- Hey, everybody, we are
back with Dr. Alexa Altman, and we're here to run you through part of what an EMDR
session would look like. Now, obviously, in like 10, 15 minutes, we don't have time for all of
the like treatment planning, history gathering, resourcing,
what else am I missing? - Right, all the prep
basically, and the setup. And we might even not even close it down the way this would typically
be a 90-minute session, an EMDR session typically is 90 minutes. We're gonna do just a showcase
of what it could look like. - Yeah, so for those you out there who are considering it, it's not as scary. You get an idea of what the
tapping could look like, so it's not so bizarre maybe
when you first just try it out. - Yeah, I think that's a good word. It can be bizarre and it's
unlike traditional talk therapy. - Totally, even talk therapy is bizarre. The whole situation of going to a stranger to talk about tough things is
weird and we can be nervous. And so, hopefully, this will help you better understand what it can look like. And there are certain protocols and she's a specialist. Okay, tell us what we're gonna learn. - And we'll do some demo, and then I'll explain through it, which is your therapist is not gonna do. But so EMDR follows an
eight-step protocol. And it's pretty structured in the sense of how you achieve a target to reprocess, what you do with that target, what desensitization means
and looks like in a session, and how you know when you're done. - Okay, 'cause is a
target always a memory? 'Cause a target really means something that's emotionally charged, right? Or a trauma, potentially, if
that's what you're working on. - Right, usually it's a symptom. - Oh, okay. - Well, that's how we get
into the target, right? What is the symptom you're having? What's the memory that's
attached to that symptom or the present-day stressor? So a target can be a
present-day experience. It can be at past memory. And the target can sometimes
be a future experience. So, typically, an EMDR will start at the first or worst experience to then work through the
present-day kind of triggers, or how it's elicited in the present day. And then, we do something
called a future template, is we imagine the future experience that was distressing in the present and how you would react
or respond in that future. So we kind of clear
past, present and future. - Okay.
- So for today's demo, what we thought we would do is talk about a present-day stressor. And in EMDR, we do something called the float back technique, which is we float back
to an earlier experience, or life event, that we
think has kind of the root of maybe why the present-day stressor might be causing some maladaptive behavior or some of the symptoms. - Gotcha, okay, cool.
- Yeah. So why don't you tell me a little bit about what's currently going on, and some of the symptoms you're having, or beliefs you're having, or some of the things that we talked about might be a bit distressing. - Yeah, so I have my book
coming out this September called "Traumatized," and because I'm not a trauma specialist, I had to do a ton of research,
and reading, and preparation. And like I felt honestly
with my first book, I'm worried that people are gonna hate it, or that it's not gonna be received well, or I'll be thought of as stupid, or not good enough or something like that. - Right, so that present-day stressor, what we're looking for are the symptoms and the negative beliefs really that you have about yourself, or the maladaptive beliefs. So some of the things that you said is, "I would look stupid, or people won't like it, it might not be good enough." - Yeah, I think I definitely
struggle a lot with like self-talk around kind of what
people call imposter syndrome where you're like, "What
do I know, who am I?" And so I think that that
has kind of fed into this and it definitely is the like, "I'm not good enough," belief. - "I'm not good enough," okay.
- Yeah. - And then when you
think about that belief, "I'm not good enough," and
the present-day stressor, where do you feel that in your body? - Throat.
- Throat. Okay, what does it feel like? - Like heavy. - Okay, so heaviness in throat. And is there an emotion attached to it? - Probably sadness.
- Sadness, okay. Good, and so something
we're gonna get into in EMDR is what is your subjective
units of distress? How distressing is that to you
in your throat the sadness? - Probably like a- - Between one and 10.
- Like a six or seven. - Okay, six or seven. Okay, what would you like
to believe about yourself? - That I am enough and that, you know, yeah, more confidence.
