What is EMDR? Part 1

Tyson Conner  00:10

Do you want to learn about psychological growth without sorting through the jargon? You're in the right place. This is the Relational Psych podcast. I'm your host licensed therapist, Tyson Conner. On this show, we learned about the processes and theories behind personal growth and experience a little bit of it ourselves. Join me twice a month for candid conversations about therapy and psychological concepts with real mental health professionals using understandable language and simple experiments that you can try yourself. Keep in mind this podcast does not constitute therapeutic advice, but we might help you find some. So today, I am here with Dr. Olivia Painter. Dr. Painter is a psychological resident here at, Relational Psych, one of my co-workers, and she's also an undergraduate psychology adjunct professor at Azusa Pacific University. Dr. Painter, welcome.

‍

Olivia Painter  01:06

Thank you.

‍

Tyson Conner  01:08

So today, we are answering the question, What is EMDR? And we're not going to answer that whole question today? Because that's a very big question. So this is actually the first of a two part episode. Today, we're going to cover just very broadly, what is EMDR and we're gonna get through the first half, there's four of eight stages in the process of EMDR. That's what we're going to cover on this episode. Then on a future episode, we're going to cover the remaining half -- the other half of EMDR, and then a few other things that you want people to know. 

‍

Olivia Painter  01:44

Yes, all the goodies. 

‍

Tyson Conner  01:45

Great, because we're talking about trauma today, we will be talking about the sorts of things that could cause trauma. Specifically, we have conversations around trauma related to family members, trauma related to accidents, car accidents, we talk about spiritual trauma, we talk about medical trauma. None of these things go into detail, but this is a trauma treatment. And so we will be talking about trauma. So if you're especially sensitive to any of those things I mentioned, know that we don't get much more in depth just mentioning them. And be kind to yourself, go ahead and skip this one, or, you know, skip forward, forward 15 seconds, if we're talking about a topic that feels overwhelming. Or just you know, beware be aware, be kind, we don't want you to be surprised. We don't want people to need EMDR because of our podcast episode about EMDR  - that would be self defeating. So what is EMDR?

‍

Olivia Painter  02:48

Yes. So EMDR stands for Eye Movement Desensitization and Reprocessing therapy. So it's an evidence based form of treatment to help lower distress associated with traumatic experiences.

‍

Tyson Conner  03:02

So there's a few things I'd love to hear explained real quickly. I'm sure that the actual like eye movement desensitization, we'll get into that later. But what do you mean, when you say evidence-based? That feels important, that feels like that means something specific?

‍

Olivia Painter  03:16

Yeah, absolutely. So there's been research and multiple studies done since this came out in the 1980s, to show that this was something that was normed and something that was beneficial for people who experienced various forms of trauma, anxiety, PTSD, panic, where this distress was lowered across the board.

‍

Tyson Conner  03:39

So our regular listeners will know what it means for something to be normed, because that concept comes up a lot. But for folks who maybe this is the only episode you're listening to, just to reiterate, when something is "normed", it means it's been tested repeatedly with different populations and different groups of people over and over again. And so we have a sense of what the common normal response is. So when you say EMDR is an evidence based practice, it sounds like this is a kind of therapy that came out in the 80s. And basically, ever since then, people have been researching it to see does it work? And the answer has been, "yeah, more or less."

‍

Olivia Painter  04:18

Yes. 

‍

Tyson Conner  04:19

Awesome. Continue. 

‍

Olivia Painter  04:22

So with this, what we're doing is healing trauma from a neurological standpoint. So what we're working on is essentially rewiring the brain in ways that your body naturally does already by itself when it sleeps.

‍

Tyson Conner  04:37

Okay, so EMDR is using the body's natural sort of neurological processes that usually happen when we sleep. So using that process that our brains already have to heal trauma while you're awake.

‍

Olivia Painter  04:52

Exactly. So essentially, what a therapist is doing is guiding you through a process where you get to heal yourself.

