Loosening the grip of PTSD A case example of PTSD treatment utilizing EMDR, Hypnotherapy and Cognitive restructuring

Exposure types of therapies such as Eye Movement Desensitization and Cognitive Restructuring have the best outcomes in the treatment of Post therapy. Exposure therapy might be good with an accident victim who is afraid of driving through an intersection. The therapy is combined with desensitization strategies and relaxation techniques so the person can safely visualize driving successfully through the point of an accident. However, with more complex PTSD cases related to long term abuse or with a person who has long term symptomology, exposure therapy could be dangerous.

I recently began using EMDR after beginning my training in this phenomenal approach. I also utilize ongoing clinical training from two mentors. One has been providing EMDR treatment for 20 plus years plus another who specializes in the field of clinical hypnotherapy in the treatment of trauma.  It was drilled into my head many years ago to constantly seek clinical training because the lives therapists serve are actually very fragile.

So far I have helped a few people along the way. In using any type of new approach my policy is to seek guidance from the experts.  EMDR is is no exception.  One needs to use caution any time a traumatic memory is explored. With EMDR images and memories emerge. It is like riding on a train gazing out the window as one’s life experiences pass them by. I’ve been a psychotherapist for 20 years and a PTSD survivor as well, so I am very cautious with every person I serve.

EMDR or Eye Movement Desensitization and Reprocessing is more than just an approach.  It is the belief of myself and others that EMDR is a successful means of treatment for PTSD and for those who are affected by unresolved childhood issues.

Trauma, critical childhood experiences, memories of abuse or neglect, and the associated feelings become stored in the amygdala part of the brain.  A scent in the air, the time of year, a simple taste or a sound can bring the experiences to consciousness often in the form of anger or fear! People who have been affected also tend to redefine who they are and what they can do. Irrational thinking errors and beliefs evolve, often affecting esteem, level of confidence and social, vocational and recreational functioning. An example of an irrational belief would be “I’m not important. I’m a failure, I’m defective or I’m worthless.”

Irrational beliefs can also evolve from something a person in authority might say on a continual basis. For example, I was never good at math but my high school algebra teacher made the statement, “I don’t know how someone could be so stupid and still breathe.” Another person I knew was a great baseball player in grade school. He won awards, etc.  then was assigned a coach who decided to single him out. The coach began to make fun of him and was overly critical of his every move. This person quit playing and never picked up a baseball bat again, truly believing he  had failed the game. Even though this wasn’t an obvious sign of abuse, it did have a lifelong impact on the person. EMDR and cognitive restructuring helps people challenge irrational thoughts and beliefs, to redefine who they are!

Traumatic or abusive events that resurface take over the emotional hemisphere of the brain and shut down the rational or intellectual part of the brain. By following the therapist’s fingers the eyes move back in forth as in REM sleep.  During REM sleep the eyes also move back and forth bringing up images or at times unresolved issues from the past.  Images or pictures from the past do come up! This becomes complex with abused or long term trauma folks, especially those who may have a tendency to disassociate.

With EMDR both the emotional and the rational hemispheres of the brain are engaged. This is a huge component of its efficacy to help the patient resolve childhood and traumatic issues. This is where the baseball player resolved what the coach had to say and began to play baseball again. This was an easy one. The case below was a little more difficult.

With this person’s permission, I am sharing what recently happened during a session with me. This person is a successful salesperson who is currently going through a divorce after 20 plus years of marriage. The person felt betrayed because their spouse was cheating and was flaunting that it is not against the law to cheat on a spouse. This person works and has always taken great care of the children. Their background included a lot of childhood neglect. Many years ago they evolved irrational beliefs: “Nobody loves me. Everyone else is happy except me. I’m not valued. I’ll never be happy.” I began to see this person for anger control issues. I’ve used hypnotherapy and Brief Cognitive Therapy addressing their belief system trying to build up their level of confidence, and relaxation exercises to reduce their anger.

Recently, this person presented for a scheduled session almost in a rage and was unable to focus or concentrate on work. An agreement to use EMDR was facilitated.  Following the protocol and from earlier sessions an imagined safe place evolved.  EMDR therapy began after the person calmed down utilizing some hypnosis techniques focusing on the five different senses of smell, touch, hearing, sight and taste. They were relaxed and experienced a childhood scene with feelings of safety and security. Having the person imagine their own personal safe place is key, as shown below.

