“This is Stupid!” (Or, Maybe Not)

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“THIS IS STUPID…!” That’s what a client told me recently in the midst of doing EMDR Therapy. Undoubtedly, I’ve had many clients who probably thought what I was doing was “Stupid!”, but this was the first client who verbalized their doubts and frustration. I shouldn’t be surprised to hear such a response. The very nature of psychotherapy is difficult and challenging; but, it’s still difficult for a therapist to hear. Most therapists are giving their very best efforts to be helpful. Some deconstruction and contextualization of the situation are in order. First, a word about EMDR Therapy.

My website is replete with information about EMDR Therapy; from a separate web page to official websites. The reader is encouraged to vet this remarkable therapy. Succinctly, ­Eye Movement Desensitization and Reprocessing (EMDR) was developed in the 1980s by psychologist Francine Shapiro, PhD. As with many discoveries, Dr. Shapiro made the chance observation that eye movements can reduce the intensity of disturbing thoughts, under certain conditions. This humble beginning launched years of experimental and clinical research, and has now evolved into one of the leading and most recognized treatments for trauma throughout the world. My succinct description of EMDR to clients goes something like this: “Research suggest that when distressing events are paired with bilateral stimulation–visual, tactile, and/or auditory–there is the potential that those events will be desensitized and reprocessed.” Although no one knows how any form of psychotherapy works neurobiologically in the brain, EMDR appears to be similar to what occurs naturally during dream or REM (rapid eye movement) sleep. Therefore, EMDR Therapy can be thought of as a physiologically based therapy that helps a person see disturbing material in a new and less distressing way. Again, the reader is urged to read the seven or eight paragraphs on the EMDR page of this website.

Since EMDR Therapy often (not always) asks clients to think of their distressing event while following side-to-side movements with their eyes, you might think that my client’s “THIS IS STUPID!” was referring to this process. At first, that’s what I thought. In his new book Why Therapy Works; Using Our Minds to Change Our Brains (2016), Pepperdine University professor and psychologist Louis Cozolino, PhD, talks about his initial disdain for this kind of therapy. He writes:

“Like many other forms of treatment, EMDR consists of exposing the client to feared memories in a structured, sensitive, and caring manner. But unlike other methods, it adds a series of eye movements or other forms of sensory stimulation to the process. I dismissed it for a long time because it seemed somewhat faddish, and I thought that waving a finger in a client’s face seemed unbecoming of a professional. There was also a certain strange…feel to the whole thing that put me off. In my decades of doing therapy, I had seen hundreds of fads come and go, and I was waiting for this one to go away as well. Not only did it not go away, but clinicians I respected began saying positive things about it.”

Dr. Cozolino proceeds to talk about his training and personal experience of EMDR – as a client. Asked by his therapist to “come up with some troubling thing in (his) life that (he) wanted to work on,” he picked a rather innocuous (he thought) issue: his negative reaction to monthly faculty meetings at Pepperdine.  What ensued was not only surprising, but meaningful. He writes:

“Two things about this experience were quite compelling. The first was that instead of working hard to rethink and organize my memory, it was if I was watching these internal events taking place on a screen. The (process) unfolded before me as if I was a witness (to the experience). The second compelling aspect of the experience was that in the faculty meeting in the week that followed, I felt unburdened of the extreme emotions that had plagued me in the past. The meeting was as boring and unproductive as ever, but clear of the baggage that I always brought in with me. I was impressed with the results. EMDR had opened a new window in the world of memory.”

Like Cozolino, you might think my client’s statement–“THIS IS STUPID!”—was referring to the “process” of EMDR Therapy. I quickly realized this was not the case, based on what was said next:

“THIS IS STUPID! YOU CAN’T CHANGE THE PAST! YOU CAN’T CHANGE MEMORY! IT’S WHAT FACTUALLY HAPPENED!”

I realized in that moment that a little more preparation, indeed education, was needed before continuing EMDR Therapy. We used the following therapy session to process my client’s resistance. The conversation focused on the relationship between trauma and memory. The remainder of this post represents the content—and sequence—of that discussion. Because I tend to convey such information in footnotes, my resource partners–on this occasion–included Louis Cozolino, Peter Levine, and Dan Siegel.

FIRST, Explicit and Implicit Memory

“Broadly speaking, there are two types of memory: those that are explicit and those that are implicit, the former being conscious and the latter relatively unconscious. These two memory systems—each of which has at least two broad subcategories—serve separate functions and are mediated by distinct neuro-anatomical brain structures” (Levine, 2015).

           – Explicit Memory: Declarative and Episodic

Declarative memories are conscious memories about which we can tell (declare) factual information. “Most lay persons, as well as many therapists, tend to think of memory primarily as this concrete form….”

Episodic or autobiographical memory is the awareness of ourselves within the context of a declarative, or factual, memory situation.

NOTE: Explicit memory is the kind of memory my client referenced when saying, “THIS IS STUPID! YOU CAN’T CHANGE THE PAST! YOU CAN’T CHANGE MEMORY! IT’S WHAT FACTUALLY HAPPENED!” A deeper understanding of memory was needed for therapy to proceed.

