Interview with Shenhui Lin: this is EMDR therapy applied to trauma

The human mind has a great capacity to store information, but this process is not only a purely intellectual phenomenon: a good part of human memory is made up of emotions.

This makes sense, since in this way it is much easier for us to learn quickly: the emotional guides us to wanting to repeat certain experiences and to avoid others, depending on the consequences they had for us in the past. But this logic is a double-edged blade.

And it is that some experiences are capable of leaving us very painful emotional marks, traumas, which constitute a psychological problem. Luckily, there are psychotherapeutic resources that allow us to overcome these traumas, such as EMDR therapy. Therefore, here We will interview an expert psychologist in its use: Shenhui Lin.

• Related article: "What is trauma and how does it influence our lives?"

Shenhui Lin: harnessing the potential of EMDR for trauma intervention

Shen Hui Lin She is an expert psychologist in EMDR therapy, an area in which she has been helping her patients for many years from her practice, Iniciativa Kintsugi, located in Providencia, Santiago de Chile. On this occasion, he will talk to us about the way in which this type of therapeutic intervention is used to treat psychological trauma.

What is EMDR therapy and what is the main characteristic that distinguishes it from other forms of psychological intervention?

EMDR Psychological Therapy, whose acronym in English refers to Eye Movement Desensitization and Reprocessing, that is, Desensitization and Reprocessing through Eye Movement, was created in 1987, by Francine PhD in Psychology Shapiro. It is a psychotherapy treatment that was originally designed to relieve the distress associated with traumatic memories.

Shapiro's adaptive information processing model postulates that EMDR therapy facilitates access to and processing traumatic memories and other adverse life experiences to bring them to a resolution adaptive.

EMDR Psychotherapy initially emerged for the treatment of Post Traumatic Stress Disorder, being used with great success in war veterans in the United States in Iraq, Afghanistan and Vietnam.

In fact, EMDR is currently the therapy recommended by the WHO for these effects and with which veterans at the United States Department of Veterans Affairs and Department of Defense, among others.

EMDR therapy is a psychotherapeutic current that reconciles from neuroscience different theoretical frameworks of psychology, such as psychoanalysis, the humanist, or the cognitive behavioral, allowing to conceptualize the human being as an integrated whole, placing special attention on the functioning of their emotions, beliefs, somatizations, level of consciousness, bonding systems, types of attachment, life experiences, under the umbrella of neurobiology.

EMDR therapy facilitates access to the traumatic memory network, thus enhancing the processing of information, forging new associations between traumatic memory and more adaptive memories (SPIA). It has been studied that these new associations result in a complete processing of information, a new learning, reduction of distress, along with other disturbing emotions and the perception of the world without distortions product of the trauma.

One of the aspects that I like the most about EMDR therapy is that it uses a three-pronged protocol, which allows us to address the person's past, present, and future. That is, past events that have laid the foundation for dysfunction are reprocessed, forging new associative links with adaptive information; work is done on the current circumstances that cause anxiety or other symptoms and the internal and external triggers are desensitized; and finally work on future events, to acquire the necessary skills for adaptive and healthy functioning.

In your day to day working with patients, what are the main problems with which you use this type of therapy?

EMDR is more than a psychotherapeutic technique, it is a theoretical approach that also has specific techniques and protocols for its application in the psychotherapeutic process. EMDR is my psychotherapeutic current under which I conceptualize and approach the problems of my patients.

People who suffer from various problems, symptoms and disorders usually come to me at the Kintsugi Initiative. Low self-esteem, significant difficulty relating to others, especially with partners, feelings of loneliness, fear of not being loved, excessive anxiety and previous diagnoses of depression...

People also arrive who, despite the years that have elapsed, continue to feel tormented by the events related to the coup in my country, in Chile in 1973. Experiences that many people have relived with the events of the so-called Social Outbreak that recently occurred in our country on October 18, 2019, emerging the appearance of new disruptive processes on the individual and collective psyche, which have triggered re-victimization and traumatic conditions pre-existing

On the other hand, the COVID-19 pandemic situation and the quarantines in which we have been affected globally are triggering various discomforts that we are dealing with. Both in the frontline professional staff, with whom we have worked directly from the Kintsugi Initiative, as in the general population, high levels of anxiety, symptoms of stress, insomnia, perception of loneliness, insecurity, fear, confinement, panic attacks, depressive symptoms and post-traumatic stress disorder.

What are the characteristic aspects of trauma that make it respond well to this type of treatment?

Emotional trauma is known to have a neurological correlate. When we are exposed to traumatic situations, and even more so if they are repeated, our neural activity is affected.

