I’m an EMDR Convert

Call me weird but my niche is trauma. Over the last 25 years I have gotten really good at hearing, discussing all kinds of awful stories from clients. I can hold these stories, and at the end of the day, I go home and live my life as if some spacey force field surrounds me from absorbing the pain into my own heart. Recently however, I decided that I could not be a trauma therapist if I did not know anything about EMDR therapy. The most I remembered from the first time I heard about it (in around 1993) was about watching a pencil eraser go back and forth and somehow people felt better afterwards. It seemed a little like voodoo to me. But after the last 3 months of training, I decided that it’s more like magic.

Real magic, like having my own wand in Diagon Alley with Harry Potter and friends and knowing all the right spells and potions at my disposal. Okay let me qualify this: I am a total newbie. I literally just finished the second weekend at the Maigberger Institute in Boulder, Colorado, with the amazing Barb Maiberger. Barb teaches four groups per month, then follows them up with online meeting consultations. I have had a private practice for a few years and many of my established clients were psyched to try this modality with me and I have been able to witness some amazing things in a short period of time. So before I say more – just what the heck is EMDR therapy, you ask? Well, I am here to tell you, since one of the assignments is to draft an explanation for my clients.

Eye Movement Desensitization and Reprocessing therapy is a modality that can be used with adults, teens and young children. It has been extensively researched and shown to reduce symptoms associated with most kinds of traumas and generally disturbing events and emotions. There are 8 phases that will take place as the client is ready for them.

The treatment will use one or more of the following types of Bilateral/Dual Attention Processing stimulation (BLS). This keeps the client and therapist in the past and the present at the same time: Each client can choose what they prefer: Eye movement by following an object, hand buzzers, tone through headphones, tapping by the therapist or self-tapping.

EMDR Therapy does not erase memories, it merely takes the emotional connection away from an event so that a person can recall and discuss the events without distress or disturbance. Research has also shown that the brain continues to re-process even after the session and well into the future. Clients may experience dreams, flashbacks, emotions and other sensations following the treatments especially after the trauma work begins. This is normal as it shows that your nervous system is doing its work.

Many of you may have heard that in June 2019 the creator of EMDR, Francine Shapiro, passed away at the age of 71. She discovered the properties of her theory quite by accident, as many good ideas come along, and being open to something that the Universe was trying to tell her. As a graduate student in Psychology, she followed up with good old-fashioned inquiry and research and started nothing short of a revolution. People with long term traumatic symptoms – war veterans, crime victims, people with chronic pain got relief! Even after years of traditional therapies, within a few sessions, they were able to think about or talk about their traumas without feeling as though it was happening all over again. Like I said: Magic.

Ok, magic and science. One image that came up in my mind when watching my first demonstration on Day One was the idea of hypnosis. In the movies, we always see some Victorian doctor in a gray suit with a curly mustache swing a big, gold, pocket watch in front of someone’s face until they become sleepy. In this state, the doctor is able to access memories, or implant some suggestion that later comes out unknowingly as a behavior the doctor wanted the patient to complete. Okay, that is pretty creepy and not what the purpose of any legitimate therapy is. But the bilateral stimulation has definitely been known for a while as a powerful method for brain stimulation. Plenty of new science on the brain is out there and practitioners, writers, researchers are clamoring to have the next breakthrough: like plugging our heads into a screen and making images appear. I’m not so sure that is a world I am interested in, as my reality, anyway. I’ll take it as science fiction instead.

I am a convert now. I don’t hear all the stories as much in sessions. I find myself taking deep breaths with my clients, nodding, and saying “go with that,” a lot while observing waves of emotion in my clients through their tears, twitches and relaxation responses. They end their sessions looking like they just came out of a nice dream, stretching and smiling, yet they were fully awake in the room the whole time. I tried it while in training, as we have to do on one another, and discovered that a number of things that used to get me going on an angry rant are no longer bothering me. It is a very peaceful feeling, to be able to let it go. I have studied for 25 years to do play therapy, Cognitive Behavioral Therapy (CBT), Solution Focused Therapy, art therapy, and this is becoming my go-to and I don’t have to give up any of the above! I hope to keep going to get certified, which will take a couple years to do, so until then I will keep practicing, training, and consulting. Advice? Interested therapists should find an EMDRIA approved training, and don't cheap out on this one. There is too much to learn in what might look like a bargain. Potential clients: always look up where your therapist got their training, just in case they did cheap out! 

Only Twelve Rules? We can do that!

