Friday, July 24, 2020

Training internal resilience

I want to point to an interesting article by Eva Holland on relieving trauma, which is very relevant to the potential mental0health fallout from living through our current pandemic. Some clips describing a therapy called E.M.D.R., eye movement desensitization and reprocessing:
E.M.D.R. was developed in the late 1980s and greeted with much skepticism at first. “It sounded like yet another of the crazes that have always plagued psychiatry,” Bessel van der Kolk, a trauma expert, wrote in “The Body Keeps The Score.” But clinical trials and peer-reviewed studies that spoke to its efficacy piled up over the three decades since its invention, and Dr. van der Kolk and many others eventually adopted it as part of their therapeutic practice.
It works like this: A therapist prompts the patient to move their eyes back and forth, rhythmically, behind their eyelids. (Devices that beep or buzz help to encourage and regulate the eye movements.) At the same time, the therapist talks the patient through the traumatic event or events at issue, leading them through a series of questions about how their body is reacting to the discussion. It is a strange, and strangely physical, experience. The precise mechanisms at play are not fully understood, but the theory is that something about the eye motion, combined with the focused discussion, can lay the intrusive memories to rest.
E.M.D.R. taught me an important lesson: that internal resilience can be deliberately cultivated...I had never before thought of resilience as a muscle I could train and strengthen. The idea felt empowering.
In a reversal of this therapy, the therapist asks the client to recall four resources from their memories: a places where they have left safest and happiest, a nurturing figure, a protector, and a source of wisdom. The author reports:
As I held a vibrating pod in each hand, and as my eyes rolled back and forth behind my eyelids in time to their pulsing, following the vibrations from left to right and back again, I thought about my grandmother — my nurturing figure, who had died when I was 18. I pictured her at the open kitchen window of her suburban bungalow....The pods pulsed. My eyes moved from side to side. I felt loved and safe. To my surprise, I felt stronger, too. In the time since, I have sometimes called up those sensory memories of my grandmother when I’m upset, or when I feel in need of support. It always helps.
The article proceeds to discuss further techniques for cultivating resilience that do not involve paying a therapist.

3 comments:

  1. "The most reasonable conclusion to be drawn from the extant literature is that EMDR is no more effective than standard treatments that rely on exposure to anxiety-provoking stimuli and is almost certainly effective because it happens to incorporate such exposure. In the words of Harvard psychologist Richard McNally, “What is effective in EMDR is not new, and what is new is not effective.”"

    https://quackwatch.org/related/emdr/

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  2. Thanks for your comment and link!

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  3. Van der Kolk's book is worth reading. He advocates EMDR as part of a suit of treatments. It certainly doesn't claim that EMDR is universally applicable or effective and he specifically says it is contraindicated in cases. He says he initially told his students not to mess with it but slowly came around. Getting good comparative studies is difficult, even unethically fraught.

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