When Talking isn’t the Answer

I am writing this blog from my calm place. I know it is my calm place because Mary Jo (Klinic’s Clinical Director) and I identified it as such during the first of four eye movement desensitization and reprocessing (EMDR) sessions I completed with her.  Eye Movement Desensitization and Reprocessing (EMDR) is an integrative psychotherapy approach that has been extensively researched and proven effective for the treatment of trauma and many other mental health problems (EMDR Canada https://emdrcanada.org/emdr-defined/) and  in 2013 the World Health Organization (WHO) added EMDR as a recommended intervention for people who have experienced trauma.  The WHO describes EMDR as:

Eye movement desensitization and reprocessing (EMDR): This therapy is based on the idea that negative thoughts, feelings and behaviours are the result of unprocessed memories. The treatment involves standardized procedures that include focusing simultaneously on (a) spontaneous associations of traumatic images, thoughts, emotions and bodily sensations and (b) bilateral stimulation that is most commonly in the form of repeated eye movements.  Like CBT with a trauma focus, EMDR aims to reduce subjective distress and strengthen adaptive beliefs related to the traumatic event. Unlike CBT with a trauma focus, EMDR does not involve (a) detailed descriptions of the event, (b) direct challenging of beliefs, (c) extended exposure, or (d) homework. (Guidelines for the management of conditions specifically related to stress, WHO, 2013)

Almost exactly one year ago Klinic trained eight of our counsellors in EMDR in hopes of integrating this new tool to the ever-growing basket of services we offer at Klinic, including other non- talk-based therapies such as auricular acupuncture, yoga, mindfulness-based stress reduction, and art therapy.

As part of their training, all eight counsellors had to participate in their own EMDR sessions, and in order to assist me in better understanding some of our therapies, over the last month I have participated in four EMDR sessions and one auricular acupuncture session.  These modalities are often used together either in conjunction with, before, or in place of, more traditional talk-based therapies at Klinic.

So back to my calm place… I am in the sunroom at the cottage.  It is fall, there is a lovely breeze and the sound of the wind in the trees and the lake in the distance is like a balm to my busy mind.

When you start EMDR your first activity is to identify a calm place that you can start and end each session in, sort of a grounding place where you can always return to.  After you have chosen this place you identify a goal that you want to work on, something that brings you distress when you think about or experience it.  Like many people I have a bit of a menu of options.  For many people with severe trauma there may be a single incident, or in the case of complex trauma, it may be many. It also may not be clear from what life experiences the distress arises from.

I have decided to work on what I would label as heat intolerance.  Mary Jo and I discuss the challenges of this in that this is a real physical experience for me–from a very young age I have developed heat stroke quite easily and at times have become very ill.  Given this propensity for heat stroke, over time I have developed some aversion to excessive heat that likely causes more anxiety than called for.  I am interested in the fact that I cannot pinpoint a moment in time this distress started.  Mary Jo indicates that it does not matter and that part of the process is to link back to earlier incidences of feeling the distress.  Interestingly, it may or may not be associated with the ultimate issue; in my case, there appears to be no real connection other than similar feelings of distress.

Mary Jo, Clinical Director of Klinic

Mary Jo, Clinical Director of Klinic

As part of the first session we work on floating back to my earliest memories of feeling similar sensations of distress.  After we have identified these, Mary Jo has me rate my level of distress then dutifully work through several series of eye movement retraining using her hand to guide my eyes through the bilateral movements believed to help held trauma release.  Though, like many forms of therapy, it is unclear the exact process of how EMDR works in the brain, it does appear to mimic what happens naturally in the brain during REM sleep (EMDR Canada).

Over my four sessions I find that the earliest memories do lose their power and in fact become increasingly foggy.  Mary Jo and I note many interesting things about how distress moves through my body as a very physical sensation, and how by half way through every session I start yawning uncontrollably.  I am beginning to wonder if I am going to need to put a cot in Mary Jo’s office…. Mary Jo does note this is something other clients share as well and we agree that it likely that for me relaxation and sleepiness are rather synonymous.

In between my first and second session of EMDR I also sit in on an auricular acupuncture session with one of our counsellors, Michelle.  Klinic clients can participate in these sessions on a drop-in basis once or twice a week. I am in a Tuesday afternoon session. All told, from the time Michelle starts putting the needles in the first client, we are together for about 90 minutes.

michelle

Michelle, one of our counsellors

Auricular Acupuncture came to Klinic from the Nova Scotia addiction field after we hired a counsellor who had been using it with her clients in Nova Scotia.  After some investigation it was determined there could be a real benefit, as most of our counselling clients are impacted by trauma and addictions.  Like EMDR, this is another modality that can be highly accessible to people who are not ready to start talk therapy or do not connect well with talk therapy.

When Mary Jo and I discuss these approaches and she notes that “Many of our clients (and often ourselves) do not have the self-awareness and reflection required, or a coherent narrative of what happened in their life, that would make talk therapy immediately beneficial.  Everything we experience impacts us in multi-system ways, where talk therapy really focuses on just our thoughts.”

One of the places auricular acupuncture has been really embraced at Klinic is in our Evolve program for men who have behaved abusively. I actually experienced this when I sat in on an Evolve men’s group earlier this year.  Mary Jo notes that “They really like the acupuncture and meditation at the beginning of group-  when they get a sense of calm inside, these guys can feel out of control a lot, it’s a healthy kind of power- for some of them the absence of rage is calm- this introduces them to another level by by-passing the thinking brain.”  She goes on to share that “Once you are calm enough you can start to connect to your life differently- sometimes this needs to be a precursor to therapy.”

In my hour with the needles, I definitely note the sense of calm that is created, likely supported by the inviting environment that is set up by the counsellors including tea and soothing sounds.  I also noted the sense of community; it is evident that people who are attending regularly have developed real connections to the space and each other, and they are happy to share their experiences with me. One participant tells me frankly that this group has been the only thing that ever helped her find a sense of calm, and that she comes every week.

Over the past month I have metaphorically returned to my calm place many times working with Mary Jo, it is interesting to now physically return to my calm place to reflect on my experience.  I am honestly quite interested in the shift I have felt since starting these sessions with Mary Jo, and very curious to see how they will play out in my real world life.  Maybe it’s time to try out hot yoga again…

For more information on auricular acupuncture use and efficacy http://acudetox.com/phocadownload/Research_Summary_2013%20%282%29.pdf

To access the WHO Guidelines for conditions related to management of stress

http://apps.who.int/iris/bitstream/10665/85119/1/9789241505406_eng.pdf?ua=1