The Number 1 Trauma Treatment: EMDR Explained

Lucky us!  Scott Giacomucci, MSS, LSW, CTTS, CET III, trauma specialist, psychodramatist and all around amazing therapist has shared his insights and explained that complicated title: Eye-Movement Desensitization and Reprocessing, also known as EMDR.  The following is a handout Scott put together for his clients to help explain what EMDR is and how it's done:

EMDR: Eye-Movement Desensitization and Reprocessing

Often, when something traumatic happens, it seems to get locked in the nervous system with the original picture, sounds, thoughts, feelings, etc.  Since the experience is locked there, it continues to be triggered whenever a reminder comes up. It can be the basis for a lot of discomfort and sometimes a lot of negative emotions, such as fear and helplessness that we can’t seem to control. These are really the emotions connected with the old experience that are being triggered.

What is EMDR?

 Eye Movement Desensitization and Reprocessing, is a late-stage, trauma resolution method.  Developed in the late 1980's, EMDR currently has more scientific research as a treatment for trauma than any other non-pharmaceutical intervention. Based on empirical evidence as well as thousands of client and clinician testimonials, EMDR has proven an efficacious and rapid method of reprocessing traumatic material.

EMDR appears to assist in processing of traumatic information, resulting in enhanced integration - and a more adaptive perspective of the traumatic material. The utilization of EMDR has been shown to be effective with a variety of conditions including generalized and specific anxieties, panic attacks, PTSD symptoms (such as intrusive thoughts, nightmares, and flashbacks), dissociative disorders, mood disorders and other traumatic experiences. Theoretically, EMDR is about integration - bilateral hemispheric (right/left brain) integration; triune brain (brain stem, limbic system and cerebral cortex) integration; and mind/body integration, but practically, it’s about convincing the mind and body that the traumatic event is, indeed over. EMDR helps to put the past in the past, where it belongs, instead of staying stuck in it (feeling like it is happened all over again in the present-with the same thoughts, emotions and body sensations- that accompanied the event in the past).

The eye movements (or other bilateral stimulation) we use in EMDR seem to unlock the nervous system and allow your brain to process the experience. That may be what is happening in REM, or dream, sleep: The eye movements may be involved in processing the unconscious material. The important thing to remember is that it is your own brain that will be doing the healing and you are the one in charge.

How is EMDR Done?  (Parnell, 2006)

• Establishment of Safety and Resources - Safety within the therapeutic relationship and safety within each individual EMDR session. During each EMDR session, your therapist will begin by activating your own internal resources. (S)he will guide you in an imaginal, multisensory imagery exercise designed to activate images, emotions and body sensations of safety, protection, nurture and comfort. Once these images have been activated, the actual trauma reprocessing will begin.
• Activating the Traumatic Memory Network - The therapist will ask a series of questions regarding the traumatic memory. The purpose of these questions (or script) is to activate the entire traumatic memory network.
• Adding Alternating Bilateral Stimulation - Once the entire traumatic memory is activated, the therapist will add alternating bilateral stimulation using:

a) buzzing in your hands by turning on the Theratapper

b) alternating auditory tones via headphones or ear buds

c) moving his/her hands back and forth, so you may visually track the movement

• Reestablishment of Safety - regardless of whether the traumatic material was completely processed or not, the session will end at a pre-set time. Before you leave, you will be stable, embodied, oriented and calm. Depending on you and your therapist’s preferences, this may be accomplished in a variety of ways including, but not limited to re-activating your own internal resources, breathing exercises, prolonged muscle relaxation, etc.

Looking to continue EMDR therapy?

-You might begin by asking your IOP/PHP counselor for a recommended outpatient counselor who is skilled in EMDR.

-At the EMDR International Association website (EMDRIA.org) you can navigate to the “Find a Therapist” tab and search for a certified EMDR therapist in your community.

 The current treatment guidelines of the American Psychiatric Association and the International Society for Traumatic Stress Studies designate EMDR as an effective treatment for post traumatic stress. EMDR was also found effective by the U.S. Department of Veterans Affairs and Department of Defense, the United Kingdom Department of Health, the Israeli National Council for Mental Health, and many other international health and governmental agencies.

