CORONAVIRUS (COVID-19) RESOURCE CENTER Read More
Add To Favorites

Inside PTSD 'Pressure valve': Treatment of disorder involves reprocessing of memories

Tribune-Democrat - 3/30/2020

Mar. 30--With a combination of in-depth scientific understanding and a sense of humor, Ellen Stewart refers to Eye Movement Desensitization and Reprocessing as "the closest thing to a real-life magic show I'll ever be involved in."

Stewart, a licensed professional counselor with Croyle-Nielsen Therapeutic Associates Inc., uses the technique to treat clients who are dealing with pain in their lives.

Developed by American psychologist Francine Shapiro in the 1990s, EMDR involves helping patients -- including veterans who are living with post-traumatic stress disorder after experiencing the horrors of war -- work through issues that are often rooted in childhood experiences.

"When we're hurt as kids, when we go through bad things, those memories are actually stored in the wrong part of our brain," Stewart said. "They're stored closer to our sympathetic nervous system, and they're really supposed to go into our prefrontal cortex, which is like behind our forehead. But instead of going to the file cabinet that doesn't really care about anything, the sympathetic nervous system senses danger.

"The amygdala, and the thalamus and the hypothalamus kind of have this party where they're throwing a plate around to each other, trying to figure out what do I do with this? Do we fight, do we fly, do we freeze, or do we forget it? Sometimes what happens is the plate falls and cracks and it doesn't leave that area of the brain."

The goal is to "bring resolution to the root," which is a "tricky" process, and to "find out why isn't the pressure valve working," Stewart explained.

Processing emotions

She walks a patient through a process during which the individual makes a list of bad things that have happened, trying to find the earliest moment when that negative feeling developed and with what memory it is associated.

The client remembers the worst part of the experience in a mental "screen shot" and talks about what is happening in the image -- details, negative thoughts, what positive emotions does the individual want to have instead, where does the person physically hurt.

Eye movements are then used to help process the negative feelings, so the triggers to the traumatic experiences can be removed.

"That prefrontal cortex of the brain -- behind the forehead where we want our memories to go -- that does not connect to our sympathetic nervous system in a straight line," Stewart said. "I don't know why we're made this way, but they don't talk to each other. You can't think your way through being upset. You kind of have to find a different way to integrate both parts of the brain.

"So by looking to the left and to the right, to the left and to the right, by looking up and by looking down, it's a way of getting the brain to talk to itself, to the other parts of itself. Then that memory doesn't get erased, but it gets reprocessed, so that the negative emotion will leave, completely leave, it will leave the body where they feel it in their body the most. It will completely go away."

Stewart said developing empathy for the client's experiences is important.

"I've never seen someone turn into a pink mist vapor, but my clients have," she said. "And they understand something I don't have, so I just treat that with respect and say, 'I don't understand that. I do understand this. But I don't know that. But I have respect for it.' "

Can you 'turn that off'?

About 20% of Stewart's clients served in the military, including those involved in Cambria County Veterans Court Program, which provides forms of assistance, including mental health therapy and substance abuse counseling, for veterans in the criminal justice system.

PTSD is more common among the veterans she treats than in the rest of her overall group of clients. And the disorder manifests itself in a variety of ways -- from obvious violent outbursts to subtle signs that might not even be noticeable to untrained eyes.

"They're the ones that back into the parking space," said Stewart when talking about veterans with the disorder. "They never pull in forward. They can tell you who in a restaurant owns a gun and who doesn't own it. They have learned to read and to be hyper-vigilant because they had to because, if they weren't, they were going to be dead.

"So how do you turn that off? And why are some people more hot-wired? Why do some people have the ability to let go of it and other people don't? There are genetic reasons for that and environmental reasons for that."

Stewart said a key to the process is "treating their vulnerability with great dignity and respect."

"We go through the process of that trauma," Stewart said. "We give their trauma voice and we find a resolution and reprocess those memories so that they're not triggered all the time. It's almost like digging up land mines. When you reprocess a trigger, it takes away that land mine, so they're not as triggered. They're not going to blow up as quickly or as often. They have a safe area they can function from."

___

(c)2020 The Tribune-Democrat (Johnstown, Pa.)

Visit The Tribune-Democrat (Johnstown, Pa.) at www.tribune-democrat.com

Distributed by Tribune Content Agency, LLC.