Transcript: Episode 98
98. Guest: Roger Solomon (EMDR)
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[Short piano piece is played, lasting about 20 seconds]
Several months ago we received a question which we read in an episode about EMDR. We contacted the EMDR Institute which was organized by Francine Shapiro. Between that time and the scheduled interview, Francine Shapiro passed away. We offer our condolences to her family and friends and those at the institute who knew her well and cared so much for her work. We are grateful for Dr. Roger Solomon stepping in to complete the interview as scheduled. That was very kind of him during a difficult time for them personally and professionally.
For those not interested or even triggered by EMDR, this is not an episode to listen to. Feel free to skip this episode.
Additionally, Dr. Roger Solomon works from the three phase model with stabilization and memory work and rehabilitation, just so you know that going into the episode. Further, he does use some language that can be triggering for some people. When he speaks of integration, he’s not talking about personalities or alters or making anyone go away, he’s talking about the memories themselves and the different components of the memories being integrated back together. For example, sensory input, the actual memory of what happened, the things you heard or saw or felt and different emotions as well, all of these different pieces of memory are stored in different parts of the brain when trauma happens. So when he’s talking about and uses the word integration, he’s talking about the integration of those aspects of the memory, back into one experience rather than being stored in different parts of the brain.
He also uses the word maladaptive. He’s not talking about the person being maladaptive, but the process of storing memories in separate parts of the brain being maladaptive, because it’s inefficient in trying to recall or how it intrudes when it’s unwanted. That’s the part that’s maladaptive. So when he says therapy helps us become more adaptive, he’s not saying that you fail before you had therapy or without therapy, he’s saying that with therapy, you can have a more adaptive and efficient process of memory recall and functioning in the present, because you have access to all those different parts of your brain.
We very much appreciate Dr. Solomon's time with us and his participation and interview. Dr. Roger Solomon is a psychologist and psychotherapist specializing in the areas of trauma and grief. He is on the senior faculty of the EMDR (Eye Movement Desensitization and Reprocessing Institute) and provides basic and advanced EMDR training internationally. He currently consults with the US Senate, NASA, and several law enforcement agencies. Dr. Solomon has provided clinical services and training to the FBI, Secret Service, US State Department, Diplomatic Security, Bureau of Alcohol, Tobacco, and Firearms, US Department of Justice, US Attorney’s, and numerous state and local law enforcement organizations. Internationally, he consulted with the state and police in Italy. Moreover, Dr. Solomon has planned critical incident programs, provided training for peer support teams, and has provided direct services following such tragedies as Hurrican Katrina, September 11 Terrorist Attacks, the loss of the Shuttle Colombia, and the Oklahoma City Bombing.
Dr. Solomon has expertise in complex trauma and collaborates with Dr. VanderHart and others on the utilization of EMDR as informed by the structural dissociation of personality. He has authored 42 books and book chapters pertaining to grief, trauma, complex trauma, and dissociation in law enforcement.
Welcome, Dr. Solomon.
Interviewer: Bold Font
Interviewee: Standard Font
Hello! Now this is for the iPod presentation on EMDR, is that right?
Yes.
Podcast? Yeah, alright.
Tell us a little bit about --
I’m Roger Solomon and I’m a psychologist and I’m on the senior faculty of the EMDR Institute. So, I don’t know if your listeners know that just three weeks ago, and a couple days ago, Francine Shapiro passed away, which is a very significant loss to me personally and to the field of psychology and the world.
Yes. I’m so sorry.
Yes. So, it is really heartfelt for me right now to be doing this podcast and I really want to say “hello” to the listeners.
A powerful thing - her work was so significant and contributed so much that was unique at the time. And it is a hard loss for sure.
Mmhmm.
I met her at an Evolution of Psychotherapy conference years and years and years ago.
Mmhmm. Yes, that was certainly one of her favorites. Alright, so I’m glad that you were really able to hear her.
Yes.
I’m also going to say that I learned EMDR in 1990. I had already been in practice for 11 years as a psychologist. I’m a clinical psychologist. And in 1993, Francine Shapiro needed more trainers, and with 12 other people I became a trainer, and had been with the EMDR Institute ever since.