Months 3 and 4

The third book the budding book club read was too long to delve into in just on month. We read The 12 Rules for Life, An Antidote to Chaos by Jordan Peterson. Before this choice was made, we didn’t know that there has been some controversy around this author. Some said he is sexist, but I honestly didn’t investigate the concerns and just wanted to listen (in my case) with an open mind. Dr. Peterson is a professor of Psychology in Canada (no I am not going to give you his resume), and formerly of Harvard. He is originally from some small town or city in Canada where it gets really cold and miserable for more than half the year.

Anyway, he came up with a list of 12 Rules that people should live by and filled in the chapters with anecdotes and examples from his life, his friends’ lives, examples from contributors to his list that he elicited from an online forum. He made some pretty convincing arguments and showed himself to be a bit of an overachieving philosopher: someone who could really be interesting at dinner parties, but also someone who made you ready to go home as soon as dessert was finished. At least for me, someone who gets over stimulated easily in social situations. Your brain will get full quickly. This is why it took my group two months to digest it all. If being able to digest all of it was even possible.

The rules have interesting titles such as: Stand up straight with your shoulders back; Do not let your children do anything that makes you dislike them; Tell the truth or at least don't lie; Be precise in your speech. Certainly good advice and the stories add a lot of richness that illustrate why these concepts are important to living a good life. It was difficult arguing with many of these although I have heard some criticisms about his views on gender. Having been someone who needed a lot more caretaking after having children than I got, I agreed. When you are the one having children, it is up to your partner to step up and fill in where you are unable – though temporarily – so you do not also have to take care of your partner who feels set aside upon the arrival of a baby. It just made sense to me and I might feel differently had I adopted a baby and wasn’t in the vulnerable post partum state of mind and body many years ago.

Many concepts were complex and I know of several moments where I thought Dr. Peterson’s concepts intersected with Brene Brown’s and I thought, “a whole other book could be written at this point,” but more information kept coming to me and the thought came and left. I may go back to it, and see if I still think so after more reading. There is also a more in depth discussion of The Book of Genesis than I ever had in college that was a completely different take on the story of creation. Mind blown. Being allowed a glimpse into the way someone thinks who is a thinker, researcher, lecturer, for a living is fascinating for me, an observer of people on a close up basis. He does, however, read his own audio book, and let’s just say that not everyone has a good voice for dictating. He has a bit of an accent, being Canadian, and can sound like a big old nerd. However, knowing it is his voice lending itself to his ideas gives it a flow I have found hired voice actors don’t always provide when reading more technical material.

In short, following, integrating and living these rules will help humans live a less chaotic life. The book club continues to work on being people who stand tall, pet cats, being good listeners, letting kids take reasonable risks to become independent.

General Rating - A

Book Club - Get Comfortable with Cursing

On April 10, 2018, the Personal Development/Self Improvement book club met to discuss our second pick – The Subtle Art of Not Giving a F*ck - A Counterintuitive Approach to Living a Good Life by Mark Manson. I did have some reservations about the title, knowing that the women (so far, only women) were going to have to say the F-word repeatedly… it turned out to be just fine. During my local advertising of the meeting, there was more “buzz” in our neighborhood social media. People would chime in that they felt they needed this idea in their lives, and others who had read the book were enthusiastic about the choice. In my role of facilitator, I would read the book in advance before I proposed it to the group, and I was surprised about this one. We (or I, I should say) originally thought we would talk about Braving the Wilderness exclusively, but after two meetings, we got bored. We were hungrier than that, apparently.

Mark Manson was a blogger, freelancer, “influencer” if you will, online. He spent a lot of time in his youth traveling, womanizing, and appearing to do very little, if you ask me. Yet by the end of his adventures, he was able to tie in all of his experiences into a simple philosophy of not letting everything drive you insane with worry (The “Feedback Loop from Hell.” Sounds about right). People use the expression “I have no more f*cks to give,” ad nauseum, but do they understand what it is to truly let go of all of the petty worries that come our way? We want to worry about important things, that we have some control over, that have meaning. It’s not a book that tells us to freeload and do nothing all day, as some might imagine from the title. It’s deeper than that. For one thing, it helped me not judge a title quite so quickly. We all have great lessons from our growing up, and adult experiences. He was a kid who seemed to be on the road to self-destruction at one point. It’s easy to write off someone young who looks like they don’t care, yet most of the kids we think of – and we all know someone – are struggling, and haven’t had the support they needed, and are responding to stress.

What was nice, is that after reading Braving, then this book, there were some parallels to take note of, such as needing connection in difficult times, and we were also able to talk about ways we used some of the new ideas and skills in our lives. The women began to share more personal information, and were given and able to give support. We could point out the ways in which we were letting petty worries get in our way, and cheer the times we were not. Also similar to Braving, is the idea of standing out – and being who you are, not the way society, peers or family want you to be. We have to make  choices about what is important to us that align with our personal value system.

