PTSD and Trauma Self-Help and Self-Care: Safely Use EMDR Techniques Without a Therapist
What is EMDR?
Eye movement desensitization and reprocessing (EMDR) is a psychotherapy developed by Francine Shapiro, which works to alleviate the symptoms of post-traumatic stress disorder (PTSD).
According to Shapiro, when a traumatic or distressing experience occurs, it may overwhelm normal cognitive and neurological coping mechanisms. The memory and associated stimuli are inadequately processed, and stored in an isolated memory network.
The goal of EMDR therapy is to process these distressing memories, reducing their lingering effects and allowing clients to develop more adaptive coping mechanisms. This is done by having clients recall traumas while following the therapist's hand movement, a light bar, alternating audio noises, or vibrations.
My experience of EMDR therapy
I experienced social anxiety throughout my teenage years, and was only diagnosed with PTSD relatively recently. This diagnosis explained the nightmares, dissociation, and severe feelings of "emptiness" and grief that I'd been facing for many years.
I went through my fair share of unhelpful therapists, one of whom was convinced I was suffering from nothing more than depression, and I contemplated trying to repress the negative memories and feelings once more.
However, I began therapy with a private EMDR therapist, and he has helped me considerably. I had an introductory session in which I explained my symptoms, and then approximately eight EMDR sessions. EMDR suited me because I dislike explaining my memories and experiences in depth to a relative stranger, and the therapy simply requires you to follow hand movements, a light bar, or similar stimulation, and then describe how you feel.
In my case, the significance of other memories and events became clear, and I was able to confront the negative experiences in a much more rational way than before.
Using EMDR for self-help
If your symptoms are severe, I would certainly recommend seeing an experienced therapist for a course of EMDR. Personally, I found that after a few sessions I was ready to help myself independently, although I made sure that I was at a safe point in my course of EMDR before doing this.
I've never aimed to overcome my PTSD entirely: as I've suffered from it for so many years, it's become almost a part of me. However, I wanted to leave the negative symptoms and emotions behind me. Through a course of therapy and regular use of EMDR self-help techniques, I can happily say that I have achieved this.
I'll now outline some of the techniques I use, which are largely sourced from Francine Shapiro's wonderful book Getting Past Your Past: Take Control of Your Life with Self-Help Techniques from EMDR. This book is a great way to complement EMDR therapy sessions, or to address less severe incidents of trauma or past negative experiences. Therapy
1. A happy future
- Relax and take several long, slow breaths. If you find your mind wandering, take another deep breath and bring it back to the exercise.
- Focus on a future situation you'd like to deal with.
- Decide how you would like to be seeing, feeling, acting and believing in that situation.
- Bring up a safe/calm place in your mind, perhaps by identifying an experience in your past where you succeeded.
- Now bring up the positive cognition "I can succeed". Fous on the positive feelings that come up, such as strength, clarity, confidence or calm.
- Focus on an image of doing well in the future situation. Focus on the positive feelings and emotions and adopt a posture that helps you feel confident.
- Run a movie in your mind of handling the situation well from start to finish. Make it colourful, exciting, vibrant and full of detail, and enjoy the positive feelings that come up.
- Imagine a challenge arising, such as a computer not working, and imagine handling it with confidence and calm.
- Run the movie through to a successful conclusion, and end the exercise feeling confident, well-equipped and ready.
2. Belly Breath
To help lower disturbance, inhale slowly and deeply while feeling your tummy expand. Then slowly exhale and feel your belly contract. Repeat several times until you feel a greater sense of calm.
3. Body Changes
Change your posture or facial expression to move from anxiety to excitement or other positive emotional states.
One of the most successful ways I have used to overcome anxiety associated with trauma is to blur the boundary between anxiety and excitement. When I experience low levels of anxiety and feel butterflies in my stomach, I ask myself, "how is this different from feeling excited?"
If you're nervous about a future event, try concentrating on the positive aspects of what you are about to do. Also, try moving your mouth into a smile or changing your posture. Shapiro suggests imagining a superhero giving the presentation. Allow yourself to step into the image and take that same stance. When we feel defeated, our postures automatically collapse. Bring your shoulders back, straighten up, lift your chin, smile, and you may well convince yourself that anxiety is irrational.
