By Veronique Theberge and Dr. Jennifer Blanchette, Psychologist
What is trauma?
Trauma can take many shapes or forms and can be triggered from a variety of situations or events. It is associated with a range of physical and emotional responses to a distressing or disturbing event that overwhelms a person’s ability to cope. What might be traumatic to one person may not be to another, which makes making sense of trauma a rather complex exercise.
"Over the course of a lifetime, it’s common to be exposed to a traumatic event, whether it is a violent act, a serious injury, a sexual violation, or other shocking event. In response, many will experience traumatic stress—a normal reaction to an abnormal event. People may even experience traumatic stress by just witnessing a highly distressing event or having a close family member or friend experience such an event. " (APA, 2022).
Veronique’s experience of trauma
During my recovery journey from encephalitis and acquired brain injury, I came to notice that an incredible amount of trauma originated from the acute phase of the illness, but also from the lack of support that was experienced at various stages of my recovery.
In an earlier blog “Trauma, the Chicken of the Egg?” I mentioned some of the physical and emotional responses that I have been navigating with the associated trauma such as anger, fear, sadness, hopelessness, fatigue, racing heart and headaches only to name a few. I mentioned using and developing key skills linked to resilience to help me recognise, process and get past some of the trauma. Resilience has been an incredible tool for me to learn to better manage some of the associated responses, but it didn’t always stop them from occurring.
For this very same reason, trauma has been a recurring topic at my monthly psychologist sessions. Through Cognitive Behavioural Therapy (CBT) we worked on identifying and recognising some of the triggers and we slowly started to peel the layers one by one. CBT has definitely been helpful in creating a sense of awareness and provided me with additional tools to manage certain aspects of the trauma, but I personally felt that it didn’t get rid of that tight knot that I was experiencing in my chest. I was therefore keen to explore other avenues that may be suitable for me to consider in my quest to truly become ok with some of the trauma experienced since being ill in August 2017.
Background on Veronique’s trauma?
In spite of all the good work done internally and during therapy, there were still a couple of areas of unprocessed trauma in my case. The first one was linked to my misdiagnosis. The tardiness in diagnosis meant that I missed out on antiviral treatment which could have potentially reduced the amount of damage sustained by the brain. The second area of ongoing trauma was linked to the constant struggle to get support from the medical specialists. The cross-over between these two was my feeling of being dismissed as an individual. I was pretty good at rationalising what had happened, at recognising its ongoing triggers and at trying to manage the associated responses, but I was really struggling to process the feelings of deep sadness, hopelessness and fear of being dismissed once again. Not only was this trauma keeping my body in a state of fight or flight, but it could also be paralysing at times. So the next question I had for my psychologist was “Is there anything else that we could explore to help me process this trauma further?” And that’s how I was introduced to EMDR.
What is EMDR?
“EMDR therapy is extensively researched and widely recognized as effective trauma therapy. EMDR stands for Eye Movement Desensitization and Reprocessing. It is a form of therapy that helps people heal from trauma or other distressing life experiences. EMDR therapy is recognized as evidenced-based treatment for PTSD and other trauma and stressor disorders (EMRIA, 2022).”
Furthermore, Trauma is defined as experiencing or witnessing a frightening, dangerous, or violent event that can overwhelm our natural coping and body’s stress response system. Exposure to death, injury, abuse, or sexual violence often causes trauma. Other events such as relational problems, interpersonal difficulties, and job stress can also cause a traumatic response in the body. We all respond differently.
What is it like to go through EMDR Therapy:
While it’s different for every client, the goal of EMDR is to completely process the traumatic experience so they are no longer stressful to remember. There are three parts or prongs to EMDR.
Future Situations or Emotions about the issue.
EMDR can be “faster” than other therapies in a sense as most of the “processing” of traumatic memories is nonverbal. Speed is not the goal, safety is most important. Some people with few traumatic memories quickly go through phase 2 of EMDR (resourcing/safety) while others go much more slowly.
