A Walk in The Park
EMDR, The Amygdala and The NLP Practitioner
EMDR: Eye Movement Desensitisation Reprocessing.
The explosion of EMDR as the philosophers stone of psychotherapy is a good demonstration of what happens when therapists get hold of a good idea. They manage to turn what is little more than a simple technique into an entire bloody religion.
Much touted as the dramatic and "controversial" cure for trauma, EMDR is rapidly becoming accepted as the treatment of choice for Post Traumatic Stress Disorder, phobia and an entire array of human maladies.
EMDR is a simple process - it involves little more than encouraging the client to wiggle their eyes back and forth whilst concentrating on something that makes them feel bad; but be warned! This can be a dangerous maneuver according to some EMDR therapists, demonstrated by the following advisory:
UNDER NO CIRCUMSTANCES SHOULD YOU ATTEMPT TO PERFORM EMDR ON YOURSELF! IN ADDITION, WHEN SEEKING OUT AN EMDR THERAPIST, YOU SHOULD ONLY WORK WITH A THERAPIST WHO HAS COMPLETED AN EMDR INTERNATIONAL ASSOCIATION (EMDRIA) APPROVED COURSE. WORKING WITH AN IMPROPERLY TRAINED PROFESSIONAL CAN CAUSE SEVERE EXACERBATION OF EXISTING OR SURPRESSED (sic) DISTURBANCES .
Total paff! If a treatment is potentially dangerous in the ways suggested, it means one or two things:
1. It is a "POWERFUL" technique and therefore undoubtedly effective in the right hands,
2. Control and authority is maintained by those who have invested financially in learning the appropriate theology.
EMDR theology talks of "contemporary trauma such as rape, combats, illness, accidents as well as childhood experiences[being]locked in the nervous system in the way that they're input." The theology also refers to the "metabolism" of information by the brain. This theology is extensive, the evidence is small and it's practitioners sometimes verge on the evangelical.
However, I have to say that for all the bullshit it does seem to work.
The difficulty lies in the game of "diagnostic categories". Where the "survivor movement" blurred the distinctions on just what constituted a sexual assault, EMDR therapists and others have confused the issue on just what constitutes a post-traumatic stress disorder. Once only the realm of combat veterans, these days PTSD has become the malady for the new millennium. Where there is someone to blame, there is a compensation claim. Where there is a possible trauma, there is a possibility for a diagnosis. Where there is a diagnosis, there is invariably an bountiful supply of CA$H.
Compare two clients of mine:
Client "one" presents to my office. Her presenting complaint is that of nightmares, anxiety, depression, feelings of worthlessness, suicidal ideation, partial agoraphobia and worsening drug and alcohol abuse. She experienced no symptoms and had a happy marriage and was in full time employment prior to a two day abduction and serial gang rape. From this attack she became pregnant and contracted genital herpes. This incident had occurred approximately 18 months previously. She was now separated from her husband (who had made the appointment for her to see me), unemployed and experienced a variety of physical ailments without a specific pathology of origin.
Client "two" presents to my office without an appointment. She complains of suffering from "Post Traumatic Stress Disorder." The previous day, whilst stationary in her car at traffic lights, another vehicle collided from the rear with her vehicle at approximately 20-30 mph. The damage to her car was extensive, but both cars were driven away after the accident. Neither driver suffered any physical injury.
Client "one" denied any 'psychiatric' complaint other than "depression", she was quietly spoken, withdrawn and desperate to change the intrusive thoughts ("my living nightmare, every time I close my eyes, I see it happening over and over.") She wanted to repair her marriage which had deteriorated rapidly in the 4 months following the attack despite the well-intentioned interventions from a counselor.
She asked me to help her to rebuild her shattered life.
Client "two" told me that she suffered from "PSTD" (sic). I asked her how she knew that to which replied, "well I must be because I just had an accident". She requested that I quickly write her a letter stating that she had "PSTD" (sic) and that I must hurry it up because she was on her way to a solicitor for legal advise.
The attackers of client "one" had never been caught and she was frightened that they would one day return to carry out their threats to kill her. She had attempted suicide twice and had not sought medical attention after either attempt. She drank a bottle of spirit each night in order to help her sleep.
Client "two" wanted me to write a letter providing a diagnosis. I suggested that it would be quicker to eliminate any "PSTD" that she had post accident than to write her a letter. She accused me of trying to rob her of a chance to "get what she deserved" (meaning CASH) and told me that I was just like her GP who she had seen earlier that day.