Focusing on the scene from their past, EMDR began. After about 5 minutes feelings of anger began to evolve and the therapist redirected the person to their safe place. A few moments later the tears began and painful images of their childhood surfaced.  An image of a forgotten childhood birthday emerged. At this point, the person’s heart rate began to escalate and the EMDR was stopped. The person was led back into hypnotherapy using breathing and progressive muscle relaxation. Through hypnosis the safe place was imagined, heart rate returned to normal, and the person had the feeling of exhaustion. The process of restructuring beliefs into positives such as “My kids value me!” was processed with more EMDR. The disturbing feelings were contained while building on the person’s resources to handle any stress that might come up during the week.  This person left my office feeling emotionally drained, with no signs of anger and an irrational belief partially resolved.

The person later that afternoon returned to work and was able to complete all their tasks. Two days later, the person is experiencing a  continued state of calmness with no signs of distress. We have an agreement that if stress is experienced, they are to call my office at once.

EMDR is not magic. There is a lot of work left to do. Recovering from childhood issues is like peeling an onion, one layer at a time. That afternoon we chipped at just a piece of that layer. EMDR is a gradual safe process that has a proven track record when done according to protocol and with the right therapist who is properly trained in this therapeutic technique. It is not for the novice nor to be tried on oneself! Whenever any traumatic or childhood memory is explored it needs to happen in a safe place, in a safe way, and with a skilled therapist.

John Lee LMHC owns the copy rights on the above article

Resources for Veterans/Palm Beach County

Veterans Suicide Prevention Hotline 1-800-273-TALK, Veterans Press 1 The Department of Veterans Affairs’ (VA) has founded a national suicide prevention hotline to ensure veterans in emotional crisis have free, 24/7 access to trained counselors. To operate the Veterans Hotline, the VA partnered with the Substance Abuse and Mental Health Services Administration (SAMHSA) and the National Suicide Prevention Lifeline. Veterans can call the Lifeline number, 1-800-273-TALK (8255), and press “1″ to be routed to the Veterans Suicide Prevention Hotline.


VA: VA Benefits: 1-800-827-1000:

Beneficiaries in receipt of Pension Benefits: 1-877-294-6380

Education (GI Bill): 1-888-442-4551

Health Care Benefits: 1-877-222-8387

Income Verification and Means Testing: 1-800-929-8387

Life Insurance: 1-800-669-8477

Mammography Helpline: 1-888-492-7844

Special Issues – Gulf War/Agent Orange/Project Shad/Mustard Agents and Lewisite/Ionizing Radiation: 1-800-749-8387

DCoE Outreach Center (Defense Center of Excellence)
866-966-1020
Resources@DCoEOutreach.org
What we do: • Provide an authoritative source of information and resources on psychological health (PH) & traumatic brain injury (TBI) issues• Help service members, veterans, and their families by connecting them with the resources they need to promote their resilience, recovery, and reintegration• Compile in-depth information and tools related to a PH or TBI inquiry
• Assist service members, veterans, families, leaders, healthcare providers navigate the
system of care• Respond to information requests about the DCoE• Support the Real Warriors Campaign.
Who we serve: • Service Members• Veterans• Families• Military Leaders• Clinicians• Researchers• Educators• Support personnel• Chaplains.
Benefits of our Center:• Specializes in providing in-depth information and resources related to the spectrum of psychological health matters and traumatic brain injury, not available elsewhere• Brings in-depth PH & TBI information/tools to warriors, families, clinicians, leaders• Collaborative in approach, facilitates networking and partnerships among DoD, VA, federal agencies and community organizations• Augments existing military and federal contact center and services.  Our Capability: • 24/7 availability of our Health Resource Consultants (most have masters or doctoral level degrees and healthcare experience)• Respond by phone, email, instant messaging, chat, fax• Respond to specific research requests

VETS RESOURCE CENTER
7305 N. MILITARY TRAIL, BLDG. 6, WPB; 422-8262
Provides information and referral to shelters, halfway houses, case management programs, substance abuse programs, food and clothing pantries and showers..

