Trauma

Considering trauma therapy? How to tell if EMDR is right for you

If you have been searching for trauma therapy, chances are that you have come across the term “EMDR”. While there are many types of therapy that can address trauma, EMDR has become well known in the counselling world as being an excellent and fast option for processing difficult life events. But how do you know if EMDR is right for you? I hope this post will provide you more clarity and answers.

What is EMDR?

What is EMDR and how do I know if EMDR is right for me?

EMDR stands for Eye Movement Desensitization and Reprocessing. Many clients come to counselling expecting a traditional talk therapy session. They may expect to share lots of details about their lives, and have the therapist ask stereotypical questions like, “How does that make you feel?” EMDR is not at all like this.

EMDR involves the use of bilateral stimulation (BLS) to process traumatic events. BLS is a fancy way of saying that a therapist will be adding some visual, auditory or tactile prompts during therapy. For example, you may be asked to follow a ball moving across the screen or listen to audio prompts. A shift starts to occur when you combine these sensory inputs while also thinking of a traumatic event. The understanding from EMDR creator, Francine Shapiro, is that this combination activates an adaptive neural network in your brain. What we see is that EMDR clients feel calmer when they think about these disturbing situations. To learn more about what an EMDR session is like, I’d encourage you to read this earlier post or watch the following video:

Why use EMDR?

EMDR has been proven to work quickly in processing disturbing events. This is especially the case for those who have survived a single traumatic event (as opposed to complex trauma where a person has survived years of distressing circumstances). This therapy can be used irrespective of when the trauma occurred, be it yesterday or 50 years ago. EMDR has been effective in meeting the needs of diverse clientele regardless of age, race, gender and other identifiers. Beyond past events, this therapy can also help clients work through fears of a similar trauma happening again in the future.

How to tell when EMDR is working:

For clients who have had success with EMDR, they will notice several indicators to healing:

How do I know when EMDR is working?
  • Clients can speak and think about these traumatic events more calmly
  • Clients notice a change in their thinking pattern. Negative beliefs are transformed into more compassionate and positive perspectives. For example, a client who initially believed “I should have done more” may shift into thinking,”I did the best I could.”
  • Clients notice improvements of PTSD symptoms (e.g. intrusive thoughts, flashbacks, nightmares, anxieties, hypersensitivity).
  • Clients’ physical pains starts to ease. They can speak about the trauma without feeling tense, clenching their muscles, or experiencing other signs of constriction.

What prevents EMDR from working?

While all of this sounds great, there are some factors that can affect whether EMDR is right for you. As with any therapy, there is no guarantee that one approach will be the miracle cure. While EMDR has a high success rate, the following points should be considered:

1. Readiness:

Before starting EMDR, clients have to be open to addressing a painful part of their lives. While this may sound obvious, I want to emphasize how incredibly hard it is to sit with memories and thoughts that you have worked to avoid. Avoidance is a natural way to manage anxiety. If we find something frightening, we protect ourselves by staying away. As with any form of therapy, readiness involves taking the chance to stop avoiding in order to address these fears. This is much easier said than done.

2. Learning to work within our window of tolerance:

For EMDR to be the right approach for you, your therapist has to ensure that you are prepared. The goal of this therapy is to process disturbing events without overwhelming you. This means being able to think about these events without feeling emotionally hijacked. The point of EMDR is not to relive the trauma, but to recognize you are in a place of safety while thinking of a difficult past experience.

IS EMDR right for me? Trauma counselling online and in Kitchener, ON

If you go beyond your window of tolerance, the work will not feel safe. Your therapist will be monitoring how quickly or slowly to take trauma processing based on your emotional state. There may be pauses in treatment to help calm your system (e.g. deep breathing, relaxation exercises, calming visualizations, distress tolerance skills, etc). You may spend several sessions focusing on these calming skills before beginning BLS. This does not necessarily mean that EMDR cannot be used; however, there may be a delay in starting trauma processing.

