What is EMDR Therapy?

What is EMDR?

Eye -movement desensitization and reprocessing (EMDR) is an experiential, non-talk therapy that has been around since the late 1980’s, developed by Francine Shapiro. EMDR is typically known for its use in treating trauma, including post-traumatic stress disorder (PTSD). It is also commonly used for other things that people seek therapy for, like anxiety, depression, or phobias.

How does EMDR work?

In a nut-shell, EMDR therapists following a structured 8-phase protocol and use different types of bilateral stimulation to help clients process distressing memories. The science of how the change mechanism/process works is still emerging, but it is generally understood that the combination of eye movements, bilateral stimulation, and auditory tones can help the brain process the distress that clients feel in their nervous systems and reprocess memories so that they feel less intense.

I did my EMDR training in April 2022, so I have been using it in treatment with my clients for almost 2 years now. I did my training through EMDR Consulting and what I loved about their specific approach is that they teach a processing continuum. What does that mean? Having a processing continuum means that the therapist can adapt the 8-phase protocol to the client’s needs, readiness, and emotional capacity so that the process is helpful and not overwhelming. Gold-standard EMDR protocol focuses on having clients target their first/worst experiences of a distressing memory or negative belief. What I’ve found in my practice is that first/worst isn’t always the most helpful (or safest) place to start. Sometimes it’s helpful to start with something smaller (a distressing memory but perhaps not your MOST distressing memory) and to work through the process so you can get a feel for how your body and emotions respond to the process. Starting with a lower level or day-to-day anxiety trigger can be a helpful way place to start.

Preparing for EMDR work

Before we ever do any processing, a few things need to be in place: building the therapeutic relationship, learning and practicing regulation tools, and target sequence planning.

Building the relationship & learning regulation tools

First, I focus on developing a strong relationship with my clients. We need to know each other well, and you need to feel safe within the therapeutic relationship to be able to get into processing work, which can be intense or emotionally overwhelming. We do a lot of work to ensure you have the regulation skills you need to handle the experience of connecting with the strong emotions and memories that you want to process. This looks like spending time learning and practicing different tools to help cope with strong emotions – often using breathing techniques and some visualization scripts, including visualizing a peaceful place and practicing containing distressing emotions/thoughts/experiences. We might discuss safe and protective figures that could be helpful to imagine as we’re doing the processing work. We often spend one or two sessions just learning and practicing tools, and clients get the homework of practicing them outside of session so they can see how they work with real emotions in real time. We also work on creating a STOP signal (usually saying “stop” or gesturing stop with their hands) so that clients can communicate at any time that they need to stop the process or take a break. As with any therapy, clients are always in the driver’s seat of therapy, including during process, and need to feel empowered to end the process or part of the process at any time.

Target sequence planning

Once you feel comfortable and successful using emotional regulation tools, we move into planning the specific targets you want to process – these are the images, memories and experiences that cause you to experiences stress and that you want to change your responses to. Sometimes I use the analogy of having a bookshelf and the distressing memories we will target are books on the shelves. We spend time naming them and thinking about how to categorize them according to what they’ve taught us about ourselves or how they’ve made us feel. By doing this, we are able to identify a negative belief or perception which is associated with the distressing memory or experiences. Books that fall into the same genre (having the same negative beliefs) are thought to belong together and we will typically process them together. Negative beliefs can be things like, “I’m not good enough”, “I’m not safe”, “I’m not in control”. They are often related to themes like safety, security, and responsibility, and can be tied to early experiences in life. We spend time planning what negative belief best describes the image you want to process, so that we can make things that trigger those negative beliefs feel less powerful. We also identify a positive or adaptive belief that we want your nervous system to identify as true e.g. “I am enough”, “I can control what I can”, “I’m safe now”, as a way of increasing your resilience and adaptive coping skills in the present. Once we have planned all these out, it’s time to get into processing.

