emdr therapy

EMDR From a Patient’s Point of View – Book Review

Every Moment of a Fall: A Memoir of Recovery Through EMDR Therapy. Carol E. Miller. Scaffner Press, 2016. 228 pp.

I was intrigued when the publisher invited me to review Carol E. Miller’s book Every Moment of a Fall: A Memoir of Recovery Through EMDR Therapy. I have been in clinical psychotherapy practice for a decade specializing in an evidence-based treatment initially utilized to heal trauma. Eye Movement Desensitization and Reprocessing (EMDR) was first developed in the late 1980s by Francine Shapiro. It has since grown into a widely known and sought out treatment for addressing a variety of mental health challenges.

I’ve had the honor of witnessing the recovery process of hundreds of individuals using this technique. I am continually in awe at the capacity people find during this treatment to recover from unimaginable events and difficulties. Whether one is dealing with the effects of a one-time traumatic event or the daily distress of growing up in an environment of violence, instability or victimization, I have come to believe deeply in a self-healing ability that is innate and that can be accessed by all of us. There is no reason for anyone to carry trauma through life. Growing awareness about the need for proper treatment is changing the way people are being diagnosed and making recovery a reality.

Miller’s book is a pioneer in conveying the patient’s point of view in EMDR treatment. Her story is timely as more than a decade of research on trauma is now manifesting in a push toward trauma informed care in most medical, mental health and substance misuse recovery centers across the nation. Miller chronicles her experience of using Shapiro’s EMDR protocol with a trained clinician. During the treatment, a patient holds a distressing memory in mind while the therapist guides her eyes rapidly back and forth. The hypothesis is that when the eyes move this way, as they do in REM sleep, a cross-brain wave pattern is produced that allows a person to both access memories of a trauma and process the emotions surrounding it. EMDR sessions can be very personal and I was curious to see how Miller would approach writing about her therapy.

Miller’s memoir details her experience at age sixteen of surviving a private plane crash, which was piloted by her step-father. In the accident, she was pinned in the wreckage for hours. Her parents were critically wounded. Her twelve-year-old sister was killed. Miller writes about her experience of using EMDR therapy in a compelling way that gives insight into her own struggles throughout her life as a result this event. Further, her story highlights many of the common factors people face when multiple traumatic experiences compound and are not treated appropriately.

Trauma treatment often starts with education. Often, the word trauma feels too severe or not applicable to people. Miller states this was true for her about the crash. She recalls that her therapist insisted, “Until you address that trauma… you’ll only get so far in any relationship.” She responds, “I’m startled to hear her use the word trauma. Nothing about my story feels traumatic. It’s just oppressive. Harder and harder to carry.”

After a traumatic event, a person is left to process both the direct experience of that event and the secondary impact of how it is handled by others. I find quite often that people experience their trauma in isolation; family members or others around them don’t know how to give the right support because they don’t understand the importance of treatment or don’t know how to talk about it and in worst cases, the events are outright ignored or denied.

Without adequate support or proper treatment, people remain confused about why events occurred and their responsibility in them. Miller describes her post-traumatic stress symptoms that started to develop after the accident and became pronounced in college. About those years of her young adulthood, when she should have been developing a healthy adult identify, she writes instead:

“I don’t sleep much…When I doze, I dream some variation of the same thing: I’m being chased through a dark house. Sometimes in the dream I find the door and escape, but when I run into the street I am hit by a car, the warm metallic taste of blood rising in my mouth.
I lose track of my parts, gone numb for days at a time. I can’t taste. I can’t hear birds or footstep or my own breath. Other days my ears ring and a shrill panic knifes high in my chest.”

PTSD involves “stuck” memories and part of what EMDR helps address are the negative cognitions a person develops in relation to themselves and the event. Most often, feeling responsible, at fault, or that the events happened because one is bad, unworthy or somehow deserved it can be why memories remain unprocessed by the brain. When left unchecked, these thinking errors trigger feelings that often result in unhealthy behaviors and interpersonal patterns. The memory becomes like a knot that the mind can’t untangle and process, constantly triggered by the current environment.

