is not the traditional moving back and forth of my hand while the client watches my hand without moving her head.  I find that people can develop migraines, if they are plagued with that horrible tendency.  Some become dizzy and uncomfortable.  Instead, I use a cool little device I call my tappers. The client holds a small disk in each hand. The disks are connected by wires to a small box that I control.  It sends a vibration alternately to each disk and establishes a very calming rhythm.  When I turn the tappers on, the client’s eyes are closed and she is “seeing” the event as if she were watching a movie.  When I turn the tappers off, my client relates what was just seen.  This process continues until the event has been completely relived.

We use a couple of scales to measure emotional and cognitive response to the process.  We don’t stop repeating the story until no more new information comes up, and both scales reach a final number. By that time, the client is typically so relieved and free of all the misery  that she is more than willing to tackle a different situation on her way to putting PTSD behind her.

Of course, what I’ve shared with you here is a very simplified description of a rather complex process

You can find certified providers of EMDR at http://www.emdria.org and following the search options. One of the things I like best about this process is that there are no pills.  The pain of the event is resolved not with psychopharm, but with facing the situation and repeating it over and over in a relaxed and safe setting.

I was looking at a video several days ago about treatment for soldiers who suffer from PTSD. It wasn’t EMDR, but the process was very similar.  Group sessions were held in which each veteran was asked to tell his story in as much detail as he could recall.  Painful, frightening?  Yes, at first. But with the repeated retelling, a measure of peace was found.

It takes a lot of courage to talk about what happened. In sexual assault cases, it takes a special kind of courage because the victim has been revictimized so often by our tendency to minimize the crime and maximize the blame onto the victim.

Next week, because of  some feedback I’ve received, I want to do a post on male victims of sexual assault and how it affects them both differently and the same as it does for women.

EMDR: How it Works

One of the primary keys to relieving the anxiety that comes with trauma is for the victim to talk about it.  The person needs to repeat what happened over and over again, and with the retelling, the emotions become more manageable.

Here’s a rather clinical video talking about why EMDR works.  You may find it a bit dull, but it really does a good job of describing the theory behind EMDR:

Here’s another one that talks about the way the brain reacts to trauma by creating habits of “fight or flight” that result in anxiety, depression, and PTSD.  I found it very interesting, if a bit long.

And with both these videos, I think I’ve given  you enough to think about today 🙂  We’ll continue the topic next Friday.

Trauma Therapy/EMDR

It’s Friday Counseling Issues time, and I’m going to a new topic.  Had more than enough of pornography!

I am a fully trained and certified EMDR provider.  I think tody I’ll tell you briefly what that’s about, and then we’ll talk about different kinds of trauma and PTSD (Post-Traumatic Stress Disorder).

When I was first introduced to EMDR, I thought it sounded like voodoo.  However, as I looked into it I became more interested and finally decided to get the training, which is intense and not inexpensive.  I have not regretted a minute of time or a cent of the money I spent to get the training.  It has changed my practice to having a more specific focus.  I still do other kinds of counseling, but trauma therapy has become my first love.

EMDR stand for Eye Movement Desensitization and Reprocessing.  That’s a lot of psychobabble for a relatively simple concept  The process itself is based on the knowledge gained from sleep studies, particularly with soldiers returning from Viet Nam who were deeply traumatized.  The best thing we had to offer them, really, was lots of medication.  Some of those soldiers are still in VA hospitals, never having regained their ability to function in “normal” life.

During sleep studies with these soldiers, the observation was made over and over that when they were in deep sleep (rapid eye movement, REM)  they were NOT experiencing flashbacks, night terrors, hallucinations or other symptom of anxiety. Rather, as long as their eyes were moving rapidly under their eyelids they were completely relaxed.  It was when they began to come up out of REM sleep that the symptoms began to reappear.

