The dilemma of sexual abuse treatment remains the need for disclosure. For a variety of reasons, adults abused as children hesitate to tell anyone else what happened to them and as a result are unable to get help to manage their problematic feelings and behaviors in the present day. People may hesitate to meet with a therapist because they don’t feel ready to deal with the memories they are having. This is a healthy and appropriate response. It takes strength and courage to deal with difficult traumatic memories, particularly when those memories may be revisited. It simply does not work to ‘force’ this process. You will know when you are ready and that is the time to contact a therapist.
What is EMDR?
EMDR is an approach to therapy that is particularly helpful for people who have experienced something traumatic. That can be something we would normally think of as traumatizing (a sexual assault, an earthquake, a bank robbery) or an experience that was disturbing and personally traumatizing (an incident of bullying, humiliation, betrayal, complicated bereavement). To begin, a relationship is established between the client and therapist. After trust and safety have been built, by hearing your story, the therapist will identify situations or ‘targets’ for EMDR processing. These are often individual events (i.e. the time in grade 4 when the older kids bullied me or the time my babysitter touched me sexually). On the day of EMDR processing you will be asked a few questions about the event to identify a negative belief associated with situation (i.e. “The world is an unsafe place”), an image, as well as emotions and body sensations that you are noticing. Your therapist will use ‘bilateral stimulation’. This means, your therapist will have you move your eyes, or tap your knees, or play music or sounds in your right, then left ear. The bilateral stimulation helps to activate the way messages travel in the brain and helps you to process (digest, if you like) the lingering aspects of the memory.
Your therapist will do some bilateral stimulation (eye movements, for example), then stop and check with you what you are experiencing. You might be having images, often like a movie of your life playing. Or you might have body sensations (tingling in your hands or an upset stomach or quickened breathing). Or you might be focused on emotion. Or you might have thoughts. Typically you will cycle from images to thoughts to emotions to body sensations while you are processing. As well your therapist is observing while you are processing – whether your face flushes, how your eyes are moving, your breathing, your facial expressions, your vocalizations. Your therapist will ask you to pay attention to certain aspects of the processing at different points (okay – notice your sadness or okay – notice that pain in your shoulder). At other times your therapist may ask you a question.
With sexual abuse, this means targeting instances of abuse. As a result, sometimes people experience powerful emotions or body sensations during the EMDR processing. This is certainly not guaranteed, however. Sometimes the shifts that people notice are subtle or gentle and not experienced as distressing. Your therapist will be guiding the process and has the role of keeping you safe. That means if you are experiencing a distressing emotion or body sensation, your therapist may allow that to happen for a few minutes. However, if the distressing emotion or sensation does not seem to be shifting, your therapist will use techniques/strategies to take you away from those distressing feelings and for you to relax and feel grounded.
Will we only spend time processing difficult memories?
During the initial sessions where the therapist is building a relationship with the client and is hearing the client’s story; after the relationship of trust has been developed, we may begin processing difficult memories. What is also common with survivors of sexual abuse, however, is to use EMDR processing to build strength. This usually involves developing images of a safety (for example, Grandma’s kitchen or the dock by a cottage) and images of strength (for example, Wonder Woman or a protective guard dog), then using EMDR processing to reinforce and integrate those images. Particularly for survivors of abuse, the strength-building EMDR commonly happens before processing any difficult memories by helping you to associate more with the feelings of strength and/or safety. As well, you may alternate between processing a difficult memory one session and strength-building in the next session.
How will EMDR help?
During the abuse, a person may have felt intense fear, humiliation, helplessness, and loss of control. It is possible that the victim thought he or she would die. It is also possible the person felt pleasure (a common response – bodies respond to stimulation). All of these feelings could have been traumatizing. During the experience, there only so much the person could tolerate/be aware of. The rest of the experience got recorded in the memory system, almost as if it is ‘stuck’ there. The goal of EMDR is to process or ‘digest’ the memory so it is no longer ‘stuck’. At the end of processing a memory, the person will still remember that he/she was abused, but the fear or upset stomach or belief that no one can be trusted will be gone, and the image of the abuse will have faded.
©Jeremy Tomlinson, M.Ed., R.M.F.T., R.S.W., EMDRIA Certified
http://www.jeremytomlinson.com
jeremy@alternativehorizon.com
Jeremy Tomlinson, M.Ed., R.S.W., has been a psychotherapist in private practice in Toronto, Ontario, Canada for nearly 10 years. He does individual and couple counseling, sex therapy and EMDR. He works with many survivors of childhood sexualized abuse, particularly male survivors. He is a part-time professor in the Social Service Worker program at Humber College.