Individual Therapy
While we are all part of systems, such as our families, and are influenced by them, we are also unique individuals. We each have particular life experiences, positive, negative or even traumatic. We have our own combination of temperament traits, as well as patterns of relating and expressing ourselves.
Child Therapy
It is within the family that children develop their sense of safety, security and self confidence. When a child is in crisis the whole family is affected. Seeing parents in order to gather information is my first step in trying to understand a child's puzzling behavior. Unusual behavior is often a child's way of trying to tell us something important. Understanding a family's history allows me to problem solve with them so that together we can shift family dynamics to allow the child to engage in more desirable behavior.
Sometimes behavior changes may be caused by a traumatic event. Children can even experience ordinary events as trauma. As a result of trauma, real or perceived, a child might exhibit unusual aggression, or withdrawal or phobias, or a new avoidant, or obsessive, behavior. Traumatic experiences can shift our nervous system, which can make children hypervigilant or fearful. When this is the case, I use EMDR to help children relieve the tension in their nervous system and restore emotional balance. While it is hard to face scary material, being able to use imagination and go at their own pace creates a sense of safety for children that makes EMDR non threatening. I have often seen dramatic changes occur in only a few sessions of EMDR: fears disappear, sleep problems resolve, and play and peer interactions return to normal.
Trauma and EMDR -- Eye Movement Desensitization and Reprocessing
Why I do EMDR
While I am a traditionally trained psychologist, and look critically at new therapy techniques, I became interested in EMDR because of the positive results reported by trusted and experienced colleagues. After looking at some of the research on the effectiveness of EMDR, I decided that there was enough evidence that this method was offering something new and valuable that might my benefit my clients. I therefore decided to become trained in using EMDR. I completed Level I in 1996 and Level II in 1997. I become a Certified EMDR practitioner in 2000. Certified requires ongoing continuing education in the practice and theory of EMDR.
While I do not think that EMDR replaces regular therapy, I find it a valuable addition to the tools and techniques I can use in treating clients. Here is some information that might help you determine whether EMDR might be something you’d like to consider.
What is it?
Eye Movement Desensitization and Reprocessing, or EMDR, is a powerful psychotherapy technique which has been very successful in helping people who suffer from serious and stressful emotional problems, for example: trauma, anxiety, panic, disturbing memories, and post traumatic stress. EMDR is considered a breakthrough therapy because of its simplicity and because it can bring quick and lasting relief. EMDR does not involve the use of drugs or hypnosis. It is a simple, non-invasive patient-therapist collaboration in which healing can happen effectively.
How does it work?
No one knows how any form of psychotherapy works neurobiologicaly, or in the brain. However, we have reason to believe, based on current research, that EMDR has a direct effect on the way the brain processes information. The EMDR technique uses, a natural function of the body called rapid eye movement, or REM. Rapid eye movement occurs naturally in the brain during sleep. Scientific research tells us that the rapid eye movements during sleep mean that the two sides of the brain are processing a person’s daily emotional experiences. This normal information processing helps us resolve ordinary stress from our day. When experiences are beyond a normal level of stress, they overload the system and resolution does not occur. Instead, the disturbing material gets locked in only one part of the brain, which causes full processing to be disrupted. When this happens we see symptoms such as nightmares, flashbacks, hypervigilence, heightened distress or avoidance of all triggers reminiscent of the original distressful experience. These symptoms indicate incomplete processing. EMDR acts to reengage the brain to finish processing the stuck memories. Research indicates that the eye movement patterns of EMDR activate both sides of the brain, which allows the brain to finish processing the stuck memories, and to return to normal functioning.
What is an EMDR session like?
First, the therapist works with the client to identify a specific stressful experience as the focus of the treatment session. Next, the therapist asks the client to recall feelings surrounding the experience, as well as any negative thoughts, body sensation and memories. The therapist then holds her fingers about eighteen inches from the clients face and begins to move them back and forth like a windshield wiper. The client tracks the movements as if watching a ping pong match. The client is asked to focus on the disturbing experience,and notice whatever comes to mind without making any effort to control direction or content. Sets of eye movements are continued until the memory becomes less disturbing and is associated with positive thoughts and beliefs about one’s self; for example “I did the best I could.” During EMDR clients may experience intense emotions, but by the end of the session, most people report a great reduction in the level of disturbance.
What is the advantage of EMDR?
