|Photo courtesy of PA Legion Auxiliary|
A severe anxiety disorder, Post-Traumatic Stress Disorder (PTSD) can develop as a result of living through events that cause extreme psychological distress. These events may include experiencing a threat to one's life or to someone else's safety, or enduring a threat to one's physical, sexual or psychological well-being. Some of the diagnostic symptoms of PTSD are reliving the experiences through flashbacks and nightmares, avoiding any stimuli that may trigger further trauma and persistent over-arousal, such as hypervigilance or the inability to fall or stay asleep, control one's anger or concentrate. These symptoms lead to significant impairment in an individual's ability to function in social and occupational settings, as well as in other areas of life.
PTSD rates are high among those who have seen active combat. In Canada, retired Lt-General Romeo Dallaire brought PTSD to the forefront. After serving as the Canadian Commander of the UN Mission to Rwanda in 1994 and trying in vain to stop the massacre of 800,000 Tutsis and moderate Hutus, Dallaire experienced repeated flashbacks of the genocide after he returned to Canada. In one instance, while driving to the beach with his family, he saw road workers stacking wood at the side of the road and experienced a flashback in which he saw the workers stacking corpses rather than wood. He had to pull over and describe the overwhelming images to his horrified family. On another occasion, he reportedly fainted in a Montreal supermarket. The scent of fruit had overpowered him, triggering a memory of rotting fruit and corpses at a Kigali market during the mass killings.
After two suicide attempts and years of reliving the carnage, Romeo Dallaire was found in a park in Hull, Quebec, semi-conscious and curled up in a fetal position in June 2000. With the help of medication and therapy, he went on to write about his experience in Shake Hands With the Devil and become a Liberal Senator.
Although there is some debate about what is the best therapy for treating PTSD, Eye Movement Desensitization and Reprocessing (EMDR) therapy is commonly used. This approach received the approval of the American Psychological Association in 1999 and is now recommended as an effective treatment for trauma by the American Psychiatric Association and the U.S. Departments of Defense and Veterans Affairs.
In 1989, psychologist Francine Shapiro discovered EMDR. At the time she was experiencing trauma in her own life, and after going for a walk, she felt remarkably better. Later, she remembered that while she was walking, she had been moving her eyes from side to side, the same rapid eye movement we do when we dream. As you may know, dreaming is how we process and deal with our emotions.
Confessions of a Trauma Therapist, Mary K. Armstrong tells Shapiro's story, which happened at about the same time that researchers were looking at the interplay between the cognitive left and emotional right hemispheres of the brain, and how the limbic system played a role in trauma. According to Armstrong, the traumatized emotional side of the brain cannot access the rational thinking of the left brain, but somehow a connection must be made.
In her book, Armstrong spoke of her own experience with EMDR. With another psychologist, Armstrong chose to work on a traumatic memory of her father choking her after sexually assaulting her. Armstrong summoned this painful visual memory while following the psychologist's fingers with her eyes as they moved from left to right. In the session, as Armstrong processed her memory, she saw her father come towards her and stop just before he was about to choke her. He then gradually faded from her view, and she felt enormous relief. She managed to reprocess the memory and desensitize this traumatic event.
In Confessions, Armstrong writes, "EMDR theory demonstrates that the eye movements allow for bilateral stimulation of the two halves [of the brain], thus changing the way we experience an event."
In her own private practice, Armstrong has successfully used EMDR to treat a wide range of cases in which the reactions of her patients did not make rational sense. As examples, she cites rape victims who believe that their perpetrator still poses a danger, or a car crash victim who believes that the accident will reoccur if he gets back into a car.
She also states that trauma is cumulative and that it is relatively easy to work with a young person, as opposed to adults, who have built up years of layers after a traumatic event. To illustrate this point, she refers to her own personal history as the daughter of a sexually abusive father and a narcissistic mother, leaving her devoid of a self. As a result, she made poor decisions, which resulted in an accumulation of negative experiences for many years of her life.
Armstrong cautions that EMDR is only a technique and requires a skilled psychologist who is comfortable with strong emotions, has a thorough knowledge of trauma and can provide a safe environment for the patient. In fact, throughout her book, Armstrong advocates a gentler therapy for trauma called Focusing, which could easily be the subject of another post.
The Boston Globe, Jeet Heer
Confessions of a Trauma Therapist, Mary K. Armstrong