These days are tough and stressful, and if we all expend our energy on things that aren’t important while ignoring things we can do something about, we’ll all just implode. And if you don’t have control or the ability to save the world, find the thing you can do about it – even something that seems very small. We can pare down the BS and building up the value, instead.

Rating given by Book Club - A

A Year of Self Help Reading – Braving the Wilderness

Last year, I started a book club. Yes, I know, very un-interesting of me. However, I had been inspired to start this club due to Brene Brown’s book “Braving the Wilderness” that I read about a month before the first meeting was held. The idea was also a way for me to try to meet new friends, since I work an an independent practitioner with no day to day coworkers. The book club was dubbed The Personal Development Book Club in my community and has had a nice core group of women for a little over a year now. Braving the Wilderness poses the challenge to people to truly be themselves, hold on to their beliefs, even if they are not in the majority opinion in the crowd they happen to find themselves in. This can mean finding yourself in a hostile environment, or finding yourself left completely alone and ostracized from your community based on your expressed beliefs. The fear of this happening also keeps the status quo nice and strong, which in turn keeps many people quiet and complacent instead of speaking up.

I had recently found myself holding different beliefs from those around me – I am an East Coast Liberal (woot woot) who grew up in a pretty diverse neighborhood and City (New York) with little affluence or buffering from the harsh reality of poverty and crime. My friends were White, Jewish, Jehovah’s Witnesses, Black, Dominican and Puerto Rican, Cuban, you name it.  I have seen how social programs, multi cultural public schools and curriculums, scholarships, gun buy-back programs and access to cultural experiences can bring a child out of the cycle of poverty and make a dream a reality. However, when I moved to Colorado, I found a much less diverse population, less diversity in political opinions and a more traditionally “conservative” viewpoint. I stood out when I spoke up.

I am perfectly comfortable with this, I am diplomatic to be sure, but I don’t back down if someone gets offended and tells me I’m wrong. I also don’t go looking for a fight; I simply “speak truth to bullshit,” as Brene puts it. If you think immigrants are crossing the border to come to live in your house, I will ask how many times this has happened to you or your loved ones. I already know the answer.

What I wanted to do with my book club, is to help others sort through the moments in life they have felt on their own and empower people to embrace their role and comfort in The Wilderness. I knew that in order to accomplish this, we all needed support from one another and some analysis of those defining moments to try to change. A person can read all the self help books in the world and never be a different person. They could quote all the authors they wanted and never be a different person. Having others to listen to you, speak truth to your bullshit, give you honest feedback and a plan for the next opportunity, is priceless. In the group, I am the only therapist, but it is not group therapy. A therapist can also do these things in a mental health setting. People willing and able to try make the difference.

In short, I highly recommend this book. It is well written and research based. Brene Brown doesn’t just throw out a word like “belonging” or even “love” without creating a questionnaire, holding a focus group, coding and analyzing data and then presenting a formal definition. As far as self help books go, that is also priceless. Many books also use real data to support their assertions, but not all. Every month we post the date and book to the neighborhood and hope for a few new faces. The book club read a different book and got together to discuss the concepts and how they can be applied to life. I will usually print out some questions I find online, sometimes from the authors themselves and sometimes from other book club sites. And as book clubs go, there is plenty of talk about our lives, eating and sipping wine, and forming lifelong attachments.

The Work Book

After working with a particular child for a short while I found myself re-creating the same exercises in session that I've done with many kids in the past. I thought, I should just make this child a book that we put all these worksheets in. But then something better popped into my head: the work we were doing could help a lot of kids.

Below I pasted in the introduction to my book, and I cite The Kempe Center for much of the framework. I don't understand why this content has not become standardized to all mental health training. It can be used in so many situation with so many clients. It was designed to treat sexually abusive youth, initially. But it is truly universal. It should be viral. Teachers should know these skills as well. So please consider using this with your client caseload - each child should have a book of their own to document their progress and ability to self-regulate and plan for their own safety. You can find it on Amazon.com and search "Preventing and Treating Abusive Behaviors: A Workbook for Children and Teens. 

