Getting Past Your Past

 

For those of you who read this blog, you will know I start EMDR treatment this week for my Complex PTSD.

In order to follow my progress it may be useful to know a bit more about what I am letting myself in for therapeutically.

Below I simply use excerpts from a great paper by Dr Shapiro, the originator of EMDR treatment who explains more eloquently than I can how EMDR works in freeing oneself from one’s past, suggesting perhaps that the negative “voice” of the past, but which stalks our living present,  talks to us via unprocessed memories from the past.

This makes sense to me because without memory we cease to be our SELF. It seems reasonable to suggest then that ironing out the temporal  wrinkles of the traumatic past by physiologically re-experiencing them in EMDR therapy will free us from maladaptive influence they have on our self perception and for them naturally to be replaced by more adaptive and realistic views of ourself as reflected by our relationships with significant others and via our life achievements.

The negative voices of the self are neural ghosts which still haunt us because they contain emotional and cognitive information in memory networks – previous experience became stuck like ghosts in the machine and by reprocessing these memories to disentangle their emotional grip we can safely exorcise these neural ghosts from our representations of self.

Borne in trauma, these responses were the responses often of children to trauma, they were traumatised responding to traumatising events.

They are out of kilter reactions to these events which colour present responding to everyday events although these events are no longer traumatising in themselves.

Previous events continue to colour our emotional responses to others and to ourselves. The critical voice that previous events were somehow our fault continue to live in negative critical self talk.

In other words we continue to be re-traumatised in our reactions to the world and ourselves. The voices of the child traumatised is the voice we still hear in our minds as adults. We still listen internally to a traumatised child’s voice in leading us in our responses.

It is not dificult to see how this becomes maladaptive and pathological. We are acting on cues from the past rather than seeing reality in the present as it is.

The past exercises an influence in us via these memory networks – when they are reprocessed and embedded in long term memory, replaced with more adaptive memory of who we are now then the past exerts less of an negative influence in the present. And we begin to heal in the present having gotten past our sometimes traumatic pasts.

That’s my take on the theory anyhow.

Here’s Shapiro’s take on it.

“EMDR is a comprehensive psychotherapy approach that is compatible with all contemporary theoretical orientations. Internationally recognized as a frontline trauma treatment, it is also applicable to a broad range of clinical issues. As a distinct form of psychotherapy, the treatment emphasis is placed on directly processing the neurophysiologically stored memories of events that set the foundation for pathology and health.

The adaptive information processing model that governs EMDR practice invites the therapist to address the overall clinical picture that includes the past experiences that contribute to a client’s current difficulties, the present events that trigger maladaptive responses, and to develop more adaptive neural networks of memory in order to enhance positive responses in the future.

While clinicians from the various psychological modalities agree on the symptomatology of the well-known disorders, their ways of conceptualizing and treating them differ as a result of the specific theoretical paradigm to which they adhere (Barlow et al. 2005). For EMDR (Eye Movement Desensitization & Reprocessing), this paradigm entails the view that psychopathology is based on memories of earlier disturbing experiences that have been incompletely processed by the brain’s inherent information processing system.

Incomplete processing means that a disturbing event has been stored in memory as it was originally experienced with the emotions, physical sensations, and beliefs fundamentally unchanged. Regardless of how much time has elapsed or whether the person remembers it, the memory remains unaltered and provides the basis of current responses and behaviors.

Most mental health professionals would agree that current clinical issues are based at least in part, on previous life experiences. However, the hallmark of EMDR therapy is the emphasis on the physiologically stored memory as the primary foundation of pathology, and the application of specifically targeted information processing as the primary agent of change.

The Adaptive Information Processing (AIP) model (Shapiro 1995, 2001, 2002, 2007; Solomon and Shapiro 2008) guides the clinical application of EMDR…

EMDR’s three-pronged approach of past, present and future guides the clinician in identifying and processing, (1) the relevant past experiences that inform the client’s problems in the present; (2) the ongoing present experiences that continue to trigger maladaptive responses to current life demands; and, (3) templates of future actions to optimize the client’s capacity to respond adaptively given the current context of their lives. This article provides an overview of both the theory and practice of EMDR as a distinct integrative psychotherapy approach…

EMDR processing can eliminate the dysfunctional emotions and physical sensations inherent in the memory itself changing the client’s experience in the present. Similarly, the processing of pivotal memories has been reported to result in the normalization of attachment style in adults and children (Madrid et al. 2006; Kaslow et al. 2002; Wesselman 2007; Wesselmann and Potter 2009). It is important to emphasize that memories of even ubiquitous events appear to set the foundation for a wide range of pathologies…

… its overarching goal is to achieve an alteration of the underlying condition that is generating the dysfunctional response in the present as part of a comprehensive treatment effect. These outcomes are achieved by placing memory networks and information processing at the center of both treatment and practice.