(Giacomucci 2017)(References: EMDRIA; Linda Curran; Laurel Parnell)

Scott Giacomucci, MSS, LSW, CTTS, CET III is a certified trauma treatment specialist and licensed social worker in Pennsylvania. He is a graduate of Bryn Mawr College where he received his Masters in Social Service (MSS) with a concentration in clinical social work. He facilitates trauma treatment services at Mirmont Treatment Center serving a variety of populations including young adults and emergency responders (veterans, police, fire, etc..) in both individual therapy and group sessions. Scott has a gentle, non-judgmental treatment approach that honors the inherent worth of each individual. He utilizes a blend of treatment modalities including both traditional talk therapy and experiential therapy which have been research-proven as the treatment of choice for treating trauma. 

To learn more about Scott Giacomucci and the work he does, you can visit his website at: http://sgiacomucci.com/

Any comments or questions?  We'd love to hear from you!  Please comment below.  For confidential questions, email TiffanySpilove@yahoo.com.  If you need help finding an EMDR therapist, please call 610-314-8402, I'd be happy to help.

WHAT IS PTSD AND DO I HAVE IT?

Post-traumatic stress disorder, also known as PTSD, is an indication from your body that it needs support in sorting some things out.  Traumatic memories are stored in a different part of your brain than the rest of your memories.  When therapy is completed successfully, brain scans show that the trauma memory has been moved to a different area of the brain.  This alternate area of the brain doesn’t trigger your mind to get confused, your adrenaline to rush, and your body to be on alert.

Here are some of the symptoms of Post Traumatic Stress Disorder from the Diagnostic and Statistical Manual (DSM-V):

A stressor such as actual or threatened serious injury, threatened death or witnessing of death or actual or threatened sexual violence.

Intrusion symptoms such as

• intrusive memories
• traumatic nightmares
• dissociative reactions such as flashbacks
• prolonged or intense distress after being exposed to a trigger

Avoidance symptoms such as persistent efforts to avoid anything that triggers traumatic memories.

Alterations to thoughts and mood symptoms such as

• not being able to remember important parts of the traumatic event
• believing bad things about yourself and/or the world
• blaming yourself for the traumatic event
• overwhelming emotions such as horror, shame or anger related to the trauma that continue to happen even long after the event
• losing interest in things that you used to enjoy
• not being able to feel positive emotions such as joy

Reactive symptoms such as

• exaggerated startle response
• difficulty concentrating
• sleep difficulties
• hypervigilance
• aggressive or irritable behavior
• reckless or self-destructive behavior

If you are ready to listen your body signals and get some support to untangle the memories and put them in their proper place, I can help.  My name is Tiffany Spilove and I LOVE working with people to heal their past.  I want to make sure that you find peace inside your body and your mind.  I have specialized training and experience helping people who have gone through sexual abuse, physical trauma and emotional pain.    

Call me today for your free 15-minute phone consultation at 610-314-8402 and find out if therapy is a good option for you

Sure Fire Ways to Get Grounded and Reduce Anxiety

Your body feels jittery and like you want to crawl out of your skin.  Your heart races, your mind goes a million miles a second and you can't sleep.  Sometimes, you just wish you could find a little peace - a little reprieve from this constant state of feeling charged up.  Anxiety, social anxiety and panic are such difficult things to have to deal with.  The good news is that there's hope and some sure fire things you can do to help calm your nervous system.

What grounds you?

Getting grounded, as in, feeling your feet on the earth rather than in your head - starts with your intention at the beginning of each day.  The things that help people feel grounded can be different for everyone, so you need to find things that work for you.  The first place to start is to think about what you can do each morning, upon awakening that will help you get centered and begin your day with a peaceful intent.  Some mindfulness meditation could be helpful, reading from a daily book of inspirational readings, praying, doing some deep breathing, singing, chanting, walking or exercising in a mindful way - these are a few ideas you can begin with.  

As far as inspirational reading goes, I personally like these two:

A Deep Breath of Life by Alan Cohen

The Language of Letting Go by Melody Beattie

Whatever you choose to do to help you get grounded in the morning, make it into a ritual.  

Our bodies find comfort in repeating the same actions on a regular basis.  You will be teaching your body that every morning, you find peace through grounding and it will set you up to stay grounded and calm through the rest of your day.