This workbook is a mixture of various exercises and treatment concepts that I use in my work with children and adolescents in therapy. It is based on the principles of Perpetration Prevention developed by the Kempe Center, in Denver, Colorado. I was trained by Gail Ryan, MA to teach others how to address sexual behaviors in children and teens including problem behaviors and abusive behaviors. Over time it became clear that these concepts can be applied to a number of situations where children’s behaviors become abusive. The concept is simplified as “Abuse is Abuse” meaning if someone is doing harm to another person, an animal, to property, or themselves, it is still abusive behavior and needs to stop. We do this by teaching children the goals of Communication, Empathy and Accountability. We also do not want to diminish the needs of the child engaging in problem behaviors. Therefore, we use many of the exercises to explore identity, assets versus risks, what their high-risk cycle looks like leading up to their abusive behaviors. Children still need to learn pro-social behavior and make friends in typical environments despite having experienced or exposed to violence, trauma, and loss. The table on the following page outlines the types of abuse we wish to stop and ultimately prevent.

A cautionary note to parents: This book is ideally used within a therapeutic relationship. If your child is engaging in problematic behaviors, especially sexually abusive behaviors, please seek professional help. This book can be used in conjunction with a multi-disciplinary treatment team for the management of sexually abusive behaviors. A professional will have the background to utilize these concepts to their fullest benefit.

The High-Risk Cycle exercise introduces the concept of a Trigger – something seen more and more often in the media. However, it is more than a place, or subject in our case. We want children and teens to identify the emotion associated with the triggering topic or event. Some examples are:

Not feeling liked, valued; feeling policed; feeling left out or rejected; feeling unsafe; afraid; feeling unheard or misunderstood; being mistaken, falsely accused or assumed guilty, feeling jealous, feeling uncomfortable with compliments or comments on appearance.

When a parent or caregiver is aware of situations that are potential triggers for their child, they can mitigate the child’s risks by observing and addressing the issues directly and as quickly as possible. Remember that if your child had a trauma, it is not a predictor of future behavior. Having plenty of normal activities and interactions can balance out their development. That is what the scale activity is meant to achieve. Children and Teens often feel that they will not be able to change their destinies, even if they have experienced consequences of their behaviors. It is critical that they believe in themselves.

In the exercise about their body, children and teens can learn to identify where they hold onto their anxieties and other emotions. Some hold tension in their throats, or trapezoid muscles, others may get stomach aches. This tuning in helps children and teens connect back to their physical selves and create the mind-body connection that is important in mindfulness practice, and not relying on dissociation to cope with difficult feelings.

Of course, there is more that can help your child engage in self-discovery and healing.

I hope you find this workbook useful for your kids and your clients! I believe it has been needed for a long while!

Meaning...what?

I checked in with a friend of mine recently and she said she was "okay but still searching for the meaning of life." I responded, "that's a given, the search never ends, does it?" She responded in a way that suggested I knew what the meaning of life is and I needed to share my secrets. So why just tell her when I could tell a whole bunch of people at once?
I used to think the meaning of life was a search for love - true love. I was young then. So... very... young. But as I grew older and I had more and more life experience under my belt, that goal changed. The goal kept changing. Why? Because I met the goals. I was growing, learning, evolving, gathering, every day of my life. What good would it be to hold onto something that was years behind me as a goal? Like goals, meaning is what we make of our experiences, and what we crave above all else. And when we find it - will it be enough? Will it fill that empty space inside us that we can't define with any words?
That depends. You'll know when you get there, right? It's different for everyone, because we're not robots. Some want money and derive meaning by making money. Go ahead and roll your eyes, but that means it's not Your Meaning. Some want to see their kids be successful and happy, some find meaning in music or art, some find meaning in friendships and relationships. There is no Meaning Of Life, in other words, for everyone. There is no old man on the mountaintop who holds the secrets and riddles you to get the answer out of him. I also think that once you stop searching, and settle into a life where days melt together and you hardly feel the will to live, you need to get back to your search. Actively.
You may need help getting up and getting motivated to do this. I have been facilitating a book club this year for Self-Help books. I never read very many before but I find them, well, helpful. None of them promise a 3 step program to making all your dreams come true. They offer inspiration, advice, philosophies, research findings and stories of experience. Starting there on your new journey could be right for you. If you think you are too deep into your funk, finding a therapist might be the right first step. I know, you don't want to do that. It's embarrassing, and they make you talk about your past and your pain. It's hard work to look at all the things that have been holding you down. It's also very freeing. You might find that you can finally move forward. And when you can move who knows where you will go?
My friend and I are both going on 50 years old, in the next couple of years (she's older than me nah nah nah nah nah). So neither of us can expect to find meaning in the same things we might have found meaning in when we were going on 20. When we were 20 and in college together, we were just trying to get our papers written, meet boys, and not gain the Freshman Fifteen. I tell my kids that college sounds stressful, but it's the best time of your life; in the best of circumstances of course. No real bills to pay, away from home, but still tethered safely, time to learn and time to play. There will be no other time like that. So meanings change. We get jobs and have families to support and have to fix the car when it breaks down and take care of our older parents.
It's not about being famous or doing something "amazing" with our lives. Being ordinary or average isn't the worst outcome we can have. We watch our friends have kids, we watch our kids grow up, we go on vacation either to a resort or in a tent. We can make meaning out of all of that ordinariness if we want, little by little every day. With some bigger pushes in between. So what do you want? What do you value? Who are the people you need around you? Is there anything holding you down that you are avoiding dealing with? Be introspective, question your world, notice things, learn new things, talk to people you might not otherwise talk to, get out of your safe box. The meaning will be there.