- Yeah, okay. So what we're gonna do is we could in EMDR process this present-day experience and we'd get some good out of that. But where we get really
the biggest punch out of it is for us to go back into the
history, into your history, and really kind of float back and discover was there an earlier experience of not being enough or not feeling enough, that may have created a little more gusto in the present-day experience
of having to perform, and having to bring
something into the world, or something like that. - Yeah, I mean, I definitely, I played a lot of sports growing up, which is kind of performative. I remember, I think it had
to be like middle school. I played for this like
select softball team. And my coach, like he rode us hard. Like it was a like very intense and very competitive situation. And there were multiple times
where I would be yelled at, or like, I got yelled at
for saying, "Sorry," a lot. You guys know how hard that is for me. And then, I like apologized for
that 'cause I got yelled at. I'll be like, "I'm sorry." And he was like, "Right
there, like stop it!" And I remember this
particular like tournament. I don't remember where we were, but I remember being yelled at. And then I just sucked like
the rest of the weekend. Like struck out all the
time, like missed things, 'cause I was so upset essentially, like feeling like I
wasn't doing good enough. - That feels like a good
place for us to land. So the target, if we're kind of defining
some of our EMDR terms, the target's going to be
this particular experience. And what we're looking for, in really discovering
and exploring the target, is what's the image that best represents the worst part of this experience for you? - Being yelled at, 'cause the coach was out in the field and I was in the dugout and he was yelling at me from there. I remember it like vividly.
- Okay. Coach yelling at you through
the dugout, in the dugout. Okay, and then what were you
believing about yourself? - That I was terrible.
- That I'm terrible. - That I don't belong on this team. Like I suck, this is bad. - Okay, and then what's the
emotion you attached to that? - I think sadness, but at
the time, I was very angry. - Okay, oh, okay, so some sadness. - But I definitely do pufferfish when I'm like protective of myself. - Okay.
- Where I'm like, you know. - Okay, and where do you
feel that in your body? - Probably in my arms and my throat still. - Okay, so arms and throat. And then your subjective
units of distress. How distressing is that
on a scale of one to 10? - Probably like a seven or eight. It moved up a little bit from before. - This might take you
out of it a little bit. Some therapists do this, some do not. We're also looking for
a positive cognition. What would you like to
believe about yourself now when you think about this experience? - I guess, I mean, it's tricky. 'Cause I think part of it could be like, that it made me better. Or that I learned something about myself, 'cause it was like a teaching moment. Or that I am good enough,
'cause I was good at softball. I know I was, like looking back, like if I think about it, I know I was. I don't know, does that work? - Yeah.
- Okay. - So actually, "I am good enough." We're looking for a positive
self statement about yourself. Yeah, "I'm enough, I'm
good enough," right? And how valid does that feel? One being not valid at all, seven being completely true. - Probably like a three or two. - Okay, yeah. Right, okay, that's
good, that makes sense. So what we would do next, we'd move into, can I pause for a second?
- Uh huh. - I wanna make sure I did
that rating scale right. 'Cause I don't use that one, hang on. Okay, I did do it right.
- You did? Perfect, look at you.
- I don't use the POC ever. I hate ratings. - I hate ratings.
- So I don't do it. - And it's just a guess.
- It's too cerebral. - People are like (groans). - And it takes you out of it.
- Yeah. - So did you notice you were feeling it, and then when I had you rate it, you went cerebral?