Tell me more about the Institute itself. What is it doing?
Well the Institute is Francine Shapiro’s organization. So it was the first EMDR training organization with Francine Shapiro as the director, and she began doing training, and as the institute and other people also started providing training and now the institute has many international trainers, not all in the United States, but really in every continent, except in Antarctica.
Oh wow, so it’s really a worldwide thing now? It has spread everywhere.
Yes, it is. And I do want to say that EMDR has gone beyond EMDR in the EMDR Institute. There are international associations. In the United States, there’s the EMDR International Associations. Well, which is a non-profit independent organization that sets professional standards. So there are also EMDR trainers who are a part of the EMDR Institute, but have met professional standards to be able to provide EMDR training.
So there are people -- because I have listeners all over the world -- we are -- the podcast airs in about 53 counties so far -- and so there are people who are not just in America, but anywhere in the world who know about EMDR, certified to do it, or trained to do it appropriately.
Yes, that’s correct.
Oh, that’s good news.
[Laughs] Indeed.
[Laughs] Okay, so just to back up a little bit, for an EMDR perspective, how do you talk about trauma?
Okay so, when a disturbing event occurs, usually we can think about it, talk about it, and dream about it, and then it becomes integrated. Now that as we glean the important survival information and retain the memory with appropriate emotions and it’s something that becomes a part of the past and informs our future. But if there’s an experience that is too much, then this experience, this memory, can become maladaptively stored in the brain. It gets stored in state specific, excitatory form, unable to process. It’s something that’s just too much to integrate.
So using that definition of trauma, certainly your tsunamis and your earthquakes and robberies and auto accidents and other situations that meet criteria for post-traumatic stress disorder are indeed traumas. But given the definition that we’re talking about experiences that are too much to integrate. It’s also important to consider the seemingly small, but very impactful experiences.
For example, for a child, mothers angry look can be something that’s too much and that experience becomes maladaptively stored. Or for a child that needs help, and is crying and the father turns his back, this is another seemingly small, but quite impactful experience that can become maladaptively stored.
So in terms of the adaptive information processing model, which is the model that guides EMDR therapy, a trauma is an experience, a memory, that is maladaptively stored in the brain, unable to process.
So when you’re talking about maladaptive and not being able to integrate, you’re talking about the different aspects of the memory and the experience itself, with the memory and the emotions and all of those aspects being pulled together into one processed memory that’s in the past?
Uh, that’s correct. So, uh, initially the memory, a traumatic memory, is stored in let’s call it trauma time. The experience is not over. It continues to be triggered and reenacted. And what is maladaptively stored are the images; the beliefs, for example, I’m going to die; or I’m not good enough; or I’m powerless; the emotions; the sensations; the perceptions that were there at the time. All of this becomes maladaptively stored - unable to process. And then when there’s some kind of present trigger, that memory, that maladaptively stored information, comes up, and now the person is starting to act in the present on the basis of the experience of the past.
So, up may come the fear, the “I’m not safe”, the perception of danger, and the sensations that stem back to the previous trauma, whether it be as an adult or in childhood.
So some of the thoughts and feelings and sensory experiences and even patterns of interactions that we have in the present, are really from memory time?
That’s correct. The past is present.
Okay. So how would you talk about dissociation? How would you explain what that is?
Alright, now dissociation is when -- let’s tick up the trauma a notch. Now, when the experience, especially in childhood, the experiences are too much and it happens early and often, there’s the memories that get maladaptively stored. And with repeated trauma, that memory network gets larger, and can develop its own first person perspective. So, what happens with dissociation is that there’s a division in the personality and you certainly want to have one part of the personality engaging in every daily living, but now there’s a part of the personality that’s holding this trauma, that’s living in trauma-time. So we can look at dissociation as a split or division in the personality - one part engaging in everyday living and now there’s a memory network with the maladaptively stored information with its own individual sense of self.
