How Do You Heal Core Trauma?
An expert on trauma and addiction breaks down the meaning of EMDR.
Posted September 26, 2018
Dr. Jamie Marich is an EMDR bad-ass. Sure, that’s a kind of crazy way to identify someone, but it’s true.
Here are her stats: she travels internationally teaching on EMDR therapy, trauma, addiction, expressive arts, yoga and mindfulness while maintaining a private practice in her home base of Warren, Ohio. She is the founder and director of The Institute for Creative Mindfulness, developer of the Dancing Mindfulness practice and co-developer of the Yoga Unchained approach to trauma-informed yoga. She is also the author of five books on trauma recovery, most recently EMDR Therapy and Mindfulness for Trauma Focused Care (with Dr. Stephen Dansiger). Oh and she’s over 16 years sober.
While I’d dabbled in EMDR before (I went to a therapist in the '90s and asked her if we could figure out if I had any repressed memories, she waved a pencil back and forth in my face, and nothing happened), I knew a time would come when I’d have to dig in and really do it. But who wakes up in the morning and says, “Today I’d love to go pay someone to make me cry about all the things I’d rather forget”? I waited until I was, as they say, going through it and decided, since I was already sad, I might as well capitalize on that and try breaking down the thought patterns that were causing me to suffer more than I needed to.
I’m about 25 appointments in and I can say without hyperbole that it has been one of the most significant experiences of my life. While I love my regular therapist, EMDR has a way of making you go, “Why in God’s name have we been talking about all these issues all these years without ever SOLVING them?!!” Through EMDR, I have dismantled destructive thoughts in ways I never thought possible and been able to shed those labels my family gave me so that I can step into my greatness.
We all deserve to step into our greatness, as Dr. Jamie Marich knows better than anyone. Below are snippets from the conversation I had with her when I interviewed her over Facebook Live.
ANNA DAVID: Let’s start with the basics. What is EMDR?
JAMIE MARICH: EMDR stands for Eye Movement Desensitization and Reprocessing and, as you and I were sharing in our chat before the interview, it is a terrible name. It really is reflective of the historical context of which the therapy was founded.
There’s this story which is almost the stuff of legend now that Dr. Francine Shapiro, who came up with EMDR, was taking a walk the park and was contemplating some terrible things that had happened to her. She is a cancer survivor and had recently gone through some issues around that. Because was a very devoted student of mind body medicine, she was used to experimenting with her body to see “If I do this with my body, how will it affect my mental processes and vice versa…”
So she was taking this walk and discovered that her eyes started doing this bizarre back and forth thing as she was processing her thoughts and feelings, and so from there she started trialing and erroring with her friends saying, “Follow my fingers. As you reflect on these thoughts, feelings, emotions, notice what happens.”
It’s not as simple as “Just think of the trauma—follow my fingers and it’s going to go away.”
ANNA DAVID: How is it more complicated?
JAMIE MARICH: There is a method and a protocol that therapists need to be trained in so they can do EMDR safely and properly. But the reason it’s a horrible name and a clinical misnomer is that it was eventually discovered that you didn’t need the eye movement component to have a lot of the effect. You could do it by having earphones and hearing alternating beeps or by being tapped or by holding pulsers.
The mechanism at play really is this back-and-forth stimulation. We sometimes call it bilateral stimulation or dual attention stimulus…that oscillating motion back and forth.
ANNA DAVID: What does the bilateral stimulation do?
JAMIE MARICH: The easiest way I can explain EMDR is that it really helps us go deeper into the brain than talk therapy alone. A lot of people who’ve had experiences with EMDR will say things like, “I’ve mulled over this issue in talk therapy for years and years and years, and it just never quite shifted. I have good cognitive understanding, but at the heart and the body level, I still feel stuck.”
EMDR is one of the approaches that can help us go deeper than talk alone. It’s probably the most effective method I have seen for allowing me to access the holistic person and allow these shifts to happen more effectively and more quickly.
ANNA DAVID: What percentage of your clients are you doing EMDR with and what percentage are you doing just talk therapy?
JAMIE MARICH: I do EMDR with all my clients. Because once you get known in an area as doing it, a lot of people end up finding you. Of course I do other things—I do 12-step facilitation and expressive arts therapy, there are other things I bring into the mix. But EMDR is my primary method.
ANNA DAVID: While I know how it works, how can you explain it to someone who’s never done it?
JAMIE MARICH: The client and therapist talk about something and the therapist asks the client the level of distress around the issue, from 0 to 10. After doing some of the stimulation, the therapist asks, “What are you noticing now?” as opposed to “What are you thinking about now?” We want to be open to the full range of your experience. Some people will give us the thought that’s on their mind. But if what you’re noticing is that your chest is on fire, tell us that because that means your body is giving you that information. The magic EMDR phrase is “Go with that” because we want you to be able to be with that but then keep allowing more to be revealed. At the end of the session, we ask the level of stress again, with the idea that the number goes down.
ANNA DAVID: I know it’s for reprocessing memories but is it also so people can access repressed memories?