Adaptive Information Processing Model

The theoretical foundation for the therapeutic application of EMDR is the Adaptive Information Processing (AIP) model developed by Shapiro (1995, 2001, 2002, 2007)…

According to this model, and consistent with neurobiological findings, one identifies and makes sense of new experiences within the context of existing memory networks. In addition, the information processing system functions to move disturbances to a level of adaptive resolution. What is useful is incorporated, what is useless is discarded, and the event serves to guide the person appropriately in the future…

when an event is not fully processed, the experience remains stored in memory with the emotions, physical sensations, and beliefs that were part of the original event. As a result, the memory is not integrated with other memories that were successfully processed. Consequently, when a similar experience occurs in the future, perhaps involving an authority figure like an insulting teacher, it triggers the unprocessed memory, which then automatically colors the perception of the present experience.

When clients seek psychotherapy for current problems in their lives, they are often focused on their symptoms as the problem. Consequently, the clinician wants to understand what the client is actually experiencing in the present, i.e., negative thoughts and feelings, uncomfortable body sensations that are out of proportion to the situations that are triggering the negative responses. Additionally, similar to other approaches such as psychodynamic therapy, the EMDR clinician seeks to identify the relevant past experiences that are perpetuating the maladaptive patterns of response, resulting in the client’s clinical complaints. According to the AIP model, the pathology is not driven by the person’s reaction (e.g., belief, emotion) to the past event as is postulated in cognitive-behavioral approaches. Rather, the reaction itself is informed by the responses and/or perceptions inherent within a dysfunctionally stored memory or network of memories that are disconnected from networks containing adaptive information.

…Clients are often relieved to understand that their problems have a neurobiological basis, as well as the universality of their human experience as a counterpoint to the common belief that they ‘‘should have’’ been able to resolve their problems on their own. We suggest that the presence of these unmetabolized components of memory explains why clients will often describe their childhood traumas in the same kind of language and intonation they used when the event occurred, and demonstrate the emotions, postures and beliefs consistent with that developmental stage. They do not merely describe the feelings of shame and helplessness of the past, but actually experience these emotions and physical sensations in the present.

These unmetabolized components of memory are accessed in a systematic way during EMDR processing. The targeted memory that is ‘‘frozen’’ in time becomes ‘‘unfrozen,’’ and new associations are made with previously disconnected adaptive information related to survival, positive experiences, and one’s sense of identity…

…processing allows an unpeeling of the veil to reveal and then resolve the core emotional source of the imagery (Shapiro 2001; Wachtel 2002). As this assimilation occurs, new insights and emotions emerge and the earlier affect states and perceptions are generally discarded. With the foundation of the fully processed memory, clients are no longer subject to the same emotional volatility, distorted perceptions and intense somatic responses, and instead experience a new sense of self that is congruent with their current life situation…

The client’s experience is more informed by the present, allowing for greater flexibility in their reactions, thus increasing the likelihood of developing more adaptive patterns of response that are informed by the current context of their lives…

In addition, new memories can be successfully incorporated as the therapist assists clients to acquire the social learning necessary to fill in their developmental deficits. However, until the processing of the earlier memories is complete, the dysfunctional neural storage will hamper the desired personal growth…

While specific stabilization and affect regulation techniques may be effective and highly desirable in many cases (Schore 2003), the instability is often caused by the unprocessed memories that are contributing to the dysfunction.

The overall goal of EMDR, therefore, is to address the current problems of daily living by accessing the dysfunctionally stored memories that are being triggered by the client’s current life conditions, and engage the natural neural processes by which these memories are transmuted into appropriately stored memories (Shapiro 1995, 2001, 2007; Shapiro et al. 2007; Siegel 2002; Stickgold 2002, 2008; van der Kolk 2002). The end result is an assimilation of the new information into extant memory structures. When this has occurred, individuals discover that, while they are able to verbalize the event and what they have learned from it, they no longer experience the associated negative affects and physical sensations. It is this rapid form of learning (i.e., reprocessing) that is the essence of EMDR treatment.

