CNM 037: EMDR Therapy for Processing Trauma with Dr. Sara Gilman

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Did you ever wish there was some way you could organize your emotions better? For example, if you had something happen in your life that haunts you from time to time, wouldn’t it be great if there were some way to file it away? Give it it’s appropriate place in your life, and move on?

Well, as it turns out, there is!

According to the Eye Movement Desensitization and Reprocessing International Association, EMDR Therapy is the answer. Today we’re interviewing an EMDR Therapist all about what this is, and how it has helped millions of people move passed traumatic experiences.

Dr. Sara Gilman is a licensed Marriage and Family Therapist who has spent the past 32 years working in the areas of Traumatic Stress, Addictions, and Peak Performance.  She is the co-founder and President of Coherence Associates, a professional counseling firm, and has been awarded Fellowship status with the American Academy of Experts in Traumatic Stress for her extensive work in utilizing EMDR.

Sara was elected to serve on the EMDR International Association Board of Directors, is also one of their past presidents, a contributing author in two books addressing treating trauma in 911-Telecommunicators with EMDR Therapy, and has published research about utilizing EMDR with those struggling with the co-occurring disorders of addiction and trauma, in a drug court setting.

In addition, Sara lectures nationally and appears on radio and TV discussing the topics of stress, trauma, addiction, and mental toughness. She’s passionate about inspiring people to heal and grow through life’s challenges.

I hope you enjoy my discussion with Dr. Sara, so here’s the interview…

Interview with Dr. Sara Gilman on EMDR Therapy

Brian: Dr. Sara, welcome to the show. We’re so glad that you’re here today.

Sara: Thanks Brian.

Brian: I want to start with the obvious question. I’ve heard a lot about EMDR over the last several years. At first I had no idea what that meant so I looked it up and, frankly, I thought it sounded very unusual to say the least. But I kept hearing good things about it. In fact, I haven’t heard anything negative about it since I’ve learned, so I wanted to invite you on the show to talk all about EMDR.

Question: For those of us who don’t know what it is, what exactly is EMDR therapy?

Sara: Well, EMDR stands for ‘eye movement desensitization and reprocessing’.

It’s not new even though some people think it is. It’s a comprehensive therapy model, it’s integrated some different therapeutic approaches, and it’s been around since the early 80s. It’s also been one of the most highly researched psychotherapy methods. And it’s evidence-based now for PTSD (post-traumatic stress disorder). Globally, EMDR therapy has helped literally millions and millions of people in the world, and hundreds of thousands of therapists are trained now. So, it’s not just a magical technique. It’s quite a comprehensive therapy model.

Question: Can you tell us how it actually works, and why the research says it works? Can you describe what you’re doing during an EMDR therapy session?

Sara: Wow, those are a lot of good questions. You know, we really don’t know how any of the therapeutic modalities work in our neurobiology (in the mind and the body). But what we know about EMDR is the eye movement portion is about activating both hemispheres of the brain, similar to REM (rapid eye movement) sleep, so we have this innate hardware. Whoever created us put this really cool system in place for us, like a computer, to take in all this data that we experience every day and then process it and file it in an orderly manner. That’s healthy the information processing. That’s when our mind, body and brain are healthy

Sometimes traumatic or significant experiences happen in our lives at any age, and we do our best to file them. Sometimes they’re not filed well and can produce symptoms of stress, psychological distress or even physical distress. So, EMDR sort of activates that system to help process the information that the person is focused on, to get it to file in a place that’s more efficient and isn’t causing the ongoing distress in the system.

Brian: If I can sum it up a little bit, you’re using eye movement to help the brain process potentially traumatic experiences. Is that right?

Sara: Right.

