IN THE CLEAR

A rev­o­lu­tion­ary ther­apy is said to wipe trau­matic ex­pe­ri­ences from your mem­ory, help­ing with ev­ery­thing from anx­i­ety to per­son­al­ity dis­or­ders. But is it a cure or just wish­ful think­ing? Meg Ma­son puts it to the test

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Ef­fec­tively rewrit­ing your mem­ory to make trau­matic ex­pe­ri­ences eas­ier to deal with, EMDR is the ther­apy that has ev­ery­one talk­ing.

I’m stand­ing in the car park of a hospi­tal in Lon­don, with my six-hour-old baby in my arms, wait­ing as my hus­band ad­justs the baf­fling sys­tem of car-seat straps. It’s a freez­ing, grey day and a strong breeze is whip­ping around us. In a split sec­ond, the wind catches the car door and throws it against an old Porsche parked be­side us. Out of nowhere, the owner ap­pears and, see­ing the shal­low dent, she comes run­ning to­wards me shout­ing, “You stupid girl, look what you did to my car! You bitch!” My legs be­gin shak­ing un­con­trol­lably. Still weak from labour, I feel like I’m go­ing to fall over with a new­born in my arms. It’s the first time she’s ever been out­side. Some­how, as my hus­band moves in front of me to cut her off, I make it into the car, lock the doors and give in to sobs.

That was 13 years ago. Or was it yes­ter­day? I can still hear the crack of metal against metal and feel my grip tight­en­ing around the baby as chem­i­cal fear flooded my core. Even now, if I have to go near a hospi­tal, I’m over­whelmed with dread. Dizzy, nau­seous. I can’t visit friends and their new ba­bies in a ma­ter­nity ward. I bris­tle when any­one calls me a “girl”. I fuck­ing hate Porsches.

It’s the sort of mem­ory un­likely to ever lose its sting. Or so I thought be­fore I came across eye move­ment de­sen­si­ti­sa­tion and re­pro­cess­ing (EMDR), a form of psy­chother­apy that aims to un­cou­ple trau­matic ex­pe­ri­ences from the emo­tions at­tached to them.

What takes place in a ses­sion of EMDR is both sim­ple and com­plex. While hold­ing a painful mem­ory in mind, the pa­tient fo­cuses on the ther­a­pist’s fin­gers as they move back and forth at eye level, caus­ing their gaze to track left to right. One the­ory is that do­ing so stim­u­lates the same brain mech­a­nisms as rapid eye move­ment (REM), the type of sleep that al­lows the brain to process and store wak­ing ex­pe­ri­ence. But in an in­stance of trauma – a road ac­ci­dent, an as­sault or in­ci­dence of bul­ly­ing – the brain freezes, mean­ing in ba­sic terms, the ex­pe­ri­ence never gets shifted to the part of your mem­ory where neg­a­tive emo­tions are no longer present. Which is why, with lit­tle or no trig­ger, we can hear, taste, see and smell the event, and re-ex­pe­ri­ence the fear and sense of pow­er­less­ness we felt at the time. Again and again and again.

“Trauma is held in the body so, al­though we log­i­cally know it’s over, we never feel it’s over,” ex­plains Claire Kul­lack of the EMDR As­so­ci­a­tion of Aus­tralia. “[The process] en­ables the trauma mem­ory to feel like a his­tor­i­cal event, re­mov­ing the con­stant el­e­ment of dan­ger the trauma sur­vivor ex­pe­ri­ences.” Some­how, by stim­u­lat­ing the brain’s nat­u­ral pro­cess­ing, the mem­ory quite lit­er­ally rewrites it­self be­fore your eyes, con­form­ing to a ver­sion of events that would have been man­age­able to you, and will re­main that way from now on.