So I can also explain it another way, and that is everything within us is geared towards survival. So we have, let’s say, action systems for everyday living. That’s going to be self-care; socialization and play; attachment; exploration, which is work; survival of the species involves reproduction, we have children; and then there’s caregiving, when the children come, caregiving action system. And we also have action systems for psychological defenses when there’s a threat, particularly inner-personal threat, and that’s fight, flight, freeze, collapse, which is submission, total submission. There’s also the attachment cry, hypervigilance. So these are action systems that we have for psychological defense, and usually these two different categories of action systems are working together. When a significant trauma occurs, that’s too much. Again, that memory gets maladaptively stored. Something that’s too much can interfere with our ability to function in everyday life.
So there’s that split in the personality. That experience, the memory, can become dissociated held by another Part of the personality. So that enables the person to go on and engage in everyday living. So, again, one Part of the personality engaging in daily living and there could be other Parts of the personality holding the trauma. And again, for the dissociative disorder to occur, it’s early and severe abuse. So the memory network develops its own sense of self. So it’s a memory living in trauma time with its own sense of self.
And of course, we can talk about a continuum of the severity of dissociation or separation in the personality. Does that make sense?
Yeah, yeah. So you’re talking about from the continuum, the sort of normal end where everyone does it in different ways to some degree like highway hypnosis, to a more extreme version because of trauma?
Yes. You just mentioned, actually, very normal reactions such as highway hypnosis or being overly absorbed in something. And we can also look at it this way - let’s say for example, we all have self states or ego states. And maybe I might get scared or angry - I get triggered and then I get scared and I start to back off, or angry and I start to yell. And then I’m aware that I was scared and backed off. I’m aware that I was angry and I yelled, and so I go, “I’m sorry I yelled at you, but I got angry.” So that’s more on the normal end where there’s not a separation.
Now if there is on the continuum of trauma, early and repeated trauma with severity, causing a division in the personality, there’s this sense of separation. So it can be that I got angry and I watched myself get angry or I was thinking I don’t want to yell. I don’t want to yell. It’s the wrong deal. I shouldn’t do this, but I couldn’t help myself. I got triggered and this Part of me just hijacked me, kidnapped me, and came forward, and started yelling. So there, that’s when there’s separation.
Mm.
Some separation. And then what a dissociative disorder would be when there’s a clear cut me and not me. So there can be Parts of me that maybe feel young, but separate, and that Part has its own sense of self and feels separate from me as an adult. So, and Parts can be organized by age, by function, by belief system, among many lines - there’s your continuum. And again, I know we have people who may be listening that have complex trauma or dissociation and what I like to say to people is that dissociation is something to be understood, respected, not feared, and also treated. And I like to say to people, where there is complex trauma, that things happen when they were young, usually involving the caregiver, as something that happens interpersonally, and memories got maladaptively stored in the brain and that memory network got bigger and developed its own sense of self and this emotional Part can be reenacting the trauma, not knowing it’s over, and can be proved. Those are the dynamics and I really like to explain it in a way that minimizes shame, helps a person understand what’s going on so they can see the way out.
So when you’re talking about treatment, you’re talking about sort of putting together and processing some of those memories that were stored in separate pieces, instead of being stored as one experience.
That’s correct. You can have different Parts that hold different perspectives of the same memory, or Parts that hold different kinds of memories. So what we would do -- I want to explain that depending on the degree of dissociation, we don’t just jump right on into the memories -- first, we would do some preparation. We would do stabilization, teaching coping skills, relaxation skills, mindfulness. The ability to lower arousal and agitation and calm oneself is very, very important.
Then when the person is able to have one foot in the present, thinking of the negative experience, and being present with the therapist, and one foot in the past, being in touch with that negative memory, with the one foot in the present, in the here and now, one foot in the past with the memory, then the person would be ready to do memory work. And that is the second -- that would be the next phase of treatment following stabilization. And here is where EMDR can be very helpful. So we start processing those maladaptively stored traumatic memories.
Then there’s a -- even after that, a person now starts to reintegrate… the personality starts to reintegrate or rehabilitate. So the person would need to learn new skills, deal with fears of intimacy, of going out and engaging life.