Miller’s experience also gives insight into what is called complex trauma, meaning there may or may not be one single traumatic event but multiple experiences of loss, fear or violence. Miller chronicles how through the EMDR process, she begins to remember earlier issues and is able to gain insight into how beliefs she developed about herself because of these prior incidents were exacerbated by the plane crash and by the way it was handled within the family. With the help of EMDR treatment, she is able to understand how these old negative beliefs and behavioral responses led to a series of unhealthy and abusive relationships, inability to achieve in her career and ongoing depression that kept her from leading a fulfilling life.

I applaud Miller’s achievement in conveying her EMDR process, which is often difficult for clients to put into words. Her story is courageous and gives insight into how she used appropriate resources for recovery and was able to move forward in life. Miller’s journey is one of hope for all who are curious about EMDR therapy or have been burdened by unresolved trauma and afraid to find the right support.

Winter Dreaming: Words Born of Stillness

This winter, the short days and long, dark nights felt at first like a luxury, like a warm blanket to curl up in and enjoy the turn inward. On cue with Candlemas or Imbolc, which is the halfway point between winter solstice and spring equinox and the first hint to start waking up for spring, I notice a restlessness starting; a sense that the night (and winter) will never end and I’m kind of over it.

My “Winter Dreaming” writing project has kept me focused this season. It has helped me stay true to my intention to consistently connect with my creativity amidst my busy life. Trying to be intentional and living a creative life everyday helps me deepen my own mindfulness and awareness practice.

I dedicated one full day a week to writing in nature over the summer and fall of 2015 (see blog posts titled Plein Air Writing Project to follow that adventure). The results were generative and rich for me artistically and noticeable in my increased energy levels, reduced anxiousness and a return of a sense of meaning to my endeavors.

In this winter dreaming, my creative writing efforts have been more restful and introverted in tone. What I found inspiring in nature during its summer expression and fall exhalation, I now find in quiet contemplation and letting my mind wander and wind itself through the seemingly endless nights.

I’m learning a good lesson: When it is quiet, let it be quiet and wait. 

This is the message of one my favorite books by Clarissa Pinkola Estes The Faithful Gardener: A Wise Tale About That Which Can

Never Die. It is a wonderful story about the possibilities born out of the quiet, empty, fallow times in our lives, which can either be experienced as deficient emptiness or rejuvenating space, and probably a mix of both. The cycle or rhythm of stillness is found on a macro level through seasonal changes and at a micro level each night as we sleep and wake. We can learn to trust nonactive states, knowing our energy for future endeavors is born here and will arise again and again. She says, “What is that which can never die? It is that faithful force that is born into us, that one that is greater than us, that calls new seed to the open and battered and barren places so that we can be re-sown. It is this force in its insistence, in its loyalty to us, in its love of us, in its most often mysterious ways, that is far greater, far more majestic and far more ancient than any heretofore ever known.”

If that is too right-brained for you, I’ve also found scientific evidence to support the benefit of focusing inward, of unstructured time spent in solitude. The book Wired to Create explores the creative mind. Authors Kaufman and Gregoire state, “Neuroscientists have discovered that solitary, inwardly focused reflection employs a different brain network than outwardly focused attention. When our mental focus is directed towards the outside world, the executive attention network is activated, while the imagination network is typically suppressed. This is why our best ideas don’t tend to arise when our attention is fully engaged on the outside world.”

So there it is— a scientifically proven, free ticket to slacking off a little bit, maybe a lot. A recent top 10 list of creativity enhancing activities includes: imaginative play, daydreaming, solitude, intuition, openness to experience, mindfulness and passion (feelings!).

