Case Study: EMDR Treatment – Emma

Case Study: EMDR Treatment – Emma

After witnessing her husband having a terrifying seizure, Emma was diagnosed with PTSD. She underwent EMDR treatment and in this case study, she explains the process behind her EMDR using ‘tapping’, processing ‘smaller’ memories first, and how EMDR can make your trauma ‘lose it’s grip on you’. 

“I was diagnosed with PTSD late in 2020.  My husband had a seizure in his sleep, and it really affected me.  I became hypervigilant, not sleeping and jumping at every little thing.  I wasn’t eating, I was snappy and angry, and I couldn’t focus on anything.  I was having flashbacks – moments when I would re-live the moment I woke up to my husband having the seizure, and experiencing it as if was happening right then – and flashforwards, when I “just knew” that something bad was about to happen.  These flashbacks and flashforwards were crippling. The came into my head uninvited, in full HD colour and they made me feel absolutely devastated.

After a few weeks I contacted TalkWorks, our NHS counselling service.  My initial phone consultation took about 45 minutes and at the end of it I was told it sounded like I had PTSD, but they had to look at my responses to their questions to be sure.  I can’t say I was surprised, but part of me was still thinking “maybe I’m over-reacting to all this?”

A week or so later I was told I met the criteria for a PTSD diagnosis, and I began therapy.

I had an incredible therapist, and the first thing she did was explain PTSD to me. She told me that I was having flashbacks due to the fact my brain hadn’t processed the trauma properly, and that it kept “bouncing around” in my amygdala, instead of being filed away in the hippocampus, which is where memories are stored. Being told this made me feel so much better; I wasn’t overreacting, this was a brain thing and not an ‘Me’ thing.

My therapist talked to me about the therapy options – CBT and EMDR.  I knew about CBT but EMDR was new to me.  She explained that whilst EMDR was highly effective in treating trauma, and that it involved less talking than CBT.  This was very appealing to me; I was really struggling with my trauma. I couldn’t talk about it to anyone, so talk therapy was not something I wanted to do. I did a bit of my own research and decided that I wanted to try EMDR. 

I’m not going to lie; I was scared about starting EMDR. I wasn’t keen to relive the trauma and that did make me very anxious.  My therapist reassured me that I was in control the whole time, and that she would be guided by me when moving on to the different stages of therapy.  This made me feel a lot more confident. We would work on building a toolbox of techniques to help ground me and these could be used whenever I needed them.  My therapist gave me a rough timetable – 60-90 minutes sessions for an expected 14-16 weeks, and for the first time I felt that there was an end in sight.

My treatment sessions were done online over ‘Teams’. The first few sessions were all about creating a toolbox of calming techniques – deep belly breathing and creating a safe place for me to visit – and building a trusting relationship with my therapist.  My safe space was valuable as I was able to visit it whenever I needed to calm my mind.  When I found I was having intrusive thoughts in my safe place, we created Box, a place to put the unwanted thoughts.  These sessions took 3 or 4 weeks; my therapist wanted to be absolutely sure that I was able to draw on them if I needed them and gave me the additional time I needed to feel completely ready to move on.

I was nervous about my first processing session, but again my therapist talked me through what we were going to do and reassured me that if I needed to stop, we could. She gave me a safe word and a hand action.

We decided a good way to start would be to work on an early “touchstone” memory; one that wasn’t as scary, perhaps, as the recent trauma memory, but could be processed. It would give me an idea about what to expect and how I would feel.

I used the tapping technique and my therapist guided me back to an early memory.  I gave it an anxiety level rating and a negative emotion that I believed about myself, and then we started processing….

When I processed, I would tap my shoulders in a certain way and, in the words of my therapist, “be an observer on this journey, and just watch the scenery pass by. That’s all you have to do. Just observe”.  I would tap, and all these memories and emotions would appear in my mind. Things that I had no idea I could remember, really small details, were all as clear as if they had happened yesterday.  After a few minutes, my therapist would ask me to stop, take in a deep breath, and tell her what I had seen.  She’d ask me to process a specific memory, and we’d begin again. I processed that early touchstone memory for 2 weeks.  My therapist and I revisited the anxiety rating and it had dropped right down.  The memory was no longer vivid. It was just a memory.   