And so we continue to process memories and teach new skills. So there’s these very broad phases of treatment - stabilization, and number two, memory work, and number three, personality reintegration and rehabilitation. Again, three phases of treatment isn’t necessarily linear. Look at it as a spiral. We can do stabilization, now the person’s ready for memory, memory work, and so we start to process memories. But a lot of emotion comes up, so we do more stabilization. Then more memory work and now the person is ready to engage in some new skills, but that can bring up new memories, so back to memory work.
So we can be going back and forth in these three phases of treatment.
And then when you’re talking about the rehabilitation -- you’re talking about -- you mean being able to stay in the present and function, and may be aware of the past, but able to continue functioning in the present, and cope with whatever’s coming up from the past, as opposed to being lost in it, or not aware of it, or another Part of them doing it for them?
Well said.
Okay.
Yes, indeed.
So before we apply EMDR to that, tell me just how you would explain what EMDR is.
Okay, EMDR is a therapeutic approach, a methodology, of eight phases basically, to process these maladaptively stored memories. And EMDR is a therapeutic approach. Again, we make the assumption that present problems are the result of maladaptively stored memories. So what we do with EMDR is we will access these memories and then apply the standard protocol, standardized procedures, to process these memories, so that instead of being isolated living in trauma time, they can be integrated into the wider memory system.
And so the memory meaning the memory of what happened and the different aspects of the experience of it, that’s what we’re integrating, is the sights and the sounds --
That’s correct. Well said.
Okay.
Yes.
Okay. What can someone who, if they have a clinician who is certified with EMDR, what would they expect in a session? I know that’s a very general question and not exact to an experience, but generally, what kind of experience would they have?
Okay, well again, there’s a wide variety of experiences. So on one hand, for a memory to integrate, a person may experience now what was too much then. So sometimes processing can be intense. Usually it’s not as intense as the original experience or it doesn’t last as long, but it can be intense. And we certainly inform our clients, when there’s been significant trauma, that that can happen.
Having said that, I’ve also worked with people who’ve really been able to process significant traumas and get through it without high intensity, certainly some intensity. But when the person is ready for EMDR, on one hand, there can be processing the emotion. EMDR facilitates the processing, going places where words don’t go, but it’s also a very efficient, very efficient therapeutic methodology. Trauma isn’t stored in the areas of the brain where there’s words. Talking is helpful, but talking’s not sufficient. So a person may have talked through the incident, but there’s still symptoms. We have to go to places words don’t go. These are amygdala-based memories, implicit memories. So EMDR is able to go in and access these experiences at a neurological, physiological level, and able to change the way that these memories are stored in the brain.
And that’s part of why it’s so intense, because you’re pulling together these different pieces that are stored in different parts of the brain --
Yes.
-- Back into one experience?
Yes. Now, I want to say it’s not intense for everybody.
Okay.
Okay, but I certainly don’t want to say that you can go with complex trauma, a childhood history, and do everything in three sessions without any intensity. So, just to give an example, I’ve worked with many first responders who’ve been involved in traumatic incidents. And there with a single-episode trauma, we find we’re able to get through the experience very efficiently, within I certainly find a lot can be done of a traumatic memory, one to three sessions. That’s again with single-episode trauma. And as we continue up the continuum, again, there would be more preparation and with more preparation and the ability to calm and understanding the different aspects of the memory and what happened and being prepared for it, the intensity is not overwhelming. In fact, a major aim of EMDR treatment, of course, of complex trauma, is to keep the person within the window of tolerance. And the person is always in control. There’s always a stop signal, and there’s ways to prepare the personality so the processing is not so intense.
So again, I don’t want to say that it’s always going to be easy. What I do want to say is that there’s methodology, stabilization strategies, resourcing methods that we use, safe calm place exercises that we use, so that a person can go through a very difficult memory and stay within their window of tolerance and understand what happened and the impact on the memory and on their lives, and then start to put the memory behind them so they can go forward in life.
