Sarah Jenkins, MC, LPC, AZ Counseling, Therapist, Counselor, EMDR, PTSD Treatment, Counseling Services, Arizona, AZ



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Archive for the ‘Depression, Anxiety, and PTSD: Healing Our Wounds’ Category

An Introduction To EMDR & The AIP Model

Monday, July 5th, 2010

EMDR celebrated its 20th year in 2009 and is a researched-based alternative to traditional “talk therapy” in the treatment of trauma. Francine Shapiro created EMDR and initially utilized it to help veterans struggling with Post Traumatic Stress Disorder (PTSD).

EMDR utilizes a combination of therapeutic approaches with bilateral stimulation, i.e. the use of alternating, right-left tracking that can take the form of eye movements, sounds, or tactile stimulation. EMDR “gets to” the underlying trauma. It unfreezes the symptoms that are “locked” in the nervous system, so that it can “let go” of them on an emotional and logical level. I tell my clients that it is like an emotional detox of sorts.

Contrary to popular belief, EMDR is not “just moving your eyes back and forth,” or “listening to back and forth tones,” its a comprehensive treatment model, taking into account a variety of therapeutic modalities. As I mentioned in a previous post, the EMDR “protocol” is an eight phased approach, each phases builds upon the next to allow the client to release and reprocess the event(s) that are contributing to his or her symptoms.

Consider that our brain has two hemispheres; the left is more logical and the right, more emotional. Experiences that are traumatic for us cause the hemispheres to get out of sync. For example, you may know that what happened to you “is over” but it doesn’t feel true. Your logical left-brain, and subjective right-brain, are in conflict. Instead of actually “processing” what happened, the upsetting, scary, or traumatic experience get “stuck” or “frozen” in the nervous system.

Here’s what we mean by the term “processing.” Because the cognitive and ands sensory aspects of traumatic events are stored “maladaptively,” in the nervous system and in a state dependent form, they can still “intrude” into your present life and cause symptoms in the present. We EMDR therapists want to help your nervous system store the material in a more adaptive and healthy way.

In other words, instead of the trauma being locked in the nervous system as it was at the time, causing symptoms, the nervous system can reprocess what happened, including the images, thoughts, sensations, feelings, in order for it to really know that “it’s over.” Instead of your body being stuck in a fight, flight, or freeze response, still seeing what happened, feeling what you felt at the time, or thinking about yourself as you did, we want your system to know its over, really over.

We EMDR folks call this process Adaptive Information Processing (AIP). We believe that within all of us is a mechanism that seeks to process what happened, and didn’t get the chance to; instead, it was stored, locked in our right brain, unprocessed, and in the same form as when the disturbing event(s) happened.

We also utilize the metaphor of a train going down the tracks. As we move forward and process the experiences that contribute to the current symptoms, now, we begin to move towards a more adaptive resolution. As we travel down the tracks, we process the cognitive or sensory–motor material. We pick up newer and more adaptive information as we stop at different train stations. Literally, we are linking adaptive and helpful cognitive and sensory-motor material in your existing nuero-networks, with the track you have been on, the ones that weren’t so helpful. In other words, we get what you know, logically, to link with how you stored the traumas, as you move forward along the train track. Those emotions, sensations, beliefs, and images that got stored at the time in their state dependent form, are now transformed and stored in more adaptive ways, ways that enable you to feel present, grounded, and no longer hijacked by the events of the past. And if you are like any of my clients, you may be seeking something similar.

Facing Facebook…

Monday, January 11th, 2010

I don’t know what it is all about, but all of a sudden, my friends are buying sheep. They find stray goats, are raising chickens, and send their loved ones roses. I, occasionally, get the odd picture of what their more rural life is comprised of, the odd picture of their farms, and all of the latest happenings as they lose their goats, find lost black sheep, and harvest their crops, all in the span of a few hours. And, being a girl who was raised on a farm, with memories of bailing hay and sheering sheep, I get quite confused. For, Facebook’s “Farm” game application captivates its farmers, ironically, to stay inside. And, while social networking is unquestionably powerful, and I am a part of it’s web, I am constantly reminded of my, our, need to be conscious, in it.