‍

Tyson Conner  04:59

That sounds pretty nice. How does that work?

‍

Olivia Painter  05:04

Great question. So there's eight different phases through the EMDR process. But essentially, when you get to the reprocessing phase, which is about halfway through the eight phases, what you're looking at is stimulating that bilateral stimulation. 

‍

Tyson Conner  05:20

Okay, what's that? 

‍

Olivia Painter  05:22

So that is rapid eye movement. So what you naturally do by yourself, when you're sleeping, when you get to REM sleep, where your body is processing what you experience on a day to day basis - what a therapist who's EMDR certified is doing is mimicking that same bodily response by either using their fingers and you following it as you reprocess the trauma or through things called butterfly taps where you do it on yourself or through handheld buzzers.

‍

Tyson Conner  05:49

So, a lot of us might have learned about REM sleep - rapid eye movement sleep - in like high school biology class or something like that. As I understand it, Rapid Eye Movement is something that happens when you're sleeping. And it is sort of like evidence that you are dreaming, or that your brain is at a certain mode of processing, right, that we experience often as dreaming, although we don't always remember it. 

‍

Olivia Painter  06:18

Yes. 

‍

Tyson Conner  06:19

So the the eye movement thing? How is that related to what's happening in your brain? And what is the thing that's happening in your brain? 

‍

Olivia Painter  06:30

Yeah, great question. So we all have neural pathways in our brain. And this eye movement is our way of making sense of what happened in our day to day experience. So when we get to REM, which is one of those four levels of sleep, that is when our brain tries to make sense, utilizing those neural pathways, of what's happened in that day.

‍

Tyson Conner  06:51

The analogy that I would use with, when I worked a lot with like kids and families, I would say like, "if you imagine that your brain is like a bunch of pathways through the woods, right? The pathways that get used the most are the easiest to travel through. And so the pathway from the stream to the big tree, if people are going that way a lot, then that pathway gets wide and easy to use. But, you know, if you only use a certain pathway when it's raining, and it hasn't been raining in a while, then that pathway might start to get a little overgrown, for instance." It sounds like -- and for our listeners, just sort of like a neurobiology 101, let's talk about like brains and how they work. Neurons are like the basic cells of your brain, right? In the same way that skin cells are like the things that knit together to make up skin, neurons connect to make up a brain and the nervous system. Neurons extend all the way through the body. And neurons are like these little like clumps of like 'thinky bits' with long arms connected to the other thinky bits. And when a brain is thinking, or processing and experiencing, when your mind is doing all that stuff, your neurons are connecting, firing and wiring together. Literally electricity is passing between different neurons. There's this idea that neurons that fire together, wire together. So a good example of that: if your grandma's house always smelled like apple pie, you went to Grandma's house, and it smelled like apple pie, and there was grandma and she gave you a big ol' hug every time. If you're walking past the bakery section of your local grocery store, and you smell apple pie, you'll think of grandma. And that's because the neurons in your brain that know what apple pie smells like, also know that when you smell apple pie, grandma's probably going to be there. Grandma could have been dead for 20 years, my condolences, but your neurons are used to connecting those things to one another. And using smell is kind of cheating, because smell is very closely related to memory, which is why smells are really powerful at bringing stuff back. And it sounds like, if I understand what you're saying correctly and if I understand the base theory of EMDR correctly, someone who's traumatized will often have neurons that fire together in ways that are very distressing. Whereas in my example, apple pie can remind you of grandma. Imagine the smell of apple pie instead reminds you of the worst day of your life where incredibly terrible, awful and painful things happened. Now, anytime you smell apple pie, your brain goes to that place and it's distressing and overwhelming. It's scary and sad. It sounds like what EMDR tries to do is disconnect those things. Allow the smell of apple pie to just be the smell of apple pie. And maybe it still reminds you of the worst day of your life. But you don't get caught in it the same way.