Processing using bilateral stimulation

During processing, we follow a script where I’ll ask you to recall distressing memories and then have you focus on bilateral stimulation, which does the desensitization and reprocessing. In my practice, I use a combination of low-tech and high-tech tools – it’s all based on what a client is comfortable with and what works for your body and preferences. I have a light bar available – many clients choose to follow the light with their eyes. I also have headphones which play alternating tones in sync with the light movements, and theratappers, which you hold in each hand and they vibrate in sync with the sounds and lights. Often people like the combination of these three tools together, while some prefer only one or two modalities. Other clients prefer to use tapping on their body (e.g. on their arms or legs) or might ask for me to tap their legs if that feels safe and comfortable. Others might like to do what I call the old school way of using eye movements where I move my hand back and forth and they follow it with their eyes.

What do you notice? Go with that

After several passes back and forth (using between 15-30 seconds) of the bilateral stimulation, I check in with the client, asking them to take a breath, let it go, and tell me what they notice. Sometimes clients may experience vivid memories, while others will have thoughts or emotional experiences come up, or notice sensations in their bodies (e.g. tightness in their chest, rising emotions like anger, etc). There’s no right or wrong way of doing the processing – clients simply need to tune into what they’re noticing, and then I’ll let them know to “go with that” or “notice that” and we’ll continue on with the BLS.

The goal is to reduce the physical and emotional distress associated with the target image we want to process so that the negative belief feels less true, the associated felt-sense of distress in the body decreases, and a more adaptive or positive belief increases. To measure distress levels and how they are changing over time (the goal is to decrease them), we take a measurement of how distressing the experience feels. This is called a SUD; it’s a scale between 0, no disturbance, and 10, highest disturbance possible, and we measure it before we start processing. I often check in throughout the processing session to see if the SUD has changed. For some folks, depending on what we’re processing, the SUD can move quickly. For folks processing a lot of memories attached to the same negative belief (e.g. processing childhood trauma), if may take several sessions to see noticeable change or decrease in the SUD scale. We move at the pace of your individual nervous system and approach this work in a way that helps you to feel decreased distress over time - changes will happen at the pace that your body feels comfortable with.

Increasing adaptive beliefs

As I mentioned earlier, EMDR also involves in increasing adaptive or positive beliefs. Once the distress is processed down to a manageable level (as close to a SUD of 0 as possible), we typically shift to installing the adaptive belief. We also use a rating scale to measure it, which ranges from 1 (not very true) to 7 (the truest possible). We try to get the client to experience a VoC of 7 or as close to 7 as possible.

Ending a processing session

Once the SUD is as close to 0 as possible, and the VoC is as close to 7 as possible, we end the session with a body scan. This is a way of checking to see if there are any lingering emotions or sensations associated with the negative belief or image that we processed in session. If there client notices anything, we typically circle back to addressing it with a little more processing. We may end with grounding techniques, containing any parts of the target that we were not fully processed, or spending time visualizing peaceful images and places.

What happens if you don’t finish processing in one session?

If we don’t completely process a target in session (which is often the case), then we use different strategies to ensure that the client feels like we’ve wrapped up todays work and feels safe and grounded before leaving the session. I always focus on ensuring that clients feel as well regulated as possible after processing, especially when we’ve been working with really intense or overwhelming memories and experiences. This is one of the reasons that we focus on developing tools and resources before processing - we can use these at any point in session if things start to feel overwhelming and we need to stop and focus on grounding.

After-care

Processing doesn’t end when the therapy session ends - your nervous system continues to work behind the scenes to reprocess the memories we targeted in session. This can mean feeling exhausted or increase emotionality outside of session, especially after processing intense emotions. I often tell clients to treat themselves gently as though they have the flu - be gentle with yourself, get lots of rest, eat nutrient dense foods, hydrate, and spend time with loved ones, pets, or doing preferred activities. It’s not uncommon to have new memories, insights, or dreams come up after processing, and these are things we review together in our next session as we figure out what steps to take next with EMDR.

