Tolerating Distress in EMDR Therapy

EMDR is a type of therapy that can help individuals who have had past traumatic experiences. Traumatic experiences are challenging to address and can create significant distress. Tolerating distress in EMDR Therapy is an important skill to learn and EMDR therapy makes sure to address this skill before any memory processing occurs. Learning to manage this distress and developing a safe space is an important and necessary part of any trauma therapy. Tolerating distress in EMDR is a skill that can be taught utilizing different relaxation and stabilization techniques.

Window of Tolerance (EMDR Therapy in Philadelphia, PA and Ocean City, NJ)

When we think about trauma and tolerating distress in EMDR, it is useful to consider what is called the Window of Tolerance, a concept developed by Dan Siegel. The window of tolerance is when an individual is able to manage the emotions and sensations of re-experiencing the traumatic memory without feeling overwhelmed, or the opposite, without feeling numb. If the person who is experiencing the trauma experience becomes overwhelmed, they may experience fear, panic, rage, overwhelming thoughts, etc. This level of distress is too much to continue working with the traumatic memory and relaxation/stabilization techniques are needed. If the person experiencing the traumatic experience begins to feel numb, they may experience depression, exhaustion, disconnection etc. With this type of distress, relaxation/stabilization techniques are also needed. For a person to be able to deal with a traumatic memory, they want to feel an ability to tolerate the emotions without going into either extreme.

Grounding and Relaxation Techniques (EMDR Therapy in Philadelphia, PA and Ocean City, NJ)

For tolerating distress in EMDR, knowing and being able to use grounding and relaxation techniques is essential. Without these techniques, processing memories in EMDR can be difficult and moving out of your window of tolerance can interfere with the process. These techniques can help you to learn to stay within the window of tolerance as discussed above. Below are some grounding and relaxation techniques that you can try at home whenever you are feeling distressed or to practice for when you are not experiencing distress. Practicing regularly when you are not feeling distress can help you to more automatically use these techniques when you need them. Some of these techniques may not work for you and that is o.k. You can always switch to another technique that does. It may be useful to try all of them (even if you find one that you like) to have the experience of the technique. Most of these techniques are discussed in Dr. Shapiro’s book “Getting Past your Past”.

1. Grounding yourself with your 5 senses. One very common technique is based on being mindful of your surroundings. One positive about this technique is that you can practice it anywhere. To practice, take a seated position (however, it is not necessary to be seated to practice). Bring your attention to the environment around you. Look around and list five things you can see. Say them aloud or in your mind. Then look around and list 4 things you can touch. Again, say them aloud or in your mind. Then notice 3 things you can hear (if you can’t identify three, that’s ok.). Next is 2 things you smell, and 1 thing you can taste. Again say them aloud and in your mind. Some people find it helpful to go through the sequence again to continue grounding themselves in the present moment. If distressing thoughts or feelings come up, let them be present while attending to the items you are identifying in your five senses.

2. Safe/Calm State - Imagery can be a very powerful tool for tolerating distress in EMDR. There are different types of imagery exercises that can help with distress. In EMDR therapy, the therapist guides you through a safe/calm state exercise. The EMDR therapist will use bilateral stimulation (eye movements, tones, or taps) to strengthen this exercise, but it is an exercise that you can do on your own. First take a seated position. Think of an image or some type of sense that feels safe and calming for you (for example a forest scene, a sense of being wrapped in a warm blanket, etc.) Take note of what you see, hear, feel in that space including emotions that you feel and any sensations in your body. Focus on all of the pleasant sensations, sights, etc in this space. Continue to focus on this image and all the positive and pleasant sensations and feelings. As in the first exercise, if distressing thoughts, images or emotions appear try to let them be there while you focus on the pleasant and positive sensations in your safe and calm state.

3. The Light Stream Technique - Another technique discussed by Dr. Shapiro, the founder of EMDR therapy, is The Light Stream Technique. This technique assists in focusing on body sensations in the moment. Here are the steps for the technique:

• Focus on upsetting body sensation(s).

• Describe the sensation by trying to give it a shape, size, color, temperature, texture, and/or sound.

• Pick a color that you associate with healing.

• Imagine that this healing colored light is coming through the top of your head and through your entire body and that there is an endless supply of it. Focus on the color interacting with different aspect(s) (shape, size, color, temperature, texture or sound) of the upsetting body sensations and observe what happens to those sensations. Then focus on the healing color affecting your entire body. Imagine that until you start to feel a bit more calm and relaxed.

1. The Spiral Technique - This technique is also discussed by Dr. Shapiro. Here are the steps for this technique:

• Imagine a mildly upsetting situation and think of an image that represents it.

• Notice where you are feeling disturbance in your body.

• Think of that body disturbance as an energy spiral. Notice if you feel the energy moving in a clockwise or counterclockwise direction. Now try to change the spiral to move in the opposite direction. Notice how the sensations change. If they change for the better, continue to imagine the spiral moving in that direction. If they don’t, see if there are any changes when you move the spiral in the original direction. Continue to focus on this energy in whichever direction creates positive change for you.