‍

Olivia Painter  10:07

Absolutely. So that's definitely a part of the process. Trauma also can get stuck in those neural pathways too. So sometimes we might have neural pathways that are really clear. And sometimes it gets stuck. And we don't know how to get through the forest. So what EMDR is also doing is clearing out kind of that stuck piece in the brain where we feel like we can't go on. When we maybe notice we're at the store with the apple pie and feel like we get triggered out of nowhere. And we don't think about grandma, we think about something that's totally unrelated. So it's doing the both-and there.

‍

Tyson Conner  10:41

Gotcha. So sometimes trauma can sort of create - to use the the pathways to the forest analogy - a traumatic experience can create looping paths, where people get stuck and don't know how to get out, basically. And then this process is to try to provide a way out of that loop. 

‍

Olivia Painter  10:58

Right.

‍

Tyson Conner  10:59

Cool, how does that work? 

‍

Olivia Painter  11:03

Great question. So there's eight different phases that we work through in the EMDR process. The first few sessions, depending on the individual, and whether they're coming in for a specific acute circumstance, or whether they're coming more for complex trauma/repeated events is going to change the amount of sessions that each client will need. But the first piece we would do is called history taking. So essentially, what you're doing here is creating a trauma timeline, like with your therapist, of all the events in your life that have caused you any type of level of distress.

‍

Tyson Conner  11:37

Now, is that true? Like, so if I'm coming in for EMDR, for like a car accident, there was a moment, it was less than five minutes that the events happened. And I'm coming in for EMDR, is my timeline about the car accident or is about my whole life?

‍

Olivia Painter  11:55

So it depends on what you are wanting to do in your work. I think it's important as a provider to offer a timeline that goes from our earliest childhood experience to our current experience. Some providers offer care that would just focus on a particular acute situation. The thing with trauma is that it's connected. And we don't always know where and why it's connected. And so I think it's important to be able to work through all trauma and adversity, even if we're just here for a car accident, because that car accident might load onto an early childhood trauma that maybe wasn't distressing, or that we noticed was distressing.

‍

Tyson Conner  12:31

Yeah, so here we're talking about something that comes up a lot when I talk with other Relational Psych people is that our approach here tends toward the more -- I don't know -- holistic, integrated, less sort of chunked off, I suppose, then maybe other people's might. It's just a difference in how we practice, other people practice differently. Research seems to indicate it all works. And we have reasons for doing it the way we do. And one of the things I hear you talking about is something that I've actually kind of heard more broadly in like the psychotherapy and mental health kind of conversation, especially over the past couple years; that we've had this idea of trauma, as being so specific and isolated, that might not actually be the best way of thinking about it all the time. Like you just said, a car accident, I might come in because there's a car accident, and it makes it so that it's really hard for me to drive, right? But what I'm hearing you say is, it might be really hard for you to drive, because that car accident is connected, the trauma of that car accident is connected to other traumas you've had before. So just working through that one trauma might help, but you might get more benefit from connecting to the other traumas too. Okay, sounds complicated.

‍

Olivia Painter  13:49

It can be, but it's interesting. So with the history taking piece, you'd create what we call the trauma history, like, timeline. During this phase, I also like to offer the dissociative index, which is like the DES index. And what that's looking for is the frequency of dissociation. 

‍

Tyson Conner  14:09

What's dissociation? 

‍

Olivia Painter  14:11

So that's anytime where we don't feel like we are present and grounded maybe in our own body. Whether, that looks like depersonalization or derealization, feeling like maybe we're watching a movie happen in front of us or feeling like we're outside of ourselves, watching ourselves. We may be physically present, but we're not mentally and emotionally present.

‍

Tyson Conner  14:30

And that's a common response to trauma. A lot of times when people are traumatized, when they get triggered, they will dissociate in one of those various ways. "Out of body experience" might be some of the language our listeners will be familiar with. And why do you give that measure?

