Monday, April 24, 2017

The Magic of EMDR: How Sarah Gained a Newfound Understanding

I’ve been using EMDR for many years now.  An initial skeptic, I’m now a firm believer of its capabilities.  I’ve been impressed by this treatment's effectiveness in uncovering deep wounds and unconscious self-blame time and time again. Often, difficult life experiences or trauma can leave us with an unreasonable sense of responsibility as well as self-doubt. Part of EMDR’s effectiveness is not only in examining those faulty assumptions, but in understanding the body's states and emotions that accompany them. Usually, these are unconscious states with high reactivity and a stuck pattern. EMDR can reduce this reactivity so that new patterns and new self-assessments can occur.
Image Credit: North Boulder Counseling

Recently, I saw Sarah. She was referred after having tried several different treatment approaches. For the last couple of years, she found herself unable to drive to new locations. If she was familiar with a location, she was fine, but panic ensued if it was someplace new. Even thinking about it felt overwhelming. She found herself avoiding activities and making excuses for not attending outings with friends, work get togethers, and invitations to unknown places. Her life was becoming more and more restricted.   
After we did a history, we uncovered several upsetting incidents related to driving. We chose a couple to target. The one I thought would be most traumatic, an angry husband fed up with her fear and purposely driving into oncoming traffic, was not on the top of her list. Instead, it was something that seemed much more innocuous-- getting lost in a subdivision.  It was this experience that held all the energy and caused panic. Most of us know the frustration that comes with getting lost in a labyrinth of winding streets, but for Sarah, it brought on a panic attack: narrowed vision, heart palpitations, shallow breathing, and trembling.
As we prepared the EMDR protocol, I asked Sarah to imagine this scene, being aware of her body and any negative thoughts. The feeling that emerged was “I’m not competent,” as well as shame and anger at herself for not being able to manage a seemingly simple situation. As we continued with the eye movements, something shifted, and a new thought emerged. This can happen, where a more salient thought bubbles up. This new thought was not about her competence, but instead her invisibility. When she called her husband for help, he was annoyed and refused to come to her aid since she couldn’t tell him where she was. It was a replay of earlier childhood experiences where she had been denied help.  
As the oldest of five, she had excessive responsibilities. Her parents were neglectful and put her in charge of her siblings, expected her to make dinners and babysit. On the few occasions she asked for help, she was told she could handle it. So, even though fearful, she stopped asking and developed a belief that her needs were illegitimate. When her husband refused to help her when she was lost, she had the same sense of being invisible. Being denied help when she was distressed and fearful exacerbated a sense of helplessness and self-blame. She needed reassurance and guidance, precisely what was absent in her childhood.
As we continued with more eye movements, her distress began to recede, and at one point, she could see herself upset but not immobile. Instead, she imagined going up and down the streets until she found the right location. At this point in the processing, she imagined a way to proceed and was no longer stuck in frozen fear, but had new energy and confidence.  
While initially not very believable, she settled on, “My needs matter and I can expect help when I need it.” Sarah rarely asked for help. Instead, she was the one who extended help.  If she was distressed, she found ways to distract herself that didn’t involve other people. Yet this new idea of her worthiness to be seen and cared about was gaining strength. After a few more sets of eye movement, her face began to soften and a smile emerged. “It still feels weird, but I like it.” Sarah had had so few life experiences of being able to rely on others, it was hard to believe it was possible. She was pleased by this idea, and could now see the legitimately of her needs and allow for more self-care and reliance on others.  

It’s hard to understand in advance what hidden experiences might impact our current functioning. Sarah herself was surprised that her early experiences of being denied help were behind her current driving aversions. She knew something was off, and had been diligently seeking help, but logically understanding that her fears were unfounded was not making things better. I believe the magic of EMDR comes from being able to tap into the unconscious patterns that stay locked in our nervous system and being able to unlock their power so that more adaptive patterns can emerge. For Sarah, her fear of driving to new locations has all but disappeared.

Thursday, March 9, 2017

How Do We Maintain Happiness?

Image Credit: Huffington Post

Just recently, I finished The Book of Joy by His Holiness, the Dalai Lama, and Archbishop Desmond Tutu. These two men provide such wonderful wisdom, sharing the same belief that joy or happiness come from within. This is something that few of us cultivate and something that which our materialist society insists can be found externally. The message we receive from our larger culture is that we will be happy when, and if, we have a bigger house, a better job, the right clothes or more money. Yet, these two men maintain that this is not where true happiness resides. It is not about acquiring more things or more money; These are not the sources of happiness. Nor is happiness solely reliant on self-interest. Rather, it is about taking care of yourself, and expanding that care towards others as well. It is about mindful living, emotional resilience and being generous towards others.

The narrator of the book sites a research study that I found very interesting, and in many ways, parallels the thoughts of the Dalai Lama and Desmond Tutu. Sonja Lyubomirksy discovered there were ultimately three factors that significantly affect happiness:

1. The ability to reframe our situation more positively

2. The ability to experience gratitude

3. To choose to be kind and generous


Reframing Our Situations Positively

How does one reframe a situation in a more positive manner? The Dalai Lama had to flee his home in Tibet because of Chinese aggression. How has he reframed this experience? It seems that, without minimizing the loss, he realized that in some ways it gave him greater freedom. He had more access to the people, could be less formal, could engage more with other cultures, and could broaden his knowledge and ultimately, expand Buddhism itself.  The Archbishop struggled through apartheid and came out believing that the struggle was worth the freedoms and equality Africans now experience. It gave him the opportunity to speak out, become a leader, and cultivate patience and optimism.They both serve as examples in how to reframe our own difficult experiences. We can each challenge ourselves to find meaning in our experiences, positive and negative. We can ask: What was there to learn and in what ways have we grown? How can our experience frame new ways of being in the future?This happens all the time when I work with clients. We process difficult experiences. Those that can accept their reality and find meaning, can move on. Others who struggle with denial or anger, get mired in negativity. If, without denying the harm done to you, you can also forgive others, you can free up enormous energy, experience more ease and create new opportunities for yourself.  


Gratitude

It is much easier to focus on the negatives in our lives than the positives. We are, in fact, primed to attend to negatives. Our biological imperative is to survive, and we are wired to notice when something is amiss. That’s the job of our fear center, the amygdala, on alert 24/7, constantly checking to see if danger is near + if we’re safe of not.   Of course, we need it, but it does skew things. In response, we have to consciously account for the positive things, so we can balance out the negative appraisals that happen automatically.   This can helps us have a more realistic appraisal of our experiences. I find it helpful to acknowledge the things I’m grateful for first thing in the morning. Or, you might like the morning gratitude prayer of Thich Nhat Hahn which one of my friends often recites. I think making this a routine practice gives us more lightness and genuine appreciation for all the ways our lives harvest ease and privilege.  


Choosing to be Kind and Generous

I think the biggest obstacle to being kind and generous is the tendency to see yourself as a victim. To then feel your anger/unkind gestures are justified because of someone else’s behavior. While people do act in ways that are unthoughtful or unkind, let that be a statement of their character. We can realize it’s not about us, not our faults. We can feel what we feel, because something hurtful has happened, but learn to be thoughtful about our responses. I think it is that, a moment of pause, that allows us to consciously choose to be kind. A long time ago, I read a statement by Dr. Wayne Dyer that has stuck with me: “When given the choice between being right or being kind, choose kind.” This is something we can all aspire to practice.