During a recent “stay-cation” I had many small goals in mind; crocheting a hat, reading, going to yoga and meditating, cross-country skiing and preparing a few good meals. I had the fleeting thought the second day into my stay-cation that I should create a list of these activities so that I could efficiently get to them all. Luckily, I resisted this urge to be productive. I started the hat and unraveled it several times before I put it away. I read parts of many books. I skied a little bit a few times. I found that my meditation practice often ended in a nap and tried to stay compassionate with this rather than becoming frustrated.
There is something paradoxical and complex about our ability to be mindfully focused and to let the attention meander. Currently, I find I have to pull my awareness back from dream states often when I am in sitting meditation. Sleepiness is one of the five hindrances in meditation practice and I’ve been having a big dose of it. My remedy is to treat it as I would any other distraction; I label it (dreaming), apply compassion (it’s ok, you’re tired) and simply start noticing my breath again. Insight Meditation teacher Tara Brach encourages students of meditation to embrace obstacles or difficulties. I notice when I allow the sleepiness, it lightens a bit. This is how it is right now and so as Byron Katie suggests, I try to love what is!

Meditation Lessons I: Sleepiness

of this sleepy mind,
the instructing Lama says:
“keep your eyes open,
set your intention to be present”!
yellow walls and the smell of incense,
silence run over by traffic and rain,
until finally, the ending ring of the meditation bell.

I’m hesitant of this bareness
where even the winter branches
with their lingering red berries
under a microscope
become cells of water
then electrical impulses

and then nothing but the space in between

-Renee Podunovich, 2016

Fall Backward: Honoring the Call to Rest

When autumn first starts to yawn it is contagious and I begin to feel the invitation to slow down, unwind, retract my energy and attention. I start anticipating the sheer, bare stillness of winter solstice with relief. My body takes cues from the yellowing tips of leaves, the morning’s snappish air, the sunlight slipping away just slightly. The planet twirls and spins and this is why seasons change and when I am in resonance with these natural signals to decelerate, I typically find myself busier than at any other time of year. In past years, I’ve dreaded winter, resisted adjusting my pace and ended up SAD! This year, holidays and all, I’m resolved to claim my quiet space, to have meaningful inner dialogues and rest in the verdant dark.

Fall flew by for me. I had been intending to neatly wrap up my summer writing project. It was late October when I mentioned this to a friend who said, “Summer is over and so is that project! What’s next?” That last part was nice to hear. It told me she is confident that I will keep finding new inspiration, especially if I set that intention and keep it with me like a compass.

I visited Capitol Reef National Park in Utah shortly after that conversation. I spent three days hiking the dry washes of slot canyons, my attention merging and twisting through towering white and orange sandstone cliffs. In those narrow and silent spaces, I felt contained and safe. The dense yet luminous surfaces existed as a boundary between my need for solitude and the pressing demands of my life. I let the canyons do their formidable work of sentinels as I soaked up the last of the season’s warm sunlight.

While hiking Cohab Canyon I rested on a flat surface of a ledge. Sounds were unapparent, only slight movements now and then in the environment, which I was able to perceive only after settling into a deep inner stillness. It seemed absolutely essential to meet that motionlessness, something I couldn’t resist doing and had to honor. So I sat in meditation, blessed now and then by a nimble, easy breeze as it travelled through the sandstone corridor. That light wind was full of a coolness that felt like a blessing or a grace.

A ladybug (in the desert!) landed on my hand and when I put a drop of water from my bottle there, she drank it. She stayed for a few minutes in my palm and for a moment, she and I were both the center of the universe and nothing at all. The slight weight of her was a focus in the immense vacuum of the canyon, an anchor in the transcendence and transparency of self. She then walked to the top of my finger, spread her odd shell-like wings and flew off.

Remembering that moment calms me still— has imprinted a sense of safety and connection in my consciousness just as the waters and time engraved these strange spaces in the land.
After my meditation, I found a pool of rainwater, hidden beneath the ledge where I had just rested. It explained the increased activity of birds, lizards, chipmunks and ladybugs I had begun to notice in this part of the canyon. Tiny tadpoles were gestating in the leftover rain and I wondered at how we had all intuitively constellated around that tiny pool of life-giving water.I mostly marveled at how I ended up in the mix— grateful for some wisdom in the body that resonates automatically with the elements and the seasons— amazed again and again each time I realize I am wholly interconnected and alive and aware.