1. Breathing Exercises. There are many types of deep breathing exercises that help to bring relaxation and calm. One of these exercises is the 5-7-9 breathing. For this exercise, sit comfortably. Inhale through your nose for a count of 5, hold the breath for a count of 7, and then exhale through your mouth for a count of 9. Repeat for at least three times and more if you would like. Some individuals do not like the part in the middle where the breath is held. You could modify this technique by inhaling through the nose for a count of 5, followed by exhaling through the mouth for a count of 9. It is important to have the exhale be longer than the inhale in order to more fully engage relaxation.

Building Resources (EMDR Therapy in Philadelphia, PA and Ocean City, NJ)

Building resources refers to strengthening specific qualities or beliefs to help tolerate distress. In EMDR Therapy, the therapist will work with you on an imagery type exercise with the addition of bilateral stimulation (eye movements, tones, or tapping) that helps you to build your resources to help with tolerating distress in EMDR. The imagery exercise without BLS can be useful to practice at home to help strengthen specific qualities and beliefs to increase your ability to tolerate distress. Below are the steps for the exercise.

1. Identify a challenge where you could use an additional resource.

2. Identify a resource - Resources can be a quality of attribute that you would like to increase. Examples are motivation, confidence, assertiveness etc.

3. Identify an experience you had or someone/something that has that resource. For example, if your resource is confidence, think about a time when you felt confident. If you can’t think of a time, is there something that has that quality or is there some figure that demonstrates that quality for you? Examples are a person in your life that has a lot of confidence or maybe someone else like a superhero, or a strong storm. You can pick any person or thing that you identify as having the quality you are looking to strengthen (in this example confidence).

4. Think of the image that you picked. Ask yourself what emotions you are feeling when you think of it and the sensations that you are feeling in your body. Continue to focus on these things and anything new that you may be noticing. Feel that resource becoming a part of you. Stay in this experience as long as you like.

Please note: If this imagery exercise becomes negative in any way, consider trying a new image or resource. You may not enjoy or respond to this exercise and that is ok. Everyone is different in terms of what exercises work for them.

Tolerating distress in EMDR is an important skill. Everyone can learn skills to tolerate distress and different relaxation and grounding techniques. If you think you may be interested in EMDR Therapy or have questions about it, please call us at 215 922 5683 x 100 to further discuss your particular concerns and how EMDR Therapy may be able to help.

You can self schedule an in-person or virtual couples therapy session at the Center for Growth by calling (215) 922-5683 x 100.

For your convenience we have 5 physical therapy and counseling offices and provide virtual therapy and counseling services in Florida, Georgia, Pennsylvania, New Jersey, New Mexico, and Virginia.

· Ocean City Therapy Office

360 West Ave, Floor 1, Ocean City, NJ 08226

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· Society Hill Therapy Office

233 S. 6th Street, C-33, Philadelphia PA 19106

· Art Museum / Fairmount Therapy Office

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· Santa Fe Therapy Office, 2204 B Brothers Road, Santa Fe, New Mexico, 87505

· Telemedicine: We have therapists who are licensed to work in Florida, Georgia, New Jersey, Virginia New Mexico and Pennsylvania

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For fun we decided to experiment with computer generated responses and see how they compared to our answers. Sometimes we were impressed with the computer knowledge. Of course, it doesn't compare to humans . . . yet.

What is EMDR Therapy?

EMDR (Eye Movement Desensitization and Reprocessing) is a therapeutic approach that has been developed to treat traumatic memories and other emotional issues. The therapy was first introduced by Dr. Francine Shapiro in the late 1980s and has since been researched extensively, with numerous studies demonstrating its effectiveness in treating a wide range of mental health issues.

EMDR therapy is based on the idea that traumatic memories and other negative experiences can become "stuck" in the brain, leading to ongoing emotional distress. The theory behind EMDR is that by recalling a traumatic memory while simultaneously engaging in bilateral stimulation, such as rapid eye movements or auditory tones, the brain is able to process and integrate the traumatic memory, leading to a reduction in the emotional intensity of the memory and the associated symptoms.

During an EMDR session, the therapist will guide the client through the process of recalling a traumatic event while engaging in bilateral stimulation. The therapist will also teach the client coping strategies to help them manage any distress that may arise during the therapy.

EMDR is used to treat a wide range of mental health issues, including PTSD, anxiety, depression, and phobias. It's also used to help individuals deal with traumatic events, abuse, and negative experiences. It is considered a safe and effective approach when conducted by a qualified EMDR therapist.

Tolerating Distress in EMDR Therapy

EMDR (Eye Movement Desensitization and Reprocessing) is a therapeutic approach that has been shown to be effective in treating a wide range of mental health issues, particularly trauma-related conditions such as PTSD (Post-traumatic stress disorder). One of the key components of EMDR therapy is the ability to tolerate distress during the processing of traumatic memories.

During EMDR therapy, the therapist will guide the client through the process of recalling a traumatic event while simultaneously engaging in bilateral stimulation, such as rapid eye movements or auditory tones. This process can be emotionally intense and may bring up feelings of distress.

Tolerating distress during EMDR therapy is important because it allows the client to safely face and process traumatic memories, which can lead to a reduction in the emotional intensity of the memories and the associated symptoms. The therapist will provide support and guidance to help the client cope with these intense emotions and to move through the process of reprocessing the traumatic memories.

It's important to note that EMDR is not suitable for everyone and it should only be conducted by a qualified EMDR therapist. It's also important to note that EMDR is one of the many therapeutic approaches available and the therapist will work with the client to determine if it's the right approach for their specific needs and conditions.