EMDR and pwPD's...

[Depression = 72% of members]

Anyone have experience with their pwPD and them receiving EMDR?  Mine starts tomorrow and was wondering what to expect.

[bruceli]

Anyone have experience with their pwPD and them receiving EMDR?  Mine starts tomorrow and was wondering what to expect.

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[Cat Familiar]

I don't have BPD, just a touch of OCD, but I've had EMDR. (love all the acronyms) Some Ts do it with tapping, some with sound using headphones. I'm sure there's other modalities too, but when I had it about 10 years ago, those were the common ways of doing it.

Basically it was very relaxing. I was asked to think of the issue I wanted to work on and then my awareness was directed from left to right through tapping. Then I was asked to assess my reaction to the issue and it was diminished somewhat. The process was repeated and again I was asked about my response, which now had greatly diminished.

I did it for a couple of issues, and I've now forgotten what they were. I think one of them might have been a fear of heights and the other one was some childhood incident where I might have been self-conscious about something--whatever it was, they obviously no longer are problems for me.

[takingandsending]

Hi bruceli.

My uBPDw is also receiving EMDR. Here's a link to a post that I made asking your very question. One of the respondents was an EMDR therapist. My wife has been receiving treatment for the past 4-5 months, and it definitely is helpful. It is really important that the therapist have the skill and sensitivity to know when the actual EMDR treatment is appropriate and when the person needs to build their foundation/safe place. We have been lucky in that regard.

Hope this helps: https://bpdfamily.com/message_board/index.php?topic=232015.msg12484494#msg12484494

Wish you and your pwBPD great luck and success.

[maxsterling]

My wife is going through EMDR.  This is her second stint with it.  The first stint ended when the T decided she was too emotionally unstable for EMDR after she got into a verbal altercation with the leader of a group therapy she was also in.  The second stint - I am not sure if she has actually started the EMDR, but from what I know, the T is new, fresh out of school.   My worry is that this, too, will end badly.  It just seems to me that she still is not emotionally stable enough, and that she shouldn't be doing something like EMDR without some other kind of talk therapy at the same time.  Right now the EMDR therapist and our MC are the only therapies she is in.   

[takingandsending]

Yes, Max.

I agree with your concerns. I have them too, but we lucked out with a really experienced and skilled T. From that link that I posted on EMDR, the therapist even stated that the therapy is broken down into foundational phases and EMDR phase, followed by a kind of recovery/safety phase. If the foundation isn't present, then it may cause further dissociation/disordered response.

bruceli, I think it's important to encourage your partner to ask to go at a pace that is okay for her.

[Patti Jane Levin PsyD]

I'm a therapist who uses EMDR as my primary psychotherapy treatment and I've also personally had EMDR therapy for anxiety, panic, grief, and “small t” trauma. As a client in my opinion, EMDR therapy worked extremely well and also really fast. As an EMDR therapist, and in my role as a facilitator who trains other therapists in EMDR therapy (certified by the EMDR International Association and trained by the EMDR Institute, both of which I strongly recommend in an EMDR therapist) I have used EMDR successfully with panic disorders, PTSD, anxiety, depression, grief, body image, phobias, distressing memories, bad dreams, Dissociative Disorders, BPD, and many other problems. It's a very gentle method with no significant "down-side" so that in the hands of a professional EMDR therapist, there should be no freak-outs or worsening of day-to-day functioning.

One of the initial phases (Phase 2) in EMDR psychotherapy involves preparing for memory processing or desensitization (memory processing or desensitization - phases 3-6 - is often what is referred to as "EMDR" which is actually an 8-phase method of psychotherapy). In this phase resources are "front-loaded" so that you have a "floor" or "container" to help with processing the really hard stuff, as well as creating strategies if you're triggered in everyday life. In Phase 2 you learn a lot of great coping strategies and self-soothing techniques which you can use during EMDR processing or anytime you feel the need. There is a special EMDR protocol for dissociative disorders and complex PTSD. The treatment of trauma and dissociation with EMDR (or any therapy) requires special/extra training. Be absolutely certain the therapist has specialized training in DD, as well as advanced training in EMDR therapy. Neither EMDR nor any psychotherapy should go digging for memories. Memories are gone - may be buried/held in different parts - for good reasons. It's really a brilliant protection. Always talk with your therapist at the beginning of your work about what you already know is grounding for you.

In phase 2 you learn how to access a “Safe or Calm Place” which you can use at ANY TIME during EMDR processing (or on your own) if it feels scary, or too emotional, too intense. One of the key assets of EMDR is that YOU, the client, are in control NOW, even though you weren’t in the past, during traumatic events. You NEVER need re-live an experience or go into great detail, ever! You NEVER need to go through the entire memory. YOU can decide to keep the lights (or the alternating sounds and/or tactile pulsars, or the waving hand, or any method of bilateral stimulation that feels okay to you and your parts) going, or stop them, whichever helps titrate – measure and adjust the balance or “dose“ of the processing. During EMDR processing there are regular “breaks” and you can control when and how many but the therapist should be stopping the bilateral stimulation every 25-50 passes of the lights to ask you to take a deep breath and say just a bit of what you’re noticing, anything different, any changes. (The stimulation should not be kept on continuously, because there are specific procedures that need to be followed to process the memory). The breaks help keep a “foot in the present” while you’re processing the past. Again, and I can’t say this enough, YOU ARE IN CHARGE so YOU can make the process tolerable. And your therapist should be experienced in the EMDR techniques that help make it the gentlest and safest way to detoxify bad life experiences and build resources. Your therapist should also be using a variety of techniques to make painful processing less painful, like suggesting you turn the scene in your mind to black and white, lower the volume, or, erect a bullet-proof glass wall between you and the painful scene, or, imagine the abuser speaking in a Donald Duck voice... .and so forth. There are a lot of these kinds of "interventions" that ease the processing. They are called "cognitive interweaves" that your therapist can use, and that also can help bring your adult self's perspective into the work (or even an imaginary Adult Perspective). Such interweaves are based around issues of Safety, Responsibility, and Choice. So therapist questions like "are you safe now?" or "who was responsible? and "do you have more choices now?" are all very helpful in moving the processing along.

