Emdr not clinically indicated for cptsd?

[Boatsetsailrose]

Hi I'm interested in emdr as a treatment for myself...
The psychiatrist said that it is not clinically proven as effective for cptsd..
I have however via this forum heard many talk of its helpfulness...
Does anyone have any research to back this up?

[Kizzie]

I took a quick look through the literature and here's what I came up with Boats:

Research Articles

Jarero, I., Roque-López, S. & Gomez, J. (2013). The Provision of an EMDR-Based Multicomponent Trauma Treatment With Child Victims of Severe Interpersonal Trauma, Journal of EMDR Practice and Research, 7(1). https://connect.springerpub.com/content/sgremdr/7/1/17

Korn, D. (2009). EMDR and the Treatment of Complex PTSD: A Review. Journal of EMDR Practice and Research, 3(4), http://www.coping.us/images/Korn_2009_EMDR_with_PTSD.pdf

van der Hart, O., Nijenhuis, E. & Solomon, R. (2010). Dissociation of the personality in complex trauma-related disorders and EMDR: Theoretical considerations, Journal of EMDR Practice and Research, 4(2). https://connect.springerpub.com/content/sgremdr/4/2/76 .

van der Hart, O. et al. (2013). Dissociation of the personality and EMDR therapy in complex trauma-related disorders: Applications in the stabilization phase. Journal of EMDR Practice and Research, 7(2). https://connect.springerpub.com/content/sgremdr/7/2/81

van der Hart, O. et al. (2014). Dissociation of the personality and EMDR therapy in complex trauma-related disorders: Applications in phases 2 and 3 treatment. Journal of EMDR Practice and Research, Volume 8, (1). http://www.onnovdhart.nl/wp-content/uploads/2008/09/EMDRTSDPPhase.pdf

Book

Knipe, J. (2019). EMDR Toolbox, Second Edition: Theory and Treatment of Complex PTSD and Dissociation. https://books.google.ca/books?hl=en&lr=&id=BWtZDwAAQBAJ&oi=fnd&pg=PP1&dq=complex+trauma+emdr+therapy&ots=jG2FMrnesV&sig=h3oUQ7ps5nka45WFBdi8OM-NaTU#v=onepage&q=complex%20trauma%20emdr%20therapy&f=false

There isn't an abundance of empirical studies about the efficacy of EMDR for Complex PTSD and those there are are mainly by professionals who are invested in this particular treatment approach.  There are far more studies about its use with PTSD which as we know is different from Complex PTSD.   

[Boatsetsailrose]

Thank you so much kizzie I really appreciate your looking and posting
Kind regards

[sanmagic7]

hey, bssr,

as you probably already know, i am an emdr therapist.  with the right emdr therapist, one who fits w/ you and is trauma-educated, emdr can most certainly be helpful w/ c-ptsd. 

many psychologists, psychiatrists, and even therapists lean heavily on empirical evidence, research outcomes, and what's they find in the literature regarding treatment outcomes.  as kizzie mentioned, there is not a lot in the literature about emdr and c-ptsd.  since it's not yet in the DSM (the bible of diagnoses), many in the mental/emotional help field don't even recognize it as something real.

kizzie gave a great list - thanks kizzie.  all i can give you is my opinion and experience.

a trauma-informed therapist who is familiar w/ dissociation, anxiety, panic, etc - all those demon symptoms of c-ptsd - will usually be very helpful in dealing w/ someone suffering from c-ptsd.   it may take some searching to find one, but they are out there.   as you've seen on the forum, several members have had a worthwhile experience utilizing emdr as part of their treatment plan.  others, not so much.  but, the ones whose experience has been positive say that it's really, really helped them.

and, i also belong to an emdr therapists' forum where i've read about positive results re: using emdr w/ complex trauma.  i've read about struggles that t's have had, also, in not knowing how to deal w/ it.  the original emdr training was, as kizzie mentioned, focused on ptsd.  it's the t's who have broadened their horizons to include getting educated about dissociation, etc., who have been the most helpful.  many are only lately understanding that c-ptsd is a real thing.  it's been frustrating getting the word out there and having it be accepted.

at any rate, w/ the right t, emdr can be invaluable in treating c-ptsd.  it may take some looking around, a few try-outs, but if can be extremely effective.  i hope any of this was helpful.

sending love and 

[Kizzie]

I should add I had two bad sessions with an EMDR T who did not work on grounding and safety with me (and I had some 2-3 day long intense EFs), and then 2 yrs later about 6-7 sessions with T who did.  It did help me to deal with the problem I went in for (depressed and EFs due to Trump's NPD), but I did have some anxiety which lasted about a month. 

I am not a psychologist but FWIW my sense is that EMDR can help to deal with specific issues/memories, but b/c our trauma is cumulative and layered (in contrast to PTSD), it can stir up other trauma.  As such, EMDR may need to be longer term that the usual 6-8 sessions with PTSD and need extra/continuous work on grounding & safety.   And as you wrote San, the T must be aware of the differences between PTSD and Complex PTSD and trained/experienced in how to deal with these differences. 