3. Complexity:

Complex trauma and complex mental health (e.g. personality disorders, addiction) can take time to heal. Even with a fast approach like EMDR, clients may spend many months or years working through painful memories. You may have to spend a significant amount of time addressing these other mental health needs before starting to work through traumatic events. This does not mean that EMDR therapy is not helping; however, clients must be patient to work through these additional needs.

4. Current life stressors:

Is EMDR right for me? Learn about this form of trauma therapy

Are there current life stressors that are getting in the way? It is hard to focus on a past trauma if you are thinking about current financial struggles, work demands, or a recent arguments with your partner. When life feels unsafe or stressful, you may have a hard time focusing on the past. It is understandable that current needs keep distracting you. In these types of situations, you may need to pause EMDR, and address what changes need to occur today to help life feel more stable.

5. Fear of recovery:

This is a difficult point to make because the majority of people want to get better and the title insinuates that a person is avoiding healing. That is not my intent. There are a lot of changes that will happen in your life because of recovery. This may include embracing new routines after years of living a certain way. It may involve returning to work where there are old triggers and difficulties waiting. Perhaps recovery involves acknowledging that your parents were not kind or well-intentioned people. There is an understandable fear of what recovery might mean for a survivor, and those fears need to be supported and addressed prior to opening old wounds.

Is EMDR still right for me?

Trauma is a fact of life. It does not, however, have to be a life sentence. Not only can trauma be healed but with appropriate guidance and support, it can be transformative.

Peter Levine

While the concerns mentioned above may influence your therapy journey, EMDR can still be the right approach for you. It is best to speak with your therapist about these influences in order to problem solve. The solution may be to do EMDR in a slower manner to prevent overwhelm. Alternatively, your therapist may use a combination of other therapy styles (e.g. Internal Family Systems therapy, DBT) to address other mental health needs alongside trauma healing.

Traumatic events happen to every individual, and we cannot prevent it from taking place, unfortunately. While some recover on their own, many of us experience lasting symptoms from traumatic events. If you continue to be plagued by a traumatic event, reach out for support. EMDR may be the therapy you are looking for.

All the best,

Kasi

Kasi Shan, MSW, RSW
Kasi Shan, MSW, RSW

Kasi Shan Therapy is located in Kitchener, Ontario. She offers in-person and online appointments supporting individuals with struggling with trauma and perinatal mental health.

Depression · Mental Health · Parenting · Pregnancy and Postpartum

Will I have postpartum depression again?

For anyone who has survived postpartum depression, you know how painful and unsettling life felt after your baby arrived. During that first year, you are overwhelmed with feelings of irritability, helplessness, anger, rage, sadness, and anxiety (just to name a few). The fear of ever facing this experience again causes many parents to hesitate about having another child. There is nothing that they want to avoid more than those intrusive thoughts, hours of sobbing, or crippling anxiety. I hope this post will offer you some support and guidance in considering your next steps.

You have the right to say no

Pressures for nuclear families are constantly pushed at parents. I hear many well-intentioned family members asking when moms will be pregnant again, and expressing concerns that their children will be lonely if they do not have siblings. Firstly, let’s all agree that these folks need to chill out. No one should tell you what your family should look like. There are many, many single-child families who have wonderful, happy lives. If you have decided that one is enough, please rest assured that you are making the right decision. After all, it is your body, your lifestyle, your family, your income, and all of your resources. While loved ones may comment, at the end of the day, you have to take care of this little person. You are absolutely entitled to decide that you don’t want this option.

Many factors will influence your mental health

postpartum depression. Mood and anxiety disorders. Kasi Shan Therapy. online counselling. Counselling in Kitchener.

There are a lot of vulnerabilities that influence mental health. When it comes to postpartum depression, the list can include: poor sleep, stress, hormonal changes, physical wellness, relationship struggles, financial worries, history of mental health, multiple children, and complicated pregnancies/deliveries. This is not an all-encompassing list; however, it does address some important influencers during the perinatal period.

