Trauma and EMDR: An Interview with Julian Royce

First of all, can you give me a brief background of who you are and the work you do?

I work professionally as a mindfulness based, trauma-informed psychotherapist, meditation teacher, coach, occasional consultant and am the creator and host of A State of Mind Podcast. My professional endeavors came out of my personal journey to dig deep and discover the roots of our suffering, dis-ease and the environmental destruction we are collectively causing. I had the good fortune to study abroad in India and then spent a year in Nepal studying and practicing the Buddhist teachings and philosophy. This was inspired in no small part through realizing that our own mind or consciousness is the source of our words and actions and, consequently, of much of our suffering and happiness. Going to the root of the matter, without disregarding or disrespecting the more obvious material world, is really the only way that these deeper issues can be addressed.

We live in a culture that is so externally focused and materialistic that the necessity of this inner work is often over looked or dismissed. This culture of ‘the West’ and of the U.S.. is increasingly becoming the dominant culture of the whole planet. I think it is incredibly important to personally and collectively question some of the assumptions of our dominant culture. These include things like materialism, consumerism, the drive to always be competitive, to always want more and to never be satisfied and to co-create lives dominated by stress and effort around material concerns. This is a big subject, but it is worth noticing that materialism often goes along with a kind of nihilism that denies the possibilities of things such as spirit, or of consciousness existing before and continuing after the death of the physical body, or that animals and plants and the rest of the ‘non-human world’ can also experience emotions such as happiness and suffering. At the same time, the traditional religions, such as is found in forms of Christianity, tend to emphasize an afterlife at the expense of caring for the earth and the world we have now.

This materialistic outlook also tends toward an approach of prescribing pharmaceutical drugs to address our mental health issues, all of which arise from imbalance in our system. Over reliance on prescription medications then leads to a host of problems, such as the opioid epidemic, the build up of toxins in our bodies over the years, not to mention the polluting of our rivers and lakes with the excess drugs that are leave our body when we urinate into a toilet. Luckily, it is possible to cultivate balance in our bodies and minds and to heal ourselves and others in relationship, without over reliance on prescriptions and even without changing our external circumstances; our minds are infinitely more powerful than most of us realize. These are the kinds of things I tend to think about and offering personalized therapy, meditation instruction and coaching are powerful ways I have found to help address these issues on an individual level.

What exactly is EMDR therapy?

EMDR Therapy is quite a mouthful! ‘EMDR’ stands for ‘Eye Movement Desensitization and Reprocessing.’ Dr. Francine Shapiro, who discovered EMDR, later said that if she had to do it over again, she would have just called it ‘reprocessing therapy.’ Through the hard work of Dr. Shapiro and many other researchers, EMDR is one of the most studied and evidence based research supported forms of treating trauma that we have. Knowing about the research can help give you confidence in this form of therapy.

So what exactly is EMDR? It involves 8 phases and each of them is important. Even though 8 phases sounds like a lot, if you meet with a well trained and qualified EMDR therapist consistently, you can clear up massive and seemingly overwhelming trauma in as little as 5 sessions. Of course, it may take longer than that and Complex PTSD, in which a person has experienced multiple traumatic events over their life, as well as developmental PTSD in which a person has had to live in an environment or situation that is itself traumatic (such as an abusive home) can take longer to process and heal. That being said, it is important to know that EMDR is one of the fastest and safest approaches to healing all types of trauma.

The Eight Phases of EMDR are:

1.        History Taking

2.        Preparation - EMDR Therapy Readiness

3.        Assessment

4.        Desensitization

5.       Installation

6.       Body Scan

7.       Closure

8.       Reevaluation

The second phase, Preparation, is especially important. Not everyone is actually willing or ready for EMDR. If you have taken the time and energy to seek out an EMDR therapist, then it is obvious that you are wanting to heal your trauma. However, it is important to make sure that you are in a good enough place in your life to handle the intensity and upheaval that can come from successful EMDR Therapy. It is also important to be really honest with yourself and see the resistance that may be there to showing up fully for this process and to bring that resistance up in the sessions. At the end of the day, EMDR can only have limited effectiveness if the client is not being present with their own experience and participating with the process. This doesn’t mean you have to make some kind of super human effort; it just means that you need to be ready and show up as best you can, however you are, to each session.

The phases of Desensitization, Installation and Body Scan are where we are directly working through and healing trauma. The main technique, discovered by Francine Shapiro, PhD., is one of Bi-Lateral Stimulation. She originally discovered this process through taking a walk in a park, and in her mind she kept replaying a difficult and traumatic situation. As she walked, she spontaneously began looking with her eyes from side to side. She discovered that after her walk, she felt much better and much more at peace about her traumatic experience. This lead her to studying if moving one’s eyes from side to side while processing trauma could make the process more effective. Indeed, subsequent studies have validated this discovery.

When I use EMDR with clients, I mainly use bilateral stimulation not through eye movements, but through having my client tap either side of their body. This can be done through giving oneself a ‘butterfly’ hug and tapping either side of one’s chest with the hands, or simply through tapping one’s knees. The tapping or stimulation needs to happen in a back and forth rhythm. It is essential to work with a qualified therapist through this process and it is not recommended to try to work through trauma on one’s own in this way. This is for a number of reasons. On the one hand, there can be large upheavals and emotions and it is possible to become destabilized, especially if one has been living a functional life for years through suppressing or putting to the side the traumatic events of the past. In fact, this kind of suppression is a very intelligent thing, especially for children, and can help one to build a good life for oneself. The issue is that the trauma is still held in our nervous system and will continue to cause issues in our life and relationships until it is fully processed. Another reason to not do this on your own is that is is very easy to disassociate during it and to not even realize that this is happening. And one other reason is that much of our trauma, especially psychological trauma, comes about in relationships. Working with a skilled therapist is a chance to heal this trauma in relationship, and that can make all the difference in the world.  