- Yeah. We use it to think about
it, to get like logical. - That's why I don't do it. Okay, so I'm gonna talk
to the audience again. So what we just did
was identify the target and we activated the memory network by noting the emotion, the sensation, the cognition, and the image. And so what that does, it really opens up the memory capsule, or the memory storage, and then the reprocessing phase starts. And what the reprocessing stage is, essentially just to kind of demystify it, all it means is you're gonna
bring up all that material. I'm gonna recite it back to you. Please, do not try this at home. - Do this only with a
trained professional. - Yeah, and then we're gonna elicit the bilateral stimulation, or you're gonna self elicit
it and do it to yourself. And then, as a therapist, I'm just gonna invite you
to notice whatever comes up. So it's really kind of a
free associative experience. You cannot do it wrong,
you cannot do it wrong. In traditional talk
therapy, at this point, a therapist might respond or give you, you know, a statement
or something soothing. In EMDR therapy, the therapist is actually much
more quiet and just present. Because you're in a memory channel, we don't wanna take you out. So if you're used to talk
therapy, it's a bit different. What I invite patients to do when they're bringing up the experience, it's kind of like sitting on a train, watching the scenery go by. You're watching it. You're not in it reliving it. You're just gonna kind of watching, again, that dual awareness of kind of watching the
scene, watching the scene. When I invite you to pause the tapping, and you might know when you wanna pause, but oftentimes the
therapist will say like, "Okay, take a pause," right? And then, the therapist is
gonna ask, "What do you notice?" And you just report
anything that you noticed. It could be a change in thought, a change in feeling, a change in sensation. Okay?
- Okay. - And, again, you might feel like, "Is this going anywhere,
what's this going for?" I can tell you what we're
looking for, but I think- - It's kind of better to not know. - That's right. - 'Cause then you get too in your head. Almost like with the rating scale, where you're like, "I
don't normally do this 'cause it pulls you out," and it does. Like it does kind of pull you out, or from my experience.
- It does pull you out. Normally, all this
explanation would happen before the session. I would do a ton of explanation. So before you even start an EMDR, you know what the tapping looks like, you know what's gonna be asked of you, you know that you're gonna
kind of be free associating. When we bring up the memory, some people like to close
their eyes and go inside. And some people like to
keep their eyes open, 'cause it feels more safe or comfortable. There's no wrong way to do it.
- Okay. - Okay?
- Okay. - Okay. Yes, so what I'm gonna invite you to do, just 'cause we've been talking it got you out of it a little bit, I'm gonna invite you to
go back inside, okay? And I'm gonna invite you
to pull up the experience of the worst part of that image, when your coach is yelling
at you through the dugout, and you can feel that
sadness in your throat, and in your arms, and some of that anger, and that belief, "I'm not enough." And once you have it, if you really have that felt experience, I'm just gonna invite you to tap. (hands tapping arms gently) Okay, I'm gonna invite you to pause. And then you're just gonna
take a really big, deep breath. (Kati inhaling deeply) And let it all the way out. Okay, and whenever you're ready, just let me know what came up, what you noticed.
- That was crazy. Like, first of all, it was
hard to focus on it for a bit. And so I had to like keep pulling, almost like meditation for me, where I have to keep bringing
it back to the breath. I was like, keep bringing
it back to that experience. And then, my therapist always said like, "It's why I got strep throat as a kid, 'cause I'd hold things on my throat." And I could literally feel
it soften and lighten. Not a ton, but like let's say 30, 40%. - Okay.
- Yeah. - Okay, we're gonna go with that. So I'm sure your therapists
say that all the time, go with that. Meaning we're on a train track, we wanna stay on the track. So I'm gonna invite you to close your eyes and just go with it.
- Okay. Tapping still?
- Mhmm, you're doing great. You are.
- Thanks. - Yeah, just gonna keep it moving, letting all that material go by. (hands tapping arms gently) Okay, I'm gonna invite you to pause. Again, take another big breath. (Kati inhales and exhales deeply) Yeah, what'd you get that time? - Kind of more sadness, it was weird. It felt like it kind of floated, not floated away completely, but it was like, "Oh yeah, that was hard." And I remember it, and
it was like I was in it, but it wasn't as intense. I wasn't as angry.
- Good, go with that. (Kati laughing) - More? Okay.