4. Butterfly Hug
I've outlined this technique in my Hub that outlines techniques to overcome social anxiety without medication. The "Butterfly Hug" is often used in trauma therapy, and has had success in helping those affected by natural disasters. I use the technique regularly, and find it so useful for difficult moments.
- Cross your arms in front of you, with your right hand on your left shoulder and your left hand on your right. Close your eyes.
- Bring up an image of a safe or calm place along with a positive word that you associate with it. Let it fill your mind.
- Wait until you feel a state of safety or calm. Do not try to force this, but see if it comes naturally when you think about the safe or calm place and the associated word.
- When you feel safe and/or calm, tap your hands alternately on each shoulder slowly four to six times. Make sure you only do this when you feel calm and safe.
- Take a breath and see how it feels.
- Try it for one more set.
- Open your eyes.
- If the positive state increases, once again just close your eyes, allow yourself to feel the feelings, and bring up the word. As you feel the positive sense arise, again alternately tap each side four to six times.
You can use this technique to handle momentary disturbance, but it's good to reinforce the good feelings every so often when you're in a calm and safe place. This keeps the technique strong for when you need it most.
5. Cartoon character
When I'm having a bad day, I tend to have a critical voice telling me I haven't done something well enough, or that I'm not good enough. If you catch this happening, try remembering a cartoon voice from your childhood. Donald Duck and Popeye are ideas, although you can probably come up with something far more personal and amusing.
Close your eyes and bring up the critical voice from before. Notice how your body changes when you think of it.
Then make the voice in your head sound like the character and notice what happens. For most people, the disturbing feelings that go along with the critical voice disappear. The cartoon voice is instead associated with pleasant and funny memories, which can dispel the negative feelings you felt before.
This technique doesn't deal with the root cause of PTSD or trauma, of course, but it can get us back to a place of balance so we can deal with the current situation rationally and away from the influence of the past.
6. Four Elements
This technique can help ground you when you're feeling dissociative or affected by past memories.
- Earth: Grounding, Safety in the Present/Reality: Take a minute or two to "land" and truly be in the present. Put both feet on the ground and feel the chair supporting you. Look around and notice what you see, alongside what you can hear.
- Air: Breathing to Centre Yourself: You may have a favourite breathing exercise you can do here. Alternatively, breathe in through your nose to the count of four, hold it for two seconds, then breathe out for four seconds. You can repeat this around a dozen times, focusing on deep, slow breaths.
- Water: Be Calm and Controlled to Switch on the Relaxation Response: Pay attention to your mouth, and see how much saliva you have in it. Make more by moving your tongue around and imagining the taste of lemon, chocolate, or a favourite food. When you are anxious your mouth often "dries", although this technique can reverse the response and help you relax.
- Fire: Light Up the Path of Your Imagination: Bring up the image of a safe place or another positive resource. I usually imagine myself being in a large library, or being safe with my family. As you think about the positive thought or memory, focus on where you feel it in your body.
- Now remind yourself that you are safe, and that you can continue to feel the security of your feet on the ground, feel centred as you breathe in and out, feel calm and in control as you produce more saliva, and let the fire light the path to your imagination to bring up an image of a place where you feel safe or happy.
If you are feeling disturbed, concentrate on the upsetting sensations in your body. Identify the following my asking yourself, 'If it had a _____, what would it be?" Fill in the blank with each word below:
- sound (high pitched or low)
Just notice the shape and its other characteristics. Now ask yourself: "what is your favourite colour, or one that you associate with healing?"
Imagine a light of this colour is coming in through the top of your head and directing itself at the shape of distress in your body. The light directs itself at the shape and resonates, vibrates in and around it. As it does this, what happens to the shape, size or colour?
If you find that the negative feelings change, then continue using the technique until you feel comfortable.
If your regularly feel "I'm not good enough", or doubt your own ability to recover, make sure to access daily the memories that allow you to feel worthwhile. Remember events where you felt valuable or loved, or moments when you felt full of confidence and ability.
Savour those positive memories, feel the feelings, and let yourself enjoy them. Now concentrate on your body. Notice how you breathe, stand, and hold your head when you bring up the positive memories. if you feel yourself getting triggered, try changing your breath and posture back to the way you feel in the positive states.
Daily practice can help embed these positive emotions, beliefs and body sensations in habit, and make them more available when you need them most.