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Eye Movement Desensitization and Reprocessing (EMDR)

Articles

IVA PERVAN

Msc Clinical & Health Psychology, YTT300 Yoga & Meditation Teacher

Program Manager AT DARA Koh Chang

In 2016 EMDR (Eye Movement Desensitization and Reprocessing) celebrated its 27th anniversary. As is often the case with scientific breakthroughs, its discovery was accidental. In 1987, Dr Francine Shapiro, an American clinical psychologist, whilst walking in a park, realised that she coincidentally moved her eyes back and forth when she was having an emotionally disturbing thought. She noticed that in doing so, the emotional thought became less distressing. By this chance observation, she discovered that eye-movements could reduce the intensity of disturbing thoughts when practised under certain conditions.

She began the first research studies on this topic not long after that in 1989, whereby it became clear that EMDR (then called EMD or Eye Movement Desensitization) was an up-and-coming treatment for victims of trauma and patients suffering from Post-traumatic Stress Disorder (PTSD).  The newly discovered success of EMDR was published in the Journal of Traumatic Stress.

Since these first studies in 1989, EMDR has become one of the most well researched therapeutic therapies in the field of psychology. It has developed and evolved by and with the help of psychologists, therapists and researchers from all over the world. This form of therapy has been identified as a valid treatment for psychological trauma – in 2013, the World Health Organization recommended EMDR as a treatment of choice for PTSD. EMDR was initially used solely for the treatment of trauma and PTSD, but since then many uses for EMDR have been found.  The main focus of EMDR therapy is how to deal with how memories are processed and stored in the brain. EMDR is intended for use as an adjunct to other therapies, not as a replacement for them. Nowadays EMDR is used to treat a wide range of conditions such as anxiety, depression and addiction from substances like alcohol, drugs and prescription medication.

WHAT IS EDMR AND WHAT IS IT USED FOR?

EMDR is a psychotherapeutic approach that was developed for the purpose of working with distressing, disturbing or traumatic memories. Examples include psychological trauma arising from,

  • Traffic accidents,
  • Violent experiences,
  • Various types of emotional, physical or sexual abuse

Even the unexpected passing of a loved one can warrant the therapeutic use of EMDR.

Disturbing memories from one’s childhood, like being bullied or harassed systematically, can benefit from EMDR. 

Traumatic incidents with parents and peers can have a very negative effect on a person’s sense of self-worth. These events can set the groundwork for the emergence of a wide range of mental health issues in later life, including vulnerability for clinical disorders like anxiety, depression, addiction and post-traumatic stress disorder. Eye movement desensitisation and reprocessing can help people come to terms with negative childhood experiences. When processing the memory with EMDR, emotional memories are reprocessed in a more constructive way. We could say that EMDR helps to store the memories in a more ‘neutral’ way, instead of eternally remaining in the mind as a chaotic and disturbing recollection.

FINDING THE RIGHT CLINICIAN

The theory behind EMDR is that present psychological difficulties are often the result of distressing life experiences that have not been stored in memory properly. Such recollections are referred to as ‘unprocessed’ or ‘blocked’ memories. These traumatic memories may need some help to become processed, and EMDR is one of the therapeutic ways to achieve this. A psychologist or therapist practising EMDR should have a solid background in mental health before they even embark on initial EMDR training.  Extensive further training in EMDR training (along with experience in dealing with clients with psychological traumatic recall) is highly desirable if the clinician is to be able to work through the protocol with clients in a truly successful way.

WHY ARE TRAUMATIC MEMORIES SO DAMAGING IN THE ‘HERE AND NOW’?

If someone is experiencing recurring symptoms from a psychologically traumatic event (and possibly correlated PTSD symptoms), it is possible that their brain wasn’t able to constructively ‘process’ the information at the time of the event (as it normally would have been able to with, say a more  ‘normal’ or ‘less traumatic’ experience).

When this processing of the traumatic event doesn’t happen in a constructive way, simply recalling the event or trauma, in any way, big or small, might feel as bad as it did when the event actually happened, with many of the negative emotions and bodily sensations reoccurring.

