Watching the Scenery Outside the Train

by Monica Ross

Part three Sometimes the brain takes in the stimulus of what is happening in present day, as in the example with the dog in the previous post, and registers it as similar to the traumatic event we went through. When that happens, the unprocessed memories that the brain is holding surrounding the original trauma get triggered.

The part of the memory though that is actually getting triggered in this instance is the implicit layer of information. Remember, the implicit layer is all of that sensory data taken in.

What is the implicit layer of memory composed of? It’s composed of all the bodily sensations we experienced during the event--so the racing heart, the sweatiness, the shakiness, the impulse to pull away, the way the experience affected the senses.

Because there is no data within the implicit layer that locates the information taken in at a specific place and time, remember it would have been the explicit layer that would have helped with that--then I perceive that I am in danger now, today.

The explicit and implicit got disconnected during the trauma and remain disconnected throughout time unless worked through and worked on. So, today we react when getting triggered. But the danger typically was really back then, back in the past at the time of the trauma and not today.

An unprocessed memory is really a fragmented memory because of the fact that the implicit and explicit information get separated. It’s as simple as that. What then is EMDR attempting to do?

Again, the goal is not to erase the traumatic memory or in anyway take away the awfulness of what actually happened. The goal is desensitization and reprocessing. It’s to be able to identify when coming across any triggers, that the threat is not occurring in present time.

As therapists we want for our clients to be able to bring up the traumatic memory without bringing up the associated anxiety and disturbance today. So that instead of feeling anxious and disturbed when recalling the event, our clients instead feel fairly neutral about it and are able to go about their daily lives.

They gain new insights and new perspectives that, as I like to say, repurpose the memory for our clients’ benefit. The negative belief about oneself that arose because of the event erodes and a more positive belief about oneself takes its place.

Often one traumatic event is related or linked to other traumatic events in life. An EMDR therapist might refer to all of this trauma as “debris” from the past.   The goal is to get rid of the debris.

I remember when I was 17 years old and working my first job making deliveries. I pulled out of our workplace parking lot into traffic. I looked to the right before entering the busy two-lane street, but I didn't give one final look to the left. Someone came from the left and didn’t see me and crashed into my driver’s side.

From that experience I learned to look right first and then left again before entering traffic. At the time I remember being extremely rattled by the event, but today I can talk about it with no problem.

That is an example of the brain’s ability to heal and repair and learn from an experience. I didn’t go through EMDR to work on that one. But sometimes, during some types of trauma, our brains are unable to heal and repair and so we go on living with the anxiety that the traumatic experience created.

As therapists we’re not trying to place the client back in the memory as much as we are taking the client to a safe place where they can witness the memory without actually being in it. They maintain dual awareness of being both in our office and being in present place and time and looking through the memories of their lives. Some EMDR therapists will refer to this as kind of like being a passenger on a moving train looking at the scenery passing by through the window.

These traumatic memories may have taken place yesterday or 50 years ago.

Remember several posts ago when I was talking about the ACES study? Also I’ve posted some on my facebook page about the hippocampus and the neuroscience of depression and how some studies have shown that people with depression have a smaller hippocampus?

Here are some studies that link PTSD to atrophy of the hippocampus as well.

Gurvits, T. V., Shenton, M. E., Hokama, H., Ohta, H., Lasko, N. B., Gilbertson, M. W., … Pitman, R. K. (1996). Magnetic Resonance Imaging Study of Hippocampal Volume in Chronic, Combat-Related Posttraumatic Stress Disorder. Biological Psychiatry40(11), 1091–1099.

And here are some studies linking PTSD as result of childhood physical and sexual trauma to lower hippocampal volume.

Douglas Bremner, Penny Randall, Eric Vermetten, Lawrence Staib, Richard A. Bronen, Carolyn Mazure, Sandi Capelli, Gregory McCarthy, Robert B. Innis, Dennis S. Charney, “Magnetic resonance imaging-based measurement of hippocampal volume in posttraumatic stress disorder related to childhood physical and sexual abuse—a preliminary report.” In Biological Psychiatry, Volume 41, Issue 1, 1997, Pages 23-32

And here is a pilot study showing the effectiveness of EMDR in treating low hippocampal volume--note that other studies have also shown that both pharmaceutical drugs and behavioral interventions have also been effective in neurogenesis in this region of the brain.

Letizia Bossini, M.D., Maricla Tavanti, M.D., Sara Calossi, M.D., Nicola R. Polizzotto, M.D., Gianpaolo Vatti, M.D., Daniela Marino, M.D., and Paolo Castrogiovanni, M.D. “EMDR Treatment for Posttraumatic Stress Disorder, With Focus on Hippocampal Volumes: A Pilot Study." The Journal of Neuropsychiatry and Clinical Neurosciences, 23(2), pp. E1–E2

All of these things start piecing together and make sense...trauma, PTSD, depression.

So that concludes this three part series on EMDR. Peace.