History of mental health struggles (including postpartum depression with your first child) is only one contributing factor. Postpartum depression symptoms typically decrease between one postpartum period to the next, showing that we have the capacity for healing. Research has found that there is high variability of whether parents’ symptoms of postpartum depression increase or decrease in future deliveries.

What does this all mean for you? Just because you had postpartum once does not guarantee you will have it again. If you had experienced significant distress in your first experience, err on the side of caution and seek support as soon you are pregnant. Postpartum depression is treatable. Your recovery experience improves when you do not prolong suffering.

You know more today than you did during your first pregnancy

Many first time parents feel nervous and uncertain about taking care of their babies. I mean, why wouldn’t we? If we are not surrounded by babies all the time, or if it’s not within our line of work, it makes sense that we are not experts on this topic. Since there are many unknowns during the first year with our child, we can feel inundated with worries about the baby’s well-being and our own capacity to parent.

Postpartum depression. perinatal mental health. Worries about having a second child.

As cliché as this may sound, practice makes perfect. Consider how vulnerable you felt when you first took your little one home versus how you felt six months or even 2 years in to parenting. You’ve gone from feeling incompetent to suddenly having a knack for diaper changes, effortless feedings, and confidence in bedtime routines. That level of skill and knowledge took you weeks of trials and errors before you could confidently move forward. This is the beauty of having a second child. That level of uncertainty and worry still exists; however, it is significantly more muted than the first time experience. You are much faster at handling all of those questions from your first time simply because you have the experience in your tool belt.

Understand your vulnerabilities

postpartum depression and experiences. journal. mental health.

As painful as it may seem, I encourage you to sit down and reflect on your first-time experiences of pregnancy and postpartum months. What was hardest for you? When did you struggle the most? Did you have support available, and was your support team actually helpful? Were you able to rely on your partner? What kept you down on your hardest days? When did circumstances improve? Did you use medication, or were you able to manage without? What resources did you bring in the last time?

Knowing what was hard the first time can give us a working plan of how to handle the situation differently this time around. Some moms are so clear that they do not want to have another child while COVID-19 is still a concern. Other moms are aware that sleep training is what they needed in order to feel more stable. Many moms know that attending counselling and couples counselling helped them work through anxieties as they surfaced. It sucks to have to learn from our hardships. Knowing what did and did not work can help you decide what to do differently this time around. When you have the awareness, you have a lot more control and influence over the situation.

Find a community

The stats are very clear. About one in seven mothers and one in ten fathers experience postpartum depression. Yet, we live in a world where we suffer silently. Joining a support group, or connecting with other safe parents is one of the best things that you can do for your system. Let go of the pinterest-moms in your world. Don’t try and find validation from your next door neighbour who always looks well-presented and has the most well-tempered baby. These people will (hopefully, unintentionally) make you feel lousy. FInd parents who help you feel less alone. Your worries are similar to the stressors that others have also experienced. Find those who have survived postpartum mental health, and hear about their experiences. Learn what worked for them to not only have this level of encouragement, but to also find strategies that you want to employ.

If you experienced postpartum depression with your first child, it’s highly likely that you felt overwhelmed or frustrated with parenting. The circumstances are much more complicated if you are a single parent, or if your partner works long hours. While this is no one’s fault, feeling isolated in your parenting is an important factor to keep in mind. Gather your support team and come up with a plan that will support your needs. This may involve asking your mother to stay with you for the first week, or asking a friend to check in daily. You might contact resources like a lactation consultant, a postpartum doula, or a sleep-training specialist earlier into your postpartum experience. Your support team can be informal like friends or family, or professionals. Irrespective, these folks are helping you to fill in the gaps. There is a reason for the saying “it takes a village to raise a child.” No one should be expected to do it all alone.