With every recollection of the event, the trauma might, therefore, feel as severe as going through it for the first time, every time.

This is because the feeling, images, smells and sounds remain unprocessed and still evoke the same distressing responses as they did at the time of the actual event. The improperly processed traumatic event (or in some cases multiple events) interferes with a person’s life, causing multiple negative symptoms.

Addiction, to either a substance (like alcohol or drugs) or addiction to an avoidant/compulsive behaviour (like gambling or porn), is a common negative outcome from improperly processed traumatic memories.

SYMPTOMS OF PSYCHOLOGICAL TRAUMA

Some of the symptoms of psychological trauma include (but are not limited to,)

  • ‘Flashbacks’ to the traumatic event
  • Significant disruption of life events,
  • Sleep disturbance and nightmares,
  • Irritability,
  • Outbursts of anger,
  • Difficulty concentrating,
  • Feeling ‘jumpy’ or being easily startled, and
  • ‘Hyper vigilance’

Some people turn to addictive substances as a way to avoid dealing with traumatic incidents. Using EMDR in a therapeutic way can have a profound effect on the way that the brain processes difficult information.

EMDR therapy can help addicts create a greater sense of daily ‘mental comfort’ by helping them properly address difficult memories and life experiences. This is often the key to helping addicts build enduring recoveries

HOW IS EMDR PERFORMED?

EMDR works very quickly and effects can be noticed from the very first session. The effects on the client can be intense and profound – and therefore being mindful of the possible thoughts, feeling and emotions that may arise in the aftermath of the sessions – is very important.

Whilst performing EMDR in session, therapists use a set of standardised protocols that incorporate elements from many different treatment approaches. In using the standardised protocols, the client and therapist are assured to utilise the therapy in the correct way and quality of the therapy is ensured.

EMDR is composed of series of phases. The clients’ problems are identified. The goals for the EMDR session are established and the client is prepared for the memory processing. During processing the client is directed to attend to aspects of the memory, while the information processing system is simultaneously stimulated with eye movement or bilateral auditory clicks. The processing starts and counterproductive emotions are resolved. New, more useful thoughts, feelings and memories are created.

WHAT IS AN ACTUAL EMDR SESSION LIKE?

Your psychologist or therapist will ask you to recall the traumatic event that you have like to work on. Special attention will be afforded to feelings and images that are strongly associated with that traumatic event. The rule of thumb is

‘The more detailed the recollection of the event(s), the better’.

After the processing has commenced, the therapist will ask you again to recall the traumatic event.

Whilst simultaneously recalling the trauma, you will be engaged with a distracting stimulus, such as the rhythmic movement of the therapists’ hand and/or listening to alternating left and right ear ‘clicks’ via headphones.

These distracting hand movements or sounds are called a ‘set’.

After each set, there is a little pause or break and the therapist will ask the client what sensations came up. Usually, this will be a stream of thoughts and images concerning the disturbing memory – but feelings and bodily sensations can also emerge.

After each set, the client is also asked to concentrate on the most obvious change and once again another set is performed. The sets will eventually lead to a decrease in the emotional charge of the memory and its present day ‘power’ over the client. It thus becomes easier to think about the event. In many cases, the memories themselves become somewhat faded or diminish in intensity. Sometimes less unpleasant aspects of the memory are in fact recalled, but the client and therapist are perfectly positioned to go ahead and effectively to deal with these revelations if they should arise. Another possibility is that new insights or thoughts may develop in the clients’ consciousness and these new perspectives can give the recollection a less threatening implication.

In this way, EMDR can profoundly help people to accept and come to terms with past traumatic experiences, and get on with the business of living the rest of their life as expansively and productively as they can.

 

Things like periods of active addiction, (which are often ‘downstream’ of past psychological trauma) lose their wellspring, and become,

well,

just another memory.