The Art of Connection

Don’t get me wrong; I am a big advocate for technology. In fact, any and all of my loved ones reading this will giggle and attest that I am zealous in my passion for it. Nevertheless, I am also noticing that as technology increases, connections that are usually developed by sitting in another’s energy, by witnessing their feelings, by being present, seem to be dwindling. We send emails, texts, and messages via social networking applications. Nevertheless, we may never talk. We may communicate, but never speak to or see each other. Then, as a result, the lone “farmer” never gets out to meet with those who are real, outside of that made up world, found in the reflection of his or her computer screen.

I mention Facebook because, in the last year or so, it seems to have reach it’s tipping point. It is a rarity for my clients not to reference its impact on their lives. It’s rare for my friends to not mention it and admittedly, even for me. It is, truly, a brilliant medium. And, whether it be the old connections that are rekindled, or even the fears and anxieties that can resurface as a result, the power and impact of social networking on our lives, even our businesses, is irrefutable.

And, you are likely to be hearing similar stories all of the time. Old high-school friends who, still, remember why their friendships didn’t continue. At the same time, beautiful stories of people finding each other after years of wondering what had happened, and making up for lost time. Just as in anything, social networking has its blessings and its curses.

I was recently struck by an example of social networking’s power while walking down Mill Avenue. Overhearing a college student discussing her anxiety about being dropped by her friend, I then realized that her friendship had been broken off online. She was no longer allowed to be a “friend” to this person, via Facebook. Similarly, a man learning that his romantic relationship was over because, suddenly, his girlfriend’s status reflected that she was “single.” In both instances, technology had been the medium by which they had learned that their relationships were over. No phone call. No in person discussion. Technology.

Facing Our Friends

Don’t get me wrong, social networking has its place and is here to stay. Nevertheless, I believe that it is imperative that as we continue to go online, that we must also be conscious to call, see, and experience the energy of those people we are connecting with. In other words, while we can be “friends” online, we must also remember how to “do friendship” outside of the online community as well. And, as a result, we can allow our relationships to evolve because of social networking, to expand our connections, but not replace them. In other words, getting out into the world, meeting, and enjoying the presence of those we are truly friends with.

Granted, as any social psychologist will tell you, the power of proximity on the maintenance of friendships is undeniable. And, social networking allows me to connect with friends all over the world, many of whom I would be otherwise challenged to maintain such contact with. But, if we are sitting at home, in front of a computer, wanting to reach out into our communities, to share our feelings, connect with people, it often means calling, seeing, and being mentally conscious in our friendships.

I get it. I do it. Texting is easy. Email is easy. Nevertheless, in my counseling practice I am constantly struck by how these two forms of communication often replace a one-on-one dialogue. For example, my clients often tell me that they “had a fight” with their husbands, girlfriends, and friends. As they relay the conversations back to me, I then realize that it was via text or email. There was not opportunity to witness the body-language, feel the atmosphere, or look into the other person’s eyes and witness the loved one’s inner experience. What I call a “flat” communication ensues, one that email and texting easily misinterprets or confuses, thus creating more conflict. The ease of technology also allows us to perpetuate a “distance” in our relationships. Rather than working on why it feels safer to communicate via that medium, the individuals may depend on it to maintain the dynamics of the relationship. Instead of changing them and increasing the intimacy, those emotionally challenging dialogues continue via a medium that can challenge emotional intimacy.

All this being said, dive into the online community and social networking. Heck, explore it and learn about its many wonders. It truly is fascinating. Nevertheless, I ask that we all continue to be conscious in our relationships. Don’t have those tough conversations via technology; learn how to communicate one-on-one. Call up some of those friends on Facebook, and, ironically, meet them face-to-face. For, if we text or email our friends, maybe we can remember how to call them back, talk, and be conscious of our true need to make connections, socially.

Finding Our Voices In Three Stages

Tuesday, November 17th, 2009

I’m sitting in the woods as I write this article, camping on the Mogollon Rim. I am peaceful. For, as I sit around the campfire, listening to the voices of those around me, mine does not seek to be heard. It doesn’t need to and there is peace to be found in my meditative silence. But, I also know that if I wanted to, I could. I also know that my loved ones that surround me this evening would hear me. But, as this awareness comes to me, it also reminds me that for many, having a voice, or deeming whether it feels okay to speak or not, brings anxiety and trepidation. And, it is with this thought, that this article’s voice was heard.