You know, we experience things what I call ‘holigraphically’, and that’s how we remember them. Sights, sounds, smells, visuals and feelings in our body and physical manifestations. So, if something’s not filed well, one of those is still hanging out like an image or a body sensation (like a flinch). So, when you activate the system to finish filing that, it’s sort of like it re-digests it in a way so that is no longer swirling around and causing any kind of distress. I like to use the computer analogy – when you feel like you’re not running efficiently, like you’re ‘buffering’ and you’re just not on your game, and there is something in the way – EMDR can reboot the system to reconnect and refile information that you don’t need to be experiencing.

It doesn’t delete the memory, you can still remember. It’s just that when you remember something that used to cause you upset, you simply remember it without the upset.

Brian: Considering the audience that is listening to this show right now, the thing that we have in common is we’re dealing with codependency issues, and a lot of times that’s brought on by traumatic experiences in younger years. About 20% – 25% of our audience suffers or has suffered from narcissistic abuse and there are various traumas that other folks may have endured.

Question: How do you know who is a good candidate for this type of therapy?

Sarah: That’s a great question. I do want to say personally, right when you’re texted me originally I was really taken aback by your blogging and your podcasts because I used to be the queen of codependency. Due to my own EMDR therapy I have been demoted, and I’m happy to say that.

I grew up in an addictive household and struggled with some things in my own adult life, I’ve dealt with recovery and addiction and then became a therapist. The most well-rounded codependents end up as therapists, right? So how does EMDR apply to this group of us?

When we grow up in an environment where we’re the caregiver and we’re overinvested in someone else our sense of ourselves, our self-esteem and self-worth begins to get influenced by this other situation. It can become confusing internally. We can go through traumatic experiences. We can have internal beliefs where we might say, “I should have been able to help. I should have saved them. I should have known what to do.” And then we have a diminished sense of our own selves.

EMDR processes and refiles some of those difficult situations. Some of them are scary when we think someone else’s health and well-being is at risk, or if we’re on the receiving end of violence that’s very threatening to the system. Even though we may have to revisit some of those memories and experiences, EMDR gets to refile them in bigger groups almost like helium out of an air balloon. The pressure, tension, sadness or whatever it is gets to dissipate because we don’t need the emotional energy now, we just need to restore our sense of ourselves.

The cool thing about EMDR is when the negative data gets refiled, what emerges is a positive thought, feeling, or body sensation. Perhaps you can now see the addict for who they are and not for their disease, and then realize that ‘I did everything I could’ or ‘I didn’t know what I didn’t know’. These positive thoughts come up in the midst of EMDR therapy and you feel more empowered. You have a more positive view of yourself, you’re less wrapped up in that fault that we get into as codependence (caregiving and over-involvement), and the healthy boundaries become easier for us to do without guilt and shame. After thirty years of being a therapist, I know that shame is a heavy burden, and some of the most beautiful EMDR sessions that I’ve been able to participate in have helped facilitate the release of shame, and the hold that it has on someone. That is powerful. I’ve been a therapist for a long time, and I was a therapist for ten years before I got trained in EMDR in the 90’s, and I didn’t have any tool in my tool belt that could release that the way that EMDR does and that’s where we call it the ‘magic’.

Twenty-five or thirty years later, we know now that that’s our neurobiology supporting our growth and removing and refiling things that we no longer need to be tripping over. We didn’t know that twenty-five or thirty years ago, but we kept doing EMDR because we’ve seen the results and the freedom that it really brings when your system is filed more efficiently and you feel so much better about yourself.

Question: If somebody were going to sit down into an EMDR session with you, what should they expect to experience? What would it look like?

Sarah: Well, a lot of it depends on what someone is coming in with. We see everything from significant childhood trauma to post-traumatic stress, a single incident where they’ve been through something life threatening, or even athletes and entrepreneurs come in because they’re hitting this roadblock.

When someone comes in, we definitely want to get some history, we want to find out what the whole picture is basically, and what the person is coming in for currently. Oftentimes in life there’s what I call a ‘perfect storm’; a current event can set off these ‘pop-ups’ of negative emotions that weren’t filed well and you didn’t know it until the current event triggered it. Then EMDR can start either with the current event and begin to process that which will reveal the links to the past events related to that.