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Addiction: An Unconventional Disease Part 3

Articles, Australia, International, Understanding Addiction

Welcome back to our final chapter of looking into the complex and unconventional disease that is an addiction. In our last article, we reviewed the differences between dependence and addiction and confirmed that addiction is indeed a disease. Today we put this topic to rest by looking deeper into intricacies of the human brain, its function and the terrible damage a long lasting drug abuse can bring.

Triggers and cravings.

The part of the human brain that responds to instincts is called the midbrain. It is a small knot of processes in the middle lower stem of the brain. It is responsible for such basic instincts as the “fight or flight” response, which determines how to tackle various obstacles. This happens subconsciously and is very hard to overcome. If met with a threatening situation, this part of our brain decides if you should fight to survive or run to survive. Addiction affects this part of our brain in a rather devastating manner. It becomes swollen with blood, as a natural response to oxygenate and provide more processing power to it. It is the natural way for humans to not overthink things in pressing situations. Midbrain is responsible for people coming to seemingly strange decisions in a time of extreme stress. It is what causes a person to jump off a 50ft sheer cliff into a river in order to save himself from an attacking predator. During this kind of situations, the midbrain hoards a majority of blood that would provide oxygen and cognitive capacity to other parts of the brain, more specifically the frontal cortex which determine our rational thinking capacity.

This complex process is what makes an addict act out of character. A usually loving and caring human being, when addicted and in biological and mental need of drugs can suddenly turn to cheating, lying, manipulating and aggression. Even inner barriers are broken in favor of what brain thinks is surviving, using drugs to reward brain with dopamine and put it to ease. Very respectable people have found themselves resorting to prostitution and crime to fuel their need for drugs.

What are triggers?

Have you ever had an incredible craving for pickles? Or perhaps a tub of ice cream with chunks of cookie dough? Seems oddly specific, but these things happen, let’s try to understand why.
When the human brain secretes dopamine to reward a beneficial behavior, it also triggers another chemical response. It releases Glutamate. It is what makes us remember what is it that triggered the release of dopamine. It allows us to store in our memory specific combinations of taste, smell, activity, and even vision. This is the reason why you sometimes crave a childhood treat. What would you do for a Klondike bar?

If your body is low on sodium, because of glutamate your brain remembers that eating a pickle provided sodium and was therefore rewarded with dopamine. The crunch of the pickle, its salty sweetness, even smell. It all comes back to you and before you know it, you are elbow deep in the pickle jar.

This same system, unfortunately, records things that are bad for you, but the brain is unable to differentiate. All it knows is that when you had a rail of cocaine, it made you feel great and now that you see spilled salt on the glass surface of some café, you suddenly feel the craving to do cocaine. This can happen years after getting clean and sober. These triggers are what cause most if not all relapses.

Brain damage.

The human body is an incredibly complex and self-sustaining mechanism. It just works, even for people who have no clue how it works. The body of a scientist works in exactly the same way a body of musician or race driver would. You don’t need a manual for your body to operate it. It has many clever self-preservation mechanisms built in.

Every drug is usually a mixture of various chemicals. Most of the time it is one particular chemical that triggers the release of dopamine, but there may be much more in the cocktail that works in conjunction with it. These by-products need to be broken down and absorbed by our bodies natural self-repair system. It is important to understand, that human body is able to regenerate almost any cell in its organism. Almost. The one that does not also happens to be one of the most important ones – nerve cells. The human brain just so happens to be made almost entirely out of nerve cells. For the drug to trigger the release of excess dopamine it has to find its way to your brain somehow. Usually by hitching a ride in your bloodstream, expressway to your brain. And once the cocktail of chemicals in the drug reach your brain, they leave a lot of garbage there.

When the human organism is trying to break down by-products of methamphetamine, for example, the result is a type of acid that literally burns nerve cells. This leads for the cell to work at sub-optimal capacity and as a precaution it kills itself. This self-destruction protocol, that is built in every cell of our bodies is the main reason why everyone doesn’t die of countless cancers. As a result of drug abuse, the only non-regenerating cell in our bodies – the brain nerve cell is forced to kill itself to avoid cancerous growth. This kills the cognitive capacity of various parts of our brain and leaves it riddled with dark spots of low or no activity at all.

