A Comprehensive Guide to Trauma Therapy and EMDR
One of my biggest passions as a therapist is guiding clients as they take on the brave and beautiful work of addressing their trauma. While I primarily work with women these days, I started off my career in treating trauma within the VA mental health system. Trauma can affect anyone, whether you’re a combat veteran, a mom with three kids, a student, or a career executive. It can also look and feel different for each person. I want to take a little time to answer the most asked questions I get about trauma and PTSD, as well as to give you a deep dive into EMDR therapy as it’s one of my most requested services.
What is Trauma?
Sometimes we’re faced with unthinkable events in our lifetime in which our safety or the safety of our loved ones is threatened, either psychologically or physically. When this happens, our bodies respond naturally (think all the BIG emotions) as we try to take in an overload of information. While these emotions can be incredibly uncomfortable, they are our bodies’ natural response system in order to keep us safe during very confusing and chaotic moments.
So… Is What I Experienced a Trauma?
It’s important to note that in today’s society, the word “trauma” can be used as a catch-all for how we deal with hard things. These days you can hear anything from, “Dating is so traumatic” to “I was traumatized by the traffic this morning.” While we can certainly address your stress process while being stuck in traffic and explore the disappointment of dating or its impact on your self-esteem in therapy, these events do not meet the criteria of trauma. When we dive into the topic of trauma here as well as within the therapy space, we are explicitly referring to trauma as an event that threatens your safety either physically or psychologically.
Here are some things that can cause trauma:
A serious car accident
A medical trauma (e.g., lifelong medical complications following surgery, heart attack, stroke, almost losing a child during birth)
Sexual assault
Childhood neglect
War and/or terrorism
Natural disasters
Abuse (sexual, physical, emotional)
Being the victim of a crime
Death of a loved one
Witnessing domestic violence
How is Trauma different from PTSD?
Let’s say you were in a terrible car accident where you came close to losing your life. We would expect that you might not feel interested or even capable of getting back behind the wheel or even as a passenger for a little while. This is trauma and it can cause us to pause while our body and mind attempt to process a horrible event. This process is natural and normal.
Let’s say, however, that quite a bit of time has passed and you’ve continued to avoid cars or any kind of travel. Maybe you’ve adjusted your job to work from home, and order in your groceries and meals. Maybe you have a hard time socializing and your world is getting smaller because anything that triggers reminders of the accident leads you to create more rules around your safety. This is where a trauma therapist may start to assess whether you’re struggling with a trauma or a diagnosis of PTSD. Let’s take a look at some of the symptoms of PTSD.
How Does a Trauma Therapist Diagnose PTSD?
A Trauma Therapist will use the DSM-V (Diagnostic and Statistical Manual of Mental Disorders, 5th edition, TR) which is the guide that contains the criteria that providers utilize when choosing the appropriate diagnosis. With regard to PTSD, the criteria includes the following:
Exposure to actual or threatened death, serious injury, or sexual violence in one (or more) of the following ways:
Directly experiencing the traumatic event.
Witnessing the event (in person) as it occurred to others.
Learning that a traumatic event happened to a loved one. In the cases of actual or threatened death to a loved one, the event must have been either a) violent or b) accidental.
Experiencing extreme or repeated exposure to the details of a traumatic event. For example, emergency responders who get called to the scene following a natural disaster will likely witness serious injuries or death. Or within the criminal justice system, lawyers, physicians, or law enforcement may be repeatedly exposed to scenes of child abuse.
What Does PTSD in Women Look Like?
When we explore the criteria for PTSD, you will notice that they are grouped into 4 main clusters: 1) Intrusive Symptoms, 2) Avoidance Symptoms, 3) Changes in Mood, and 4) Physical and Emotional Reactivity.
Intrusive PTSD Symptoms in Women:
Repeated and unwanted memories of your trauma(s).
Repeated and distressing dreams in which the content or emotions associated with the dream are related to your trauma(s).
Dissociation, in which you lose contact with the present moment. During these instances, you may feel like you are reliving the trauma(s). Dissociation can occur on a spectrum, where at its most extreme - an individual may completely lose contact with their present surroundings. Flashbacks are considered a form of dissociation.
Intense or prolonged psychological distress (thoughts or feelings) when exposed to internal (memories, dreams) or external (people, places, smells, sounds) reminders of the trauma(s).
Intense or prolonged physiological distress in response to reminders of the trauma(s). This can include headaches, lightheadedness, nausea, pain, tingling, and numbness.
Avoidance PTSD Symptoms in Women:
You work hard to avoid any internal reminders of the trauma, which can include memories, thoughts, or feelings.
You work hard to avoid any external reminders of the trauma. This can include any number of things that directly bring reminders for you like: avoiding people who look like, smell like, or sound like the individual(s) who perpetuated your trauma. It could be avoiding places that remind you of your trauma(s) as well as certain sounds, situations, smells, or objects.
