EMDR: a miracle therapy?

Most people have heard about EMDR, a therapy that Shapiro created. It’s supposedly THE treatment for PTSD or other trauma related things. What bothers me is all the websites that say how well EMDR works. You’ll read phrases such as: “you only need 3 EMDR sessions and you’ve gotten rid of your PTSD”; “it has a 100% succes rate”; “it’s not as emotionally hard as other treatments” etc. Or you’ll read how it works for everyone and every kind of trauma or multiple traumas. When I tell someone I’ve PTSD, they usually immediately ask me if I’ve done EMDR. I haven’t. Most people can’t accept that I haven’t and still dare to say to people that I’m trying everything. EMDR isn’t right for every trauma and every person. It can go (drastically) wrong too.

There already are many articles on how EMDR works, so I don’t want to go there. Except that, according to all the information I could find, so far researchers don’t really have evidence that moving your eyes (or other left-right movements) actually work for processing. They do have evidence that the therapy works, they just don’t know how and if the left-right movement truly help. The only research that did have this evidence, was done by the creator of EMDR herself. That research was based on a group of people who got EMDR sessions where they could talk as long as they needed and show all their emotions. And the control group who only had 20 minutes and then had to leave. She also claimed that she could cure everyone within 1 hour with her EMDR. The claims they make about EMDR are now less high, but still high. However, I don’t want to write a whole article on EMDR being a placebo or anything. And even if it is a placebo, if it would work for me to lessen some of my symptoms, I would still be glad. What I do want to do with this article is make people a bit more cautious. It isn’t a miracle therapy or suitable for everyone and I’m worried about the extreme focus of the professionals on EMDR for PTSD.

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[Photo of a woman holding 2 fingers in front of another woman’s face at a small distance]

It’s very tough to go through EMDR, because it triggers a lot. You need to have a safe place where you can recover the rest of the week, preferably with someone around you who you trust and can help you. You might need to (temporarily) stop work/school etc. Your symptoms will first become worse and if the therapy works for you, will become less. Sadly, I’ve heard enough stories not ending with the symptoms becoming less. I’m not saying you shouldn’t do this therapy. I just want to shine a light on the other side of the story, since we can read a lot about the miracles. You can find more about bad experiences with EMDR here on the PTSD forum.

I think it is often underestimated how hard EMDR can be for the client. They say you’re in a safe place during the session (which often takes 45 minutes). It might take quite some time before this therapeutic environment can be a safe place for you, at least in my experience it does. When I read that it happens in a safe place, I immediately wonder: what happens when you leave? I mean, you can’t stay in the safe, therapeutic environment till your next session. It’s something to think about. You don’t want to go in unprepared, this also applies to the people supporting someone going through EMDR. The memories and flashbacks won’t stop just because the 45 minutes are over. Sadly, PTSD doesn’t work that way.

I think it’s very important that professionals first establish if the client has enough tools/techniques to handle their emotions, BEFORE starting EMDR. So far, I’ve only met one psychologist who talked about this with her clients. It’s so important that you can handle yourself, before you start “diving in the deep”. And I’m sure that if professionals give it a thought, they wouldn’t want to trigger patients in automutilation or suicidal tendencies. But they often don’t think about this.

Another point of concern is that EMDR doesn’t work well for multiple (and/or long-lasting) traumas or complex PTSD. Having multiple traumas really multiplies the complexity and difficulty. Not a lot of therapists can deal with multiple traumas. As always it’s very important to know beforehand, how much knowledge and experience your therapist has.

If EMDR is the right way for you, I’m happy for you. I’m not trying to discourage people to try any treatment. I’m just trying to spread some awareness, because as for every treatment: you need to think carefully about it, before trying. Every treatment can have (serious) negative side-effects. This doesn’t mean it’ll happen to you too, but like I said, I’m worried about the massive amount of one-sided information on EMDR. There is no treatment that works for everyone or make you forget every bad thing that ever happened to you.

Take care while being on your healing journey!
Photo source

 

 

Letter to my gynaecologist

I’ve translated the letter I sent to my gynaecologist. She never replied, but it did give me some closure, because I could finally tell her how I felt about everything she did. I really wanted her to understand how she hurt me, because I don’t want her to hurt other women (she only treats women) in the same way and it would have helped me heal from this trauma. I still don’t think she actually understands, but writing this down and actually sending it to her did help me a lot. 

Dear Doctor,

For a long time, I have been in doubt whether I should do something with my complaint in regard to your consultations. I have decided to try to put it into words again. A while ago, I wrote you an email in which I tried to explain what went wrong for me. Because of that email, we made an appointment to talk about it. At the beginning of that appointment, you made it very clear we were not going to talk about my previous experiences and feelings. You treated it like a regular appointment and I was not allowed to say anything about my complaint. Even during this final appointment, I felt as if I was not allowed to make my own choices. I felt pressured by your decisions and there was no space to talk about the things I wanted to discuss. I have tried this again after the appointment by sending you another email (for example that I wanted to try TENS).