 

Addiction is a devastating brain disease, there is no other way around this fact. It is steady, ruthless and indiscriminate in its path. It affects the person both physically and mentally. It affects the people around the addict. Drugs bring so much suffering for a short boost of pleasure. It is just not worth it.

Turn to your loved ones and friends today. Seek professional help as your own cognitive and decision-making skills are in jeopardy and as an addict, your personal opinion can be compromised and extremely biased. Call Dara rehabilitation today and learn how you can turn your life around.

unconventional-disease-dara2

Addiction: An Unconventional Disease Part 2

Articles, Australia, International, Understanding Addiction

Welcome back. In our previous article, we explored what is a disease in a bid to understand how addiction can be classified as one of them. Today, we look at the other side of the coin. We will try to identify what is an Addiction to better understand how it influences human body in the same way a disease would.

What is Addiction?

Drugs affect your body in a myriad of different ways. There are uppers and downers, relaxants and energizers. Whatever you want to call them, they all affect the dopamine levels in your brain. What is dopamine? It is that sweet content feeling you get after a good meal. Your brain rewards you for taking care of it, so to speak. If you eat something that is beneficial to your body, your brain releases dopamine that provides a good feeling, to promote this kind of activity. Is there something that you like doing that makes you feel happy and content? Being thirsty and having a nice cool refreshing glass of water can be the best feeling in the world, right? It’s because you are dehydrated and as soon as you rehydrate, your brain tells you “that was good, when thirsty, please do that again”. Having sex feels good as well because it is a survival mechanism. During intimate moments and especially at orgasm, your brain is flooded with dopamine so you feel good and would do that again, as soon as possible preferably. The need to procreate is a very basic and strong instinct in everyone, ensuring that you enjoy this process is just nature’s way of making us understand, that it is something we should be doing.

Various drugs, cocaine, for example, cause an extremely high amount of dopamine to be released in your brain. The human brain is a remarkable organ and can learn and recognize patterns subconsciously. Over time, this repeated boost of unnecessary dopamine confuses the brain and rewrites itself to cater to this new external stimuli.

For example, let us imagine a child that gets rewarded for doing good and helpful deeds by his parents. He washed the dishes, mowed the lawn or cleaned up his room and his parents gave him some pocket money. Now, all of a sudden, parents start giving him large amounts of money for nothing and before too long the child considers this the norm. He expects this money to be given to him for no reason and when that does not happen, the child is upset.

When an addict’s brain is repeatedly flooded by dopamine, it begins to rewrite itself in such a way, that it considers the dose of drugs the ultimate survival behavior. It suddenly needs drugs to survive, or so the brain has been tricked to think.

Addiction and dependence.

To touch up on differences of addiction and dependence from the previous article, with long enough fake dopamine boosts, the brain forgets how to properly self-regulate and can bring with it a long list of other complications. This depends on the drugs very widely, but there are some substances that if abused for a long enough period, and then suddenly stopped can cause life-threatening problems. One such substance is alcohol, the most wide-spread drug known to man. If a severe alcoholic is suddenly denied alcohol, the person can suffer fatal cardiac arrest, breathing complications or even stroke. For this very reason, every rehab facility has a detox program, which slowly and delicately reduces intake of these brain altering drugs, in an attempt to re-teach the brain how to function properly. Once dependence is taken out of the picture, the rehabilitation of addiction can begin.

A disease, by definition, alters or impairs a function of a specific organ or cell type. Since drugs have such a profound impact on how organ of the human brain functions, addiction is without a doubt a disease. An odd one at that, since it is one of the very rare types of diseases that is consciously self-imposed, yet operates and does its damage subconsciously. It is impossible to contract it from an animal or insect bite, nor is it a sexually transmitted disease. It is non-contagious and very hard to identify as a disease because the organ that needs to be used in its identification is the very same organ that is being affected. That is why denial is such a popular stance among addicts when someone looking in from outside, points out symptoms of addiction.

