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

2 Responses

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