So it’s --
In an adaptive and productive way.
So it can be a difficult thing, but part of the purpose is managing it along the way, regulating that along the way?
Yes, with affect regulation strategies taught as needed, before the memory work, and they it can be applied during the memory work, so that the client is certainly able to maintain affect regulation within their comfort zone.
So how is EMDR useful for dissociation specifically and when should it not be used or not used yet? Does that make sense?
Okay, I understand. And I do treatment of complex trauma and dissociation. So contraindication is when the memory is too much. A person has to be able to stay present, you know, one foot in the present and one foot in the past, and when there's dissociation, there can be a phobia, a phobic avoidance of going to the past. So we would not want to jump right in and do memory work. It can really be too much. So there needs to be appropriate assessment to -- uh oh -- okay, yeah. So there needs to be an appropriate assessment to level the dissociation and what’s needed and then appropriate stabilization skills. Now some people may not need a lot of preparation… may really be ready. And other people may need a lot of stabilization skills. So we want to do that assessment.
And so after the person has the ability to calm themselves, especially affect regulation, then we can do the memory work. So the contraindication is that there’s not sufficient capacity yet or readiness, emotional readiness, to process the memory.
Okay. So part of it is sort of like what you were talking about with regulation during the process. Part of it is being ready to engage in the actual EMDR process or the memory work and being prepared to be able to face that and to stay present and to do the work of regulating. Is that what you mean?
Yes! You’ve covered the component. So certainly before the memory processing, the person knows what to expect, the person is prepared, the person already has the coping skills. Then during memory processing, there’s a variety of strategies to control the level of emotion and affect that may come on up. And certainly the person is able to say “stop”. EMDR is very interactive. And again, it’s very important that the person stay within their window of tolerance. And certainly, going through the memories, a collaborative process with the client and with the client in control.
How would the client know to advocate for something or ask for EMDR or to say “stop” or to empower themselves in those ways? How do they do that?
Well, first of all, if there’s any disturbing memory, EMDR therapy can be appropriate.
Oh, okay.
Alright so, and again, for people out there, there is a book, came out a few years ago, written by Francine Shapiro, that’s called, Getting Past your Past which can also explain the process.
Oh, thank you!
Yeah, Getting Past Your Past and she wrote it for the general public, and there’s a lot of case examples in there and even some stabilization exercises.
So when some people talk about EMDR being difficult with trauma, is that what they’re talking about? That they just were not ready yet or the therapist maybe didn’t respond to their need to pace it differently or -- ?
Yes, that can certainly be…is something that happens, is that sometimes processing can take place too soon. That happens and what’s important is that the therapist recognizes this and the client, again, can indicate their distress, and then stabilization can continue.
How does someone find a therapist or a clinician who is trained in EMDR?
Well, the EMDR Institute and the EMDR International Association have websites, and there’s always a section there on “find a clinician”, but it’s also important for any time a person engages in therapy, to talk to the therapist. Does the therapist have experience with the current problem that they have? So EMDR therapy is still therapy. The clinician needs to know about the research and therapeutic treatment strategies for the particular clinical population that they’re working with.
So if somebody has a grief issue, what’s important is the therapist has some knowledge and experience in working with grief. For complex trauma and dissociation, the therapist should also have education and be knowledgeable about these psychological conditions and familiar, very familiar, with the treatment strategies. And also, the modifications to the EMDR protocol that would be appropriate for the particular population.
And of course, like anything else, it’s also important there’s a good fit between the therapist and the client as well.
So just having someone who does EMDR is not enough? They still need to know how to apply EMDR to those specific issues, but then like any therapy, they also need to click well with the person, so that they can work together well in the therapeutic process?
That’s correct. Yeah, that’s correct. Knowing EMDR with what we teach in our basic training is sufficient to process trauma. And I would say most clinicians are familiar with the development of psychology and would readily be able to apply EMDR to anxiety and depressive conditions.