Grounding exercises are essential. You can use some of the techniques in Dr. Shapiro's new book "Getting Past Your Past: Take Control of Your Life with Self-Help Techniques from EMDR." Dr. Shapiro is the founder/creator of EMDR but all the proceeds from the book go to two charities: the EMDR Humanitarian Assistance Program and the EMDR Research Foundation). The book is an easy read, helps you understand what's "pushing" your feelings and behavior, helps you connect the dots from past experiences to current life. Also gives lots of really helpful ways that are used during EMDR therapy to calm disturbing thoughts and feelings.

For Dissociative Disorders, as with any complex PTSD/trauma, the "front-loading" of resources, and a phased treatment plan is essential. Please read the 2011 revision of International Society for the Study of Trauma and Dissociation (ISSTD) guidelines for treating adults with dissociative disorders available for free public download: isst-d.org/default.asp?contentID=49

Also good to read:

"Amongst Ourselves: A Self-Help Guide to Living with Dissociative Identity Disorder" by Tracy Alderman

"Healing the Heart of Trauma and Dissociation with EMDR and Ego State Therapy" by Carol Forgash

There are other kinds of Resource Development strategies that can be used depending on the skill level and experience of your therapist (Google "Resource development and installation" and find articles by Janina Fisher, Debbie Korn, and/or Andrew Leeds, ask about John Omaha's AMST - Affect Management Skills Training, or the Imaginal Nurturing protocol).

Many organizations, professional associations, departments of health of many countries, the US Dept. of Defense, and the VA, all have given their "stamp of approval" to EMDR therapy. There are over 24 randomized studies (plus over a dozen non-randomized) of trauma victims, and an additional 24 studies have demonstrated positive effects for the eye movement component used in EMDR therapy. Such as:

American Psychiatric Association (2004). Practice Guideline for the Treatment of Patients with Acute Stress Disorder and Post-traumatic Stress Disorder. Arlington, VA: American Psychiatric Association Practice Guidelines. EMDR therapy was determined to be an effective treatment of trauma.

Department of Veterans Affairs and Department of Defense (2004, 2010). VA/DoD Clinical Practice Guideline for the Management of Post-Traumatic Stress. Washington, DC. EMDR therapy was placed in the "A" category as “strongly recommended” for the treatment of trauma.

And significantly: the World Health Organization has published Guidelines for the management of conditions that are specifically related to stress. Trauma-focused CBT and EMDR are the only psychotherapies recommended for children, adolescents and adults with PTSD. “Like CBT with a trauma focus, EMDR therapy aims to reduce subjective distress and strengthen adaptive cognitions related to the traumatic event. Eye movement desensitization and reprocessing (EMDR): This therapy is based on the idea that negative thoughts, feelings and behaviours are the result of unprocessed memories. The treatment involves standardized procedures that include focusing simultaneously on (a) spontaneous associations of traumatic images, thoughts, emotions and bodily sensations and (b) bilateral stimulation that is most commonly in the form of repeated eye movements. Like CBT with a trauma focus, EMDR aims to reduce subjective distress and strengthen adaptive beliefs related to the traumatic event. Unlike CBT with a trauma focus, EMDR does not involve (a) detailed descriptions of the event, (b) direct challenging of beliefs, (c) extended exposure, or (d) homework.” (p.1) (Geneva, WHO, 2013)

[Cloudy Days]

My husband was doing EMDR for awhile and has some pretty severe trauma he was trying to work through. I began to dread the days that he would have EMDR because it seemed to leave him raw and very emotional. They were never good days for us. However it did seem to make him stop dwelling on what it was that he was working on once the day passed. he has several severe traumas in his life so it's a long process especially for him. I can't say that I look forward to him doing it again, he has taken a break from it for awhile. He was using vibrating pads he held in his hand because the other method seemed to be triggering his mind too much. My husband also got kicked out of group, but it was for sharing a little too much. He just started going to group once again. Keeping my fingers crossed he can handle it this time.

[Patti Jane Levin PsyD]

My husband was doing EMDR for awhile and has some pretty severe trauma he was trying to work through. I began to dread the days that he would have EMDR because it seemed to leave him raw and very emotional. They were never good days for us. However it did seem to make him stop dwelling on what it was that he was working on once the day passed. he has several severe traumas in his life so it's a long process especially for him. I can't say that I look forward to him doing it again, he has taken a break from it for awhile. He was using vibrating pads he held in his hand because the other method seemed to be triggering his mind too much. My husband also got kicked out of group, but it was for sharing a little too much. He just started going to group once again. Keeping my fingers crossed he can handle it this time.

Sounds like he could use a lot more of Phase 2 - resourcing! And using the pulsars, with eyes closed, is probably not a great idea. Better to keep one foot in the present which works best with eye movements.

[Cloudy Days]

I remember him talking about her trying to get him to go to a safe place or calm place. He was diagnosed with Brain Damage as well as PTSD and BPD, the doctor thinks his brain damage is causing him to have a hard time with the eye movements. he would get severe headaches afterwards and his mind would race to the point I couldn't be around him. Once he started using the pulsars he seemed to tolerate it better.