EMDR, PTSD, Neuroplasticity and “Limbic System Therapy”

 

Eye Movement Desensitization and Reprocessing (EMDR) is an evidence-based therapy used to treat post-traumatic stress disorder (PTSD) . Dr. Bessel van der Kolk, the Director of the Trauma Institute in Boston, is a strong proponent of EMDR for the treatment of trauma.

Learning and reconditioning of existing circuits occur when neuronal connections are built and rebuilt. What wires together, fires together. (Istock:Sahskinw)

Dr. Bessel van der Kolk, over a lifetime of treating persons with trauma, has evolved the treatment of trauma to include what he calls “limbic system therapy” (van der Kolk, 2015). Limbic system therapy uses body-based therapies to focus on calming reactive hyper- and hypo -aroused emotional brain centers using body based therapies.

When the emotional brain is highly reactive, it’s taking too large of a place in your daily life, as you’re over-reacting to the daily hassles of life. The limbic system’s rightful place is in the background, attending to maintaining homeostasis, connecting with others and appropriately protecting you from real dangers.

What’s been discovered over the years in researching and treating trauma is that verbal therapies are not always effective in treating PTSD. The emotional brain is imagery and feeling based, doesn’t use language, so it responds to non-verbal, body-based interventions to infiltrate its ingrained patterns.

And why are these body-based therapies effective? At one time, it was thought that the brain and nervous system were static. In the past two decades, research has shown clearly that the brain and nervous system are highly plastic. so, our capacity for neural plasticity gives us endless possibilities for learning and adaptation. We all have some sort of expertise that we’ve repeatedly used over the years. Some of us are painters, some of us are computer programmers, some of us are engineers, some of us are boaters, some of us are expert equestrians.

All of these skills are deeply imbedded into our mind and body via the connections in our brain cells, called neurons. The more we do a particular something, (like speak English with a New York accent or driving car, even a stick shift car) the more this skill becomes embedded in patterns in our brains and bodies.

The much used skills connect up a whole lot of brain neurons and motor neurons in the muscles. And then eventually they become a nice gift package all tied together with a fatty substance that conducts impulses quickly called a myelin sheath! So you nd things you do alot, much faster! All of this learning is possible due to the ability of the enormous plasticity and adaptability and healing abilities of the human body and mind system.

The traumatized brain has gotten a fear response imbedded into its circuits. It is imbedded deeply due to the necessity of survival, and fear hormones will imbed the fear memory deeply into the emotional brain so you don’t forget it, so you will run away next time it happens. But then the fear response, on high alert, misinterprets all sorts of sensory input and over-reacts in relatively safe situations. Thus happens under conscious thought.

So we need to process the imbedded fear circuits from the bottom up, from the emotional centers up into the neo-cortex, the thought centers. And reconnect them.

EMDR is a therapy that engages the emotional system and the thought system at the same time. The goal is to engage the emotional memory and the thought centers at the same time in a very safe way. The goal is to choose a fairly safe traumatic memory and move through the emotions of the memory, while experiencing it in a more detached manner, with the neocortex also engaged. This process reconditions the memory circuits at a neuronal level, actually storing them differently, with memories enriched with new personal insights and understanding.

EMDR does take place over a period of time and you need to be patient. A single incident trauma, like birth trauma, necessary medical procedures or a car accident, will usually take less time to work through than chronic, multi-incident trauma, such as combat, first responder, or childhood abuse situations.

Below is one example of a study done on the efficacy of EMDR and its ability to recondition the emotional brain circuitry.

Bessel van der Kolk and his team conducted research over eight weeks, in persons suffering PTSD, comparing treatment options of Prozac, a placebo and EMDR. Persons using Prozac showed between a 30% and 42% improvement, with 1 in 10 showing scores that indicated complete cure. Persons using the placebo showed a 42% improvement. Persons treated with EMDR showed the most improvement as the scores of 1 in 4 people treated indicated a complete cure. In addition, EMDR had the best result over time, as six months later, as the scores of 60% of the EMDR group indicated cure (van der Kolk, 2015). At a talk at the Trauma Conference of 2017, Dr. van der Kolk reiterated his clinical and research findings that EMDR as the most efficacious treatment for PTSD.

So this treatment is based on mindbody therapies.

We have the capability of re-learning and re-conditioning older, established patterns. Our patterns of behavior are actually neurologically wired into the brain through early experiences. Repetition of a certain emotional and behavioral response strengthens the supporting neurological connections. The neurons responsible for our behaviors are established in a strengthened physical pattern that underlies our most easily used responses. As Carla Hannaford says in her 1995 book, Smart Moves, “Learning is a strengthening connection between neurons.” When the body is incorporated into learning the brain is more fully activated and integrated.

That’s why yoga is also a great mindbody healer. More on that later…

Hannaford, C (1995). Smart moves: Why learning is not all in your head. Arlington, Va.: Great Ocean Publishers.

van der Kolk, B. (2015). The body keeps the score: Brain, mind and body in the healing of trauma. New York: Penguin Books.

 

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