Move your body

When we struggle with depression, our body wants to shut down, isolate, hide, or retreat. This makes a lot of sense when the world feels too much. Of course, you want to escape and disengage. It’s far safer in your home than to socialize, take the baby out, or pretend that everything is normal. When we stay hidden away, we can get caught in this safety net for a long time. Sure the world may feel safer when you’ve stayed away, but it’s also felt bleak and painful everyday that you’ve been hidden. If you are ambivalent to have another child because of this shut down experience, there are strategies that can help. There are many coping strategies that can be employed to use address anxiety and depression. The key is to find the right set of skills that fit for you.

One effective distress tolerance skill is to increase our activity level. I get that exercise is not everyone’s cup of tea, but I want to emphasize how quickly it can help you in getting out of a funk. When it comes to a crisis situation, getting even 2-5 minutes of intense exercise will force your physiology to change. Your shut down system is forced to be more alert with this sudden intensity. After this burst of working out, we have about 15-20 minutes of reprieve. We feel more regulated and think more clearly. This gives you a chance to look at your current setup and schedule. You may find you have more capacity to get out of your room, go for a walk, or call a friend. Things that felt unmanageable, suddenly feel more accessible.

Seek treatment

Postpartum mental health is not based on will power. Crying everyday, or stressing about spending time alone with the baby is not a normal part of parenthood. If this is your experience, I want you to know that it does not have to be like this. Postpartum myths can prevent us from seeking out help, and I can appreciate that these are genuine barriers. Whether it’s due to internal shame, external pressures, cultural expectations of motherhood, or any other factors, it can be hard to shift away from this perspective. However, the best part of working in perinatal mental health is that I know it gets better. I see mothers improving within a year or two of delivery. This may involve regular therapy, a community of support, various coping strategies, use of medication, or a combination of interventions. With support, postpartum mental health can improve.

Postpartum depression does not have to define your experience

If you are feeling scared of having postpartum depression again, please reach out. Just because you struggled with your mental health the first time does not mean it will happen again, or that it has to get as bad. There are numerous preventative and reactive interventions that we can incorporate to help you feel more resilient. Reach out when you feel ready.

Take care,
Kasi

Anxiety · Mental Health · Trauma

Understanding our Window of Tolerance

A few weeks ago, I wrote Why is everything harder after trauma? In continuing the conversation about trauma’s shift to our nervous system, I came across this great little video that explains the window of tolerance in a very accessible way. For my fellow learners, I hope this piques your interest! For fellow parents, I hope this opens the door to speaking to your teens and children about common signs following trauma.

As a refresher, the window of tolerance is a term that describes our ideal state. It shows the most effective state of arousal where we can thrive and handle daily stressors. When we experience too much trauma or distress, our window of tolerance narrows, and we become more emotionally vulnerable (i.e. more quick to shut down, become angry, etc.)


Knowing more about window of tolerance is only the first step. Let’s bring this to your own experiences. Try this quick assessment to see how you normally respond when you are out of your optimal zone. Check off the symptoms that you typically experience and rate the intensity of these behaviours from 1 (mild), 2 (moderate), or 3 (severe).

Window of tolerance and hyperaroused. Kasi Shan Therapy support individuals needing support with perinatal mental health and trauma.

Here are few simple exercises that you can practice to get you back within your window of tolerance:

  • Mindfulness practice: i.e. Pay attention to your external environment by noting 5 things you can see, 4 things you can touch, 3 things you can hear, 2 things you can smell, and 1 thing you can taste.
  • Focusing on getting grounded by pushing your feet firmly into the ground
  • Deep breathing
  • Progressive muscle relaxation exercises
  • Exercise
  • Using items that soothe or activate your physical senses (i.e. eating comfort foods, being wrapped in a warm blanket, soothing music, touching an ice cube)

We do not have to be in these states of distress forever. For further information and support, please reach out.