You don’t have to go through every single incident in your entire life. Through EMDR, your system tells us which things are linked to which, and what really does need to be refiled. It’s a really efficient therapy which is great.

Question: In your opinion, is it realistic that the negative effects of traumas that we might experience can be completely eliminated by EMDR, or is there always going to be some kind of residual effect that has on a person?

Sara: I don’t know if I ever say “Ever, never, always, completely, etc.” because life continues to happen.

What we don’t know moving forward is something in our current life may trigger something that we didn’t know was tripping us up. If EMDR doesn’t completely eliminate it, keep coming back.

For me personally, I have my own EMDR therapist and have for many years, and I go in for regular what I call “reboots” whether I think I need it or not. There’s always something that can be restored and improved. What we do see with EMDR and things like PTSD, research indicates that there’s a significant reduction in symptoms and then those that qualify for the diagnosis of PTSD no longer qualify. That’s amazing. We can see that post-traumatic stress disorder is a healable condition and so is codependency.

Codependency is often trauma-based. Codependency is not an illness; it’s a condition of an environment in which we experience some things. And so to the degree that it gets in our way and diminishes us, that is what EMDR can help resolve so that we don’t keep up those codependent patterns. Those patterns are based on some things that we actually developed in childhood for survival reasons, but they don’t work as well as we get older. We need a new set of things to do.

What we’re really looking for, Brian, is post-traumatic growth. If somebody comes into an EMDR therapist who’s got this comprehensive training lots of tools and tool belt, you want to take the post traumatic injury (something that’s happened like a relationship breakup) and move that information into an area where the system will give us what we call “post-traumatic growth” which is growth out of the difficulties. It can bring meaning and a positive sense of yourself out of some very difficult experiences.

Question: If someone came into your office and you learned a little bit about them, is there ever a circumstance where you would recommend against EMDR for any specific person?

Sara: Well it’s more about the specific conditions for that person. If somebody is in an active addiction where they are still struggling, although we will still do portions of EMDR and stabilization (remember EMDR-trained therapist are licensed mental health professionals, so they have a lot of training in a lot of things), people can have EMDR if they’re actively using chemicals, but it’s less efficient. As we know, trauma and substance abuse have a vicious circle relationship, so we definitely want to get started with the EMDR but we have to really pace things.

For people who have had significant injuries, perhaps a brain injury, a TBI, or a long history of childhood abuse, it’s about pacing it and starting with making sure the individual has the ability to stabilize and rely on building up their resources before the actual trauma processing starts. But all of that is the EMDR. The minute you pick up the phone and call a therapist, if they’re trained in the EMDR, they’re already thinking in this regard. EMDR isn’t just eye movements or bilateral tapping. It’s a way of looking at our neurobiology and how to intervene to help them be healthier. A lot of people think it’s just this technique of eye movements, and you can just kind of make your eyes go back and forth and you’ll feel better (you might feel better or you might feel worse). So, it’s not just a technique, it’s really a way of looking at it. So, a trained therapist will be able to assess how quickly to get into the EMDR actual trauma processing piece of the protocol.

Question: To your point, for the person who looks into EMDR and thinks, ‘Well, this looks really easy, it looks like I’m just moving my eyes back and forth and reprocessing,’ what would you say to someone who thinks that they can try it on their own, or that they don’t need help doing this?

Sarah: Well, I commend the person that they are being proactive and want to take care of this themselves.

Dr. Francine Shapiro who founded and developed this EMDR therapy wrote a great book just to address this, and it’s called Getting Past Your Past. It talks about what we can do for ourselves in terms of stabilizing and working through memories vs. when you say, “Well, I probably should go in and get some assistance to help facilitate this at a greater level.” You never know what’s going to come up when you start doing any kind of eye movements, but there are some things you can do. One is called the ‘butterfly hug’ where you cross your arms in front and you’re bilaterally tapping your shoulders or your legs. We teach this to children.

