Trauma Work: EMDR, Brainspotting and Sensorimotor Psychotherapy

 

Often, stubborn emotional and physiological issues can have roots in one or a number of traumatic events.   Unprocessed and unintegrated physical and emotional trauma stays in the body as chronic tension, hypervigilance, intrusive thoughts, mood disorders, phobias and general anxiety.  It’s important for the therapist be aware of  this possible history when beginning a course of treatment with a client.


Because we all have different psycho-biological needs and preferences when working with painful material, I have cultivated three main approaches that I’ve found to be quite useful, gentle and  synergistic when working with trauma. 


Trained in EMDR, (eye-movement-desensitization-and -reprocessing, Shapiro, 1987 ) I use this bilateral method to help regulate physio-emotional overwhelm of the traumatic experience(s). This method, using rhythmic eye-movement and tactile stimulation, often results in an immediate sense of relief as it helps engage the more resourced parts of the brain that hold the awareness of the client’s resilience and ultimate survival of the trauma.  This process has the effect of helping the client uncover, integrate and then re-organize these traumatic memories in more functional and useful form, or, as I like to say, it helps to file it in a more appropriate place.


Brainspotting is  a recent development of EMDR  discovered by Dr. David Grand, renowned EMDR specialist and trainer.   Dr. Grand noticed that when an  eye position was held in place, the client was able to deeply and  comfortably,  process painful emotional and traumatic material. This process is similar to EMDR processing, using  biolateral stimulation, but much less eye movement.

Eye position provides  direct access to the limbic systems within the body’s central nervous system where traumatic and emotional memory is stored. The containment of the held eye position allows for safety and ease with processing difficult material.  Because this process works in the reflexive areas of the brain, holding the eye position seems to serve to de-condition previously conditioned, maladaptive emotional and physiological responses.

    Brainspots are discovered together as client and therapist observe the effects of eye position as the eyes move across a visual grid. Once a reaction, or reflexive movement, such as a blink, body movement, change in expression, change in breathing pattern,etc., is discovered, that spot is held, with the help of a pointer, to see what kind of information is stored there. Client and therapist work together to choose pace and intensity in processing.  Bilateral music or sound recordings are used in conjunction with Brainspotting to enhance the processing.

    Brainspots are also helpful in accessing and developing internal resource states which are often used in conjunction with the processing of traumatic wounds. Developing resource states is an emotional and physiological process that can become a permanent part of a person’s sense of self.

A third method I use in working with trauma is Sensorimotor Psychotherapy. Developed by Pat Ogden, Hakomi Cofounder in the 1980’s,  Sensorimotor Psychotherapy, like Somatic Experiencing,  is a process in which unassimilated physiological responses to trauma are resolved using mindfulness and body awareness processing.  Unassimilated somatic reactions evoked in trauma involve the truncation of both discharge and defensive responses which is shown to contribute to many PTSD symptoms.   By using the body  as a primary entry point (rather than cognition or emotion as in regular psychotherapy) Sensorimotor Psychotherapy directly treats the effects of trauma through the body, avoiding the confusion  of psychological resistance. Once the nervous system has calmed, emotional and cognitive  processing takes place with more ease and insight.

SMP is founded on the same 5 principles as Hakomi: Mindfulness, Non-violence,Unity,Organicity and Mind-Body Integration. The work is very similar, having the same roots,  though in SMP the therapist keeps the process focused on the unfolding of the somatic traumatic activation rather than the missing emotional needs.  Once the symptoms are diffused, the emotional work can begin.

The session begins with a talk about personal resources, supports and pleasures in life.  When talking about trauma, the therapist tracks with the client any signs of discomfort or disconnection.  At that point they stop talking about the trauma and stay with the body’s natural movement towards discharge, defensive responses and relief. They work only at a tolerable level so that movement can happen while overwhelm doesn’t. The therapist works carefully with the client to stay within his or her pace.

Major Influences in my work with Trauma include:

Francine Shapiro,  Peter Levine,  Robert Scaer,  Daniel Seigal,  Daniel Amen, Pat Ogden, 

Diane Poole-Heller,  Bessel van der Kolk,  David Grand,  and many others

"The speed at which change occurs during EMDR contradicts the traditional notion of time as essential for psychological healing. Shapiro has integrated elements from many different schools of psychotherapy into her protocols, making EMDR applicable to a variety of clinical populations and accessible to clinicians from different orientations."

- Bessel A. van der Kolk, MD
Professor of Psychiatry, Boston University School of Medicine