‍

Olivia Painter  14:46

Because there's gonna be times where the work that we do is going to bring up memories that feel distressing, but we don't want to get you to a point where you feel dissociated. Because we can't do work when we're in that part of our brain. When we are dissociated, we're working from our brainstem and healing has to happen through the prefrontal cortex.

‍

Tyson Conner  15:04

Gotcha. So the brainstem is the part of the brain that's like, back your head connected to the neck. That's where like, breathing, heart rate, those sorts of things tend to to live. And what I'm hearing you say is, when you're dissociated, that's the part of your brain that's most active, right? And you kind of disconnect from the rest of your brain, 

‍

Olivia Painter  15:25

Flight or flight. 

‍

Tyson Conner  15:27

You're in that fight or flight mode. Dissociation is a way to survive something that's overwhelming. And this healing process, it sounds like only really works when you have access to more of your mind, more of your brain. Specifically, the prefrontal cortex, which listeners, if you imagine just like literally right behind your forehead, that's where that is. And that area of the brain, as I understand it, is where like, language and math and ideas, most conscious thoughts happen in that space. Cool. So you give people this measure, so that you can be aware of how likely they are to dissociate?

‍

Olivia Painter  16:05

Right. So that's something that we can be mindful of as we're reprocessing together to make sure that we don't get outside of that window of tolerance. And then we'll also do what's called the safe calm place protocol. And so that's something that I like to offer my clients, it's kind of like a touchstone. So something that can be practiced both in the therapy space, but also outside of the therapy room, something that feels safe and calm to them that utilizes each of their senses. So if at any point they get outside of their window of tolerance, it can be a grounding technique to help them feel centered.

‍

Tyson Conner  16:38

So you've used the phrase window of tolerance a few times, it feels kind of important to explain that. Can you describe what that is?

‍

Olivia Painter  16:46

So the window of tolerance is when we get to a point where we're not able to regulate ourselves. So distress might bring up a tearful experience, or we might even feel like our heart racing a little bit. But if we get to the point where we feel like we're not able to be present in our bodies, or we're not able to form thoughts, and we feel like we're dysregulated, we want to find a way to ground ourselves, because work is not going to be beneficial at that point, because that's when we go back to that brainstem that fight or flight response.

‍

Tyson Conner  17:17

Gotcha. So the window of tolerance idea is that, like, you need to have a certain amount of distress to be able to do the work. But if you have too much distress, then your mind's gone out the window, and you can't get any work done. Gotcha.

‍

Olivia Painter  17:31

Exactly. From there, once that would be completed, we'd go into the client preparation. So I like to show a visual aid usually, to my clients, of what an easy way of looking at the EMDR process. I usually show like a couple minute video of like a moving motion graphic design kind of video so they can understand what the experience looks like with reprocessing. Through that I give some psycho-ed around like what the process is - exactly what we've already been talking about the neurology behind it.

‍

Tyson Conner  18:07

And psycho-ed is psycho education, which, Listener, that's what this entire show is.

‍

Olivia Painter  18:14

Good stuff. From there, we then will do the assessment piece. So going into phase three: this is a lot about -- after we've created our trauma timeline, we'll do what's called trauma clusters. And so we all kind of have like trauma themes throughout our life. Once those are identified, we also rate what we call an a SUD score. So how distressing that event for us is from 1 to 10. 

‍

Tyson Conner  18:41

SUD is subjective units of distress. So it's kind of like when you go to the doctor's office and they say rate your pain on a scale of 1 to 10. We're saying rate your psychic pain on a scale of 1 to 10.

‍

Olivia Painter  18:53

Mhm, how distressing that event is for you. So what we would then do when we've identified those themes is we'd identify the first event that fits into that theme, the worst event that fits into that theme, and then the most recent event that fits into that theme.

‍

Tyson Conner  19:09

So what are some examples of themes that trauma clusters around?