Your responses hurt me. First, it seems as if you underestimated my ‘history’, even though I told you about the severe consequences for me. You still did the internal exam (which I did not want). Then, I actually want something and you denied me. Later in your email you say that the pelvic floor physical therapist should decide, because of my ‘history’. Especially for a patient with my kind of history, it is very important that the patient can decide herself. It all comes down to: things you do not want to happen, will not happen and thinks you do want, will happen, because this is the opposite of the so-called ‘history’. You have denied me this in two ways. There is nothing wrong with giving tips or consultation and agreement, but pushing and forcing is wrong. For me, it feels as if we have never been able to consult and agree, but you just told me what you wanted. You never asked me (regarding TENS) what I wanted and what I thought I could handle. Once again, you drew your conclusions without actually knowing me or consulting with me. It feels as if you underestimated the amount of knowledge and experience I have with myself.

The internal exam of our first appointment was against my will. I told you this and you knew about my ‘history’. You could not give me a medical reason why this exam was necessary, when I asked about this multiple times (just because you always do it, is no medical reason)  and you forced me to do it. During the internal exam, you treated me like I was only a piece of meat, that could not feel, whether it were emotions (panic) or pain. You did not take the necessary care during the speculum exam. Whithout a word, you opened the speculum completely as soon as it was inserted. This hurted me physically (I told you beforehand that I never had a fully opened speculum before, and now you even did it immediately, without pauses for my body to adjust). You did not respond or stop when I made it clear you were hurting me. During the exam you never listened/looked at any of the signals my partner and I gave you (not even my body trembling, wizened and trying to get out of the chair, or my partner asking you to stop). This exam, which I absolutely did not want but you forced me to, was a traumatic experience for me.

After the exam you told me you could not help me (and did not want to help with the painkillers etc because you did not know me). I usually had to come every 6 months, to see if the painkillers were enough and because I find it difficult to stay in touch with a doctor otherwise. I find it difficult to make contact when I have an issue or question. You put me out of gynaecologic care after our last (second) appointment and I actually don’t want to have contact with you anymore. But now I do not know how things will continue. Will there be a doctor taking over my case? Because I don’t know about this, I also do not know if your warning is a realistic one in my situation. There are other test results available which another gynaecologist could use and an exam against the patient’s will is against the law. So even if a doctor wants to do an exam and I don’t want this or not at that moment, this shouldn’t be a problem. Sadly, this went wrong. Despite not knowing if someone will continue with my case, I also don’t know what I want. The experiences I have with you are still too fresh and too painful, so maybe I will never go to a gynaecologist again. Although it might be good for my physical health.

When I received the pages you have written in my file, I was shocked about the many mistakes that are in it. There are mistakes on different topics: such as the treatments I had before, my use of medication (I absolutely do not overdose!) and that the exam went very well and with my consent. Instead of trying to get everything changed, I decided to have it destroyed.

I can understand that it was not your intention to hurt me and give me a traumatic experience. Sadly, it did turn out this way. I hope this letter will help you to understand and treat patients with a similar ‘history’ better.

I cannot emphasise enough how important it is that the patient can really talk and decide with you and that you are very careful about pushing people or forcing them. Besides that you should make sure that you actually listen to what the patient and/or her companion says and that you plan some extra time for the appointment, even if it is ‘only’ a conversation. It is important that you prepare well together before an exam. Things you could do for example: give detailed explanation beforehand about everything that will happen; ask what the patient does and does not like/what might be triggering for her during the exam and which signals she might give you (such as not responding to anything/being frozen or moving nervously with her fingers). We do not all have the same experiences and the same associations. For someone putting a hand on someone’s knee or saying certain words might be calming or encouraging, but for someone else it might remember her to her ‘history’, because the attacker did or said the same things.

Lastly, I want to report to you that I have already had contact with the pelvic floor therapist. She said that TENS for menstrual pain is not done internally, but externally (by using patches on the lower back). I wanted to tell you this, so maybe you can inform other patients about this treatment better.

Kind regards,
Mel (Hippo256)

P.S. I assume my letter will not be put into my file, or will be destroyed because this is part of the file that will be destroyed.

I am not so happy about my letter, I think I could have done a lot better. I wrote and sent it in a whim. Writing this and reading it out loud for the first time was very emotional. But I was already emotional beforehand and that’s when I got the urge to write it down. And now it’s a bit easier for me to talk or write about it. So I think I should be proud of myself, even though I could have said things better. I was trying not to insult her, because I don’t want her to be angry but I want her to finally listen to me. I hope by sharing this letter with you, this might help you when you’re having trouble with your own doctor. I was inspired by this Dutch blogpost to put my letter in a blogpost. Because when I read that blogpost, it really helped me. It inspired me, gave me some extra courage to share my letter and I knew I was not alone. Which helped me accept these things that happened with this doctor was not just all my fault.