a pool of rain
but sensed by all
the pressure of the desert
<an arid lack & willfullness of water>
yet here are hundreds of tadpoles
a flurry & commotion deep in the silence
where my eyes have adjusted
to this unperceived world, now
I am swimming in a puddle
in the bottom of (what was) the ocean
in the galaxy at night
from my dark and spacious winter dreams
I’m gathering words
reminders of our connection,
of our past and our future
together, friends
(and all beings everywhere)
-Renee Podunovich, 2015

Oranges or Rain: Choices in Perspective

When it rains, it pours. Or so the saying goes. Life gives us too much sometimes. When it rains, I’ll go to the garden anyway. I’ll sit indoors at the Orangerie, a light filled space housing walls of plants and potted citrus trees and which is filled with the scent of Neroli from the orange blossoms.

In the rain, the fragrance garden smells divine. The bees sleep on petals, their business slowed by the cool, damp air. In the rain, an umbrella becomes a miracle of invention, colors saturate— the hues and shades are pop art. Light reflects on puddles and dances freely.

Today in the rain, I contemplate silver linings. Did you know that beyond its sharp, biting leaves, thistle flowers have the most amazing fragrance? Like this, is there meaning to our suffering? Is there an opportunity in crisis?

Famous psychiatrist and holocaust survivor Viktor Frankl states, “Everything can be taken from a man but one thing: the last of the human freedoms— to choose one’s attitude in any given set of circumstances, to choose one’s own way.” –Man’s Search for Meaning

He witnessed first hand the unusual and cruel circumstances of Nazi concentration camps, and describes how some people would still choose kindness, compassion, dignity. For example, giving away already inadequate rations to help someone perceived as worse off. They refused to be dehumanized by inhumane acts. They chose a different storyline than despair.

“But is there really any meaning or do we make it all up?” ask you postmodern thinkers. Creating narratives from the events of our lives, including finding meaning in hardship, is a defining feature of being human. Whether they are “true” or not, choosing what course that narrative takes, especially during difficult events, is empowering and shifts us away from hopelessness and despair. It is the choice that is empowering.

Resiliency means “to bounce back” and one way to do this is to keep finding a way back to what we do have control over: our thoughts, feelings and actions in any given circumstance.
I believe the silver lining in hardship IS our ability to find one. For example, I have been most open-hearted during times of immense grieving and clients tell me the same. Suddenly I am aware of the fragility of life, of another’s pain, or the delicate and fleeting beauty I may tend to overlook.
There are so many cliches about getting through bad times; what doesn’t kills you…, when life gives you lemons…, adversity is your friend, etc. These cognitive strategies are meant to keep us going. We can also ask, “Where do I have control? What can I change? What can I accept and let go?” And can all the rest of it just remain a mystery—unknown and fantastic?

Silver Thistle
when rain & wind
become a chill on skin,
leave the bees to sleep on purple thistle flowers
& go to the Orangerie
with its potted trees, blossoms & oranges.
the smell of Neroli fills the humid air—
let this fragrance console you.
Find that fragrance now.
Don’t settle for just an orange
with out considering the mystery
of waxy blooms that fill a space with joy.

-Renee Podunovich, 2015

Let it Be: The Ease of Mindfulness

“It’s crowded today,” I say to the woman at the front desk.
“Oh, that’s because two busloads of school kids just arrived. I hope they won’t bother you.”
They might, they might not. So far, their vitality is contagious and I feel grateful that there is an opportunity for them to enjoy beauty, to be loud and a little wild. In the gardens they are even closer to their essential natures, not having to contain or modify what is alive inside. Their movement is natural— their gates unique, fluid and authentic.

I’ve learned over the last few weeks to let what happens in the garden do so as it will. The ongoing construction related to an expansion project, the weather, the bugs, etc. I don’t care anymore. I’m tired of being disappointed and exhausted by my own expectations and unrelenting standards. I find comfort in this mini-retreat experience each week, in getting a break from the daily grind and also from my own conditioned nature.
“To experience life directly, we need to receive the world, just as it is, in the empty, unobstructed field of fundamental consciousness.” – Judith Blackstone

When I am mindful of my five senses, let go of judgment and the need to change circumstances beyond my control, I come closer to my essential nature. When I focus on my “being” self rather than my “doing” self, I know I belong just as I am.