‍

Olivia Painter  19:14

Yeah, so a lot of my patients -- what I see is family trauma. That could be family, generally, that could be mom, dad, sibling. I see people coming from medical trauma, religious trauma. Anything that could be themes throughout your life, like school or social experiences. Sometimes they're really individualized, sometimes they're really specific. The name doesn't matter as much as just clumping the trauma together. 

‍

Tyson Conner  19:49

Sure. So if I have this car accident trauma example, then things that could cluster around that could be like other injuries? Like if If I had a brick fall on my head when I was a kid, or if I, you know, broke my leg, while horse riding or something like that. Could that potentially be a cluster?

‍

Olivia Painter  20:12

It could be, it's gonna be specific for each individual patient. So for some people, those things might fit together for some people, they may not. And so that's something that you will want to make sure that your therapist was checking in with you about. Like, okay, do these feel like they fit together? Or does that feel like it fit somewhere else? We also have a cluster called single incident traumas. So there might be things that have happened in your life that don't feel like it fits with anything. That means we can still reprocess it. It's just not in that themed bubble.

‍

Tyson Conner  20:40

Gotcha. So like for the car accident example, we could have the injury theme. It could also be this single incident trauma, not connected to anything else, that's its own particular thing. Or it could also be something else: if my little brother was in the car when we had the accident. And also, my little brother and I stayed up all night terrified that time dad had a heart attack or whatever,  those could cluster together. So it sounds like this is a point where it is a conversation between the client and the therapist. You don't want your therapist to show up and be like, "here's your little brother trauma." And you're like, "I don't know if those connect."

‍

Olivia Painter  21:18

Yes. It's very collaborative. I think as a provider, you come in kind of having an idea of what those themes are. But it's very much a conversation that you're having in the room of what feels like it fits for you. Through that, you'll ask the client or the patient what cluster feels the most distressing. And you'll start by working on reprocessing that cluster, first.

‍

Tyson Conner  21:42

You start with the most distressing cluster first.

‍

Olivia Painter  21:44

You do! 

‍

Tyson Conner  21:44

Interesting. See this, Listener, this is where I'm learning along with you. Like I'm used to more of a exposure therapy kind of model where you start with what's less distressing and then work your way up. What's the rationale for starting with most distressing?

‍

Olivia Painter  22:04

So because trauma can cluster itself together in the brain, what we're doing is clearing out distress, that's also going to clear out other distress. So something that you might have originally rated as a seven on your SUD score for a particular event. Once we clear out other trauma in that cluster, you might notice by the time we get to that event, it's no longer seven, it might be five, or three. And so the idea is by starting with the most distressing cluster, we're doing work so then when we get to those other clusters, it's going to move at a quicker rate. 

‍

Tyson Conner  22:42

Do you ever have a situation where the most distressing cluster has been identified, and you start to work on it, and the person is just too overwhelmed. They're dissociating too much. And then you have to like start with something else.

‍

Olivia Painter  22:55

Absolutely. So it's not necessarily that we start with something else, we just pause for the day. So what I like to remind my clients is not only of their safe, calm place - so that might be something we utilize when we see that we're dissociating - we try a different grounding technique, something to ground us in the moment. I also like to remind my clients of what we call the train metaphor. So we are both on a train together going on a journey together. And we're just noticing what we see outside of our window. We're not trying to make sense of why the mountains are there, or why the birds are flying, or what color they are, we're just noticing. Something that I also like to remind my clients is that we can stop at any point. So you just have to say stop or put your hand up and we can pause. And if that means we only got 15 minutes into it, that's okay. And then I give the client the choice of "Do you want to wrap up our time together here today? And we'll continue in our next session? Or do we want to transition to like more of a traditional talk therapy session?"