- Mhmm, we'll do one more. - Okay. - Good just to notice it. (hands tapping arms gently) Okay, I invite you to pause again. Okay, another big breath. Okay, what'd you get that time? - It was hard to stay there. I don't know how people feel, but like I felt like it was easy to get pulled into other directions, because it wasn't so emotional for me. Like it was, but it wasn't
at that level anymore. I was like, "Oh, my dad was there." And, "Oh, I miss my dad." Like I could have like vroo. My brain was like, "Distract,
let's go somewhere else." And I was like, "No, no, no,
we're still trying to hold." So I could see that like
that'd be difficult for me. - Yeah, so here's, and I
think, because this is a demo, what happened, which is
a really great example, first we're able to see, "Oh, wait, the sensation lessened," right? But then the second
time we're able to see, and this doesn't always happen this way, that then an emotion came in, and then you got kind of pulled into larger parts of the story, right? "Dad was there, or dad intervened," or something else happened. And in a typical EMDR session, we'd let that go, we'd let you move. It's not actually not a mistake. - Oh, okay. - Your mind and body's pulling in other aspects
of the experience, maybe that were helpful or resources. Sometimes we go back
to the original target and kind of pull you back in. But actually what we
saw was pretty typical, in that, like, it's not a linear process. It's not like we get it and we're done. It'll continue to shift and change. We know we're done, done with the session, when your subjective,
you know, the SUDS score, which is how intense does it
feel on a scale of one to 10, when you bring up that memory to zero. - Oh, okay, gotcha. - And we also know we're done when that belief of "I'm not enough," has really shifted to "I am." And there's a sense of like, "I'm a seven. I totally believe I'm enough when I look back at that experience." - Got you. - So that's how we know we're done. sometimes, you know, in therapy, you're like, "When am I done?" Well, you know you're done when you're close to a one or two, maybe it's not a one. Or, you know, that
distress is really down. So we'd finish processing that memory, and then we'd go back to your book. - Okay, and see how it applies there? - And see how it applies.
- Interesting. - Or imagine you're having to, let's say, now present your book or do a talk, and that might come up again
in a future experience. Like does that change the
future experience of it? - Yeah, this is interesting
even thinking about resources. Because my dad was there
and he stood up for me, so he was like my
protector kind of person. So it was like even my brain was like, "No, no, no, you weren't alone. Like, remember he was like,
'Don't talk to her that way. It's gonna like mess with her. She's not gonna be happy,
it's not gonna work out. She's actually gonna play worse.'" And then, my coach stopped doing that. It was like kind of like
it went to this peak, and then it never happened. - I kind of wish we had 10 more minutes and we would've let your dad come in, because that is really a great
example of what would happen. Is that your dad comes
in and he's protected, we would tap that in.
- Okay. - And maybe the positive
belief is maybe it's, "I am enough," maybe
that's where it goes to. Or maybe sometimes in a
little session it's like, "I'm safe, I'm protected."
- Yeah. - Or, "I'm okay," you know?
- Yeah. - Or, "I am okay," or, "I was okay, but I really am okay." So it's like where we start
and what we start to achieve, sometimes it can change through the work. And you're like, "No, I actually feel like what's a better belief
is, "I'm," you know? - "It's okay," yeah, "I'm okay." - "I'm okay," yeah.
- Interesting, okay. Well, that's kind of good too, because I think sometimes
we can get so caught up on what we think it's supposed to be. Like I'm supposed to feel like I'm enough, and that can shift over time. You know, but it might shift
to "I'm safe, I'm okay." - Or, "I'm protected."
- "I'm safe, I'm okay," or "I'm protected," right. - Yeah.