Here is an example of a morning ritual:

• wake

• go to comfortable spot in home designated to meditation

• light a candle or incense

• drink warm lemon water

• read from daily inspirational book

• say a few simple prayers for help with staying calm through the day

• set timer for 5 minutes 

• practice deep belly breathing for 5 minutes while focusing on flame of candle

• After breathing, spend 5 minutes making a gratitude list

• blow out candle and go for a 15-minute walk

Something as simple as this can really get your day off to a great start.  

Maintaining Balance

As you go about your day, when you notice your anxiety rising, come back to the breath you started with at the beginning of your day.  

Feel your feet

This is a tip I learned a while back that always seems to help.  As yourself "where are my feet right now?" and then look down at them and see them there on the earth.  Wiggle your toes a bit and feel them moving around in your sock.  Acknowledge that right now, in this moment, your feet are right there and they are safe, therefore you are safe.  When you start to feel panic and your thoughts race, remember to ask "where are your feet?"

Reduce or eliminate caffeine

caffeine is addictive and it's very activating.  If you are trying to eliminate anxiety, you might want to consider eliminating caffeine.  Many people will say that they use caffeine to help them find energy throughout the day and keep them going.  Well, it's a catch 22 because when we use caffeine, our bodies use cortisol to help regulate our adrenal glands.  When we over tax this part of our systems, it leaves us depleted and more tired than we started.  Therefore, if we eliminate caffeine, we may be a tired for a few days while detoxing, but after your body adjusts, you will find that you have more energy and that you sleep better.

Speaking of sleep

A large part of mental health when dealing with anxiety is getting a good amount of sleep.  When we sleep, our bodies do a lot of healing.  Our organs do their cleansing, our hormones rebalance and we are able to function more effectively during waking time.  Also, dreaming is very important for our psyches to process material from our conscious and integrate it with our subconscious.  

Here are a few tips on sleep hygiene:

• target bedtime for the same time every night

• eliminate all electronics from the bedroom

• reserve your bed for sleeping and sexual activity only - don't do work in bed

• if you are having trouble falling asleep, get up after 15 minutes and do something non-electronic for 15 minutes, then go back to bed and try to sleep again

• create a wind-down routine for the last hour before bed

For more information on sleep hygiene contact me at TiffanySpilove@yahoo.com

Anxiety reducing techniques

Here are some proven techniques to help your body and mind relax:

Tense and release

Tighten every muscle in your body.  Start with your head. Tense up your face, your jaw, your eyes, your neck.  Tense up your shoulders, your chest muscles, your stomach, your biceps, make fists as tight as you can.  Tense up your butt muscles, your thighs, your calves, your ankles, your feet and your toes.  Keep all these parts of your body as tense as possible and keep them  tensed up for a full 60 seconds.  Then release.  This tense and release will help your body reduce anxiety symptoms.

Deep Breathing

Put one hand on your belly and the other on your chest.  Take a deep breath in and try to push your belly hand all the way out with the breath into your diaphragm.  Inhale slowly to 4 counts, then hold for 4 counts, then release slowly for 4 counts and repeat.  When you practice breathing slowly, it will help to slow down your heart rate, thus reduce anxiety.

Bi-Lateral Movement

Any kind of bi-lateral stimulation can help reduce anxiety.  Here are some examples: walking, biking, shifting weight back and forth from one foot to the other, tapping your thighs alternately.  Some others: drumming, swimming, scanning your eyes from one side of the horizon to the other, back and forth.  The butterfly hug is an EMDR technique where you hook your thumbs together so that your hands form a figure that looks like a butterfly.  Put your hands on your chest and tap alternatively around your collar bone area.  This is a great way to self-soothe or find relaxation in times of stress. Here's a video on how to do a different version of a butterfly hug.   

How to Find a Trauma Informed Eating Disorder Therapist in West Chester, PA

West Chester, PA is a dynamic place to live.  If you already live here, you probably know that - if you don't live here, you might not have heard of it.  We have the wonderful West Chester University right here and an historic downtown with cute shops and great restaurants.  With Everhart and Goshen Parks in town and and Valley Forge in our back yard, we sure are lucky to have so much nature at our fingertips.