In those brief moments of being free from my own fixations and willfulness, gratitude washes over my heart. I can count on the effortless safety net of simply existing.
The more I “take the one seat in the center of life” as Jack Kornfield says, and the more I have faced hurts and healed from grief and disappointment, the more certain I become that I can always count on myself to handle life. The one seat of simply existing is always there and from that place I can tolerate witnessing pain; my own and the larger grief of our world.
In the best moments, I bring this trust to my daily life– my work, my relationships, my struggles and joys.

The fern garden still sleeps
loam damp, barely sunrise–
red rock is square,
round stones are black.
The guide points it out as an example
of a garden designed to blend
into the natural landscape.
I’m trying so hard
to describe my falling-in-to-
but my words
are only shadows behind my pen
created by diffuse light waking ferns.

-Renee Podunovich, 2015

Build Positive Awareness: Remember the Good Feelings

“I’ve been able to show that fear closes down our minds and our hearts, whereas positive emotions literally open our minds and hearts… they really change our mindsets and our biochemistry” –Dr. Barbara Fredrickson, Professor of Psychology, University of North Carolina

In my counseling practice, I encourage clients to bring awareness to positive states of mind in equal proportion to their difficulties and distress. It is important to draw on all available resources in difficult times, and being able to tap in to inner resources is a valuable coping skill. In this series of blog posts, I will focus on specific, practical skills for increasing awareness of positive states such as happiness, safety, calmness, compassion and connectedness.

In the book “Buddha’s Brain: The Practical Neuroscience of Happiness, Love & Wisdom”, Dr. Rick Hanson states,“When you change your mind, your brain changes, too.” Brain research shows that “mental activity actually creates neural structures” and those can be formed around positive or negative ideas. Furthermore, we can be involved in that outcome.

One way to feel more optimistic, especially during difficult times, is to Imagine Past Positive States. This means that when we focus on good memories, positive feelings arise and can be enhanced to help us feel better in the present moment. Even if the positive experience was brief, the positive emotional content exists in the memory.

We often think our memory exists in our “minds” but a faster way to access memories and associated positive emotional states is through body memory. Somatic therapies that focus on integrating mind/body awareness, such as EMDR therapy, can be effective in building what I call “inner strengths and resources”.

In fact, an introductory period of building inner resources is an important step in helping people address the more difficult emotional content related to trauma. In order to effectively process distressing emotional memories and not become overwhelmed, it is important that a person be able to experience feelings of safety, confidence, and the ability to relax and calm down when distressed. This is achieved by direct experience of such positive feelings, using memory and visualization, and is enhanced by the bilateral stimulus of the EMDR therapy.

Practice: Imagine Past Positive States & Enhance Them

Remember a time when you felt safe, relaxed and calm. Thinking of a specific place might help conjure these feelings or remembering a past event. With your eyes closed, give your mind time to bring up an appropriate image. Don’t worry about getting it “right” or that it may not “make sense”.

Using visual imagery skills, start to observe the scene in more detail, noting colors, sounds, whether you are alone or if there is a positive presence there with you. As the scene becomes more vivid, start to find a few positive words that describe the place such as “safe, calm, relaxing”.

Using somatic awareness skills, start to notice sensations in the body such as tingling, heaviness, warmth, coldness, tightness or tension. Notice how body sensations change as you focus on the positive memory. You might notice your tension lessening and a sense of relaxation and calm arising.

Once you feel the positive state, enhance it with the EMDR technique developed by Lauren Parnell of “resource tapping”.  To do it, tap your fingertips to your knees, alternating from one knee to the other, to create bilateral stimulus. This alerts both hemispheres of the brain to take note of the positive feelings, thoughts and body sensations and is “a clinically recognized system for tapping both sides of the body to release emotional and physical distress, build resilience, aid in healing, and calm the body on a deep physiological level.”

Find out more about “Boosting Positivity Ratio” at the Action for Happiness website.