Someone who makes you feel like you are "crazy"

It's spring here in Colorado and I have been very busy with so much - just not blogging. So... I had better write something, right? Well, I am seeing and getting a lot of questions about something that therapists used to refer to as "Axis II issues," when we had that sneaking suspicion that there was more going on than simple depression or anxiety. Axis II refers to a disability, such as a cognitive delay that compounds mental health issues. Axis I is the primary mental health issue, Axis III is the medical concerns or diagnoses, Axis for is the level of stress, and Axis V is the Global Assessment of Functioning (GAF) score. Zero means your dead, 100 is frankly impossible. Most people who come in for therapy fall between a 45 (outpatient level) and 65.
Many years ago I took a training with Dr. Greg Lester who lives here in Colorado. I saw him teach in New York and I have since been to a keynote speech he did at a local conference. The title of this post is from the manual I still keep from that first training. Someone with a personality disorder can make us feel like we are crazy. The DSM IV and prior (the big psychiatric "bible") used to break down personality disorders by type and title - the immature types, the anxious types etc. The DSM V, the most current publication, just lumps them into Personality Disorder. Similar to how the authors renamed autism and put it all under one title - Pervasive Developmental Disorder.
The aforementioned training was probably the most useful one I had ever attended. It broke down all of the types and behaviors, gave clear examples -mostly using TV and film characterizations, and how to treat and manage these clients, and perhaps even "cure" them of these dysfunctional patterns of interacting with others.
People who have personality disorders create drama. Drama is used a lot when we find ourselves talking about disagreements we might have with people, or sometimes even just referring to someone who has strong feelings. Clinically, drama is the creation of issues that are not initially present. The person might take on a role of victim and seek help. However when the help is not given or not viewed at helpful, they switch roles. They then take on the role of persecutor or rescuer. This switch of drama creation is the hallmark of every type of personality disorder. People who come into treatment who say they do not respond to any treatments or "always" have felt a certain way most likely also have a personality disorder. The clinician often needs to draw upon their own feelings for information - does this client make you anxious? Or angry? Do they attempt to bait you into discussions, redirect you, confuse you? These are big indicators that it is NOT you. If you are a family member, your feelings will also guide you. It's helpful to recognize these behaviors and most importantly, NOT engage with them.
This last part is extremely difficult to do. We as social creatures are hard wired to engage in debates, justify ourselves, become defensive, and want to make things work out for the best. When you are being led around through another's drama, you will feel crazy.
When someone is smart, it is harder to manage this, as a therapist. Often the treatment looks one sided. The client simply talks and talks while the therapist does not engage. This will be a very different experience for the client as most friends, relatives, and anyone else who comes into contact with them will naturally engage, defend, justify, argue. They will suddenly find themselves in a new territory that forces them to use other skills. Dialectical Behavior Therapy (DBT) is a good modality for this - the clients learn about mindfulness, what boundaries are, general social skills. Once the client becomes genuine, an engagement can happen. This is the real person after all, undefended and wanting to make a real connection despite how frightening that can be. When clients are lower functioning and very disabled by trauma and a resulting personality disorder, setting limits, learning skills of daily living and problem solving are essential.
There isn't a complete explanation of how these behaviors and traits come to be. Sometimes there is abuse, and the personality developed as a way to survive childhood. Sometimes it is a general lack of being held accountable for many years, the narcissist believes he or she is special, perhaps because they were always told this and that they could do no wrong.
Some examples of TV and film characters with Personality Disorders (just for fun) and might help you, if you are a clinician, learning to be one or just curious:
Sheldon - The Big Bang Theory (schizoid)
Hugh Grant - About a Boy (schizoid)
Nicole Kidman - To Die For (narcissistic)
Pheobe - Friends (schizzotypal)
The entire cast of Amelie (paranoid, avoidant, histrionic, borderline etc)
Mary Tyler Moore - Ordinary People (obsessive compulsive)
Michael B. Jordan - Black Panther (anti-social)
Mel Gibson - Conspiracy Theory (paranoid)