Francine Shapiro, who first developed EMDR, was a doctoral student at the time. She was working on a PhD in human behavioral psychology. She read about the studies in the VA hospitals, and wondered if it would be possible to put someone in that state of relaxation while they were awake, and asking them to relive their trauma while they were relaxed, then relating what they were “seeing” to the therapist.  Here’s a video that will help you get a better idea of the basic process:

This combination of relaxation and talk therapy has become very important in the treatment of trauma victims in all different kinds of situations, ranging from mass shootings to hurricanes and tsunamis, and including the attacks in 9/11.  There are EMDR providers who have agreed to be on call for emergency situations.  I would love to be able to do that, but I find my energy level and endurance just aren’t what they used to be.

My primary use of EMDR is in treating those who have been victims of childhood sexual abuse; adult sexual trauma including rape  or attempted rape; or victims of accident injuries and related trauma.  It’s pretty normal, when working with victims of sexual assault or childhood molestation, to find that there is either ongoing assault over a period of months or years, or multiple counts of assault by more than one perpetrator.  You can read more about this here: https://lindasbiblestudy.wordpress.com/category/counseling-issues/childhood-sexual-abuse-counseling-issues/.  You’ll need to scroll all the down to the bottom of the topic to get the whole picture.

The point of EMDR is to separate the negative emotional response from the event.  When you have an event happen that you do not want, did not invite, and cannot stop, then you also have a lot of negative emotion including fear, shame, dread, worthlessness and anger.  To separate the emotions from the event is to put the event into proper perspective so you can go on with your life minus the anxiety, hypervigilance, night terrors, and depression.

Okay, that’s enough for now.  Next week, we’ll do an overlook on trauma and its effects.

Childhood Sexual Abuse: Trauma Treatment

What you see above is a short news story describing the treatment I use to help victims/survivors of childhood sexual abuse (CSA).  It is not the only treatment, and it isn’t necessarily the best choice in ever single case.  However, it is highly effective and requires no medication.

EMDR stands for Eye Movement Desensitization and Reprocessing, which is psychobabble for a simple process.  Last week I suggested you go to emdria.org if you wanted to learn about this process.  What I’ll give you here today is a very simplified description of this treatment, which I have used very successfully with several CSA victims.

During sleep studies done on traumatized Viet Nam veterans back in the ’70’s and ’80’s, the connection was made to REM (Rapid Eye Movement) sleep and a state of deep relaxation.  During REM sleep, the traumatized veterans were not plagued with nightmares and hallucinations that destroyed their sleep, thereby increasing their dysfunction during the day.  These soldiers were victims of Post-Traumatic Stress Disorder (PTSD), for which there were very few treatments other than medication.

The connection to deeply relaxed sleep, a calm state, and the periods of REM led a human behavioral psychology doctorate candidate, Francine Shapiro, to enlist some of her classmates in a series of experiments.  She theorized that if she could help traumatized people get to that state of deep relaxation through the use of eye movement, then ask them to relive their trauma verbally, that perhaps the event could be separated from the strong negative emotion that caused so much distress.

That was the beginning of EMDR, which has since become the treatment of choice in the military. EMDR providers have been enlisted to help in major events such as the attack on the Twin Towers in 2001; the tsunamis, Hurricane Katrina, school shootings, and so on. People who survive these horrific events are often left to struggle with the symptoms of PTSD, including depression, nightmares, night terrors, hallucinations, hyper-vigilance, and extreme anxiety.

So why is it used for CSA?  Is that really a trauma?  Can’t people just get over it?

Any time you have an event tied to extremely negative emotion, you have trauma. We can’t erase the event or the memory, but we can help the person separate out the emotion so that the memory no longer interferes with daily living, or with sleep. It’s a fascinating process.  When I was first introduced to it, frankly, I thought it was baloney.  But after watching presentations, reading and studying what has been learned about the brain and stimulation of both sides of the brain, and taking the intensive training, I have to say that I’ve never found a more useful or successful way to help people deal with overwhelming anxiety linked to a trauma. It has literally changed the direction of my work, which now centers on helping victims of CSA.  Those who have stayed with me and done the work send me new clients, who in turn send me others.

The difficulty for me, of course, is that I hear such heartbreaking stories of abuse, betrayal, and the subsequent misery that accompanies CSA.  I’m thankful that for the most part I’m able to leave it all behind me when I leave the office.  Prayer and scripture are good for me, as well as for my clients.