For example, if someone survives a deadly car crash coming home from the grocery store for an ice cream run one evening, they may begin to avoid driving or cars in general, they may struggle to use the same route, may choose a new grocery store, and may no longer be interested in eating ice cream. While seemingly unrelated, they may also begin to avoid things that hold reminders of that night. So, they may throw away the shoes they were wearing, avoid the smell of the perfume or cologne they were wearing at the time of the accident. Maybe they don’t meet up with their friends for after-work happy hours and close the blinds at home to avoid seeing it get dark outside. Avoidance symptoms look different for everyone who has gone through a trauma and it is specific to your unique situation.
Changes in Thoughts and Mood Following Trauma(s):
Your memory feels a little fuzzy, especially for details of the traumatic event
You don’t trust yourself, others, or the world.
Your viewpoint may shift to thinking things like, “of course that would happen to me, I can’t trust myself to choose a healthy partner, or people just don’t care about each other.”
The future may feel hopeless.
You feel detached from your family and friends.
The things you used to like just don’t hold the same level of interest for you.
You feel numb.
Positive emotions feel foreign or uncomfortable.
Physical and Emotional PTSD Symptoms in Women:
Have a hard time sleeping.
You feel on edge - like you’re waiting for the other shoe to drop.
Feeling angry and irritable, even from the slightest things. This can show up as being physically or emotionally aggressive with those around you - or even with yourself.
You are filled with guilt, shame, and self-blame.
You engage in reckless or self-destructive behaviors, which could include: spending beyond your means, physical self-harm, unprotected or sex that puts you in danger - outside of your own values, or substance abuse to name a few.
What if I don’t experience ALL of those trauma symptoms?
While you don’t need to meet all of the criteria above to be diagnosed with PTSD, some folks certainly do experience all the symptoms above. With PTSD, you would need to have met the criteria of the symptoms for one month and to be experiencing significant distress that impacts your life across multiple domains. It’s also important that the symptoms are not impacted or better explained by a substance (alcohol, drugs, medication) or another medical diagnosis.
One thing I share with clients is that you can have trauma without having PTSD and that you can still engage in trauma treatment and work toward healing. What this means is that you may receive a different diagnosis that better fits your situation. At the end of the day, a diagnosis is simply a guide that points us toward creating the right treatment approach to meet your unique needs.
Women’s Trauma Treatment
Let’s explore some trauma therapy and PTSD treatment approaches! There are many different options for addressing the effects of trauma(s). These include EMDR Therapy, Emotion-Focused Individual Therapy (EFIT), mindfulness-based approaches, and Interpersonal therapy. There are also several types of cognitive approaches including, Acceptance and Commitment Therapy (ACT), Cognitive Behavioral Therapy (CBT), Cognitive Processing Therapy (CPT), and Prolonged Exposure (PE). I have experience in using all of these approaches in treating trauma. It is important to note that there are other approaches for trauma therapy and PTSD treatment and that it is not a one-size-fits-all approach. Your trauma therapist can chat with you about the different options and create a plan that fits your needs.
EMDR Trauma Therapy for Women
In recent years, EMDR has continued to be one of my most requested approaches for addressing trauma, PTSD, phobias, anxiety, depression, and body image concerns. With an increase in media coverage of EMDR, clients often have a lot of curiosity and questions around the approach. I’m going to spend some time here to answer the most asked questions that I receive.
Exploring EMDR Trauma Therapy
What is EMDR Therapy? EMDR stands for Eye-Movement Desensitization and Reprocessing. Many of the clients I work with have tried different types of therapy over the years and are looking for a different way to relate to difficult emotions, thoughts, or experiences. They often remark that EMDR “sounds a little woo woo,” that “everyone tells me I have to try it because it worked wonders for them” or “it’s that therapy with lights and sounds.” So how on earth does it work?
My hope is that this post will help answer all your EMDR-related questions and debunk some myths along the way.
My Experience With EMDR Trauma Therapy
I first heard about EMDR therapy during my doctoral program. It sounded a little too mystical for me and I thought of it as the “party-trick” therapy. As I was training, a lot of the focus was on creating a safe, peaceful environment, and the presence of lights and sounds just didn’t feel authentic to my style of therapy. As I did my research though, I learned that it’s an evidence-based approach that has been shown to be effective in treating trauma, PTSD, anxiety disorders, phobias, grief, loss, self-esteem, and more.
Still… I wasn’t sure it was for me. Asking clients to “listen to the sounds” or “follow my fingers” or tapping with clients during sessions felt too different from my view of therapy. Until I tried it myself…and I was sold. While different at first, these elements often fade into the background allowing clients to focus more directly on processing.
Oftentimes clients even say that those elements are what they enjoy about EMDR as they allow you to feel seen and connected. To know you’re not alone as you process hard things. At their core, these processes allow clients to know that the therapist is available, supportive, and engaged, and in that way - EMDR trauma therapy is exactly aligned with the type of therapy I want to provide.
How does EMDR Therapy work?
EMDR therapy is a structured 8-phase approach to psychotherapy that draws upon the body’s natural healing processes. When we break a bone, we go to a physician, get a cast, and are told that our body will heal itself. In the same way, our brain can typically incorporate new information, adjust to changes, and move towards a natural healing process.