Our voices, I find, are things that we often take for granted. While we may assume that it will always be there, or be readily available to make itself known, that is not always the case. In fact, the idea of having a voice, for many, creates greater anxiety then the idea of not using it. Often, a history of being unable to find, use, or express the voice, is commonplace, especially for the women and men I work with who have histories of trauma. And, maybe you are a little like them, perhaps your voice has been hidden from view, silenced, or unavailable when you needed it the most.

Of course, you already know the physicality of using your voice. You know that it is a way communicating to the world, a way of expressing yourself. Yet, we often forget that our voice is, literally, the vehicle for sharing our innermost selves, our intentions, our fears, our needs, our past, present, and future with the outside world. Furthermore, as we express ourselves to the outside world, we hear our words. Thus, we are given the opportunity to hear our innermost thoughts, which is often the most challenging, yet freeing result as they echo back to us through others’ reactions, responses, and their voices.

Yet, for many who are recovering from anxiety, depression, trauma, or addictions, inevitably, the voice struggles to be heard, or if it does present itself, it does so indirectly, surreptitiously, or through repetitious symptoms and patterns of behavior. Your voice may want to express itself, but not know how. It may be blocked. It may not know that it can. It may not know its true value. And when my clients reach the point, as they often do, that their voices want to be heard, we begin discussing what I call “finding your voice in three stages”

Stage One: Finding The “Right” To Speak

When we start to express “out loud” rather than “internalizing” or “stuffing” whatever needs to be said, we release what has restricted our voices. Nevertheless, not expressing what we want to say is the result and leads to thoughts about whether we have the right to use our voices in the first place. Regardless of what we want to say, even if we have the ability to use it, the expression of the voice requires, first of all, a belief that we have the right to speak our truths.

When we are in the first stage of finding the voice it sounds like “can I say “this” out loud? It is okay for me to “think this?” These two questions, or variations thereof, are my first clues that the voice is in the beginning stages of making itself known to my clients. Once we release the restrictions that have held the voice back, closed it off, or blocked it, the second stage involves shifting our energy towards expressing what wants to be said.

Stage Two: About Being Heard

As it may have been in the past, in the present we may or may not be heard. With this in mind, when we know that we have the right to speak, we shift into making a decision about whether we want to actually speak. And, while making this decision, it is imperative that we do so without an expectation of the outcome. If we make a decision to say our truths, and let them be expressed, we must be aware that those hearing it have free will in how they do or do not respond. Therefore, I make sure to educate clients regarding this aspect of using our voices otherwise, we risk expressing ourselves with the expectation or hope that we will achieve a specific result. The reality is that many who have not used their voices do so because they have not been heard in the past. As a result, their voices were restricted. To use our voices, to convey our truths is to do so because we desire the freedom that can come from communicating it, not because we are expecting a specific reaction from others.

Stage Three: Using The Voice

Whether or not we are comfortable saying what wants to be said, when we have discovered our “right to speak,” and considered whether we will be heard, the momentum inevitably shifts to the third stage of finding our voices, perhaps using it. And, because the voice may be stifled, blocked, or closed off, there may be a pattern of never using it. Therefore, we must learn how to use it, skillfully, consciously, and with intention. All the while, actively considering what serves our highest interest, and that of those who would hear it. Thus, we may choose to actually use it. We may even decide that expressing it to ourselves, is enough. Either way, we have done so consciously and while fully present.

When we explore our voices, the three stages, inevitably show up. While they may not appear in order, the reality is that each one is an important part of our healing process. For, as we determine our innermost truths, the choice about what to do with our discoveries asks us to hear ourselves, just as we might ask the same of others.

When We Get What We Ask For

Monday, May 4th, 2009

I recently began thinking about how often we ask for something. We may even ask for, pray for, hope for, or even wish upon something outside of ourselves, to help us “get” it. Yet, ironically, when we actually “get” what we want, is it always in our best interest? When what we ask for doesn’t arrive, perhaps, that is what’s in our highest interest? Perhaps “not getting” what we ask for, is the best thing for us.