Al­though EMDR is not widely known here, there are reg­is­tered prac­ti­tion­ers na­tion­wide and the prac­tice has ex­isted for nearly 30 years. It was de­vel­oped by Francine Shapiro, an Amer­i­can psy­chol­o­gist who in­ad­ver­tently dis­cov­ered that by mov­ing her own eyes back and forth while call­ing a dis­turb­ing episode to mind, the at­ten­dant phys­i­cal and emo­tional re­sponses were re­duced in­stantly. The prac­tice was first used to treat war vet­er­ans and sur­vivors of child­hood abuse with symp­toms of post-trau­matic stress dis­or­der (PTSD), be­fore be­com­ing more widely avail­able as re­ports of its ef­fi­cacy spread.

More than half of the Aus­tralian pop­u­la­tion will ex­pe­ri­ence a trau­matic event in their life­time. And from the 30 or so for­mal stud­ies of EMDR, it’s been shown that up to 90 per cent of vic­tims of a sin­gle trauma no longer ex­hibit symp­toms of PTSD af­ter just three 90-minute ses­sions. For vic­tims of mul­ti­ple trauma, 77 per cent re­spond af­ter six ses­sions. “It’s one of the gold-stan­dard, first-line treat­ments for PTSD and other kinds of psy­cho­log­i­cal dis­tress,” says Kul­lack.

Al­though EMDR is now recog­nised by the World Health Or­ga­ni­za­tion and Amer­i­can Psy­chi­atric As­so­ci­a­tion, scep­ti­cism per­sists in other quar­ters. And ar­guably, any form of treat­ment that prom­ises such ex­traor­di­nary re­sults in so lit­tle time should be sub­ject to sus­pi­cion. An ar­ti­cle in

Sci­en­tific Amer­i­can con­cluded that while EMDR may lessen the symp­toms of trau­matic anx­i­ety and is bet­ter than do­ing noth­ing, “not a shred of good ev­i­dence ex­ists that EMDR is su­pe­rior to other [treat­ments that] cog­ni­tive-be­hav­iour ther­a­pists have been ad­min­is­ter­ing rou­tinely for decades”.

“It does seem too good to be true,” ad­mits Dr Jon Laugh­arne, a Perth-based psy­chi­a­trist who uses EMDR. “I was def­i­nitely wary be­fore

“BY STIM­U­LAT­ING THE BRAIN’S NAT­U­RAL PRO­CESS­ING, THE MEM­ORY REWRITES IT­SELF BE­FORE YOUR EYES, CON­FORM­ING TO A VER­SION OF EVENTS THAT WOULD HAVE BEEN MAN­AGE­ABLE TO YOU, AND WILL RE­MAIN THAT WAY FROM NOW ON”

I treated my first pa­tient, a vet­eran who’d been re­sis­tant to all forms of treat­ment for 20 years. He got bet­ter so quickly, it blew my mind.”

Still, it doesn’t help that, even to­day, it’s not en­tirely un­der­stood ex­actly how EMDR works. “The ba­sic hy­poth­e­sis is that ev­ery hu­man be­ing has an in­nate abil­ity to in­te­grate and make sense of ev­ery kind of ex­pe­ri­ence,” Kul­lack ex­plains. “But in trau­matic mo­ments, there’s so much go­ing on, we’re just try­ing to sur­vive. Fight, flight or freeze takes over and the brain’s abil­ity to process what’s hap­pen­ing is ar­rested.” EMDR sup­pos­edly un­does “the freeze”, al­low­ing the brain and body to do what it’s de­signed to do. A metaphor I’ve re­cently come across: just as the body could re­pair a phys­i­cal wound as long as the site is clean, the brain can heal it­self, but only once de­tri­tus is cleared – and of­ten as quickly.

“What I love about it is that we’re trust­ing the person’s abil­ity to do this them­selves as we, the ther­a­pists, guide them,” Kul­lack says. “It’s beau­ti­ful to watch our clients as they be­gin to feel the trauma that’s been so vivid for so long be­come foggy or dis­tant, and the emo­tional and phys­i­o­log­i­cal charge fall away.”

Since so many con­di­tions, from anx­i­ety and de­pres­sion to ad­dic­tion and eat­ing dis­or­ders, may be caused by un­di­ag­nosed PTSD, Laugh­arne says ad­dress­ing the root trauma may en­able a pa­tient to bet­ter over­come the pre­sent­ing con­di­tion. “Even if it’s a mod­est trauma, treat the event and it fol­lows that mood and anx­i­ety lev­els will im­prove.”