Or, we have them do very short sets of moving their eyes back and forth because what happens is the system begins to regulate and calm down. If you keep going it may activate memories. So, there are some things that you can learn to do, but perhaps not the entire protocol on your own. Plus, I think that we can only see ourselves objectively to a certain point, and for anything beyond that it helps to have someone on the other side watching and helping facilitate because they can see things that we may not be able to see and experience.

Question: How many sessions do you find that clients typically need to have?

Sara: Well, the research indicates even for complex PTSD – 12 to 24 sessions. For a single incident trauma, you could probably come in for just a few sessions depending on your history. If it’s a more complicated set of traumatic experiences or if it’s performance work (we work with a lot of athletes, first responders and public speakers), that may be just a handful of sessions. It really depends on what you’re looking for and what the blocks are. It really varies.

Brian: Okay, fair enough.

Question: This next question is a little bit longer so please bear with me. As you were mentioning a few moments ago, EMDR therapists are trained mental health professionals so there’s a lot of training that they’ve typically been through. A lot of us that carry around baggage in our lives, and we tend to hear things like, “Well, you just need to put that baggage down and you’ll be free.” We hear about all these different things that can help us to heal emotional wounds, process traumas, reverse cognitions, regulate our emotions, and be more mindful. The list just goes on and on and on and on. So, in your opinion as a mental health professional who has experience in a lot of different techniques, what’s the winning combination of activities that someone should do to find a deep sense of self love and well-being?

Sara: Self-forgiveness and compassion (laughs), but how to get there, right?

Traditional talk therapy is often not enough. It provides that human connection and it gives us an opportunity to begin to understand, but I really believe now that we know so much more about how our systems work, and with the advances in medicine, neurobiology and psychology, this combination of a whole brain or neuro biological approach to therapy (which is EMDR) works well. HeartMath is one of the biggest stress management companies and trainers, and has done research on syncing up that heart and brain. Now, we can do this through mindfulness, heart rate variability training, being able to pick up the remote control and point it ourselves and shift channels.

If we could talk ourselves out of things we would have done it by now (and I would probably be unemployed or I’d have to be doing something else). But because we are a complicated and intricate system we need to use a variety of things. EMDR, mindfulness, we’ve got to move our bodies with or whatever kind of exercise. Finding the joy in all of it is really the key. There’s a lot of joy when you talk to an EMDR therapist because we have watched joy, latitude, compassion emerge in people that had this heaviness or cloud over them. So, whatever the winning combination is, it’s got to be (and I know everyone says it) mind-body-spirit.

There aren’t any shortcuts, and I know you know this. There are no shortcuts. We have to stay committed to consistent care and evolution. Do nothing and you will not emerge; you will stay the same. We’ll get older but we’ll probably stay the same. There’s the old saying that ‘the older we get the more like ourselves we become’. We don’t go to the gym a couple of times and stay in shape.

When you find a combination – EMDR therapy in one pocket, mindfulness, stress management tools, animals, the things that bring you a softness towards yourself and healing – you have to keep it up because life is going to continue to deal us a lot of different things.

The world is quite uncertain and often unstable. So, we do whatever we have to do to stay growing and stable. When we’re rigid, we break. When we grow and we’re flexible, we don’t break down. So, I don’t know if I answered the absolute winning combination, but for me, absolutely EMDR therapy would be in there and the tools around EMDR therapy.

Question: Would it be fair to say, based on that response, that you really have to find your own combination that works for you as long as you’re incorporating mind, body and spirit? You can’t ignore any of them?