 

 

Fighting dependence is hard enough. It is very stressful and physically taxing ordeal. Your body is struggling to remember how to self-regulate and operate at normal capacity. Fighting addiction, however, is a whole different kind of demon to slay.

Join us in our next article where we will learn what cravings are and what kind of role they play in the human brain.

unconventional-disease-dara

Addiction: An Unconventional Disease

Articles, Australia, International, Understanding Addiction

When someone tells you, that they have a disease, most likely you will recoil and think twice before shaking their hand. A disease in most people’s interpretation is something that is dirty, disgusting and most importantly – very contagious and can be spread to others. The truth of the matter is, that there are many different types of diseases and only some of them are truly contagious.

What is a disease?

A disease is a type of sickness, to put it simply. There are few ways to get a disease, the most popular being harmful bacteria or viruses. These types of diseases are contagious and can spread through direct transfer or air. They include such diseases as The Flu and Strep Throat for example. The best way to avoid such diseases is to regularly wash your hands and avoid contact with confirmed sick individuals. This type of disease has a sub-section that is impossible to catch from another sick human being but are rather transmitted only from animals and insects. They are considered non-contagious. A Lyme disease is a prime example, as the only way to contract it is to be bitten by an infected tick.

Then there are sexually transmitted diseases, which as is implied, are usually passed to another human via sexual activities. Prime examples are HIV, HPV, and Syphilis. To avoid catching one of these, protection is paramount, the most effective being the condom. Use a condom whenever you engage in sexual activities and you will be very unlikely to catch a sexually transmitted disease or STD for short.

And then there are hereditary diseases. They are relatively rare but widespread enough that most people have heard of them or perhaps even know someone who suffers from it. There are many different kinds, but some of the most prominent ones are Down Syndrome and Haemophilia. These cannot be transmitted in any conventional way. They are not contagious and cannot be caught during sex either. People with these diseases were born with them and the disease developed as they reached maturity.

Where does addiction fit in?

A disease involves an infected, defective or otherwise damaged organ in a human body. It can be a specific type of tissue that is targeted or an entire organ. Leukemia is a type of cancer but is also classified as a disease because it spreads in bone marrow, which is responsible for producing white blood cells. This is an example of a disease infecting a certain type of cell throughout the human body. As an example of an organ contained disease, diabetes is a direct result of malfunctioning pancreas.

So when a person is addicted, what type of disease is it? Before we tackle this question, it is important to understand the difference between an addiction and dependence.

Dependence and addiction go hand in hand, so it’s not unheard of to have people refer to both as if they are one and the same thing when in fact, that is not strictly true. A dependence is when a human body is physically dependent on a chemical or substance. Sounds like addiction does it not? Yet addiction is the psychological aspect of dependence. An addict in recovery will go through rigorous detox procedure when first admitted to an inpatient rehabilitation center. In this stage, the addict fights the dependence his body has for a drug or alcohol, for example. It can take days or months, but eventually, your body will no longer require the substance that caused the imbalance and will be able to safely function without. That said, any addict will tell you, that you are not out of the woods just yet. Addiction is a mental state, due to prolonged abuse of certain substances your brain can no longer function properly without them and thus your behavioral patterns of the well-functioning brain are re-written to cater to this new, dramatic and very destructive change.

So to recap, when an alcoholic needs a drink to stop his hands from shaking it is dependence, whereas if the drink is needed only to calm nerves and feel better, its addiction.

 

Join us in the next part of our blog where we will dive deeper into the human brain and pull apart facts why addiction is considered a disease.

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DIY Prison Sentence

Articles, Australia, International, Understanding Addiction

 

A meal in a restaurant is great, but a home-made feast is so much better, right? Even if the quality is on par, it’s the sense of satisfaction that one gets from something that has been made or prepared by themselves. Grandma’s home-made jams and preserves are neck and shoulders above anything you could buy in a store. Drug addicts have been attempting to apply that same idea to their hobby of choice, by growing, processing and using their own product, cutting out the dangers of dealing with shady people. Little do they know, but they are risking much more than if they would simply buy the poison.