After EMDR processing the client can recall the troubling incident without the earlier high level of distress. The client can experience the stressful event as a distant memory, rather than as a stressful trauma that is either avoided or actively relived. Thus, the client’s responses-mental, emotional and physical can return to normalcy and health. EMDR makes it possible to gain self-knowledge and perspective enabling clients to choose their actions, rather than to feel powerless over their reactions.
Who discovered EMDR?
In the late 80's, psychologist Francine Shapiro, Ph.D., observed that particular eye movements reduced the intensity of disturbing thoughts in some clients. Dr. Shapiro decided to study this effect scientifically. In 1989, she published an article in the Journal of Traumatic Stress, describing her success using a method she called EMDR. Since that time, other therapists around the world have contributed to its development. EMDR has evolved into a highly effective technique that incorporates elements from other various treatment modalities.
Are there studies that show that EMDR is effective?
Fourteen controlled studies of EMDR make it the most thoroughly researched method ever used in the treatment of trauma! A recent study of individuals who experienced rape, military combat, stress, loss of loved ones, disasters and serious accidents, found that 84-90% had relief of their emotional distress after only three EMDR sessions. Another study showed that EMDR was twice as effective in half the amount of time of traditional psychotherapeutic care. Another study of subjects with post traumatic stress revealed that the significant improvement they gained with the EMDR treatments were maintained for at least 15 months. Although some people have dramatic responses in a short period of time, others will progress more slowly. However, the results will be equally effective and long-lasting. Since the initial medical study in 1989, world-wide research has helped EMDR develop and evolve. To date, more than half a million people have benefited from EMDR therapy. Further references can be found at the Association’s web site,www.emdria.org. EMDR was approved as an effective treatment for PTSD by the American Psychiatric Association in 2004; the Department of Veterans Affairs and the Department of Defense in 2004.
What problems are helped by EMDR?
Studies to date show a high degree of effectiveness with the following conditions:
- trauma
- fears
- anxiety
- childhood trauma
- phobias
- physical abuse
- sexual abuse
- rape
- victims of violent crimes
- post traumatic stress
- depression
- overwhelming fears
- panic attacks
- low self-esteem
- performance and test anxiety
What type of training does a therapist need in order to use EMDR?
Only practicing, licensed psychotherapists, psychiatrists, social workers and counselors may receive EMDR training, or to use EMDR therapy with clients. A clinical background is necessary for proper application of the EMDR technique. This is a highly specialized method that requires supervised training for therapeutic effectiveness and client safety.
Is EMDR right for me?
One or more sessions are required for the therapist to understand the nature of the problem and to decide whether EMDR is an appropriate treatment.
A typical EMDR session is 60 to 90 minutes. The number of EMDR sessions required depends largely on whether the trauma was an isolated incident, or a chronic pattern. EMDR is considered a short-term therapy. Effective resolution can often occur in as little as 4-6 sessions.
Relationship Therapy
Even the best relationships encounter difficult times. While things often work out, at other times we can't quite get back to normal. Life stresses, disappointments, misunderstandings or unresolved conflicts can all erode positive bonds. For many couples life challenges have gotten in the way of prioritizing and nurturing the relationship. Perhaps sharing responsibilities has created tension, or old wounds still linger and need to be addressed.
Family Therapy
Ideally, healthy families provide a source of support for all members, and create bonds of loyalty that last a lifetime. Sometimes, though, families face challenges that strain those bonds and make them function less effectively. Frequent moves, job loss, health crisis, parental discord, sibling conflicts, life cycle transitions, step parenting, parental anxiety or depression, or a child with special needs, can all challenge a family's optimal functioning.
Exploring family dynamics together is a positive way to ensure that every member grows and develops optimally, and that family sharing and closeness includes all members.
Family of Origin Sessions
Sometimes I suggest to clients that I conduct a Family of Origin session. When we agree that it would be helpful, clients bring in their parents and siblings to therapy sessions to discuss their early history together. The families we grow up in hold special meaning for all of us. Our history begins in our families, where we first learn our patterns of relating. A Family of Origin session can provide a concentrated time to reflect and share each person's unique experience of those earlier times. In the ordinary course of our lives, however, it is rare though that we have the opportunity as adults to sit down together to discuss this joint history.
Family of Origin sessions are conducted in two 2 hour sessions, and are most often held on consecutive days to accommodate out of town visitors. The client and I will have prepared in a one on one meeting for the joint session.
For many years I was a co therapist with Dr. James Framo, who originated this intergenerational model of family therapy. Dr. Framo, along with Ivan Boszormenyi-Nagy, edited one of the earliest texts in family therapy,Intensive Family Therapy (Brunner/Mazel, 1965).