JAMIE MARICH: EMDR may take you by surprise; you may think, “I forgot that happened, or I never connected those two things together.” But one thing Dr. Shapiro always said is that EMDR does not bring up memories just for the sake of bringing them up. The point is not to torture you with your past, but if something is going to come up in the reprocessing, it’s because it’s connected to the issue that you’re working on. EMDR reveals what needs to be revealed.
ANNA DAVID: Why do people think EMDR is sort of woo woo?
JAMIE MARICH: It used to be considered very fringe, very alternative. Like, “Oh, move your eyes back and forth while you sense into memory experiences in your body.” But one of the things I do credit Dr. Shapiro for is she really did soldier very strongly in those early days, in the '90s and 2000s, saying. “We have to research this.” And so she developed a very technical protocol.
One of the reasons you’re asked those questions about your level of distress is so that we can measure how it’s working. EMDR is one of the three most researched therapies for PTSD. On EMDRia.org, which is our big international organization, there’s an up to date listing of all of the research reviews, literature reviews, and clinical randomized controls on EMDR. It’s really quite exquisite and it’s something I’m just proud to be a part of.
ANNA DAVID: So the research is just based on what the client reports?
JAMIE MARICH: There are some randomized controlled studies where those ratings around distress are taken into effect but we also have seen symptoms eradicated. A measure of success is if you go in as a client and have this clinical threshold that meets PTSD symptoms and then by the end of a certain course of EMDR treatment, those symptoms are eliminated.
ANNA DAVID: What sort of symptoms?
JAMIE MARICH: The major symptoms of PTSD are things like flashbacks, nightmares, intrusive thoughts and body level distress memories. You can have what we call the heightened arousal symptoms like the increased startle response, hypervigilance, outbursts of anger and problems concentrating. Also feeling intense, negative effect or having negative experiences of emotion all the time—anger or terror, shame, sadness—or just an intense negative self-image where you’re thinking thoughts like “I’m bad. No one can be trusted. I am defective.” A lot of these symptoms may sound like other diagnoses you heard of, like ADD and depression, so it really does become important to work with a clinician who can weigh out what things are affecting you. But the more we learn about trauma, the more we see that a lot of the behaviors and issues that cause human beings distress are explained by unhealed trauma.
ANNA DAVID: Is there a typical number of sessions of EMDR that people do?
JAMIE MARICH: Some of us have long-term clients for one issue or another because the nature of an individual’s disability may require that they have some type of check in on a more permanent basis. But we’re not trying to get people into therapy long-term with this. I do find that EMDR can work a lot more effectively and quicker than other forms of therapy. But I don’t ever want to sell it as a quick fix; that’s one of my pet peeves around some of the marketing around EMDR. You’ll read things online where someone says three sessions wiped out what years of therapy could never do. Now, I think in three sessions you can go very far and if you have a person with a pretty good life who has been through one single incident of trauma, you may be able to eradicate most of the symptoms. But even our international guidelines say EMDR is not done in any certain number of sessions and it really is up to the clinician and the client together to devise the best treatment plan possible.
ANNA DAVID: What actually “counts” as trauma?
JAMIE MARICH: PTSD is typically understood to be single incident…like one bad thing happens to you and so you have all of these symptoms. But then there’s complex trauma and honestly, most of us who would meet PTSD criteria, it is of the more complex variety typically—meaning it’s one thing after another that has made the trauma symptomatology a little more volatile or the trauma happened at a very developmentally vulnerable point in your life…typically before the age of eight and often by a primary caregiver.
ANNA DAVID: What do you say to people who think EMDR is not going to “work” on them or they’re scared to do it?
JAMIE MARICH: It’s a very good question. Let’s start with the fear first. I usually approach that by validating the fear because any change process is scary. The first thing I try to understand is what the fear is about. For a lot of people, it really is a fear of getting better. What would my life look like if I made these changes and shifts?
A lot of people are also scared that they couldn’t handle what may come up. EMDR can be pretty emotionally intense and so one thing I tell folks who work with me is “I’m willing to help you get ready for that process.”
And when people say, “I don’t think this will work for me,” often it’s because they’ve been jaded by other forms of therapy. So I will often explore what some of those experiences have been. Sometimes the core idea is “Nothing will work for me because nothing has worked for me so far.” And sometimes I explore that by asking the question, “Well, what does it mean to you for something to work? Well, let’s start there.” And then usually from there we can develop a plan.
I think it has the potential to work for everybody but I also know that not every therapy is the best fit for everybody so I usually try to invite people to give it three to six sessions. And if it’s not a good fit for you, then I’ll help you try to find a therapy that is a good fit. But I have honestly seen this work for about every type of client out there, if they’re willing to do some of the work required.
ANNA DAVID: Amen. Well, this has been fantastic. Where can people go to find out more information about you and EMDR?
JAMIE MARICH: Everything I’ve written for free online is on my website. I also have a big YouTube presence with mindfulness videos and EMDR demos that you can watch. Just go to YouTube, type my name, EMDR or ”trauma made simple” and you’ll see.