Promises Trauma PTSD Treatment
Many people with alcohol or drug addiction have a history of trauma. Whether this was a single traumatic event or abuse over several years, Promises trauma treatment offers an integrative therapeutic program that helps you self-heal and reduces the possibility of relapse.
Using EMDR (Eye Movement Desensitization and Reprocessing), an innovative method of psychotherapy that involves eye movements and bilateral stimulation to desensitize and reprocess traumatic memories, the new program at Promises is especially helpful for those in recovery for drug and alcohol addiction who may be at high risk for relapse if they do not get significant relief from the overwhelming emotions that can be the legacy of trauma.
The trauma treatment program is headed by psychotherapist Barbara Brawerman, who is a certified EMDR therapist and an EMDRIA-approved EMDR consultant; she has been trained in affect regulation skills training as well as somatic-based psychotherapies. With more than a decade of experience, Brawerman is able to assess each client with skill and specificity, making sure that each individual client’s symptoms are attended to comprehensively. Clients at Promises who have issues related to trauma meet with Brawerman for an hour-long session of EMDR each week and participate in weekly group therapy.
Brawerman became interested in EMDR when she realized that traditional talk therapy wasn’t working with her complex clients who had multiple diagnoses. Traditionally, different psychotherapies are used to treat different diagnoses, but Brawerman began to see that she needed an integrative model. She recognized that because trauma lives in the right side of the brain, using left-brain methods such as talk therapy keeps people who have experienced trauma stuck in the past. Brawerman needed a model that treats both the left and right sides of the brain, which she found in EMDR.
“Talk therapy often keeps patients stuck in the traumatic event, talking about it, reliving it, feeling it, and often intensifying it. Eye movements and bilateral stimulation remind the patient that they are still in the present. They’re attending to the trauma in the past while being consistently reminded that they’re now in a safe environment in the present with a therapist they can trust,” says Brawerman.
What is Trauma?
“To quote Francine Shapiro, who developed EMDR, trauma is defined as any event that has had a lasting negative effect upon self and psyche,” says Brawerman, explaining that this can include one or multiple “large-T” traumatic incidents such as physical or sexual assault, combat, near-death experiences, and rape; as well as “small-T” traumas such as rejection, neglect, abandonment, and humiliation.
When a person is traumatized, the system becomes shocked and dysregulated; the experiences split off from consciousness and are held in different pockets of memory in neural networks. If the experience is not retriggered, the person goes through life fairly successfully. But if the memories are activated by a situation, person, place, thing, smell, or even a song, then the person becomes overwhelmed and doesn’t know how to self-soothe. For people who are recovering from drug and alcohol addiction, this can lead to relapse.
“If there’s a particular incident or belief about self that has been haunting a patient, if I can help to desensitize and reprocess their experience into a more healthy perspective, then when they are discharged, they’re less likely to be triggered by that experience,” Brawerman says.
History of EMDR
EMDR is a comprehensive, integrative psychotherapy approach that was developed by Francine Shapiro, PhD, in 1987. When Shapiro was hiking and became anxious and overwhelmed, she noticed that as she scanned the environment with her eyes, moving them back and forth, she began to relax. This led her to assume that eye movements had a desensitizing effect, and when she experimented with it clinically, she found that other people had the same response. It became apparent that eye movements alone weren’t comprehensive, so she added other treatment elements and developed EMDR.
Originally designed to treat traumatic memories, EMDR has been found to effectively treat Post-Traumatic Stress Disorder (PTSD), panic disorders, anxiety, and other complaints that follow distressing experiences. Several studies report a 77 to 90 percent remission in single trauma victims in as few as five hours of treatment.
How Does It Work?
When she sits with a client, Brawerman says, she asks them to “float back” to an overwhelming experience of anxiety that they’ve had recently. Then she asks what negative feelings they have about the experience (for example, feeling out of control). Next she asks what emotion goes with that and where they feel it in the body. She then asks the client to float back to the earliest time they remember feeling the way. She again asks the client to bring up the memory, the negative cognition, the emotion, and the body state, and float back to the time they had the strongest experience of this. Then she’ll take two fingers and hold them in front of the client’s eyes, asking the client to follow her fingers as she moves them back and forth from left to right. This keeps both the left and right hemispheres of the brain involved in the process, helping to decrease the vividness and emotionality of the memories. The eye movements are also used with bilateral stimulation like taps and tones.
For many patients, the panic of the experience is stored in its original form in the memory network; because it hasn’t been adequately dealt with, whenever another situation that resembles it arises—whether through affect (emotion), smell, or body sensation—the memory network will light up as if they’re back in the original moment. However, in the initial experience, the person was not safe, the environment was not safe, and the people he or she was with were not safe. But when the memory is brought up again during EMDR, the person realizes that they are in the present and safe, unlike during the original experience. This helps them begin to transform the way they experience the present and learn how to tap into their own innate ability to heal and self-soothe.
“What happens in EMDR is that I’m facilitating your own natural healing process. I’m not telling you what to do or feel or giving you interpretations, but instead giving you the tools to tap into your own innate healing structure,” Brawerman says.
Promises understands that if you treat clients for addiction without addressing potential triggers for relapse, you leave them vulnerable to the impact of traumatic memories. Brawerman looks at what has happened to each client historically: whether they experienced “large-T” or “small-T” traumas, whether the trauma was chronic or intermittent, and what the level of environmental care was during the times of trauma. She also focuses on helping clients gain self-awareness and understand their reactions to their emotions so they can regulate them.
“As I’m sitting with a client in group,” she says, “I notice them going back and forth between being left-brain dominant and right-brain dominant. I try to mirror that to them so they can understand it and feel it and get in touch with their own capacity to self-soothe.”
Affect regulation will help them learn that they are able to make choices, feel safe, and take appropriate responsibility.
The safe and relaxing environment of Promises Treatment Centers offers an ideal place for clients with a history of trauma to begin their road to recovery, and EMDR is an exceptional tool to help them develop new skills to manage their emotions when they return home.