In the end more research about EMDR for Complex PTSD would help sort this.

[Eyessoblue]

Hi, I have cptsd and have had emdr it has worked amazingly well for some of my trauma where I just literally sit and cry through the whole thing, feel rubbish for a few days and then really good. But for some of my trauma especially the really early in life ones I don't see or feel anything, my therapist says this is more of an 'imprint' and can't be removed- I'm not actually sure what she means by this and am normally in such a state I don't think to ask!!! But like most things I e heard of people with life changing results and some with nothing at all.

[Boatsetsailrose]

Thank u both your replies are v helpful and re assuring..
I didn't know you were an emdr therapist San...
With my situation I'd be assigned (if at all) by the health service and so I don't know at this stage how much choice I would get.. But hearing how important it is for me to a t to be trauma informed and the grounding and stabilising that is needed helps me to be cautious and speak up for what I'd need. I have one particular incident that plays out problems in my life and so it may be I go and pay someone privately for treatment.. I have read that some t advertise as having all the training but actually can claim as a specialist when in fact the amount of training that has been taken is minimal.

[Boatsetsailrose]

Hi eyes so blue thank u for sharing your experiences is really helpful to hear..
Wonder what the imprint thing means....
Maybe as someone is so young it doesn't store in the brain in the same way?

[Eyessoblue]

Hi, been back for more emdr and feeling like an absolute mess today. The imprint is what happened to me when I was so young that my brain couldn't process it so it stays imprinted in my brain a bit like a photograph of what I saw but couldn't verbalise or process as I was too young to do so. Today I had to get all my memories and push them together and make a photo out of them then I had to imagine I was burning the lot, it was really intense and through my tears I managed to do it but am now left feeling so much worse than I did before I went in, am hoping it will pass. How are you getting on boats?

[Blueberry]

That sounds really rough, Eyessoblue.   

I didn't realise you do imagination work in EMDR too. With the imagination work my T does with me, things can feel really bad during or afterwards but they always improve within a few days. I hope that is the case for you too.

[johnram]

I have posted elsewhere and have copied my EMDR post here for this, lower down.   
For context - I have cPTSD and the following items - hypervigilance, depression, addictions, fight or flight response, developmental trauma, emotional manipulation from a young age.

Anyway, here is my EMDR post:
-----------
Thought i would reply given i have been doing EMDR for circa 3 months now, at about twice a week (so near 25 sessions in).

EMDR is hard, and its very tiring, and can bring up real strong hidden feelings and events in addition to those you plan to address, so here are some of my stories to help get a sense of it, note that in 3/4 years of talk therapy i never cried with any of the 3 therapists i saw:

- i had not realised the depth of pain due to my mother leaving when i was 12, even though i had discussed it in talk therapy many a time. EMDR opened it back up, and had me in a strong fit of anger and tears, however i felt something lift later
- we regressed to when i was 1 years old, there was trauma there that had never come up in normal therapy. i cried for the trauma, but i also had happy tears knowing something was settled, it was beautiful and typing this brings that tearful joy up
- we regressed to pre the age of 3/4 and i realised that i actually had a grandfather who looked out for me, i had lost or not recognised those memories in the cloud of trauma, and it was a real blessing. Again, happy tears, and again never came up in therapy
- we are trying to also address an addiction i have had for over 20 years. I have resolved other addictions on my own before and with some therapy before, but this has been the hardest. EMDR has loosened its grip but its still hanging around.
- EMDR brought back up old ways of behaving, i got somewhat close to lapsing on one of the other addictions and that hung around for a while, this is because as others have said, it brings back up the trauma, so in turn it brings back up the ways of behaving around then, that i think is dangerous for some possibly, but i feel it was worth the risk.
- It does bring up depressive feelings, and it can wipe me out, but it has also lightened the load, i am aware of renewal through it

Anyway, i am clearly a fan and a work in progress. I read it doesnt work for everyone, but i do think its worth the effort when normal therapy hasnt worked. I regret a lot of my normal therapy, as i felt it cost a lot and spent a lot of time doing exercises for the sake of the therapists lack of knowing what to do with me. However, i am truly grateful for EMDR, it is not the miracle bullet i hoped it would be, but it has given me so much that i wasnt initially asking for, that has really helped.

hope that helps, it is a big decision, and i think for us that have struggled with normal therapy and have an assortment of traumas and coping mechanisms and defenses, it can be useful.

The big risk as i understand it, is disassociation, and splitting off - something maybe to look into before you begin. My therapist did some tests on me for it, and is sometimes cautious around it when we cover a deep topic

i have written far more than i intended, but hope this is a useful note to others looking into it.
-------


hope that is useful for you and others, but do feel free to ask

[Boatsetsailrose]

Thank you John ram I really appreciate your sharing and honest reflection..