In much of my schooling before EMDR, I found that I was approaching situations from my mind to my body or from the top-down. While cognitive processes (think CBT) are important and are a part of many evidenced based therapies (including EMDR) they will never complete the picture. If we take an example of a bear chasing us, we aren’t going to stop to think about the right way to think about whether to run or chase the bear, we will just respond. Our nervous systems take over the decision.
With more bottom up approaches (such as EMDR, somatic, etc.) we approach situations through the lens of the nervous system. Naturally, if I had a bear chasing me, I would discharge adrenaline and cortisol from the act of running or actually fighting off the bear. Would I reframe the thought about the bear being threatening, NO!
In many cases, we have an incomplete stress response. To complete the stress cycle we should consider things that would likely benefit our bodies in threat or stress. Much of the time the best way is through some type of movement in our daily lives. For my clients with a brain injury, I often see them stuck in the stress cycle that Veronique mentioned. She was often stuck in her sympathetic (fight or flight) system feeling agitated, etc. or in parasympathetic with low energy (freeze) response. The ambiguity of a diagnosis for many people with a brain injury is a very helpless feeling as she mentioned. So many times, feeling stuck is a very real nervous system state. EMDR helps the specific memories of your brain injury event become unstuck by completing the stress cycle that wasn’t able to be completed. Over 70% of adults have some kind of trauma (EMDRIA, 2022), but for brain injury, I find many people don’t identify their experiences as trauma or receive necessary treatment!
Veronique’s experience of EMDR
I went into my first session with a basic knowledge of EMDR, but I didn’t want to read too much about it for fear of creating unrealistic expectations. My attitude was to take things as they come and see where the session would take me. We eased into it gradually and it was interesting to see how my thoughts would jump from one thing to the next while doing so. In my case, none of the images were really confronting, but the associated thoughts and emotions often were. I wanted to do the process justice so I let myself be vulnerable and addressed openly many of those thoughts and emotions that were passing by. Tears rolled down my cheeks on several occasions and as they were doing so, the hold of the sadness, hopelessness and fear that was associated with “having been dismissed” slowly started to dissipate.
I can’t quite put my finger on it or explain it, but a shift was definitely happening. EMDR was working its magic in a very mysterious way. The tightness in my chest was no longer and it felt as though I could breathe freely. The weeks that followed this session, I was amazed by how I could bring up some of the traumatic events addressed during the session without feeling all those heavy emotions. I still thought that the way some things were handled was appalling, but it didn’t feel so distressing anymore.
I also noticed that other events that were linked in one way or another to the feeling of “dismissal” had also lost their hold on me. It was as if EMDR carried on working its magic long after the session. It is fair to say that a lot of work had already been done prior to my EMDR session and this probably allowed me to clearly identify one of the main root causes of the trauma. In retrospect, I think our starting point “dismissal” was a key element for me. Perhaps that’s why I have seen such a shift.
Since this session, I have found myself to be much calmer and not to be overacting so quickly in certain situations. In fact, situations that used to trigger my physical and emotional responses aren’t so much of a big deal anymore. I would definitely be open to having another session to explore if further benefit could be had from this type of therapy.
Where to next?
Dr. Jennifer Blanchette is a licensed psychologist and is the host of the TBI Therapist Podcast. Her hope is to illuminate and help people find the information and clinicians that can aid brain injury recovery. She owns a clinical practice in Maine (USA) where she offers, amongst other psychology services, EMDR therapy.
Veronique Theberge is an encephalitis & acquired brain injury survivor. She is involved in advocacy work where she hopes to raise awareness of life after brain injury. She launched the Weird Wonderful Brain blog where she writes about a variety of topics linked to brain injury recovery.
Get in touch
Dr. Jennifer Blanchette’s website: I recom www.tbitherapist.com
Dr. Jennifer Blanchette’s clinical practice: www.newlifeofmaine.com
TBI Therapist Podcast: https://tbitherapist.com/episode/
Need help finding a therapist: https://www.emdria.org/.
Weird Wonderful Brain website: www.weirdwonderfulbrain.com
: American Psychological Association. (2019, October 30). How to cope with traumatic stress.https://www.apa.org/topics/trauma/stress