EMDR; Can it help generalised anxiety disorder
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Hi guys :-)
I have been referred to see a clinical psychologist for EMDR. I met him and he said he could make my memories better! But I suffer from phobias as a result of my childhood and I suffer now from generalised anxiety disorder because I have had anxiety for over 30 years. I manage my symptoms quite well but have never overcome my fears. I seem to suffer from a fear of losing control, linked to fears of becoming unwell. I am worried that EMDR may not be right for someone like me and could even make me worse. Anyone had any experiences or advice on this please?
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stephaney28634 star2sparkle
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jmcg2014 star2sparkle
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norabab star2sparkle
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We did revisit what happened to me when I was a child -- not just talking about it but imagining people being there and what to say to them - so I guess you need to be prepared to cope with that.
I hope you sparkle!
drpattijane star2sparkle
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One of the initial phases (Phase 2) in EMDR therapy 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.
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 therapy is that YOU, the client, are in control NOW, even though you weren’t in the past, during traumatic events and/or panic/anxiety. 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) 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 therapy techniques that help make it the gentlest and safest way to detoxify bad life experiences and build resources.
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.
Pacing and dosing are critically important. So if you ever feel that EMDR processing is too intense then it might be time to go back over all the resources that should be used both IN session and BETWEEN sessions. Your therapist can use 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.
I want to share a bit about the research and validation of EMDR therapy:
EMDR has been around since the late 80s and is NOT an experimental treatment or some kind of woo-woo thing. However, ask the hundreds of thousands of people who've been helped significantly around the world and they may tell you it is indeed a wonder-cure. It is considered a first-line treatment by organizations such as ISTSS (International Society Traumatic Stress Studies), the American Psychiatric Association, the American Psychological Association, the Department of Veteran Affairs, the Department of Defense, the Departments of Health in Northern Ireland, UK, Israel, the Netherlands, France, and other countries and organizations. I can't say enough good things about EMDR therapy. It's changed my life both as a person/consumer, and as a therapist. It's so satisfying to have someone come in for help and then to witness them get through their issues and finish therapy relatively quickly (compared to regular talk therapy, it's like night and day). I am both humbled by and grateful for this wonderful method that heals suffering.
There are 35 randomized controlled (and 20 nonrandomized) studies that have been conducted on EMDR therapy in the treatment of trauma to date. And more excellent research now on the role of eye movements, mechanism of action, and other Randomized Controlled Studies, not only on trauma and PTSD, but also on the use of EMDR therapy with generalized anxiety disorder, treatment of distressful experiences that fail to meet the criteria for PTSD, dental phobia, depression, body dysmorphic disorder, chronic phantom limb pain, panic disorder with agoraphobia, obsessive-compulsive disorder, and peer verbal abuse.
The Substance Abuse and Mental Health Services Administration (SAMHSA) is an agency of the US Department of Health and Human Services (HHS). This national registry (NREPP) cites EMDR therapy as evidence-based practice for the treatment of PTSD, anxiety and depression symptoms. Their review of the evidence also indicated that EMDR therapy leads to an improvement in mental health functioning.
The World Health Organization 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 aims to reduce subjective distress and strengthen adaptive cognitions 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." (Geneva, WHO, 2013, p.1) I was a member of the review committee for the World Health Organization (cited above) which examined evidence on a number of "standard" treatments for trauma, so I know how rigorous they were in making their determination for these guidelines.
star2sparkle drpattijane
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I suffer from generalised anxiety disorder but I do suffer from phobias too and also agoraphobia. However, I can't see how making my memories less traumatic is going to make any difference now. In my mind, I have already done that, come to terms with my past. It isn't as if when I am anxious, I am thinking about what happened to me when I was a kid or when I was raped, or anything. My mind is focused on how horrible I might be feeling because of the anxiety and what I can do to feel better. I do not think of any early memories (even though they are the original cause). I have already come to terms with what happened to me. It happened and that is that. I never focus on memories at all. So I just can't see how EMDR can help me. Can you enlighten me on this as you are an expert in this field. Also, what questions should I ask this psychologist to make sure that he is delivering EMDR properly, before I start with him? I really appreciate your thoughts.
drpattijane star2sparkle
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