- How we define that. The other thing that I think
was, I don't know if it will, I hope it will be helpful to see, is the therapist role in an EMDR session is to kind of get out of the way. And the processing
happens within the health of the person you're sitting across from. That once you activate the experience, you create a safe enough
container and enough resources that the person's system is
doing a lot of the reprocessing. We're there as a guide, and sometimes things
get stuck along the way, and we have interventions
to get it unstuck. But for the most part, it's a less verbal exchange. And for people that have been
in traditional talk therapy, that's difficult. They wanna talk about
everything and that's great. But in EMDR, it's a lot
less of that exchange. - I think that's what makes it so powerful and different too. Because if talk therapy is not enough, as we know through research, it's not always enough often for people with trauma specifically, it would be that extra layer. It'd be a little different. 'Cause that's very different what we did, 'cause I've never done an EMDR personally, but I've done a ton of talk therapy. And then what that experience
was, was very different. - Mhmm, mhmm. One thing though, as somebody who's received
EMDR and provides EMDR, what's really interesting is maybe there's not as
much verbal exchange, but the presence and the quality of sitting with somebody in these spaces, the therapist is still very much with you, even if I'm not
necessarily saying as much. Sometimes I think that
can even be more powerful, because you kind of really get the sense of that person holding that
space with you and for you. - Yeah, and I think it's also confidence building in a way. For me, at least, it's like, instead of having someone to ask questions or talk me through it I'm like, "It's okay to just feel this," which I think often personally
is not always the way. You know, I know therapeutically you're supposed to like just sit with it. We say stuff like that all the time, but I know how uncomfortable that can be. And EMDR like welcomes that and allows you to feel okay in it. - And stay in your own experience. - And not get pulled out.
- By talking. - Yeah, 'cause talking is so, again, it's like a different
part of your brain. It's like I'm tapping into
like my thoughtful processing, trying to make sense of it when I maybe don't need to. - It's so funny, the EMDR therapist in me wants to finish our session. (Kati and Alexa laughing) We might need to complete
that some other time. But so sometimes sessions
do end incomplete, where you don't go, maybe your subjective units of distress. - Oh.
- It's fine. - Sometimes EMDR sessions don't complete, where the 90 minutes or 15 minutes, depending on how time you have, you don't finish and the
memory is still distressing. So a therapist often, at
the end of the session, will give enough time to
close down the session. And that might look like
pulling in a resource, doing some grounding. You're not gonna leave the office, typically, if, you know, it works well, you know, that your levels
of distress are manageable and that you have some resources on-board before you leave the session.
- Yeah. Same with talk therapy too. You wanna like wrap things up, lighten the conversation a little bit so they can kind of calmly leave. 'Cause you don't wanna leave the session completely maxed out.
- Right. I often say to people though, the processing continues
two to three days later, you probably find that
in talk therapy too. So keep a journal, dreams often are vivid. Sometimes that dream
material is great material to target EMDR with. And so also what I say to people, unlike any other kind of therapy, maybe keep your daylight
after 'cause it's tiring. It's exhausting.
- Yeah, I've heard that too. And many of my patients have
told me they go home and nap. - Yeah, mhmm. - So, perfect. Well thank you so much. This was really helpful.
- Yeah. - And actually very interesting
to experience it myself. I know it was very short-lived. I'm not pretending anything here. Again, it was just a
very different experience from talk therapy. And I could understand the benefit. Thank you so much for watching. I hope that was helpful. And thank you for sharing that. And it was really cool
to get to do it myself, to get to experience it, 'cause it is very different
from talk therapy. I've never done EMDR personally, and I wasn't making anything up. It's just it's a very
different experience, and it was really cool. And, hopefully, that at least helped you see what it can be like. Obviously, we're explaining
it a little bit more and it is not exact like,
again, the treatment, planning, the resourcing, all of that, it would have happened before. But that kind of shows you a little bit about the "processing component." - Yeah, which is I think the part that kind of scares people the most. - Yeah, 'cause it's different.
- It's different. - But I think it's really powerful. And, hopefully, if you've experienced EMDR and found it helpful, or had issues, or questions, or whatever, leave it in the comments down below, because you never know who you might help. And also, we'd love to have Alexa back on to answer some of those. Thank you so much for watching, and we will see you next time, bye. (gentle music)