Center of Hope
1577 N. Military Trail, West Palm Beach, FL 33409; (561) 682-1118
*** MALES ONLY *** This is not a homeless shelter, it is a comprehensive program and shelter is only one component. Homeless clients must be willing to make a commitment to end their homelessness. As such, only appropriate clients will be accepted into the program via Social Services. The Center of Hope offers transitional housing with support services: comprehensive substance abuse treatment services; mental health screening and services; anger management classes; GED prep and testing; Adult basic education; budget management; interviewing skills; life skills, employability classes and job search; case management; reintegration services; on-site NA/AA; off-site NA/AA; transportation (when appropriate); on-site spiritual activities (by client choice); transportation to Salvation Army faith-based programs (by client choice); client newsletter; other long and short term activities for client skill-building, relaxation, and socialization.

First Stop Veterans’ Resource Center
3175 S. Congress Avenue, Suite 304, Palm Springs, FL 33461; (561) 968-1612 Ext 13
Provides community reintegrating services to veterans. Services include: job readiness skills and assessment; job training/educational referral; VA/SSA benefit information; peer support group meetings; outreach and family counseling.

Hire A Hero
5245 College Avenue, Suite 408, Oakland, CA 94618; (866) 447-3243 or 866-HIRE A HERO
Internet Site: http://www.hireahero.com
Hire a Hero is an Internet networking website helping returning military personnel get a meaningful civilian job. Hire a Hero brings together military job seekers, military friendly employers and local people who want to help our returning military personnel get started with the rest of their lives as civilians.

MHA Veterans Programs
2695 N. Military Trail, #10, West Palm Beach, FL 33409; (561) 712-0584 or (866) 832-3755
MHA is part of the BrAIVe Coalition, a coalition working alongside the VA to to build network of agencies helping Veterans and their families. Services include the following: Veterans support groups are held weekly at Peer Place–A drop-in center. Peer place provides a safe and comfortable place for consumers of mental health services to learn essential wellness and recovery skills. This peer mentoring program employs nationally recognized strategies for helping people with chronic mental illness help each other achieve the best outcomes possible in their lives. Peer Place also offers supported employment, peer mentoring, a computer lab, wellness planning and support, hosts 6 and 12 step recovery meetings including: a Schizophrenics Anonymous Group, Other supports include art and relaxation activities, and group counseling support and assistance creating a wellness and recovery plan. MHA’s Mental Health Resources Database: Contains a list of agencies and support groups that offer help about mental health and wellness in the community for veterans. www.mhapbc.org

Local Veteran’s Facilities/Centers
West Palm Beach VMAC 7305 N. Military Trail, West Palm Beach, FL 33410-6400; (561) 422-8262 Provides primary and secondary level health care to eligible veterans in a seven-county area along Florida’s Treasure Coast. Comprehensive services include medical, surgical and psychiatric inpatient care and outpatient services in each specialty. In addition, extended care services offer community residential care, adult day health care, respite and hospice in addition to nursing home care.

Palm Beach Vet Center Spectrum Center 2311 10th Ave., N. #13, Lake Worth, FL 33461; (561) 585-0441 Readjustment counseling for eligible combat/ war zone veterans and their families. Individual, marital and group counseling with focus on war trauma; claims and benefits assistance; job referral and placement services; consultation with Department of Veteran Affairs medical facilities. Group sessions by available. Counseling may also be provided to those veterans who were sexually traumatized while on active duty.


Delray Beach Community Based Outpatient Program: 4800 Linton Blvd., Building E, Suite 300, Delray Beach, FL 33445; (561) 495-1973 Services Available: Primary care / internal medicine services; Care and management of chronic illnesses; Preventive healthcare screenings and evaluations; Nutritional consultation and evaluations; Outpatient nursing care and health education; Mental health assessments, screening, and therapies for a limited number of Mental Health diagnoses; Social Services assessments and referrals.


Stuart Community Based Outpatient Clinic  3501 S E Willoughby Boulevard, Stuart, FL 34997; (772) 288-0304 Services Available: Primary care / internal medicine services; Care and management of chronic illnesses; Preventive healthcare screenings and evaluations; Nutritional consultation and evaluations; Outpatient nursing care and health education; Mental health assessments, screening, and therapies for a limited number of Mental Health diagnoses; Social Services assessments and referrals


Vetsville Cease Fire House 291 N.E. 19th Avenue, Boynton Beach, FL 33435-2291; (561) 736-4325
To help disabled/homeless and hungry veterans by providing emergency residential lodging for $100 per week. No food nor transportation provided.