|Posted by (Service User Network) Sun Cornwall & Plymouth on March 11, 2010 at 8:56 PM|
From The Times
March 2, 2010
Post traumatic stress disorder: a new eye movement therapy (??? new???)
As a 20-year-old, a writer was beaten and left for dead in his home. After years of flashbacks, he found a therapy, based on eye movement, that made his memories bearable
I’m walking gingerly down Whitworth Street in Manchester for the first time in 13 years. A few metres ahead is The Doorway. I’ve avoided going anywhere near The Doorway for more than a decade because, in its arched, Victorian splendour, it is the gruesome face and most taunting reminder of an event that destroyed my life.
In July 1997, when I had just turned 20, three men followed my flatmate (who was returning from a night out) into that doorway, before forcing him through the door of our flat. I was asleep. The intruders held us in our respective, adjacent bedrooms, and set about beating us.
They used bricks, saucepans, sticks — whatever they could find. They were crazed. For a while I could hear Jon’s cries through the wall. When he fell silent I was too preoccupied to consider why that might be. As I knelt in my blood — my teeth had split through my cheek — with kicks and blows pelting down, I could think of only one thing: will I live?
We both survived: Jon had been knocked unconscious. After we left hospital we never moved back. The only time I returned was a few days later, to collect some belongings — those that they hadn’t stolen. Our door was daubed with dustings left by the forensics team. Inside there was more dustings and, then, the blood: splatters up the walls of the hallway, smears on door handles, and, in my bedroom, a now brownish pool on the floor with my mattress and bedding drenched in it, rancid.
I vowed never to go back.
But now, 12 years after leaving the city for London, I am going back. I need to. And finally, I feel able to. Over the years, I have undergone myriad therapeutic treatments to quell the after-effects of the attack: cognitive behavioural therapy, psychodynamic psychotherapy, person-centred counselling and even group anxiety management sessions.
But recently, I have tried a treatment called EMDR (Eye Movement Desensitisation and Reprocessing), which has proved by far the most effective. My return to the flat and The Doorway leading to it will be, I hope, the final exorcism.
It wasn’t just my face that ruptured that night. My life became BA and AA: Before the Attack and After the Attack. Before, I was ferociously social. After, I withdrew, and as my wounds turned to fading scars the full extent of my mental injuries became apparent. Anxiety. Flashbacks. Panic attacks. Insomnia. Agoraphobia. And a pesky five-year addiction to sleeping pills.
Despite having learnt to prevent panic attacks, and kick my addiction to sleeping pills, still I had flashbacks, nightmares and hyper vigilance: I never put my key in the front door without checking behind me. It was then that a therapist friend told me about EMDR. Dr Francine Shapiro, an American psychologist, developed it in the 1980s. The technique uses side-to-side eye movements to help people to recover from traumatic memories.
My GP referred me to the psycho- trauma department of St Bartholomew’s Hospital, in London, and I arrived trepidatious but determined. Alison, the gentle, wavy-haired clinical psychologist explained the process. You relive the traumatic event in silence, in chunks of about 30 seconds, while your eyes follow the therapist’s fingers quickly moving back and forth a metre or so from your face.
You start at the most traumatic memory from the incident and allow your mind to explore all the other associated ones. In between the 30-second chunks you describe to the therapist where your mind took you and what you experienced.
“We don’t know exactly how it works,” Dr Shapiro tells me, on the phone from California, “but we think that by using the bilateral eye movements as you access the memories, the brain is able finally to process those memories properly in the way normal, non-traumatic thoughts are processed during the REM stage of sleep. These are then stored just like any everyday memories.” One’s mind is then able to disconnect the intense feelings from the memories. Rather usefully, this prevents “intrusive thoughts” popping into your head when you’re at a supermarket checkout.
After giving me questionnaires to assess the extent of my PTSD (How often do you have flashbacks? Can you distinguish them from reality? How often do you consider suicide?), Alison put our chairs to face each other and began. It’s like watching hectic windscreen wipers, or a metronome at full pelt. Tick tock tick tock. At first I struggled to move my eyes in such an unnatural way, but after a few attempts I was reliving the attack in palpable Technicolor.
After the first successful attempt, Alison asked: “What was happening?”
“I was kneeling down, in my bedroom,” I replied, “pleading with them to stop, telling them that I was haemorrhaging, but one of them just said: ‘So?’ That was the most painful memory — I’d never experienced such inhumanity — that moment changed me. Then it was earlier and I was giving them my bankcard and telling them my pin number. They said if it was the wrong number they’d come back and finish what they started.”
We go again. Tick tock tick tock. And then, for the first time for me in therapy, I start to cry. “Keep going,” she whispered, keeping her fingers going.
“It was once they’d gone,” I said afterwards, composing myself. “I opened my bedroom door and the sight of Jon covered in blood, but standing up, alive, made me break down.”
Sometimes, during the six weeks of hour-long treatments in which every memory, direct or related, was explored, I would have to stop. I would get dizzy. One’s brain, if determined to avoid pain, will stomp its feet and refuse to “go there”.
In the last session, Alison asked me to redo the questionnaires I’d filled out at the start of the treatment. My PTSD had reduced so much that she deemed the process a success. So did I.
What distinguished EMDR from other therapies — aside from the crucial eye movements — was, for me, the simple act of reliving what happened in silence. Describing verbally what happened, as I’d done in conventional therapy, actually prevented me from accessing my feelings.
Now, when I thought about that night, the flat, The Doorway, I felt very little. It seemed distant. The flashbacks had stopped. I was sleeping better. I had begun to feel human again.
When EMDR is successful, specialists can encourage their patients to return to the scene of the trauma, to check that it really has been effective.
So here I am approaching The Doorway. I stop outside. It looks remarkably similar to my memory, a little cleaner perhaps. I’m calm. I walk up the steps and well up: on the door are police stickers: “WARNING! Keep this front door secure. Know who you let in!” I ring the buzzer to Flat 1, hoping the current tenants will be in and will agree to let me in. There’s no answer. So, just as the burglars did 13 years ago, I get in to the building behind another tenant. So much for the stickers.
It feels equally strange and normal to be here. I knock at Flat 1. Eventually, a middle-aged woman answers. She tells me it is now the concierge’s office. After much persuasion, she eventually agrees to let me in, but only into the hall.
“It was converted about ten years ago,” she says. “It had been empty for a good couple of years before that.” I realise that Jon and I must have been the last tenants. I feel glad, as if somehow this might stop others going through what I did.
As we talk, I get little flashes of the blood stains that I saw the last time I came, but I feel no anxiety: the flat is different now, and so am I. After a few minutes I thank her and say goodbye: I’m done, I want to cast it all adrift. I walk out into the dank afternoon, cross over the road feeling peaceful and pensive and, as I pass a puffy-cheeked woman with yellow, candyfloss hair, she smiles. I beam back.
What is EMDR?
The technique uses side-to-side eye movements to help people to recover from traumatic memories.
Dr Francine Shapiro, an American psychologist, literally stumbled on the discovery. “I was walking through a park in 1987,” she says, “when I realised that I was reliving some painful memories and as I did so I was moving my eyes back and forward. When I re-played those memories, the emotional response was less powerful.”
She tested it, developed it and, two years later, published her PhD thesis on EMDR. By 1995, the American Psychological Association had endorsed her work.
Ten years later, in the UK, NICE had too.
Since then, it’s been available on the NHS for the treatment of PTSD. It has been used with rape victims and soldiers returning from Iraq and Afghanistan.