Again, if you’d like to learn more about EMDR, go to http://www.emdria.org.  It’s the best internet source for accurate information.  Be careful about believing everything you may read on other websites. Some of it is just not true. Some of it is based on only a partial exposure to EMDR, and some of it is based purely on ill-informed opinion.  It always amazes me how people who have no idea what they’re talking about can speak with such authority 🙂

Childhood Sexual Abuse: Resources

Do you get this message?  It’s time to STOP being quiet about this issue!  If you could see the damage that I see whenever I’m working with a survivor of childhood sexual abuse (CSA) you’d be ready to speak up, speak out, do something to stop what seems to be a growing crime in our society. There is an ongoing debate about whether prevalence is truly increasing, or if reportage is increasing and seeming to show more instances.  I tend to believe more that the latter is true, simply because the nature of mankind is what it is.

I was listening to the radio on my way to work (I’m writing this on Thursday) this morning, and heard about the increase in the VERY active sex trade. The discovery of those three women in Ohio, their captivity and abuse right in a “normal” neighborhood, has helped to blow the lid off the fact that children and women are daily being taken and forced into a life most Americans wouldn’t have thought possible here in the good old US of A.  How naive we are, how ignorant, and how willing to turn our eyes away.

Even more appalling to me is that we sometimes tend to blame the victims.  That makes about as much sense to me as blaming the Africans, who were captured and shipped like cargo to our shores, for their own slavery.  What on earth are we thinking!

Last week I promised you a list of resources to help those who are struggling to heal from CSA.  Below you will find some books that I recommend, and two websites as well.  There are hundreds more out there if you take the time to search.

BOOKS:

Hush: Moving from Silence to Healing After Childhood Sexual AbuseBy: Nicole Braddock Bromley

Healing the Wounds of ChildhoodSexual Abuse I-II By: Lisa Harper

The Wounded Heart: Hope for Adult Victims of Childhood Sexual Abuse [Paperback] by Dan B Allender

On the Threshold of Hope: Opening the Door to Healing for Survivors of Sexual Abuse byDiane Langberg

Websites:

http://www.shbi.org/content/BibleLessons/studysheets/Abuse.htm

I also mentioned last week that I would share with you a therapy that I use for people struggling with trauma as in Post-Traumatic Stress Disorder(PTSD).  I think I’ll wait until next week for that.  It deserves a post all to itself.  Today, just a brief description of PTSD.
Symptoms: I’ve copied and pasted this section from the website of the National Institute for Mental Health, Symptoms of PTSD:
1. Re-experiencing symptoms:

  • Flashbacks—reliving the trauma over and over, including physical symptoms like a racing heart or sweating
  • Bad dreams
  • Frightening thoughts.

Re-experiencing symptoms may cause problems in a person’s everyday routine. They can start from the person’s own thoughts and feelings. Words, objects, or situations that are reminders of the event can also trigger re-experiencing.

2. Avoidance symptoms:

  • Staying away from places, events, or objects that are reminders of the experience
  • Feeling emotionally numb
  • Feeling strong guilt, depression, or worry
  • Losing interest in activities that were enjoyable in the past
  • Having trouble remembering the dangerous event.

Things that remind a person of the traumatic event can trigger avoidance symptoms. These symptoms may cause a person to change his or her personal routine. For example, after a bad car accident, a person who usually drives may avoid driving or riding in a car.

3. Hyperarousal symptoms:

  • Being easily startled
  • Feeling tense or “on edge”
  • Having difficulty sleeping, and/or having angry outbursts.

Hyperarousal symptoms are usually constant, instead of being triggered by things that remind one of the traumatic event. They can make the person feel stressed and angry. These symptoms may make it hard to do daily tasks, such as sleeping, eating, or concentrating.

Most survivors of CSA have some, if not many, of these symptoms; in severe, chronic cases, all the symptoms will be present to some degree. It’s an awful way to live.

Next week, I’ll tell you about EMDR.  In the meantime, if you’re interested, you can look it up at http://www.emdria.org.  I am a fully certified provider.  It is the most effective treatment I’ve seen for any kind of trauma.