For Teachers: Having a Year Plan for Personal Wellness is as Important as Your Teaching Year Plan

Hey Alberta teachers - happy August 1st! We're at the halfway point of summer, which means it's (probably) only a few more weeks until you're getting things ready for September (hopefully you aren’t back at it already!). Before you get to year planning and into the details of setting up your classroom, I want to challenge you to consider this: make yourself a personal wellness plan for the year before you start to plan for curriculum.

What is a wellness year plan? Great question! It's something that can help you to stay on top of managing stress so that you can respond proactively to challenges and ward off burnout. Having a detailed plan of ways to take care of yourself during stress (both daily and over time) is just as important as having a well-crafted year plan. You’re probably a meticulous, detailed planner when it comes to the ins-and-outs of teaching kids. It’s important to direct that same level of care and attention to knowing what will support YOU before you head back into the new school year.

What might a wellness plan look like? First, identify the activities or things you've been doing this summer that make you feel rested, rejuvenated, and more connected to yourself. If you need ideas, the best evidence-backed strategies for completing your stress cycle are:
🌻exercise (especially cardio)
🌻sleep
🌻positive social connection
🌻physical affection
🌻crying
🌻belly laughter
🌻creative expression.

Note which things you have been doing this summer that make you feel good. These are same things you're going to want to build into your daily weekly schedule - I like to call these my “non-negotiables”. These are the things you’re going to return to again and again when you notice that you’re feeling the stress (both in your mind and your body) and you need proactive ways to manage it. Get really granular - take time making a big list or menu of things that you know you love to do that are guaranteed to make you feel better/regulated/connected. Maybe it’s an exercise class or walking your dog. Maybe it’s coffee with your friends. Maybe it’s watching a movie with your kids, painting, playing an instrument, or going for a hike. It doesn’t matter what it is as long as it works for you. Write these things down and post them somewhere that you’ll see them regularly to remind you to engage in them as often as possible. Stress relief is not a luxury - it has to be part of your daily plan. You have to take care of yourself first, and you need to do it well if you want to have enough energy and resources to support the other people in your life, including your students.

Next, map out known time/energy consuming dates that you know are coming. September is an exhausting month (so are December and June). Report cards, IPPs, parent meetings, extra curriculars - these are all things that will tax your nervous system. Identifying the known dates or time periods can help you to plan for extra care around those times. Maybe that means meal planning in advance, delegating household tasks to family members or even scheduling more sleep and rest when you know you'll be in survival mode. Being aware of what's coming and planning with your nervous system in mind can help you maintain the energy you need to get through those seasons - and avoid burnout.

Finally, share your plan with someone else - a partner, colleague, or friend. Getting support from others to help us maintain our work-life balance and prioritize our human needs (not just productivity goals) is an important way to stay connected to ourselves.

Need help making a wellness plan, or need to learn more about stress, burnout, and how to take care of it? Book a session with me. This is my favourite work to do, and I’d love to support you! https://york-psychology.janeapp.com/#staff_member/1

Why Summer is the Best Time for Teachers to Go to Therapy

Summer is finally here (at least it is where I am in Alberta, Canada). I remember how chaotic June felt as a teacher - somehow it was always busier than any other month of the school year. Time seemed to slow down rather than speed up the closer we got to the end. I always kept a countdown of how many days it was until July 1st. If I could make it to the finish line, then I knew I would finally be able to catch my breath, take a real break, and enjoy time spent away from working.

Summer is obviously a great time to rest, recharge, and get back to feeling like yourself (at least for a few weeks before you have to start thinking about starting to plan and prepare for the fall). For teachers, summer can also be the perfect time to start working with a therapist or to increase the frequency of your sessions. This might seem counterintuitive. Work is often the largest stressor on a teacher’s plate, so why would they need therapy when the work aspect is on pause? However, as someone who has experienced that stress as a teacher and now supports educators to manage stress, I believe summer is the perfect time for teachers to dive into therapy. Here are a few reasons why:

You can address the stress from the year that you’re carrying in your body. There is a difference between stress and stressors (I have a whole blog post about it - read more here). Stress is the neurological and physiological shift that happens in your body when you encounter a real or perceived threat (Nagoski & Nagoski, 2019). Stressors are what activates the stress responses, and they can be sensory, external, and internal causes. Work is an example of an external stressor. Just because the stressor itself has ended does not mean that you have dealt with the stress itself. If you’re like most teachers I know, you’ve been working in conditions that cause chronic stress. You may be feeling these effects in your body – they often show up as symptoms that impact your appetite or eating, sleep, energy levels, and emotions. Working with a therapist can help you to understand more about the effects of chronic stress on your body. Learning how to deal with your school year stress in the summer can help you create a plan for managing it better when you return to work in the fall.

You need support to process a challenging year. When we are living through chaotic or stressful situations, we don’t often have the luxury to pause in the moment and deal with what’s happening. It is after we have survived the crisis that we have the emotional space or energy to circle back to address the challenges we have experienced. A therapist can help you making meaning of and process the challenges of your year, to bring closure to them. I offer workshops and groups about processing and bringing closure to the year for this exact reason. Having a safe space to acknowledge and validate the things about your school year that were difficult can be an important part of the healing process. A therapist can help you with this important work.

You have better emotional availability to explore your needs. Teachers often tell me that summer is when they feel most like themselves. Without the stressors of work on their plates, educators finally have time to connect with others, themselves, and nature; to travel; or to get to those hobbies and activities they haven’t had time to do during the school year. All of these things contribute to a state of wellness. Wellness is “the freedom to move fluidly through the cycles of being human. Wellness is thus not a state of being; it is a state of action” (Nagoski & Nagoski, 2019). Being in a state of wellness and feeling good can be an important starting point for therapy, or addressing things you don’t have the capacity to touch when you’re surviving the chaos of a stressful year. For example, I use EMDR which is a form of non-talk trauma therapy. This work can be intense and often heightens clients’ emotional sensitivity for a few days after processing. Teacher clients may not have the luxury of time to do this type of work throughout the year. Summer is a great time to do some intensive work without the challenges of having to tend to students’ needs at the same time so that you can prioritize your own emotional and mental health needs.

You have the time to build new habits that you can carry into the fall. Without the busyness and stress of teaching on your plate, you are in a great position to make changes or build habits that will increase your overall wellness. It can be helpful to use your summer downtime to identify what your needs or what helps increase your wellness when you aren’t chronically busy or stressed. Maybe you notice that weekly coffee dates with your friend, regularly playing a loved sport, or taking time to engage in your favourite hobby make you feel like your best self. Play, exercise, creativity, and social connection are all things that humans need regularly to feel rested and rejuvenated. Identifying these activities in the summer when you have more time for them can give you information about what is important to continue doing in the fall. A therapist can help you to prioritize those non-negotiables to that they’re built into your life and schedule when the busyness starts up again in the fall.

Adding therapy to your summer self-care list can be an important way to not only get back to feeling like yourself, but to set yourself up for a successful return to work. Do any of these points resonate with you? I’d love to support you! I’m accepting new Alberta clients for in-person and virtual sessions. Book a free consult to learn more, or book an individual counselling session here: https://york-psychology.janeapp.com/#staff_member/1

What Is Anxiety and How Can I Handle It? New Perspectives

Let's talk about anxiety! One of the therapeutic lenses that I practice from is Accelerated Experiential Dynamic Psychotherapy (AEDP). This model has a great tool called the Change Triangle that comes from AEDP therapist Hilary Jacobs Hendel's work - the information in this post is a small snapshot of this concept. You can find her work here - highly recommend giving it a read.

Let’s talk about emotions

In a nutshell, humans have 7 core emotions: joy, fear, sadness, disgust, anger, excitement, and sexual excitement. They are typically experienced as physical sensations in the body. Core emotions are adaptive and provide us with the information we need to know about our environment so that we can survive but also thrive. Thriving is when we are wholehearted and connected to ourselves - which occurs when we are able to feel our emotions and use the information they give us for our betterment.

 What is anxiety?