Finding an Eating Disorder Trauma therapist in West Chester, PA

seems harder than it should be.  With Bryn Mawr's Graduate School of Social Work close by, Villanova and St. Joseph's University, not to mention University of Pennsylvania, Swarthmore and LaSalle, we have many talented social workers and other clinicians in the counseling profession.  So, how do you determine which person will be the best fit for you?  Choosing a therapist is a very personal decision.  If you are looking for a counselor, psychologist, life coach or therapist - I'd like to help you find someone who can help.

Here are some ways to search

Ask around

I bet you know some people who are in the mental health field or who know other people who are.  Think about asking someone who works for a rehab or treatment center, your doctor or someone at your school.  Therapists that come highly recommended are a good way to make sure they have a good reputation.  

Google

Type in to Google your town and the issue you are looking for help with.  For example, "Downingtown Anxiety" or "Paoli Trauma" and see what comes up.  In the top things that come up in your search, you will hopefully see some links to therapists that specialize in your particular need.    

Psychology Today

What you will most likely see is a result that links to a Psychology Today profile for therapists in your area that have indicated these specialties.  Psychology Today is a great site that is most commonly used for therapists to post their profiles and for clients to find a therapist nearby.  The great thing is that you can refine your search by specialty.  The unfortunate thing is that therapists can indicate that we specialize in as many topics as we'd like.  Although a therapist might indicate that they specialize in anxiety, if it's really something we want to work with, we usually spend lots of time talking about it on our websites.

Websites

Check out the websites of potential therapists.  If you are looking for help with panic attacks and the website you are visiting talks a bunch about panic attacks, that's a great sign!  If you are looking for help with PTSD symptoms and you're on a website that doesn't mention them, you might want to keep looking.  

Phone consultation

Often, therapists will offer a free 15 minute phone consultation for potential new clients.  This is a great service and a good opportunity for you to interview your potential therapist.  You are going to be spending a good amount of time and money on therapy to help you achieve your goals.  It is very important that you find the right fit for you.  

Here are some questions to get your started that you can ask your potential therapist on your phone consultation

• What model of therapy do you use and why?
• How long do your clients usually see you for before they start to see relief from their symptoms?
• Why did you decide to become a therapist?
• Do you specialize in my specific need and if so, how do you work with it?
• What can I expect from therapy if I work with you?

If you are looking for a therapist who specializes in eating disorders or trauma, here are some things to remember:

Eating disorders and trauma are very complex issues and require special training to know how to treat properly.  

A team of specifically trained eating disorder specialists is usually necessary for successful resolution of eating disorder symptoms.  

Genetics loads the gun, circumstance pulls the trigger.  

Eating disorders are caused by a complex interaction of genetic, biological, behavioral, psychological and social factors. There is no single factor and there are different opinions among experts in the field.  

For this reason, many people with PTSD and eating disorders choose to get counseling privately.  But how do you know if the therapist is legit?  How do you know if they really "get it"?  How do you know if they don't just want you to rehash your past rather than provide a strategy to help you get to the other side of it?

Here is a list of questions to ask a potential eating disorder and trauma therapist:

1. What method do you use to treat eating disorders?
2. What method do you use to work with PTSD?
3. How effective are those methods?
4. Have you worked with people who struggle with food and body before?
5. Do you believe in full recovery from an eating disorder or do you believe you have to abstain from certain foods for the rest of your life?
6. Do you get to the root of the problem or work mostly with the symptoms?
7. Do you think you can help me and why?

In an ideal world, you would find a therapist who has special training and expertise in the methods that show the best results and someone who has tons of experience working with eating disorders and trauma.  Unfortunately, this is not an ideal world.  So you'll need to search a bit further.  You'll be searching for someone that you connect with, who you feel comfortable talking to, someone who will be honest with you and you'll know you can be honest with them.  

I hope this helps you in  your search for the right therapist in West Chester, Pa.  If you want some tools to help now, sign up for my newsletter to get some tips and tools for managing PTSD and eating disorders.  If you are still feeling stuck, feel free to call me at 610.314.8402 for a free 15 minute phone consultation.  I am available to listen to what's happening and help direct you to the right person.  If you are looking for help with eating disorders or PTSD, you can read more about how I can help here.