Having successfully processed a small memory, I felt ready to move onto the main trauma.  One of the things that worried me was that I could remember what happened – I could tell people – but I couldn’t recall it.  For example, if I asked you to describe an elephant you probably could. If I asked you to close your eyes and picture one, you could probably do that as well. I couldn’t do that with the trauma. It felt like my brain was blocking it.

I really thought that when I was processing my trauma, it would be all I would be able to think about.  We did the anxiety level and negative emotion again and got to work. To my surprise, my brain moved on from it quickly. Other things came up and I worked on processing them. And while I didn’t always think they were relevant; their appearance was all part of the process. All I had to do was be an observer.

What amazed me throughout EMDR was what would come into my head. It was like being in a dream – a random string of thoughts and memories. Some would make me laugh, others made me cry. I had moments when I got really angry, and some moments when I had to stop because I felt overwhelmed. But I never felt out of control or not safe.  There were times when I would start to process something significant and it would feel stuck; my therapist would have me speed up the tapping to help it out.  It was exhausting; I didn’t return to work for an hour afterwards. During the week, my brain would keep processing. Sometimes I would encounter triggers which would make me feel anxious, and sometimes they appeared during processing. Things that I thought I had resolved – past and present issues in my life – featured in my sessions.  My therapist described this as my brain flicking through a filing cabinet and taking out a file to see what is inside. My brain looks at the file, then puts it away again. Slowly and steadily my brain was tidying everything up.

Every session was different; in some I would spend the hour sobbing and in others I wouldn’t feel anything. I remember one session when my therapist asked what I had seen while I was processing, and I said “nothing. It’s like a thick grey custard”.  Some sessions are like that and it’s all part of your brain doing its rearranging. Some of these journeys are very short and only last a session, some are longer and need an overnight stop off.

As the sessions went on, I started to notice a difference. Some things didn’t trigger me anymore. I could remember parts of the trauma I had blocked out…and they didn’t feel too scary.  I was noticing everyday things too – colours, sounds, smells. Weekends were tricky and I usually felt a little low by then.  Keeping a diary of what I was experiencing was useful; I could see patterns and triggers, and changes to how I was feeling. 

Every session would be the same: a check in on my general mental health, a discussion about how I was feeling about the trauma, and then processing. At the end of every session, I would have calm down time to help me regulate.

By week 16, it felt that my trauma had decreased significantly.  When I was processing, the anxiety I felt was less and less. The memory was less vivid. It was no longer in full technicolour with surround sound; now it was a dull coloured photograph.  When we redid the assessment that I had completed at the beginning of therapy, my PTSD score had dropped from being in the 70s to 12.  I no longer met the diagnostic criteria for PTSD. 

Now I am in recovery from PTSD things feel very different.  I don’t have flashbacks or flashforwards. Things that triggered me – ambulances, sirens, the word epilepsy – feel comfortable now.  The trauma feels very distant, quite muted and very manageable. That’s not to say that it hasn’t had an impact – it has. But I feel more able to live with it and be in control of it, rather than it be in control of me. I still feel that I am recovering from the therapy and from the trauma, but I’m giving myself time and space to do that. I think she was right when my therapist said one of the hardest and strongest things you can do is to hold up your hand and say “I need help”.  By doing that you can start to heal.

To anyone who has PTSD – please know that it’s not your fault. I remember going back to work three weeks after my husband’s seizure and someone saying to me “I’m glad he’s fine. Now it’s time to put it all behind you and move on”.  I felt really guilty. I felt that I had made a fuss about something most people would manage easily, and that added to my anxiety.

Having PTSD is not a sign of weakness. It’s not you overreacting or exaggerating. It’s your brain not being able to process the memory.  EMDR can help with that.  If you decide to use EMDR as a therapy, approach it with an open mind. It’s a journey for you and your therapist to take together. It might not always be easy, but that moment when you realise that the trauma has lost its grip is such an incredible feeling.

If you are comparing your trauma to someone else’s and feeling guilty for that – something I did a lot of – please don’t. Just because it doesn’t feel big compared to someone else’s experience doesn’t mean it’s not big to you and you don’t deserve healing. You do.”

 

You can find out more about EMDR treatment here

Photo by Marina Piano on Unsplash

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