She did not want a treatment, she wanted a diagnosis - successful "treatment" would possibly invalidate her ability to claim compensation.
EMDR therapists at a seminar I gave on PTSD spoke of curing "trauma". The NLPissed in me immediately noticed the nominalization and made me suspicious of such a claim. I presented client "one" as a case history and asked the audience just what specifically they would be curing.
"Trauma!" they sang back to me in unison.
They would be curing "Trauma!"
Meanwhile, the NLP practitioners in the room all chorused that they would use the "double dissociation technique" to eliminate the "Trauma!"
Erstwhile, the counselors in the audience recited that they would "release the trauma!" via 'abreaction' - as if the first series of rapes were not bad enough. Like the "recovered memory" therapists, this bunch got the whole thing ass-about-face. It is not that the client has trouble remembering the incident that is important, but that they have trouble forgetting.
One lone psychoanalyst chanted that he would investigate the "latent anal-retentive tendency" that meant that she was "nurturing the hurt" that she was keeping because of "the child that was lost" [i.e. terminated].
And for the first time ever in front of an audience I was struck dumb for a few moments when another voice interrupted the psychoanalyst by burbling that it would not be ethical to "interfere" with the clients pain because we would be "interfering with her karma" because clearly this client was "paying back her karmic debt."
Apparently her "past lives" meant that she "needed" to be traumatized!
I realized I was clearly in a room of lunatics when one psychologist in the room broke down in tears because of "issues" as the token GP sat at the front of the room stormed out with his hands in the air exclaiming, "JESUS H. CHRIST!!! The world's gone fucking insane!!"- and then the lights failed.
Meanwhile during the chaos I strode through the hubbub to the back of the room, collected my bag and went to get a beer. I doubt if anyone else noticed I was gone for quite some time.
In the early daze my seminars sometimes went a bit like that. A couple of medical students came along every week just for the show.
Francine Shapiro must have been ruminating on one such bad day during a walk in the park. Moving her eyes back and forth (left and right) she noticed that the kinesthetic component began to leave the memory.
Neurologically this makes sense. From scanning people who suffer from "intrusive memories" as in PTSD it was found that is was their amygdala that mediates these events. What is curious though is how all this EMDR seems to have affected Francine Shapiro's memory. For example, Dr. John Grinder, co-creator of NLP writes on his discussion forum:
"Francine Shapiro worked (administration and sales) in the Santa Cruz offices of Grinder, Delozier and Associates in the 80's. She approached me one day and told me that a friend of hers from New York has been raped and she wanted to help her through this trauma and ensure that she exited cleanly and without scars. I told Francine to put her in resourceful state (anchored) and have her systematically move her eyes through the various accessing positions typical of the major representational systems (with the exception of the kinesthetic access). I suggested that she see, hear (but not feel) the events in question - obviously the kinesthetics were to remain resourceful (the anchored state) while she processed the event. She later reported that the work had been successful.
You may imagine my surprise when I later learned that she had apparently turned these suggestions into a pattern presented in an extended training, with no reference to source, with a copyright and a rather rigorous set of decuments essetially restricting anyone trained in this from offering it to the rest of the world." John Grinder, excerpted from Whispering In The Wind Discussion Forum.
Positioned nearby the hippocampus, those little brain bits that whither and atrophy all too well with Alzheimer's Disease, the amygdalas also process "emotional sounds" (the "oooohs!" and "ahhhhs!" of pleasure and the "ughs!" and "eeks!" of pain).
The NLP Practitioner will easily observe this behavioural output by the patterns occurring in the client's ongoing behaviours.
The EMDR training manual can be summarized in a single line: "Get them to hold the picture of their memory in consciousness and make them move their eyes repeatedly left and right, up and down or where, just make them move!"
Somehow I doubt that the manual mentions submodalities.
For a long while, I taught that in the elicitation of strategies the kinesthetic never came first. I believed that the kinesthetic was always secondary to an A/V or G/O component and that it couldn't be primary and that if this appeared in the elicitation, the elicitation was wrong. LeDoux's traumatisation of rats demonstrated that this belief was a false presumption and that neural pathways existed that meant that seriously unpleasant kinesthetics could be produced in absence of a primary V/A/O/G representation. It did mean however that the "free-floating" kinesthetic could be easily anchored onto pretty much any stimuli.
LeDoux's research explained several phenomena I had noticed with certain clients that had often baffled me; these phenomena were:
- Some clients would report that their panic/anxiety "just happened" in absence of any A/V/K/OG representation that they could identify. Some of these clients would suffer a single panic attack without any obvious precipitation and would rapidly deteriorate into total agoraphobia. I naively assumed that the representation was 'stored' below the conscious threshold, even though I was not able to reach this representation with trance. There was no content.