So again, interviewing the clinicians and being able to say, This is what’s going on. Have you dealt with people who have had problems like me?” And in a conversation, you can have a sense if there’s a good fit, as well as during the first session. And then also as we start to get toward dissociation and complex trauma, it is important that the therapist have the training to deal with complex trauma and dissociation. Just knowing EMDR without knowledge of dissociation is not sufficient.
How would a clinician get more training in dissociation?
Well, there’s a variety of ways. Certainly there’s a number of different courses and workshops that are offered. There is the Society for Trauma and -- International Society for Trauma and Dissociation. And in the EMDR community, there are advanced courses on EMDR and complex trauma and dealing with dissociative symptoms.
So there are some specific EMDR trainings that is specific to complex trauma?
Yes, there is. It’s also one of the things that I engage in and I’m always learning.
So clinicians could get that information through the institute?
That’s correct. The institute or the EMDR International Association website. And I believe there’s a variety of people who offer advanced training in a variety of areas.
And these trainings are on the -- the information for them is online, on the websites?
Yes, for clinicians who are interested in more training, they can look at the website and see what’s available, with the EMDR Institute and the EMDR International Association website. That’s emdria.org. I want to emphasize that, emdria.org and emdr.com.
Is there anything else that you think we need to know, as far as an introduction of EMDR and trauma?
Uh yes, one of the things I would like to say is that EMDR therapy is now evidence-based. And research continues to show its effectiveness across a wide variety of clinical conditions. Again, all psychological conditions, at some level have experienced memories that are maladaptively stored, that would need to be processed. And EMDR therapy is an effective and efficient therapeutic modality that can be helpful.
So even with more general issues, there are roots to early experiences or --
Yes. So it’s beyond just trauma. So, interpersonal experiences negative beliefs - “I’m not good enough. I’m not lovable. I don’t belong.” These negative beliefs which relate to self-esteem issues, relationship issues, all are going to go back to earlier childhood experiences. That the negative beliefs are the symptoms of experiences that have been maladaptively stored. Negative beliefs don’t cause the problems. Negative beliefs are the symptoms of memories maladaptively stored. And EMDR therapy can be used to process these memories. And this would result in a change, in a change in the way the memory is stored in the brain.
And something else that happens with EMDR too, is the memory, it not only gets desensitized, losing its emotional punch, but more adaptive beliefs take their place. We go from “I’m not good enough”, “I am good enough”, “I’m in danger” , “I survived” , “I’m powerless” , “I have choices. So EMDR is a paradigm of resilience.
Oh wow. Really a way to not just process what’s in the past, but to live differently in the present because it has been processed.
And being empowered in the future.
That’s amazing!
And what we do is we process the past memories underlying the present problem, then we target the present triggers. What are the current people or situations that trigger the problem? And then we lay down a positive template for adaptive future behavior. So, let’s say the present trigger is feeling unsafe or not good enough when there’s a disagreement with a family member or colleague. We process past memories, where the “I’m not good enough” or “I’m not safe” comes from. Then we would process the present trigger, the recent event with the family member or colleague. And then now imagine that same event happening in the future and how we would handle it. And then EMDR can be utilized to strengthen an adaptive response.
But the other thing to realize as well is that we’re changing the way these memories are stored in the brain. Neuro-imaging research has shown that the brain looks different after EMDR processing. And as I said before, those negative beliefs shift and change to something that’s more adaptive and empowering. And of course that’s the goal of therapy, to empower the person in the present and the future.
So not just processing old memories, but also identifying some of the thoughts and patterns that are because of old memories, but then identifying the triggers in the present that stir that up, and then because of that all being processed and desensitized, being more empowered now and in the future to be able to handle things differently than before?
Yes. Well said.
That’s amazing.
Indeed. And as a therapist, EMDR has really changed the way I approach therapy. It truly is amazing.
So it’s a lot more than just processing old memories or not being upset by them anymore. There’s a lot more to it.
That’s correct. It’s not just processing old memories and being okay in the present, but also empowering the person to engage in an adaptive way in the future. Absolutely.
Aw, thank you for talking to me today.
Well really, my pleasure. And I enjoyed our conversation.
I’m so grateful. Thank you.
[Break]
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