Sometimes, we are unable to fully experience our core emotions, and that's where anxiety comes in. Often times, it shows up to protect us from being overwhelmed by strong emotions. This can be adaptive, like when you are at work and cannot afford to ride the wave of anger or sadness in the moment. The problem comes if we never dip below the anxiety to engage with those core emotions and let them run their course. We can get stuck in feeling anxious, which comes with all kinds of symptoms that can be both physically and emotionally distressing.

 How to manage your anxiety

What can be helpful is learning to notice anxiety as a cue that there are core emotions underneath that are asking for attention. In my experience, it's often fear, anger, and sadness.

When you notice you're feeling anxious:

• Pause and take a moment to breathe

• Notice the sensations that come up in your body, which are clues to which core emotions you might be feeling

• Listen to what the emotion is telling you without judging it - feelings are just information

• Think about how best to proceed

Taking time to pause, notice, listen, and think can create the space to connect with yourself and let your emotions give you the information you need to shake off the anxiety.

Not sure how to do that, or how to stay with strong emotions and process them? I love to do this work with clients, and I'd love to support you, too. Connect with me here to book a session.

Rest and Rejuvenation: How Play Can Help You Recharge

As we move through the holiday season, with many folks getting some much needed time off, it’s important to think about how we can use this time to get the most out of our break. How can rest and rejuvenation help? I’m so glad you asked.

I recently shared a post (by @RevDaniel) where he discussed some sage advice he received before taking a leave of absence: there is a difference between rest and rejuvenation. The analogy he used was the difference between unplugging and charging: unplugging simply means you’re not draining your battery; rejuvenation is something different. Both are important, but they are not the same.

Rest and rejuvenation are not the same

Rest is something we tend to be more familiar with: we know it involves slowing down and taking a pause or unplugging from some of the more strenuous, everyday demands we are faced with. Trisha Hersey of @thenapministry puts it this way: Rest is anything that slows you down enough to allow your body and mind to connect in the deepest way. Maybe that means a nap, or a taking a walk in nature. Or it could mean spending time on the couch, listening to your favourite music, or turning off all your devices so that you aren’t on call or connected for a while.

So what is rejuvenation, and how is it different from rest?

Simply, the Oxford definition of rejuvenation is “the action or process of giving new energy or vigor to something”. One of the best ways to engage in rejuvenation is through play. We can think about play as something that is purposeless, all-consuming, and fun; something we do for the sake of enjoyment with no other goal. We often think that play is for kids, but it’s actually just as important for adults – play helps us to flourish. The act of engaging in play is what rejuvenates and helps to recharge our batteries, and get our joy and energy back. (There’s also a growing body of research for how and why play is a biological imperative for humans, associated with things from higher intelligence, to social skills development, to problem solving – check out Dr. Stuart Brown’s work on play for more information).

Ways to rejuvenate

So what might rejuvenation through play look like for you? Think about the things you get lost in doing – the activities you perhaps loved when you were younger and could spend time doing for hours. Think about the things that bring you joy, that you do for no other reason than that they are fun. It can be hard to think about doing things that aren’t “productive”, but this is exactly the type of activities our brains and bodies need to feel recharged again.

Play activities could look like:

·         Playing a sport

·         Playing an instrument – solo or with others

·         Having a games night with friends or family

·         Creating art of any kind: painting, crafting, knitting, collage

·         Anything that makes you belly laugh – going to a comedy or improv show, or watching your favourite funny movies or TV series

·         Cooking or baking

·         Getting outdoors in nature

·         Building something out of Lego

·         Swimming

The key to rejuvenation is finding ways to engage in play that is meaningful for you. Think about something that’s fun, that allows you to get into a flow state where you can lose track of time. Rest can help you to pause and catch your breath; play will get your batteries recharged again.

What kind of play activities will help you rejuvenate this season?

If this post resonates with you, but you need some support to figure out what rest, rejuvenation and play look like for you, connect with me! These are goals I can support you with. Click here to book a session or email me at laurel@yorkpsychology.org.