Sara: Right, exactly. The interesting thing is when people have come in for, let’s say a portion EMDR therapy over some issues in life, what often happens (and I think you could survey tons of EMDR therapists across the globe) is that those same people will call back a year later, three years later, six months later, five years later and say, “Hey Dr. Sarah, this thing came up and I can’t really shake it. I just want to come for a ‘reboot’,” because they know how their system can feel better and restore itself. And the cool thing is that they know they’re doing it; they just need my help to help facilitate the process. So, it becomes a very self-empowering decision, and people come back all the time for a session or two or three which is really great.

Question: This is a quick question, hopefully yes or no, but if you need to elaborate that’s fine – Does EMDR always have to be done in-person, or can it be done virtually at all?

Sara: It can be done personally. I have done it and so have many others. Obviously, the human connection is key, but sometimes people don’t have access. We’ve done virtual EMDR with military in combat zones. I’ve done it with terrorist attack victims to help stabilize, and I’ve done it with established clients that either are traveling, or have gone off to school, or have moved. So yes, it can be done virtually.

Question: I’ve come to realize that a lot of the folks who listen to my show, in addition to recovering codependents, are therapists. So, for any therapists listening right now that are interested in becoming certified in EMDR, how can they get certified to facilitate EMDR with their clients?

Sara: Well, it is a commitment. For many years, I have told my colleagues who send their clients to me or to my group to do the trauma work with EMDR (even though they’re staying their primary therapist), I keep telling them, “Go get the training, go get the training”. Without a doubt, as soon as they do it, they tell me it transforms their practice. It transforms their work and it transforms how they see themselves as a compassionate caregiver. So, always start with what’s proven.

The EMDR International Association is a professional organization who has set the standards for training, From there, there are approved trainers all over the world. That’s a great first place to start. Enjoy the process. Going for your own EMDR with somebody who is trained and certified is another great first step.

There aren’t shortcuts. This training is intensive, it takes a commitment and it’s totally worth it.

Question: Excellent. What would be your biggest piece of advice for a codependence person?

Sara: I really thought about this before our talk today, and being that we teach best what we need to learn most, from my heart to your audience’s heart I really want to say, “Process your own inner challenges, take care of your blocks.”

First, you’re not being selfish. Your relationship with others is a reflection of your relationship with yourself, and so ask yourself, ‘How’s it going? How is my relationship with myself?’ Doing the thing that’s most loving and most respectful to yourself will definitely be the most loving and respectful thing to someone else, whether that someone else agrees with it or not.

Right now it’s so important that we do our own work because the world needs us all to be as healthy and grounded as possible. Finding a mentor and information like what you provide, Brian, is so important. Just keep taking one step at a time and remember that codependency is not a disorder, it’s a condition. Healthy codependency is actually a thing. Do you believe that, Brian?

Brian: I think so. I think there’s such thing as mutually healthy interdependence. There is a spectrum. That’s what I’ve come to believe.

Sara: I love that word interdependence’ because we’re human beings, we’re meant to connect. There’s a big movement now in this virtual world so that we can connect. We’re human and we want to connect, and we need to connect in healthy ways, and the best way to do that is to be as healthy as possible.

One of the cool things about EMDR is when the traumatic negative material is refiled, what emerges is a much more positive idea and sense of yourself and the world around you. We all could use that, right?

Questions: Absolutely. Just two more quick questions before we wrap. One would be if someone wanted to get a hold of you and your group to explore working with you, how could they find you?

Sara: ‘Coherence’ really means the balance of mind, body and spirit. Our phone number in San Diego is 760-942-8663 and we’re happy to answer any questions. Thanks for asking that.

Question: Absolutely. Is there anything else that you’d like to share with the audience before we wrap up?

Sara: Maintain self-compassion, self-empathy and any kind of self-forgiveness. However you get there, that is what’s going to make the difference in your life and the people around you.

Brian: Short and sweet. Thank you so much Dr. Sarah for being on the show. This has really been wonderful. I really want people to know what EMDR is and have that option. So, thank you for helping us get educated about it.

Sara: Thanks so much, and thanks for everything you’re doing.

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