- Kinesthetics (emotions) were nearly always in the mediastinum region and not, for example, in the elbows or ear lobes. From general mysticism, the most easily experienced "chakras" were also in the mediasteinum. (During my first study in India, I asked a meditating Sadhu how I could experience a "chakra." He pointed to my chest and told me that the feelings I had there in times of "worry" was my "chakra turned upside down or inverted").
- The location of kinesthetic anchors affected how well they could be used in a technique orientated session. In my early daze as a practitioner, before I had developed any artistry in my work, I relied mostly on techniques, all of which appeared to be a variation on "collapsing anchors". Sometimes a positive "stacked anchor" would be more effective on the left hand side of the body than on the right. Then I noticed how bi-lateral kinesthetic anchors could be more effective in the same way as an anchor exactly on the midline.
- Stammerers didn't stammer in trance.
Despite my best efforts, I'd never managed to achieve the outcomes I had intended with stammerers and it took me a long time to achieve any reduction in the frequency of panic with the aforementioned "category" of panicked clients.
I learned the functions of the amygdala during the same period of time that I was studying Richard Bandler's DHE (1992) audio seminar course and suddenly the lights came back on.
Since we know the specific behavioural outputs of various neurological functions, we can use the polar opposite behaviours to create a new input into these neurological functions. The more creative NLP practitioner can use this information to begin to design effective interventions that will be congruent with the specific functioning of their neurology. However, I am loathed to give any specific example of this lest this "technique" become the Grand Unified Theory of all human maladies, as therapists are wont to discover.
The frustrating thing about therapists playing the diagnostics game is that they pay no attention to either the ongoing behaviours of their clients or to the structure of what they are saying. During my own bout of insanity (or as one doctor brilliantly noted, "You are not insane, you are just a fucking idiot!") I consulted a counselor who seemed determined to diagnose me as being a latent homosexual.
Once she embarked on this course with a passion, nothing I could say would help. Initially I denied it, so I was "in denial". Later I said I had never had a homosexual inclination, so I was "suppressing it". Then just to shut her up, I admitted it so now I was "just trying to please" by being "passive-aggressive". The only benefit I achieved from this "therapy" was the realization that this dippy woman was nuttier than I ever was and I went back to taking my daily dose of Prozac'.
I felt much better for it too.
To cure someone of "trauma" is as blatantly absurd as curing someone of a tornado - it tells us nothing of the situation that the person finds themselves in post event. Reducing the implications to the rape victim as a "process of the amygdala" is possibly as damaging to that person as the event itself. At one seminar, I asked the group what they would do if consulted by a person who was experiencing "flashbacks" of imagery relating to a sexual assault made by a stranger. Almost unanimously the chorus came back that a "double dissociation" technique should be effective.
When the practitioner course attendees take the SEVEN or TEN DAYS certification as licence to act as psychotherapists, it is situations like this that the limitations of brief NLP courses become evident. Whilst the ethics and methodology of psychotherapy have their own in-built limitations, it is up to the practitioner to locate relevancies from psychotherapeutic practices in order to develop a wider understanding of the implications of undertaking the responsibilities of a licenced psychotherapist.
"Therapy is change, not adjustment. This means change - social, personal and political. When people are fucked over, people should help them fight it, and then deal with their feelings. A "struggle for mental health" is bullshit unless it involves changing this society which turns us into machines, alienates us from one another and our work, and binds us into racists, sexist and imperialist practices."
The Radical Therapist Collective.
The use of the "double dissociation" technique is not likely to address the issues facing the victim ranging form how she will view herself in relation to being the recipient of such an assault, through to the legal implications of witness testimony coming from someone who has received therapy that is clearly hypnosis based. I have been consulted twice by men seeking help for themselves with coming to terms with their partner's assaults and several times have heard crime victims state that they felt they needed to "put on a brave face" to save the feelings on their [non-victim] partners. These issues can set up some pretty unpleasant feedback loops into relationships that would be otherwise supportive.
Technique dependent interventions are as beneficial to a mass administration of a specific drug to a diagnostic group - some will respond others will not. We can move on from this archaic thinking and methodology and begin to innovate.
One of my favorite eye openers was Bandler's question, "How do you cure a phobic who has a phobia of making pictures of himself?"
It took me over six months just to understand the question. I am still learning about the answer.