The word trauma is used pretty widely these days, how would you define "trauma" and is there a particular trauma that EMDR is most successful in treating?

The word ‘trauma’ is being used more and more; it has become part of our popular culture. My perspective on it is that, as is the case for so many mental health issues, Trauma is best looked at as existing on a continuum. As such, we all experience different levels of trauma throughout our lives but most of it is less severe than what leads to full blown PTSD. That being said, if you are or have been in a situation where it is not just one instance but a continuing situation, that can definitely lead to PTSD and cause ongoing problems. An example of this would be childhood neglect. A single afternoon of not having attentive caretakers and a safe, supportive home environment probably won’t lead to a lot of issues years down the line. However, if that was one’s norm for months or years in their childhood, they likely will experience more complex or developmental trauma that can cause issues into their adult years.

A dictionary definition of trauma is that “any event that has had a lasting negative effect on the self or psyche is by its nature ‘traumatic’ (Shapiro, page 39). Trauma can be defined as anything that has happened which one is then unable to process and which leaves some amount of feeling distressed and causes symptoms that don’t just go away. Symptoms can be incredibly varied, but can include things like disturbing, intrusive thoughts and memories, a lack of confidence (in oneself, in others or in the world), painful physical sensations, tightness or rigidity, and negative, limiting self beliefs. 

Many psychotherapists and researchers choose to look at trauma in terms of “Big T” trauma and “little t” trauma. Big T trauma are overwhelming events in which your survival or the survival of others was threatened. Little T trauma occurs whenever something difficult happens that for whatever reason, you are unable to process, leaving you with feelings of distress and symptoms that continue to affect you. Despite this language, ‘Little T’ traumas can be very significant and can continue to negatively impact our lives. 

I am fascinated by how multiple people can experience the same event and have such different reactions to it. Some will be left with ongoing trauma or PTSD and others will move on, a little shaken but without lingering effects. And it is well worth noting that those people who moved on and were unaffected by one traumatic event may well develop PTSD from another traumatic event later in their life; I don’t think it is at all the case that some people are immune to developing traumatic responses to the challenges of life.

If a client pursued EMDR therapy with you, what can they expect?

When someone comes to me specifically for EMDR, I will do a more thorough intake and evaluation process with them. It is important to support them in their life in the here and now and to make sure they are stable, have a good living situation and that the basic necessities of their life are in place before delving deep into the trauma. Things like alcohol and drug addiction need to be looked at as well. I don’t believe one has to be 100% sober to engage in EMDR, but we want to make sure that their coping strategies are not potentially self destructive or could lead to a downward spiral. If someone is habitually using alcohol or substances in order to not feel, then any attempts at EMDR will have limited effectiveness.

We should be warned that in dealing with trauma, things can sometimes feel worse before they feel better. It is a bit like the nightmare that always wakes you up. Eventually we need to turn and face the monster. But doing so too soon, rushing into it, without the proper preparation and support can lead to more disassociation, acting out or other self destructive behaviors.

There is a process called ‘EMD’ (instead of EMDR) which makes use of EMDR techniques to help people with emergency situations, such as a traumatic event that just happened, or for someone who is debilitated by their trauma and has not had the time to do all of the groundwork for EMDR yet.

In terms of this groundwork, I approach trauma work and EMDR from a place that is based in Mindfulness and somatic or embodied awareness. Developing mindfulness and somatic skills in the supportive relationship of therapy is incredibly valuable for healing trauma. And the client is then able to learn how to work with their own body/mind/emotions in deeper and more subtle ways that are increasingly effective through practice and perseverance. Through this process, we learn that our own mind and body and emotions can become friends and allies in our lives, rather than a source of pain to disconnect or dissociate from.

Are there any contraindications for pursuing EMDR therapy?

While I hate to tell anyone they are not ready for EMDR, as mentioned above, it is important to have a basis of safety and stability in your life to do this kind of deep healing work. For some people, the first two phases of EMDR could take months. And if someone is actively over using drugs or alcohol in order to feel less, then EMDR will most likely not be very effective for them. It is also critical to have a safe trusting relationship with your therapist in order for EMDR to work.

A person who is actively suicidal or has a history of suicide attempts may not be a good fit for EMDR. And for highly Dissociative people, there are additional steps that need to be undertaken before beginning EMDR. EMDR is not recommend for highly dissociative people without these additional steps and preparation.

So far as I know of, there are no other contraindications to EMDR.

How can prospective clients get in touch with you if they are interested in pursuing this style of treatment?

Please visit my website and send me a message (www.aStateofMindCounseling.org) or email me at AStateofMindCounsel@gmail.com. We will set up a free consultation by phone and if we are a good fit for each other, we can then schedule our first session. There is a saying “the best time to plant a tree was last year. The next best time is now.” In the same way, the best time to start this process of deep healing was likely a few years ago. But the next best time is now! So don’t delay and find the help and support to touch and heal all the blockages that are holding you back from living the life you are meant to be living.