[MoonBeam]

Hi Boats and all.  I've written a book here and really apologize for the long post. I know you were asking for resources. I wanted to share my experience so far with EMDR as someone with CPTSD and well, it got long... (Please move or remove if it seems appropriate to do so. Plus, I'm not sure if there should be a trigger warning. I didn't share details, but the work was deep.)

Thanks for posting on this everyone. I've had 2 EMDR sessions--after an installing resources session. These were with my T who I have been seeing for around 10 months, so we have a pretty sturdy relationship in place. For me, my memories are pretty fragmented and I had no idea of which pieces would be part of a feeder memory (the beginning) and everything is just twisted all up with everything else, so I wondered how we could even begin, much less how it could possibly work. We started with something that was a theme throughout my childhood and I was able to cry a little about it--which isn't something I can do otherwise. It felt good to release a little of that emotional pressure, but we got no way near resolving anything--which was fine. I loved the image of the container we created to store heavy thoughts/emotions/memories in until we were ready to look at them in our next session.
 
The thing I hadn't expected was the dislodging of a deeply suppressed memory. A memory I had snippets of in nightmares as a teen and young adult and signs of in fears I hold that I now see are related. I had one flash of this memory previously, but it seemed so random and fragmented, I assumed it was something that wasn't even real--part of a bad dream. The memory came through clearly, a big chunk of it anyway, over the next few days after the first session. I avoided it as much as possible knowing we were doing EMDR again a few days later. I dissociated to the extent I got lost on my way to work--don't remember the drive at all and had no idea where I was when I came out of it (turns out I was in the next town over).  I hadn't experienced this in years and it really scared me.

So, we had a clear path for our next session and honestly I was anxious to try to process it. I was still questioning or perhaps more in denial that it was a real memory, but as soon as we started processing it, the emotion behind it was huge and intense and the memory fell so completely into place that it became clear in fact it was. We somehow managed to stay within my window of tolerance--I credit my T for guiding me with loads of compassion. By the end of the session, I was smiling. Something I don't do often. There was no negative cognition attached to this memory, which led me to believe this was in fact a "feeder memory"—perhaps a first traumatic event related to my CSA.

I felt elated afterwards, more myself than I have in a long time. I felt relief for two days. Then as it started getting closer to my next appt and maybe just because I was still processing such a deep memory, I started to feel intense anxiety. It was overwhelming and didn't pass. I felt like my heart was going to pound out of my chest for the next week and finally got a scrip for a beta-blocker. This helped a lot actually, to take the edge off. We haven't had another EMDR session since—that was a month ago now. I definitely went into a huge EF and realized I need more resources to handle things that might come up after experiencing EMDR. I thought I was golden 'cause I literally sailed through the two-days following the EMDR session and actually, it really took me down. Or at least that which it released really took me down and honestly it was an extremely significant memory and in that I'm grateful for the experience.

I think this is a pretty classic example of the difference between processing complex trauma and single event trauma with EMDR. With so many layers of trauma and imprinted beliefs it's a multi-step process and for me, the memories all wrap into one another. I think this too is where having a skilled, mindful T makes a huge difference. Someone who really understands complex trauma, who can guide us to stay with the current memory or belief and help untangle the mess as we move through, slowly and carefully.

The remarkable thing is that I can think of that memory now and I don't feel it in my body, the terror namely, it's not physical any more. I still have feelings to work through regarding it, sadness, anger, but I don't think that would have been possible while it was still so physically all-encompassing, which a lot of my other memories still are.

We're planning on beginning EMDR again after taking time to install more resources. I have some fear around this, but I also want the relief I felt, that sense of actually being in my body and being ok. Talk therapy is helpful, but the physiological aspect of my trauma is intense and overwhelming. That's what I think EMDR can help me with the most, along-side relational therapy and perhaps other healing modalities as well, is to release that which my body has held onto all these years, completely disconnected from my heart and head.

and so much respect to all.

[johnram]

Thank you John ram I really appreciate your sharing and honest reflection..

you are most welcome, and do reach out if you want to ask

there is someone on youtube i recommend -
Pooky Knightsmith Mental Health

this video
EMDR: 3 things I wish I'd known before I started trauma therapy

[Kizzie]

Talk therapy is helpful, but the physiological aspect of my trauma is intense and overwhelming. That's what I think EMDR can help me with the most, along-side relational therapy and perhaps other healing modalities as well, is to release that which my body has held onto all these years, completely disconnected from my heart and head.

This is my impression as well Moonbeam.  As my T explained it to me, EMDR releases the trauma from short term memory where it is stuck (and this the reason it feels like it is happening to us in the present), and moves it into long term memory so we are able to process and integrate it both physically and psychologically.  Unfortunately with CPTSD memories are intertwined or layered so the T really does need to be knowledgeable  and trained in how to deal with this. And maybe as you suggest, adding other therapeutic approaches in tandum with EMDR would be helpful, particularly those which address both somatic and psychological symptoms.

Glad you asked questions about EMDR Boats, this thread has turned out to be quite helpful