Tuesday, December 21, 2010

When The Worst Thing Is Not The Worst Thing: EMDR & Unpacking Meaning

A couple of months ago I received a request from the Mesothelioma Cancer Alliance asking me to include a link to their organization on my website (www.maybenatar.com). My contact noted that she was specifically interested in reaching out to therapists who provide EMDR therapy, as research had shown this technique particularly helpful in helping individuals deal with illness and loss.

I have not seen the research but my own experience would confirm this finding.

One has to ask how and why this is so. The diagnosis of a life threatening illness like mesothelioma is devastating. How can waving your hands in front of someone’s eyes or other forms of bilateral stimulation change that?

It turns out, devastating illness means something different to every patient, just as trauma
means something different to every “victim.” The prospect of loss of function, painful treatments, and a premature death is coded differently in each of us. And unpacking that unique meaning seems to facilitate processing. Maybe we can’t even process loss without that first step, unpacking meaning.

There are many paths to understanding meaning. Psychoanalysis utilizes free association;  relational psychotherapy uses the tool of the relationship as the main vehicle to meaning. Self psychologists focus on the state of the self; their major tool is empathy

In my, admittedly, limited experience the EMDR technique can provides a short cut to meaning.

The web of memory and meaning is an intricate, unpredictable one and EMDR can help one navigate the thicket.

EMDR is a technique that utilizes a very specific protocol that unpacks aspects of specific target symptoms and then stimulates, through the use of eye movements, taps, or alternating tones an internal process that seems to move individuals through a web of associations to the presenting images/symptoms back, back, back to some memories, earlier life experiences that may hold the key to unlocking the meaning of symptoms. This is free association on steroids.

See the following links for two short videos that demonstrate in pictures what would take me too many words to describe and describe poorly at that.



Sometimes the worst thing is not the worst thing.

One middle aged gentleman came to me when the lung cancer for which he had previously been successfully treated, returned. And it returned with a vengeance. He was at stage 4. Although he still had many treatment options and his doctors held out a great deal of hope, he was understandably devastated. He was alternately enraged and despairing. He was declining treatment, fighting with his doctors, unable to eat or sleep, alienating friends and family.

It would seem obvious that his fear of death was the primary cause of his suffering. At least that was what was obvious to me. But that is not what emerged with the EMDR treatment.

What emerged within one session was a memory of having wronged a good friend many years before, in his early 20’s. He felt enormous shame and guilt when remembering this during out EMDR session. The feelings were vivid, immediate, and intense. This one incident in which he had hurt and shamed someone else made him feel that he was a bad person.

Subsequent discussion over several sessions, revealed that some important part of him felt that he was being punished for his early cruelty. Lung cancer was the pay back.

Bringing this to light made it possible to process this event with the maturity now available to him. He found some compassion for his younger self. It was also now possible to reconsider that perhaps his misdeed had not caused his cancer. Cancer is awful. Facing death at 45 is awful. But feeling that you are a really bad person and that is why you are ill, that is worse.

Sometimes the worst thing is not the worst thing.

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