Similarly, I often stories from those who have idealized, romanticized, or wished upon something, to then be disappointed when it arrived. Ironically, it is not that the desired outcome was actually a true disappointment. Its just that that didn’t “match” the original fantasy or idealized image of it. Whether it was that the relationship didn’t “look like I thought it would be,” or that experience “wasn’t as exciting as I thought it would be,” it all comes down to expectations.

The bottom line is that our expectations often do not meet reality willingly. And, when we are focused on the struggle of not getting what we “want,” or what it “should look like,” we forget that not getting it, may really be in our best interest. In the big picture, perhaps it opens up wider possibilities than we originally asked for. And for that to happen, we must be willing to allow things just to unfold.

Grounding Skills

Sunday, April 12th, 2009

Feeling not grounded, out of your body, or not connected? Here are some quick ways to help you ground yourself and be in the present. These can be used whenever dissociation shows up in your life.

1. Count the number of objects in the room you are in.
2. Have favorite CD or song available, on an MP3 player or phone.
3. Have a favorite smell available to sniff to ground you.
4. Take your shoes off and run them into the floor, as if they were roots in the ground.
5. Have a favorite comforting object with you all the time, to hold if you need to.
6. Take a tennis ball and rub it under your feet, pressing it into your arches as you do.
7. Hold ice.
8. Remember, now is not then. Have a phrase that you use to remind you of TODAY.

When The Past Becomes Present

Tuesday, February 3rd, 2009

Already, I have come to realize that 2009 is moving quickly. Isn’t it true that we can so easily forget the here and now. I must have, since I forgot to post my January blog. Sorry ’bout that!

But, all jokes aside, the ongoing issue of how to stay in the “here and now” isn’t news to you, nor to any of us.

For example, many of my clients struggle with the “now,” especially when they have trauma. They often ask me “how am I supposed to be in the moment, but also work on traumas from my past?” It is a key question. Maybe you have asked this as well, or know someone who has…

My answer to that question is that using techniques to stay in the “now,” are what help us manage, tolerate, and get through those tough moments when the past triggers want start to be overwhelming or feel unmanageable. It is for this reason that I strongly encourage you to learn meditation techniques, practice yoga, tai-chi, or other forms of “moving meditation.” By doing so, you are better able to “sit” and feel grounded in those moments when trauma memories, triggers, or other overwhelming experiences show up. The lessons that Eckhart Tolle shares, for example, are right there to support you in your trauma work.

Nevertheless, one should also remember that “doing” your trauma work also involves accessing the more “reptilian” part of the brain that holds the trauma. That, quite honestly, is a very stubborn brain, one that knows “fight/flight/freeze” and just doesn’t “get” talk therapy or cognitive techniques. Perhaps you know somewhere who has been, despite years of therapy, working on their trauma history. Yet, they still feel stuck. That’s possibly because they were primarily accessing the “logical” part of the brain. But, the catch is that trauma just isn’t stored there. That’s why therapies like EMDR are helpful. EMDR works on that part of the brain where trauma lives, and cognitive techniques are challenged to access.

So, keep reading about how to get in the now. Learn those skills and use them. But, also stop judging yourself when the past traumas become present. You are fighting biology! Then, stop judging yourself for judging ;) Yes, the past can be released, but it just has to be accessed in a different way. Consider the gift of combining both trauma therapy and skills to help you stay in the now, as you heal from the past.

The Story

Thursday, December 18th, 2008

I wrote a “choose your own adventure” essay as part of my undergraduate college applications. The reader could chose one of two endings, the first being that I got accepted into college, the latter being that I did not, and held an unfulfilling job, one that did not enable me to express my creativity and wanting of “making a difference” and being a counselor. I loved the essay.

They didn’t like it, and I didn’t get in.

So, at the time, I created a “story” of why I didn’t. It was based on the illusion that it was due to some internal personal fault. In reality, I finally came to realize that not getting into to my first top college choice was just an event. But, for the longest time, my “story” had been that I was not “good enough” to get in. Funny enough, not getting into my top school was the best thing that could have happened to me. In the long run, my “idea” of what was the better choice, actually was not.