           – Implicit Memory: Emotional and Procedural

“In contrast to the conscious explicit memories…implicit memories cannot be called up deliberately….Instead, they arise as a collage of sensations, emotions, and behaviors….They are primarily organized around emotions and/or skills, or ‘procedures’ – things that the body does….Like bookmarks, emotions are charged signals that select a particular procedural memory out of a book of possible motor memories. They prompt…action” (Levine, 2016).

Because trauma is largely physiological (flight-fight-freeze), trauma therapy–like EMDR—pays special attention to physical sensations, impulses, emotions, and behaviors – all implicit memories.

NEXT, the Malleability of Memory

“In memory research, the initial impact of an experience on the brain has been called an ‘engram.’ If you visited the Eiffel Tower with a friend and were talking about existential philosophy and Impressionist paintings as you were having your picnic, your engram might include the various levels of experience: semantic (factual something about philosophy or art or knowledge about the Tower), autobiographical (your sense of yourself at that time in your life), somatic (what your body felt like at the time), perceptual (what things looked like, how they smelled), emotional (your mood at the time), and behavioral (what you were doing with your body)” (Siegel, 1999; 2012).

NOTE: Both kinds of memory—explicit and implicit memory—are involved in the above example.

“Some authors use the notion of ‘trace theory’ to describe the encoding, storage, and retrieval processes of memory. In this view, your engram or memory trace has both a ‘gist’ (the general notion that you were in France at the Tower) and specific details. With time, the details of an experience may begin to fade away….The gist, however, may remain easily accessible for retrieval and quite accurate. When we try to retrieve an ‘original memory,’ in fact, we may be calling up the gist at first (“I was at the Eiffel Tower when I was in my early twenties”) and then later trying to reconstruct the details. This reconstruction process may be profoundly influenced by (present factors). Memory is not a static thing, but an active set of processes….Remembering is not merely the reactivation of an old engram; it is the construction of a new neural…profile with features of the old engram and elements of memory from other experiences, as well as influences from the present state of mind” (Siegel, 1999; 2012).

LASTLY, the Malleability of Memory – Illustrated

Louis Cozolino (2010) illustrates further the malleability of memory in a story he calls “The Magic Tricycle,” which I included in my November, 2014 blog post. I shared it with my client that day, and share it again here, verbatim.

“Sheldon was a man in his late 60s who came to therapy for help with his many anxieties and fears. As a child, his parents had hidden him from the Nazis in a storage room behind the home of family friends. One day, after finding out that she and Sheldon’s father would be taken to the concentration camps, Sheldon’s mother told him to be a good boy, said goodbye, and left….Describing these days, Sheldon recalled alternating states  of terror and boredom, during which he would either sit and rock or ride his tricycle around in slow tight circles. The slightest noise would startle him and he feared that each passing siren might be the police coming for him. Each day, exhausted by fear, he would eventually fall asleep.

The intervening decades had not diminished the impact of his experiences during the war; 60 years later, he still found himself reflexively rocking or walking in small slow circles when he became frightened….In repeatedly recalling these experiences in treatment, he sometimes mentioned how he wished he could have left the house where he was hidden and traveled down the narrow streets to his grandmother’s house….

One day, I asked him for permission to change his memories just a bit. After a few quizzical looks he agreed to close his eyes and tell me the entire story again, at which point I would interrupt him and make some suggestions. As he came to the part of the story where he rode around in circles, I asked him, ‘What would you do if this was a magic tricycle and it could take you through walls without getting hurt?’ I felt Sheldon had sufficient ego strength to allow him to simultaneously engage in the role-play while staying fully in touch with present reality.

After some hesitation, Sheldon said, ‘I would ride right through the house and out onto the sidewalk.’ ‘Fine,’ I said. ‘Let’s go!’ Sheldon had been primed for our imaginary therapy play because he had spent many enjoyable hours of storytelling, cuddling, and laughing with his grandchildren….

After some mild hesitation, he pedaled though the house. As he got close to the door, however, he said, ‘They’ll see me and kill me.’

‘What if the magic tricycle has the power to make you invisible?’ I asked.

‘I think that’ll do,’ said Sheldon, and he pedaled through the front of the house and out on the sidewalk. Once he got out of the house, he knew what to do….(W)hen he finally got to his grandmother’s house she was home and, as always, happy to see him. He told his grandmother about his invisible tricycle and how scared he was in his hiding place. He went on to tell her of the end of the war, his travels, and raising his family. Finally, almost like a prayer, Sheldon told her how, many years from now, she would have the most beautiful great-great-grandchildren living in freedom, redeeming her suffering.

Over the next few months, whenever Sheldon experienced his childhood fears and anxieties, we would revisit his story and modify different details. These changes seemed to grow more detailed and more vivid in his mind. His imagination gave him the power to master many of his past fears. Because memory is modified each time it is remembered, Sheldon’s brain was able to gradually contaminate his painful childhood with his present safety and joy….He even began to tell his grandchildren stories about a little boy with a magic tricycle who accomplished great things with his courage and wit….Nothing had changed about his childhood except that now, when he remembered his hiding place, he also remembered his magic tricycle.”

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Not only does the research suggest that we can change a traumatic memory “implicitly,” we can also update a traumatic memory “explicitly.” The result with my client? They wanted to continue the EMDR Therapy we started.

Bill Bray, Colorado Springs, CO

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