Both a traumatic stimulus and a continuum of traumatic stimuli are an input of information that enters the amygdala, which is over stressed, generating an alert to the hypothalamus, to produce the hormones that activate the process of fight and flight, like corticotropin, which has direct interference in our cardiac, motor and pulmonary systems. And the hormone norepinephrine, which affects the functioning of the brain stem, lymphatic system and neocortex.

On the other hand, the hippocampus secretes dopamine, which helps to fix attention and contributes to losing its temporal and contextual capacity when exposing ourselves to traumatic events.

This hyper-segregation of hormones over-consolidates traumatic events, inhibits the ability to access positive memories over unpleasant ones, and begins to generate a sensation of hyper traumatization from which it is very difficult to escape, since the command of the amygdala has also activated the opioid centers in the brain. cortex generating endorphins that produce anhedonia and numbness, the frontal cortices are disabled and with it the ability to turn off the emergency.

According to this, EMDR becomes a true revolution, because we work with this natural system that we have all the people to process the information in adaptive modes (SPIA) which, as described before, has been locked.

EMDR therapy stimulates the SPIA so that the person can process and reprocess painful experiences in a way adequate and healthy and with it to advance in her life for her subjective well-being, overcoming trauma in a permanent.

Is it difficult to make the patient understand what the type of EMDR intervention is? Is something like a “training” stage necessary?

Not at all complicated, in general most of them understand very well what this psychotherapeutic approach implies, and already working as a team, EMDR patient and therapist in the sessions, respond spontaneously about what they are experiencing by understanding for themselves how EMDR works in them.

As EMDR therapy progresses, there are stages in which the patient attends to material emotionally disturbing in short sequential doses while simultaneously concentrating on a external stimulus. Lateral eye movements directed by the psychotherapist are the most common external bilateral stimuli. used, but a variety of other stimuli are often used, such as hand tapping and stimulation auditory.

On the other hand, EMDR therapy allows us to be very protective of the patient, that is, we care about developing resources in the person so that they learn to see yourself and your problems, without fear, in the safe environment provided by the therapeutic bond, and to regulate yourself with your own tools. For them, we are working gradually, observing their progress, holding back during the process, and at the pace of each patient.

Let's say that an adult has gone through a traumatic experience two years ago, due to a traffic accident. How is EMDR therapy used to prevent that emotional mark that has remained in your memories from continuing to cause you discomfort?

For the example case that you point out, we would work with the traumatic memories specifically associated with the accident. Although the accident itself is the traumatic moment, it is also constituted by everything that occurred prior to the accident and the consequences later, considering all the intrusive fragments of memory make up various points of disturbance that make up the "episode traumatic".

Understanding this, the fragments of memory that continue to disturb are sought, and that trigger them or cause the discomfort to be revived in the present, the which can be an image, a smell, a particular sound, negative thoughts of oneself, overwhelming emotions and the correlates bodily. To work with each of these disturbance points until the disturbance is extinguished and the facts are perceived in a less overwhelming way.

How are the first positive effects of this type of intervention usually noticed, from the patient's point of view?

The positive effects that a patient can experience are varied, since it will depend on the person himself, his initial symptoms, what is being worked on and the objectives set, each patient is different and has understood her life story in a subjective and unique way.

However, effects arise that are repeated, such as feeling relieved, relaxing, being happy and commenting in some way that "the heavy backpack that was carried is no longer there", feeling that positive thinking about oneself now makes sense, reformulating one's negative beliefs into positive ones, accepting oneself and believing in one's abilities or skills... Some patients even report a decrease in psychosomatic physiological discomfort.

Thus, patients begin to notice a change in the way they perceive themselves and the world and their relationship with the environment. And to feel self-love and that they can also be loved.

Do you think that there are areas of research in which, in the future, EMDR therapy can prove its usefulness in the face of new problems and needs to be covered?

It is most likely. Since this psychotherapeutic stream emerged, there has been so much research on EMDR therapy that it is now recognized as a treatment priority for trauma and other disturbing experiences, being officially recognized by organizations such as the American Association of Psychiatry, the World Health Organization and the Department of Defense of the United States of America and various ministries of health in Europe.

It is already possible to find favorable studies of the effects of EMDR in the treatment of Borderline Personality Disorder, bipolar disorder, depression, panic attacks, for various phobias, or for Obsessive-Compulsive Disorder, among others.

In recent years, authors such as Miller have investigated clinical cases of severe depression with psychosis, delusional dysmorphophobia, and schizophrenia that have been successfully treated with EMDR. With clinical follow-up of more than 4 years after EMDR therapy, where the patient with schizophrenia continues to be free of medication and symptoms.