On the sub­ject of “mod­est” trauma: at the be­gin­ning of my first EMDR ses­sion, the ther­a­pist men­tions she’s been work­ing with a vic­tim of one of the Paris ter­ror­ist at­tacks, and my im­pulse is to stand up and leave. Surely my ex­pe­ri­ence is too in­signif­i­cant to qual­ify. Not at all, my ther­a­pist says. Be­cause as in­di­vid­u­als, how we would ex­pe­ri­ence the same event dif­fers wildly. An­other new mother could have emerged from that car park un­scathed if her brain re­acted dif­fer­ently in the mo­ment, while for me, it be­comes a life-defin­ing event. “What I view as trau­matic may not be for you. We are unique and we all process dif­fer­ently,” says Kul­lack. “As long as those classic trauma symp­toms are oc­cur­ring – in­tru­sive im­ages, trig­gers, flash­backs, avoid­ance be­hav­iours, hyper-vig­i­lance – there’s some­thing for us to work on there. And when the person feels like their trauma has been val­i­dated and they’ve been lis­tened to, the heal­ing be­gins right there.”

It’s true that when my ther­a­pist asks me to give “a head­line ver­sion” of what hap­pened that day and I burst into tears, her quick ac­knowl­edg­ment of how in­tense the mem­ory clearly is for me comes as an im­mense re­lief. Af­ter an ex­pla­na­tion of how we’ll pro­ceed, the process be­gins, even though I’m still in­wardly won­der­ing if it’s quack­ish. But as the mem­ory rises and the bi­lat­eral eye move­ment be­gins, within min­utes I can feel the mem­ory re­form­ing it­self. In the ver­sion I’m cre­at­ing, the wo­man never comes near me. In­stead of stand­ing pinned to the spot, I watch my­self turn back to the hospi­tal and re­ceive the com­fort of a nurse. I re­alise, even as I type this now, the idea seems pre­pos­ter­ous, but hand on my heart it hap­pened ex­actly this way. And the fol­low­ing day, when I tried to sum­mon the orig­i­nal mem­ory – per­haps as a test – it wouldn’t come. All I could see was the wo­man, far off in the dis­tance, bat­tling the wind.

It sur­prised me that there was barely any talk­ing dur­ing the ses­sion – which for those of us who have at­tempted tra­di­tional “talk ther­apy”, dili­gently haul­ing a mem­ory out in a 50-minute ses­sion, pack­ing it away again and dash­ing back to work, red-eyed and ex­hausted, the fact that EMDR doesn’t re­quire ver­bal nar­ra­tion is

“I COULD STILL PIC­TURE IT, HEAR THE SLAM­MING OF THE TWO CARS AND ALL THAT STUFF. BUT AS I WENT THROUGH THE PROCESS, THOSE PIC­TURES BE­CAME RE­ALLY BLURRY. THEY’RE STILL THERE, BUT IT FEELS LIKE THEY’VE MOVED”

a rev­e­la­tion. It makes com­plete sense that, be­cause there are no words or lan­guage in that pri­mal part of the brain where trauma lives, our at­tempts to ar­tic­u­late those feel­ings into sub­mis­sion are mostly use­less.

“I saw a coun­sel­lor for three-and-a-half years,” says Maddy Hearne, a 17-year-old stu­dent. “It was okay at the start but af­ter a year or so, I knew talk­ing about the one event over and over wasn’t help­ing me.” The event was a ma­jor car ac­ci­dent that oc­curred when an on­com­ing car crossed the free­way’s me­dian strip and col­lided head-on with the car she and her fa­ther were trav­el­ling in. Hearne was 14 at the time and not only suf­fered whiplash and a knee in­jury, but emo­tion­ally, she just wasn’t the same. “I was con­stantly an­gry, mis­er­able all the time be­cause I didn’t want to go out and do any­thing. It was con­stantly in my dreams. Even if I woke up and went back to sleep, it would still be hap­pen­ing. I blamed my­self for the ac­ci­dent, I think, be­cause we were on our way to my net­ball train­ing.”