More on Medication for Depression

There is a third class of antidepressants known as MAO Inhibitors, or MAOI’s.  You can read all about them here: http://pharmacist.hubpages.com/hub/What-Are-MAO-Inhibitors.

As with the others, the targets of this class of medication include serotonin, dopamine, epinephrin–all the so-called “feel-good” chemicals that the brain produces.

The question I’d like to address today is, “If depression can be treated without medication, then why take the pills?  Wouldn’t it be better to get to the root of the problem instead of just masking it?”

There are some assumptions in those questions.  I hear the questions a lot, because unfortunately, there is still stigma attached to taking medication for “nerve problems,”  or “emotional problems.” People of faith worry about depending on medication instead of God, believing that if they could just pray enough, read the Bible enough and deal with whatever their lack of faith is, they’d get better.  What follows is how I answer all that in my office, usually in a first or second visit with someone who is typically depressed, anxious, and embarrassed to be sitting in a “shrink’s” office.  This could take several posts to really get the job done, I’m not sure.  We’ll see!

So, let’s pretend you’re sitting in my office, we’re getting to know each other, and I’m seeing clear indications of depression.  The first thing I’m going to do is reassure you that you’ve made a good choice to find some help; that you certainly are not alone in your misery, and that it WILL get better. About this time, I will point out that there’s a box of tissues sitting right behind you on the back of the little sofa you’re sitting on.

Once you’ve told me your story, or at least enough to get us started, I’m going to ask you about the stressors in your life.  That question always gets me a wide variety of responses, from floods of tears to anger to uproarious–but sad–laughter. The reason I ask that question is that more and more clinical evidence is pointing to the reality that anxiety comes first, then depression.  Anxiety is just another word for fear.  Every single one of us deals with some level of anxiety at some point or points in our lives. It can stem from marital relationships, extended family, an obnoxious neighbor, illness, financial stress, job stress– to just about anything else you can think of. These are anxious times we live in, but that’s nothing new.  The folks who lived through World War I  thought it was Armageddon.  It was supposed to be the war to end all wars.  Those who endured through the Holocaust thought nothing could ever be worse, and then the atom bomb and nuclear warfare became something new to fear.

On a much smaller, but far more personal scale, most of us experience anxiety just in the routine of our daily lives, rarely thinking about the predictions of world-wide disaster.  The disasters at home are far more consuming. So you, sitting in my office, begin to tell me that you can’t sleep, that you often have sweaty, heart-pounding moments when you think you’re going to die; you can’t get a deep breath, you feel buzzy and faint, and then it passes and you’re terrified of the next attack.

Which takes us to a conversation about anxiety, panic attacks, anti-anxiety meds, and whether or not to use those meds. Please understand that not everyone who experiences depression will experience extreme anxiety and panic attacks.  It can be a part of the total picture, but it doesn’t have to be.  Sometimes, people who live with panic attacks have some deep trauma that has never really been addressed.  This can be Post-Traumatic Stress Disorder, common among military veterans and victims of childhood sexual abuse and/or rape; victims of natural disasters like tsunamis, hurricanes, and so on.  There are special treatments for this type of problem, including EMDR, which is a specialty of mine.  You can google it to find out more about it.

All right.  Just a quick note about anti-anxiety meds and then we’re done for today.  Here is a list of the most common medications:

  • Alprazolam (Xanax) – approved for GAD, panic disorder; used off-label for agoraphobia with social phobia
  • Chlordiazepoxide (Librium) – approved for anxiety (in general)
  • Clonazepam (Klonopin) – approved for panic disorder; used off label for anxiety (in general)
  • Diazepam (Valium) – approved for anxiety (in general)
  • Lorazepam (Ativan) – approved for anxiety disorders (in general)
  • Oxazepam (Serax) – approved for anxiety (in general)

GAD, by the way, stands for General Anxiety Disorder.   These medications are almost always prescribed “as needed” and can be helpful in calming you down if you suffer from panic attacks. Also, several of the common antidepressants are considered anti-anxiety as well.  Sometimes a physician will prescribe both, suggesting the anti-anxiety be used only when absolutely necessary.

And yes, I know there’s a lot of controversy about all this.  Be patient.  I’ll get there eventually!