‍

Tyson Conner  23:55

Gotcha. Yeah, sort of like step out of the EMDR mode, and into more of a general supportive psychotherapy, which I imagine would help make it a little bit easier -- because this kind of experience is very risky, right? And so sounds like the goal is that you can create emotional safety to contain the distressing experience. So maybe sometimes when people are like, "I'm done, it's been 15 minutes." Sometimes they just gotta go for a walk like "I'm getting out of here, screw you, I'm gone." And sometimes they might want to stay and try to like, get a little bit of that interpersonal support. Just feeling like cared for, feeling like someone is interested in them, is curious with them. And then maybe when they come back, they can make it 16 minutes or 20 minutes or the whole hour, whatever.

‍

Olivia Painter  24:47

Absolutely. And I think what's important to know too, is that your mind and brain is constantly processing that. So even though we're maybe not talking about it client to therapist, your brain is naturally healing itself when you're sleeping, when you're walking around, when you're doing your day to day stuff. So the healing is taking place 24/7, whether you're conscious of it or not.

‍

Tyson Conner  25:09

So part of how it works is that EMDR intentionally gets started a process that will continue happening outside of session. By the act of doing it, you're already signaling to your brain 'start this process.' Which will then continue, whether you want it to or not.

‍

Olivia Painter  25:31

And it's - I mean, you're already - every human is doing it regardless. We're just getting it done at a quicker rate.

‍

Tyson Conner  25:38

And maybe focusing the energy in a specific area, right?

‍

Olivia Painter  25:42

So not just happening while you sleep, while you're conscious and awake.

‍

Tyson Conner  25:47

And maybe by picking a particular cluster, you're also saying like "Brain, these are the sorts of things I want you to process." 

‍

Olivia Painter  25:53

Right, right. 

‍

Tyson Conner  25:55

Do people report that that happens? When you start EMDR about like, a certain kind of issue? Do you start to like, have more dreams about it? Do you start to think about it more outside of session, that sort of thing.

‍

Olivia Painter  26:07

It really just depends on the person. But that's definitely a side effect. People can experience more vivid dreams, or if there's someone who doesn't often remember their dreams, they may start to remember them more frequently. So that's always something that we talk about. And I think that's important to check in with at the beginning of each session. "Any new insight come up for you this last week?"

‍

Tyson Conner  26:28

Yeah. Cool.

‍

Olivia Painter  26:31

So when we start to do the assessment part, before we do the desensitization piece, what we're trying to identify is the worst part of that particular memory, that event, the negative cognition that correlates with that. So what you believe about yourself--

‍

Tyson Conner  26:48

So negative cognition - cognition is another word for thought - you're saying for each trauma, there comes the worst part of a trauma, but there's also some kind of thought or belief about yourself, that's usually negative that comes with the trauma. And that could be anything from like, 'this is my fault. I'm a bad person. I'm stupid,' whatever else. Okay.

‍

Olivia Painter  27:14

And then we identify the positive cognition, so what you would like to believe about yourself.

‍

Tyson Conner  27:20

Okay, so the negative cognition is what's currently there. Positive cognition is what you want to replace it.

‍

Olivia Painter  27:28

Mhm. And then we would rate how true does that positive statement feel for us currently? On a scale of 1 to 7, 1 being very unlikely, 7 being the most true and authentic?

‍

Tyson Conner  27:39

Why 1 to seven?

‍

Olivia Painter  27:40

I don't know. That's the way Francine Shapiro created it, I have no idea.

‍

Tyson Conner  27:47

Francine Shapiro is the woman who first created EMDR. She likes the number. 

‍

Olivia Painter  27:53

Lucky number seven. 

‍

Tyson Conner  27:54

Yeah, the number of completion.

‍

Olivia Painter  27:58

So from that we identify where we feel any type of distress in our body, and what emotions come up for us. During this time. It's still a lot of information taking. So your therapist is writing or typing down this information.

‍

Tyson Conner  28:12

Okay. And this is stage four that we're in now?

‍

Olivia Painter  28:15

We're going into four. So we're currently in 3...3.5, I guess.