Last year, Hearne’s mother googled al­ter­na­tive treat­ments for what was sus­pected by then to be PTSD and came across EMDR. “I didn’t un­der­stand it at the start,” Hearne says, “but I knew I had to try it be­cause I wanted to feel bet­ter. At the time I found it so hard to phys­i­cally tell peo­ple what had hap­pened be­cause I could still pic­ture it, hear the slam­ming of the two cars and all that stuff. But as I went through the process, those pic­tures be­came re­ally blurry. They’re still there, but it feels like they’ve moved. There was a sense of re­lief that I could let go of what had hap­pened.”

Even when the trauma doesn’t oc­cur as an iso­lated event, but as some­thing on­go­ing, EMDR can be just as ef­fec­tive. “I grew up with a very un­well mother, who had se­vere schizophre­nia, un­treated un­til I was 12,” says Grace*, now 45. “When­ever there’s men­tal ill­ness in a fam­ily, you live with the fear of see­ing it in your­self. You know that your be­hav­iours and re­ac­tions are based on events in child­hood that aren’t use­ful to you.”

In adult­hood, mar­riage and moth­er­hood moved Grace to­wards danger­ous lows, and she spent many months on an­tide­pres­sants for post-natal anx­i­ety. “I could in­tel­lec­tu­alise it all be­cause of past coun­selling, which would un­lock the emo­tions but just leave me drained.” Again by chance, Grace con­nected with EMDR ther­a­pist Dr Sarah Schu­bert and, she says, “I knew af­ter the first ses­sion that some­thing had cleared in me. I walked away lighter.”

Twelve ses­sions in “the mem­o­ries are still there, but I can look at them with­out hav­ing the same re­sponse in my body,” Grace says. “My mar­riage has im­proved be­cause I don’t feel con­stantly un­der threat, mean­ing I can ac­tu­ally be en­gaged, present and less re­ac­tive. I view ev­ery­thing dif­fer­ently now.”

Such a rad­i­cal change in over­all per­spec­tive is not un­com­mon. No mat­ter how vivid, our mem­o­ries are nei­ther 100 per cent ac­cu­rate nor static, ex­plains Laugh­arne, mean­ing we can re­con­struct them and ap­ply new mean­ing by ad­dress­ing them head-on. “Mem­o­ries aren’t fixed like a video tape. They can be­come fluid again, giv­ing us the chance to al­ter them into some­thing more man­age­able, be­fore shift­ing them into the fil­ing sys­tem. That’s why we can see rapid change in our re­lated nar­ra­tive in so lit­tle time.”

A po­tent ex­am­ple from Amer­ica’s EMDR In­sti­tute: “A rape vic­tim shifts from feel­ing hor­ror and self-dis­gust, to hold­ing the firm be­lief that, ‘I sur­vived it and I am strong’... The net ef­fect [is that] clients [feel] em­pow­ered by the very ex­pe­ri­ence that once de­based them.”

I cer­tainly don’t claim to have ex­pe­ri­enced a trauma that ranks on that scale, or that EMDR would work for ev­ery­one. It’s ex­pen­sive, and a base­line emo­tional sta­bil­ity is re­quired. But af­ter a sin­gle ses­sion I know it has been life-chang­ing. While in re­al­ity I was a ter­ri­fied girl in a car park, now I feel my­self walk­ing for­ward as a wo­man whose in­stinct from her very first day as a mother was to pro­tect her baby.

But to Grace must go the fi­nal word: “For the first half of my life, events in child­hood were my an­chor. But now, as a wo­man in my for­ties, I have a drive and en­ergy I’ve never had be­fore. I’m feel­ing my­self be­come the person that, un­der­neath, I was al­ways meant to be.”

To find a reg­is­tered EMDR prac­ti­tioner, visit em­draa.org. If you or some­one you know is strug­gling, visit life­line.org.au

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