Unfreezing the brain - recovering from post traumatic stress

Monday mornings are a morning of EMDR (Eye Movement, Desensitisation and Reprocessing), my favourite. As an EMDR therapist my job is to work with people who are struggling with PTSD (Post Traumatic Stress Disorder) – as a result of any kind of trauma: being in a war zone; rape; accidents; assaults; torture; really any kind of trauma that can happen to you as an adult. 1 in 3 people after a traumatic event can develop PTSD, it’s a horrible thing to have to live with – flashbacks to the events, nightmares about the trauma, feeling constantly anxious and like you’re under attack. Like a walking, talking burglar alarm, always on alert for danger. And sometimes not being able to face certain things related to the trauma e.g. can’t go to the place where it happened, and then this escalates and can stop you getting out of the house, can’t stay in your house… You get my drift. 

The clients I am seeing this morning don’t really fit the norm for our bread and butter EMDR work. The first lady I’ve been seeing for a couple of months and she’s doing really well, we’re almost done. As a result of a number of traumas through childhood and adulthood, she has a phobia of choking and hasn’t eaten solid food for six months, living off Complans, you know liquid food drinks. We’ve been working through a long list of ‘small’ traumas (these don’t feel small to her of course) and now cheesy chips and bacon are featuring prominently in her recovery.

Because life is never straight forward, this client also has checking behaviours (Obsessive Compulsive Disorder) and if I thought about it hard, would also fit the diagnostic criteria for GAD (Generalised Anxiety Disorder) and as we treat the traumas / phobia these other issues are also getting better. Working with this case has been an absolute joy for me, the client is so lovely, we have a good laugh although we are dealing with some difficult stuff and I get the pleasure of watching someone recover, enjoy eating again (what’s not to like about that) and also make other positive changes in her life.

So to EMDR. Eye Movement, Desensitisation and Reprocessing, it’s a bad title I know and it’s hard to spell. Let me try and explain what it is us EMDR therapists do. Most of the time your body copes with new information and experiences without you being aware of it. It is believed that this happens whilst we are asleep, particularly during rapid eye movement sleep. When something out of the ordinary occurs you can become traumatised by the event or by being repeatedly subjected to distress.

These experiences then become frozen in the brain and are stored in the limbic system, which is the primitive bit of our brain that deals with senses, emotions and it’s all raw. It’s the caveman / cavewoman bit of our brain – fight, flight, freeze. And when information gets stuck here – it gets re-triggered all the time usually with the symptoms of PTSD. I think of this bit of our brain as our downstairs brain (above the back of your neck). Your ‘upstairs brain’ is where we process information and experiences so they become a memory or part of our past, also known as the pre frontal lobe, (front / top of your head) which deals with reasoning, problem solving, emotional intelligence, all that kind of thing.

EMDRs job is to help move the information from a trauma from downstairs to upstairs in your brain, which given we normally do this whilst asleep, is a natural healing process. There’s some controversy at times in the world of psychology / research about how EMDR actually does work. I really don’t care, it just does and I get to see it happen.

We start off with a thorough assessment, then prepare for treatment. Then we ask specific questions about a particular disturbing memory and use either eye movements or theratappers (which buzz alternately in either hand) to replicate what happens whilst we are asleep. With repeated sets of this, the memory tends to change so it loses the distress associated with it and becomes a neutral past memory. Sometimes this can happen in one session, other times it takes longer but what is great is seeing people not only get rid of those negative symptoms of PTSD but also seeing positive benefits for clients in other areas of their lives as well. It’s a real privilege. 

Enough theory, my next client is struggling with Obsessive Compulsive Disorder (OCD) and I am seeing her as part of a research trial. She is doing well, although she has had OCD for years and years and years, not been able to work, and has been stuck in her flat, not seeing many people. She struggles to see sometimes how well she is doing and today was one of them days. I was (hopefully) top cheerleader today and she managed to achieve something in the session today, that in our first session she told me she could never even contemplate doing. Go Girl! 

Afternoon is being on duty for the service. Psychological Wellbeing Practitioners (PWPs) are on the phones taking self-referrals as they come in. My job is to be on call to give advice and support them in making decisions about treatment options etc., deal with any other new referrals coming into the service from other professionals, crisis calls, whatever. I think there’s a bit of snobbery sometimes from other professionals about PWPs, but I’ll tell you they do a really hard job really well and I’m always impressed by how good they all are on the phones.

Zoe Marsden – Senior Mental Health Practitioner and EMDR Therapist, Leeds Community Healthcare NHS Trust