‍

Tyson Conner  28:24

So stage three is about - can you just review everything that's in stage three?

‍

Olivia Painter  28:29

Yeah, so stage three is the assessment process. So typically, you would create clusters when you do your trauma timeline together. So when you're naming all the trauma with your therapist, you would then go through and you would cluster and identify that SUD score that we talked about. 

‍

Tyson Conner  28:50

Gotcha. Okay. 

‍

Olivia Painter  28:51

The assessment piece would also include the DES evaluation and safe, calm place.

‍

Tyson Conner  28:59

Gotcha. Okay. Okay.

‍

Olivia Painter  29:03

Then you go into phase four, the desensitization. So this is when we start to do the bilateral stimulations, which is like the back and forth movements your therapist would do with their hands. Some people prefer buzzers that change frequency in their hands while they're sitting. That can be helpful for people who experience trauma more in their body, like physiologically. 

‍

Tyson Conner  29:25

Interesting, 

‍

Olivia Painter  29:26

So they can close their eyes.

‍

Tyson Conner  29:28

So bilateral just means side to side. So it sounds like what's important, the E in EMDR stands for eyes, but it sounds like you don't necessarily need to bring the eyes into it. They're just kind of there. But the bilateral stimulation is providing some kind of sensory input that shifts from one side of the body to the other side of the body: using your eyes, that's rapidly moving your eyes back and forth and back and forth. And this does something neurologically, something in the brain that signals to your brain 'start processing trauma.' And some people use like a light bar, I know, you follow the light back and forth or even the therapist's finger. And you're also saying some people don't even use visual cues, they use these sort of sensory physiological cues where you hold something in one hand and the other. And then the buzzing is the thing that brings your attention from one half of the body to the other half of the body. And that sort of rhythm back and forth is the juice.

‍

Olivia Painter  30:37

Yeah. And another way to do that is through what we call butterfly taps. So people would cross their hands across their shoulders, and they would tap. Similarly --

‍

Tyson Conner  30:45

Like a vampire.

‍

Olivia Painter  30:47

Yeah! Yeah, like a vampire.

‍

Tyson Conner  30:49

And then you just tap one side or the other. 

‍

Olivia Painter  30:53

Or you can also do it on your thighs or your knees. So depending on the comfortability of the client. So that can be really beneficial, especially when you kind of can change between those things in session.

‍

Tyson Conner  31:03

Yeah. So why don't we just do like a very brief review of like everything we talked about today? So we talked about what EMDR stands for: eye movement, desensitization and reprocessing? 

‍

Olivia Painter  31:19

Yeah. 

‍

Tyson Conner  31:20

Ha!

‍

Olivia Painter  31:20

Very good. 

‍

Tyson Conner  31:23

And the first four phases of EMDR, do each of those phases have names? 

‍

Olivia Painter  31:29

They do. 

‍

Tyson Conner  31:29

Can you go through like the names and like just bullet point, what's in each of the four that we've talked about today?

‍

Olivia Painter  31:34

Yeah. So the first phase would be the history taking phase. So that's where we create our trauma timeline together, and we identify the clusters. So those themes of our trauma as well as the SUD score for each of those events. Then we would do phase two, which is client preparation. So that is a lot of information about what the process looks like whether it's visual, or through words, explaining also the neuroscience behind the work that we're doing, guiding them through the process. Phase three would be the assessment piece. So that's when we utilize the safe, calm place protocol. So we're teaching that to the client, and how to utilize that to stay within our window of tolerance, as well as that dissociation index to make sure that we are aware of how frequently we dissociate. And then phase four is the desensitization piece. So this is part of the information taking that your therapist is keeping track of where we're naming, what is the negative cognitions and positive cognitions that are associated with our trauma.