Except sometimes, the process gets stuck somewhere along the way…
Let’s say when you were five years old that you had an unthinkable trauma occur. It’s too much to take in. Too much to process. Sometimes our minds act as a protector to shield us from hurt, harm, and overwhelm. This protection, however, can keep us stuck and hold us back from fully integrating our experience into our memory network. It’s no wonder that oftentimes, these blocked experiences and memories can show up in our current day suffering.
The 8 Phases of EMDR Trauma Therapy
Let’s take a quick look at the 8-phase protocol for EMDR to see if it sounds like a fit for you:
Figuring it Out: Phase 1
In the initial stage, we will address what is bringing you to therapy and explore your current stressors and triggers. It’s during this phase that an EMDR therapist will determine whether you’d be a good fit for engaging in EMDR.
Building Tools: Phase 2
At this stage, the EMDR therapist will ensure that you have tools in place to help you manage difficult or uncomfortable emotions. This could include visualization, mindfulness, and stress reduction techniques to help you learn to ground yourself in the present moment, self-regulate, and build confidence in your ability to sit with your thoughts and emotions.
Some clients need to spend quite a bit of time in stages 1 and 2 to get prepared for the later phases of treatment.
Assessment: Phase 3
In this phase, you will work with your EMDR therapist to identify the Target Event along with the images, emotions, sensations, and negative beliefs about yourself and the world that go along with the event.
Healing the Mind: Phases 4 - 6
Your therapist will help you connect to the target memory and will then guide you through bi-lateral stimulation, which can involve eye movements, audio tones, tapping, or buzzers. The bilateral stimulation mimics a similar process that occurs during REM (rapid eye movement) sleep, which is a processing phase of sleep.
The difference here is that you are awake, fully in control, and have support in processing your new experiences.
Closure: Phase 7
This phase occurs at the end of every session. The therapist provides support and creates space for you to process your experience and to sit with any new insights that occur during the session. This can also be a beautiful space for tapping into the resources and tools you learned during Phase 2.
Checking-in: Phase 8:
This space will allow you to check in on your progress and decide the next best steps. When you are no longer reporting distress or uncomfortable physical sensations and you are able to connect with an empowering belief about yourself, then we move towards closing our work together.
It’s time to keep creating the big beautiful life you so deserve outside the therapy room.
Myths About EMDR Trauma Therapy
Okay, let’s get to myth-busting!
EMDR isn’t “real” therapy. Myth! EMDR is an evidence-based treatment that has been extensively researched. It has been shown to be effective in treating depression, PTSD, and trauma, as well as for anxiety, panic, and phobias to name a few.
EMDR therapy only takes a few sessions. Not true! While many clients report some symptom reduction after a few sessions, the amount of time is dependent on your unique history, the extent of your trauma, and your level of readiness to work on the hard stuff.
Eye movement desensitization and reprocessing = hypnosis. Nope! You are fully awake and alert and in complete control of the session. You are the co-pilot in the therapy room and you can pump the brakes at any time.
EMDR is only for trauma. Not true! You don’t need to have experienced trauma or have PTSD to benefit from EMDR. There are a number of symptoms that EMDR therapy is effective for treating.
Anyone can be trained in EMDR. Myth! EMDR therapists are pre-licensed or licensed clinicians or specific healthcare professionals.
EMDR only works if it’s in person. Nope! Research indicates that virtual EMDR is equally effective as EMDR therapy in person. Many of my clients actually prefer online EMDR therapy as it allows them to do so from the comfort of their own homes (and even in pjs if they prefer!).
I hope this helps answer your Trauma, PTSD, and EMDR-related questions.
Start EMDR Trauma Therapy in Los Angeles, CA
Do you think you could benefit from EMDR trauma therapy? If so then Worth and Wellness is here to help you! In order to chat about starting trauma therapy or learn more about EMDR, please follow these steps:
Schedule a free 30-minute consultation.
Make your first appointment with an EMDR and trauma therapist
See for yourself how beneficial EMDR can be for your mental health
Other Counseling Services I Offer in Los Angeles, CA
At Worth and Wellness Psychology, I offer in-person and online therapy. This includes individual therapy for relationship issues, dating, and anxiety. In addition to therapy for therapists and women of color. Reach out to talk about how I can support you.
About the Author, An EMDR & Trauma Therapist in LA
Dr. Adrianna Holness, Ph.D., is a Licensed Clinical Psychologist at Worth and Wellness Psychology, serving clients online and in-person throughout California. She received her Ph.D. in Clinical Health Psychology from Loma Linda University. As a trauma and PTSD psychologist, she specializes in creating space for healing and wholeness as clients take on the brave and beautiful work of addressing life’s hardest moments. She is trained in many evidence-based trauma treatment approaches, including EMDR. She also works with clients in the spaces where trauma intersects with your self-confidence, relationships, dating, anxiety, and identity.
Disclaimer:
This blog provides general information and discussions about health and related subjects. The information and other content provided in this blog, website, or in any linked materials are not intended and should not be considered, or used as a substitute for, medical or mental health advice, diagnosis, or treatment. This blog does not constitute the practice of any medical or mental healthcare advice, diagnosis, or treatment. We cannot diagnose, provide second opinions or make specific treatment recommendations through this blog or website.