When we “write,” our stories of how we see the world, we have to learn to disintegrate the parts of the story that do not really “fit” the larger plot, the actual reality. Sometimes events that happen do not turn out as we expect, but end up being exactly the right thing for us. Nevertheless, we may create a “story” that it means something negative about ourselves, or our situation. For example, how many of you have had the realization, years later, that what you thought was best for you, at the time, really was not? Hindsight truly can be 20/20, don’t you think? Is there anything that you would want to tell your younger self from 5, 10, even 20 years ago? Is there something that you didn’t know then, but do now?

The Energy of Changing, Changes Things

Monday, November 3rd, 2008

If you are experiencing major internal changes right now, perhaps some of these questions sound familiar. “I don’t connect with the same friends as I used to,” or “I just don’t want to do the things that I used to.” On face value these statements sound, feel, and look like negative experiences and, yes, they can be extremely painful. Nevertheless, we often forget they can be part of the healing process as well.

Once you identify and heal a changed aspect of yourself, for you to be congruent with who you are, your external world is asked to change as well. Unfortunately, many of us forget that these changes often “show up” with losses in the external world, and quickly. The fact that many of them are not in your immediate control, can be even more unsettling.

As we heal and go to counseling, our energetic vibration raises, that which no longer resonates with us, has to do one of two things. Adapt and raise its vibration as well, or be experienced as a loss. In other words, if you don’t resonate with something, someone, or a relationship as you used to, changes can occur to reflect that in your external world.

Could you consider the possibility that a loss may be occurring because some aspects of your life are longer congruent with who you are, because of your growth?

Of Course, No One Expects Surprises.

Friday, July 4th, 2008

Maybe you can relate to the “ahas” that came out of an experience I had this week.

Tuesday was not really a day that I foresaw throwing me any major “surprises.” It would be a mellow one, with little planned outside of my favorite yoga class. The universe, obviously, had a surprise in store. Of course, you don’t see surprises coming. That’s the point. “No one expects a Spanish Inquisition.” Random Monty Python reference there, sorry ‘bout that.

Anyway, I strolled into yoga class. (Okay, I was running a bit late. So, here’s the reality. I probably plowed through the door.) Nevertheless, I was grounded and ready for yoga with one of my “favorite” teachers, in a class that, certainly, stretches me beyond my mental and physical limits. The class was familiar, known, and one that I have a certain “attachment” to.

That was my first mistake.

When we have an attachment to what something “should” look, sound, or be like, ironically, it increases the likelihood of there being some kind of surprise in store. It is rare for something to be “just as we thought it would be.”

I bounced off of the heat in the room like I had run into solid brick wall. 100 degrees. Unbeknown to me, I had joined a heated class. And, despite, all of my constant comments about wanting to try it, I didn’t expect that moment, TO BE NOW!

Like a dear caught in headlights, I froze. (Not gracefully I’ll have you know.) The other practitioners, albeit part of a small class, “looked” the part. Iced water bottle in hand. Suitable thin clothing. Smiling. This all stood in obvious contrast to my long pants, tank top, and metal water bottle. “The look of horror on Sarah’s face, priceless.”

Two minutes until class starts and a decision had to be made, fast. Run like mad, or stay and face my fear of the unknown. But something in me told me to take the risk. It was worth it and I reveled in it.

My awareness, my “aha,” was that the decision to join the class was really about my willingness to “get out of my groove” and look at the opportunity that I was given through surprise. I had to actually do what I feared, to get the real surprise, the gift of the “aha” itself. I realized that the actual moment when I “dove in” was when I was forced to grow. It wasn’t the class itself. The class had nothing to do with it. My lesson came through the actual decision to stay. Let’s face it; surprise leaves room for growth, even if it is born out of reluctance.

We all have had to reach out of our comfort zone, do something risky, and swim through the deep uncertainly pool that it creates. And, ironically, it often means making a decision to find the right times to run or stay.

My ego wanted me to run because it thought I was unsafe. My ego perceived that I wouldn’t be able to handle the heat, that it would overwhelm me. Yet, my spirit, that part of me that knew what was best for me, begged to differ. I’m glad I listened. I hope you do too, whatever that risk that hits you like a “brick wall” when you open the door.

Oh, and a tip: Those water bottles may be good for the environment, but they burn your hands like %#@#% in 100 degree + heat ☺

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