Self-Driven Addiction

For as long as people have been using drugs, there is always those that will make them. The age old saying “if there is sheep, there will be shearers” rings true even today. People who make it their business to produce and distribute substances that promote degradation, despair and addiction have mostly been met with disdain. There are tribal communities in Africa, that will take law into their own hands and viciously deal with this kind of individuals their own way, usually burning down the lab and lynching the suspected drug dealer. President of Philippines Rodrigo Duterte has begun a bloody and vicious vigilante approach to root out the drug problems in his country. While the legitimacy and ethicality of Philippino war on drugs are questionable at best, most will agree that the end goal is to clean up the perceived global image of the country to the rest of the world. Sober people don’t want drugs, drug addicts, producers and dealers anywhere near their children and people they love, that is a universal fact.

For drug addicts in hiding, the “Do It Yourself” or DIY approach to obtaining their choice of drug is the best option in these and many other cases. Let’s look at some illegal drugs, that can be made at home and the ingredients required.

Marijuana.

The most popular in this category is most definitely “weed” or marijuana. It is still very illegal in the majority of the world, but their seeds, however, are not. There are plenty of dubious online seed shops that will sell you great varieties of seeds, their official stance for doing so is that they are a collector’s item. Apparently, there are marijuana seed collectors out there and these fully-fledged online stores are for that kind of people. All five of them, no doubt. The rest use them to get their seeds to grow their own weed. Lucky for upstanding citizens these home-made grow-ops use ALOT of electricity and generate plenty of heat, so it is pretty easy to find and bust these. Most of the time these DIY weed farms have no more than a few plants, but the law is the law and they get the book thrown at them as if they had a whole farm since growing the drug is producing it and by definition production and distribution of the drug are the biggest offenses.

Psychedelic mushrooms.

In a very similar fashion to weed, magic mushrooms can be grown in-house. They require practically no attention and the legal part that needs buying can produce large quantities of it. You can buy the mushroom spore solutions in syringes and pouches online. Some even sell an entire, ready to go growing set, with the growth medium, supplements and everything else that is required already included in the package. The law governing psilocybin-containing mushrooms is pretty vague, as only the ready product is illegal. It usually takes for someone to go running naked in public, flinging their own feces at bystanders or a suicide or two for people to remember that psychedelic drugs are just as dangerous, if not as addictive as any Class 1 drug.

Heroin.

Hold up, you can make heroin at home? Not the most potent version of it, but it is doable. While the vile substance made on the slopes of Afghanistan is much more potent, a determined addict can make do with a much more crude and dirty method of preparing it. The Czech Republic is the biggest exporter of poppy seeds in Europe, used for culinary and food preparation these seeds contain only trace amounts of alkaloids required to produce the drug, however, addicts across the country have found better ways to get free “smack”. There is an astounding number of bush-labs across the country that become operational when the annual poppy plant crop is close to maturing. These addicts piggy-back on farmers efforts by making daily raids to almost neverending poppy fields and gathering poppy milk, by scoring the still unripe poppy seed pods and collecting the viscous sap that comes oozing out. Unfortunately, most of these drug users have only heard how to properly prepare this raw sap into something that is “safe” to use, so there are hundreds of overdoses and self-poisonings every year. Severe cramps caused by the burned and unfiltered chlorofil can break bones, provide excruciating pain and eventually death if used repeatedly.

 

As anyone who has ever attempted to produce home-brewed beer or even just tried to grow some tomatoes, it is not easy to do. Combine the effort with the extremely poisonous nature of the product you end up with, it is a very stupid idea to produce your own drugs. Not only are you more prone to overdosing, you are at constant risk of being charged and tried as a full blown drug manufacturer, not just the user. Do not make the mistake and hope that in the case of being caught, smaller quantities will allow you to go free. Drugs are illegal and should not be toyed with.