‍

Tyson Conner  32:47

Great. Awesome. Well, we're going to pause this conversation here. And we'll pick up the second half of this conversation in a later episode. Probably the next episode. So if you're listening to this while they're coming out, you have to wait for a fortnight, which is 14 nights. And if you're not listening to this when it's coming out, then load up the next one. Get ready to hear more. Dr. Painter, thank you for joining us today. Is there anything that you would like to plug?

‍

Olivia Painter  33:24

Yeah, so if this is something that you're more interested in looking into, emdria.org is a great resource where you can find additional information on what EMDR is, providers in your area who offer this service. If you are a therapist yourself and are interested in training, getting your certificate, that is also on there too. Providers can be also found on psychology today or contacting your insurance company, just making sure that you're finding someone who is certified in EMDR is important.

‍

Tyson Conner  34:02

Yes, being certified is -- this is one of those things were being certified is pretty important. With other kinds of treatment models, a psychodynamic or even a cognitive behavioral kind of approach - there's a little bit more of a kitchen sink kind of feel to it. There are some tools that a therapist can bring in or not and kind of make their own thing with it. But this is a modality -- 'modality,' for those who haven't heard this defined before, is just a way of doing therapy -- that is pretty highly technical. And you want to make sure you have someone who has had all of the necessary training, who isn't just kind of making it up based off of some articles they read on psychology today.

‍

Olivia Painter  34:43

Absolutely.

‍

Tyson Conner  34:45

Awesome. And do you have a recommendation for an experiment for something that our listeners can try out at home if something about this is interesting to them?

‍

Olivia Painter  34:53

So safe calm place the protocol can be found attached here--  

‍

Tyson Conner  34:59

In the show notes!

‍

Olivia Painter  34:59

Yeah. And that can be something that you can practice outside, whether you're in therapy or not, to have something that utilizes each of the senses within your body. A place that feels both safe and calm, if you ever notice yourself feeling distressed or overwhelmed, can be used as a grounding technique to help regulate yourself in your body.

‍

Tyson Conner  35:19

Awesome. Lovely. Well, thank you so much for coming. And I look forward to continuing this conversation.

‍

Olivia Painter  35:28

My pleasure, thank you.

‍

Tyson Conner  35:33

Special thanks to Dr. Olivia Painter, Dr. Painter can be found at Relational Psych. If you're interested in the further and learning that Dr. Painter mentioned, the link to emdria.org is in the show notes. EMDRIA for those curious stands for the EMDR International Association. There's also, in the show notes, a link to a safe calm place protocol, which we mentioned in this episode. And I realized, upon editing it, that we didn't explain it super in depth. The safe calm place is an exercise that you can do that involves some self soothing, some visualization, some breathing, to create a safe mental space that somebody can use to go to in their mind as a way of calming and relaxing oneself during moments of extreme distress. The safe calm place protocol is something that - you might have seen versions of it referenced in media. In comedies, there might be a character in a stressful situation who says something about "go to your happy place." This is kinda like a real life version of that, less a happy place and more of a safe, calm place. As the name implies, a link to one of the many safe calm place protocols is in the show notes. If you don't like that one, for whatever reason, feel free to Google and you can find dozens upon dozens more. We hope to see you for Episode Two in just a couple weeks. The Relational Psych Podcast is a production of Relational Psych, a mental health clinic providing depth oriented psychotherapy and psychological testing in person in Seattle and virtually throughout Washington state. If you are interested in psychotherapy or psychological testing for yourself or a family member, links to our contact information are in the show notes. If you're a psychotherapist and would like to be a guest on the show or a listener with a suggestion for someone you'd like us to interview. You can contact me at podcast@RelationalPsych.group. The Relational Psych podcast is hosted and produced by me, Tyson Conner, Carly Claney is our executive producer with technical support by Sam Claney and Ally Raye. Our music is by Ben Lewis. We love you buddy.

‍

Further Learning: 

The EMDR International Association: https://www.emdria.org/

Safe Calm Place Protocol: https://www.getselfhelp.co.uk/media/wwbbstpx/safeplace.pdf

‍