Police Psychology | EMDR for LEOs
By Tammy McCoy-Arballo, Psy. D.
The Counseling Team International, San Bernardino, CA
No, it is not hypnosis.
That is how the conversation usually starts when I talk to my clients about treating their trauma with Eye Movement Desensitization and Reprocessing (EMDR).
Doc, if we do this EMDR, you are not going to train me to bark at cars, are you?
Nope. I’ll have you barking at cats, I joke.
I just want to get past it, Doc. I don’t want it taking over my life. I’ll try anything.
My clients, the majority of whom are police officers and fire fighters, usually come to see me when they are at their wits end. They are anxious or depressed; they can’t sleep, or they can’t shake the intrusive thoughts following a critical incident. They do not ask many questions about EMDR when I introduce the topic. They only have one concern: They want to get better. Most of my clients report a decrease in symptoms after their first EMDR session.
EMDR is considered one of the leading treatments of trauma in adults. Numerous national and international agencies recognize the effectiveness of EMDR. The U.S. Department of Defense/Veterans Affairs practice guidelines recommends the use of EMDR in treating clients for trauma (EMDR Institute Inc., 2015). The World Health Organization, in 2013, stated EMDR was one of two recommended treatments for trauma in children, adolescents, and adults with PTSD (EMDR Institute Inc., 2015).
My own experience with EMDR shows it can be effective in less time than traditional psychotherapy. It does not take years or even months of treatment before the client experiences relief from their symptoms. EMDR does not require the client to talk about all the nitty-gritty details of their traumatic incident, which can empower the client. EMDR’s reprocessing phase only requires the clinician to know if there is change during the bilateral stimulation, clients are able to talk about the event as much or as little as they want. For men and women who want to maintain some degree of control over most aspects of their lives, this characteristic of EMDR is one more reason why it is better suited for them.
Many times, public safety personnel find their way into my office after an officer-involved shooting, they also come in after exposure to traumatic events such as a child’s drowning, or after working a gruesome crime scene, vehicle crashes, physical or sexual assaults, as well as vicarious trauma experienced by witnessing a person’s death or listening to a person suffer over the telephone. PTSD symptoms include re-experiencing the traumatic event, nightmares and recurrent thoughts of the event, avoidance of the event, trying not to talk about or be reminded of it; and hyperarousal symptoms such as hypervigilance (regularly scanning the environment for potential threats) and increased irritability (Bisson, 2009).
In my practice with the Counseling Team International, the most common complaints my clients report are intrusive thoughts regarding the traumatic event or experiencing nightmares often resulting in insomnia. All of these can lead to substance use and increased isolation from others.
Doc, my wife doesn’t understand what happened to me. She thinks I may be going nuts. I’m not sure I want her to understand what’s happening, because maybe she is right. Who wants to understand I’m having nightmares about the baby I found dead in the pool? I don’t want to talk about it with her or anyone else. Who wants to talk about it? I just want it to go away. I just need you to help me make it go away.
HOW EMDR WORKS
EMDR is a multi-phase process that involves having the client focus on a traumatic image, memory, physical sensation, or some other source of an emotional disturbance. While they are focused on this disturbance, they receive bilateral stimulation from a clinician who administers the stimulation by moving his or her fingers back and forth in front of the client’s face, or the use of hand-held stimulation devices, or the use of auditory tones via headphones (Seidler & Wagner, 2006; Shapiro, 1996).
Perhaps the most remarkable things about EMDR is that the client’s brain does its own repair work. Once the client and therapist have identified the traumatic event for reprocessing, repairing, the client simply lets their mind do the heavy lifting by traveling through the brain’s memory networks as needed. The brain naturally guides the process as the memory network is activated and the processing is underway. Oftentimes, the most difficult part of the process is getting the client to stop “forcing” him or herself to think about a specific thing instead of simply letting the process unfold naturally. Clients often report thinking about things not related to the traumatic incident during processing. This unexpected response makes them anxious and they try to make themselves think about things relevant only to the incident. I often remind them that there is no wrong or right during processing and to let their thoughts go where they will because their minds know best.
BEING IN CONTROL
Police officers, public safety dispatchers, and fire fighters are comfortable being the ones to solve the problems and being in control. A therapist’s office is one of the few places where they feel vulnerable. I spend a significant amount of time developing rapport to ensure they know my office is a place where they are free to express their feelings without fear of judgment or criticism. It is important to provide reassurance and empower them to take the lead in their treatment. EMDR work can occasionally prove challenging as some clients often attempt to control their thoughts during EMDR processing. This is why rapport with the client is absolutely essential. They have to trust their therapist and their therapist must be able to explain why their behavior is counter productive to their EMDR work.
I’ve had several clients who were so avoidant that they did not want to focus on the target memory for fear of what they might recall, which is completely understandable. When this occurs, I simply remind them their memories are images that only they have the power they give them. I suggest they view the images like one would a movie while reminding them that the movie is playing while they are safe in my office. I remind them how safe they are and how brave they are, facing that ugliness in my office. They are brave. Anyone willing to do this EMDR work is brave.
THE EMDR EFFECT
Clients who have successfully processed their trauma are easy to recognize. They come into my office and they have a carefree attitude about them. They are free from the ugliness that once haunted them, and report that everything is fine. They still have problems and life is not perfect, but they are handling it much better. They have a new perspective and gained insight about their traumatic incident. They often find themselves feeling more empathy for the people involved in their critical incident and talk about their incident with a new sense of understanding. It happened and now it is over and it does not control them any longer. That is when I realize my EMDR work is complete I can think of no better way for me to spend my time than to helping those who protect and serve.
American Psychiatric Association. Practice guidelines for treatment of patients with acute stress disorder and posttraumatic stress disorder. Arlington, VA: APA; November 2004.
Bisson, A. J. (2009). Psychological treatment of post-traumatic stress disorder (Review) The Cochrane Library Issue 1.
EMDR Institute Inc. (2016). Retrieved from http://www.emdr.com
Seidler, G. H. & Wagner, F. E., (2006). Comparing the efficacy of EMDR and trauma-focused cognitive-behavioral therapy in the treatment of PTSD: a meta-analytic study. Psychological Medicine, 2006, 36, 1515–1522. Cambridge University Press doi:10.1017/S0033291706007963
Shapiro, F. (1996). Eye movement desensitization and reprocessing (EMDR); Evaluation of controlled PTSD research. Journal of Behavior Therapy and Experimental Psychiatry, 27, 209-218.
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