If you link to this reference below it contains a case study of EMDR in practice.

Reference

  1. Shapiro, F., & Laliotis, D. (2011). EMDR and the adaptive information processing model: Integrative treatment and case conceptualization. Clinical Social Work Journal, 39(2), 191-200.

4 comments

  1. carolineturriff · January 11, 2016

    Good luck with your treatment with EMDR. I can totally vouch for it – it is one of the most effective, if not the most effective, type of therapy I’ve ever had. I had a nervous breakdown in 2013/14 caused by unprocessed C-PTSD which was caused by threats my mother made when I was a child leading me to think I would be murdered. The symptoms of the breakdown were compulsive OCD checking 10 hours a day. But once my recovery had started via medication and I went onto EMDR I achieved rapid progress in recovery from the OCD reducing it from many hours a day to a couple of minutes. We did this by focusing on the image of my mother’s rage filled face which was my visualisation of the trauma. I’ve had so many breakthroughs in my mental health because of the EMDR I have gone from someone who was genuinely crazy to practically normal all in less than 20 sessions. Although I have to say the 1st EMDR therapist I had was no good for me and I had to find another one. Your relationship with the therapist is crucial. http://bit.ly/1ER5cLY

    • alcoholicsguide · January 11, 2016

      thank you Caroline I really appreciate all this, it helps and is motivating and comforting to know it works. The therapist I am seeing also treated my wife for PTSD and saved her sanity at a time when we were running out of hope. I never went to see her in the intervening three years because it has taken me all this time to figure out what I got – I knew I had PTSD at least but my manifestations are different to my wife’s, mine is much more “complex” – C-PTSD still isn’t included in DSM diagnostics as they are usually a number of years behind the latest research. I used my own research skills over 6 years to finally get this far. I am nervous but eager to get on with it. It is strange someone in their late forties is still trying to get past his past but there you have it. I just have to accept that. Your posts have really helped Caroline and I would sincerely like to thank you for helping me with your experience and your comments. God Bless you. Paul

  2. Mark Davis · January 12, 2016

    God be with you Paul, or Higher Power. LOL. I’m 48 and only just now 2 years clean and sober, and hoping to start EMDR this year as well to address my C-PTSD. So you are not alone in many respects. Tis never too late to find peace. I am eagerly awaiting your writings to come, on your experience. I get heaps from your writings. I even recently gave a copy of your thoughts on Spiritual Malady to my GP (General Practitioner Doctor) to try to explain things I didn’t have words to explain. He’s been in practice 30+ years and he’s not had anyone diagnosed with C-PTSD before, let alone an open and honest recovering Alcoholic/addict, so I am opening his eyes to plenty, and now you are too. So keep it up. You will never know all the people you will help, but help them you have and you will continue to.

    I hope you are managing your expectations ok. Best regards from Down Under. Mark

    • alcoholicsguide · January 12, 2016

      God be with you too Mark. Thank you for your comments and encouragement, they all help! It is never too late to find peace indeed. For me I believe I have recovered enough to recover some more. It has taken a long time to realise that C-PTSD may be at the heart of it all. I think recovery has to deepen and progress as this condition of addictive behaviour seems to. I can’t rely on what I did yesterday to keep me sober today. Recovery has to continually develop or there is a danger of becoming stark raving sober. I was delighted to hear you passed my thoughts on the spiritual malady onto your Doctor. I have gradually convinced my own GP that it is a disorder primarily of emotion dysfunction which he reluctantly countenances now. His mind is more open than previously anyway – Doctors await new diagnostics and C-PTSD will not officially be a ICD-11 diagnostic until 2017 and probably longer for DSM so they are in the dark about a great many things. These means people like you and me are the vanguard. You educating your doctor is a continuation of what I hope to achieve via my research. To get a fuller understanding of what ails us, in doing so to also propose how to best treat us. We need to complement 12 step work I feel in individualized treatment plans. One size
      doesn’t fit all. Thank you for passing on the message – I do hope my writing helps, that is the point of it, to be of service to others. Keep up the good work yourself! LOL Paul

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