EMDR for depression

Case Study: EMDR helps eliminate chronic anger and depression

Lucille* (not her real name – details have been altered to protect the client’s information) started yelling at me from the waiting room before our first therapy session started. She was angry because she hadn’t gotten a text reminder about her appointment, as she used to get from her previous therapist.

Everything was a struggle for Lucille. She was suffering constantly and often angry.

People who are constantly angry are often actually depressed. When so much negative energy is directed inward, at some point it becomes overwhelming and the energy is channeled back out, like in being angry at someone you’ve never met before. (Since then, I’ve started using a text reminder system with my clients. Thank you, Lucille.)

In depression, this negative energy is always related to the past. Terrible things happen to all of us in life. We experience injuries, sickness, and the loss of loved ones. While many people are able to bounce back, people with depression struggle to get back on their feet.

Depressed people can’t bounce back. They live in endless emotional pain, sadness, helplessness, and hopelessness. And with each further event, it can get worse. No surprise that having depression feels like there is no way out.

The hamster wheel of rumination

Depressed people find themselves reliving the past, over and over again, running on a hamster wheel of pain, not moving forward. Therapists call this rumination: thinking the same thoughts without the ability to stop or change them. Rumination is draining and depressing. Rethinking their past never helps depressed people to feel better, yet most people with depression cannot stop ruminating.

Lucille was angry at her dad, at her mom (who had died 8 years earlier) and at all her siblings. She was always either depressed or angry. Every minute of her life. She was depressed waking up. She was angry when she went to the supermarket or to the bank. She was furious when a stranger said good morning to her (she didn’t like the way he was looking at her).

Notice that everything she experienced was about her, too, what therapists call “self-referential”. She never related the other side of the story, just hers.

Lucille had a lot of experience with therapy. She had seen many therapists, who had always talked about her past. Week after week, year after year, with no way out of the hamster wheel.

“Then therapy didn’t really help you,” I concluded during our first session and asked her, “Have you heard of EMDR therapy?”

Lucille had not. I explained to her that with EMDR therapy we will go back to where her depression started, but instead of me joining her on the hamster wheel and discussing it, I will help her to step off.

How childhood experiences affect mood and health?

Lucille’s childhood was chaotic. She grew up in a poor part of town with two alcoholic, drug-using parents. Her mom, who gave birth at age 16 to Lucille’s oldest sister, resented her own children for stealing her youth away. Both parents got high and drunk on a regular basis. They also had sex with strangers while Lucille and her five siblings were home.

Lucille was exposed to a lot of alcohol, drugs, sex, and violence. Her dad was angry about her mom’s sexual habits and oftentimes responded with violent attacks. Although she hasn’t experienced physical abuse herself, having witnessed her dad beating her mom left her with the kind of scars you can’t see.

Traumatic childhood memories are often retained in their own memory networks, separate from adult memories. Because they are not integrated, this cluster of memories can create a “filter” that distorts how people look at life. Such filters often lead to irrational behaviors, anxiety, and depression.

By reprocessing these memories with EMDR, the separate neural networks become integrated with the rest of the brain, and both the trauma and its associated feelings, sensations and thoughts fade.

Adverse Childhood Experiences = Health Risks

Sadly, childhood trauma is too common. In the last 1990s, one of the most comprehensive studies of the effects of childhood abuse and neglect was done on over 17,000 adult participants. Nearly two-thirds of respondents reported at least one adverse (traumatic) childhood experiences, called ACEs. Over 20% reported three or more.

Not surprisingly, the study found that the more ACE categories experienced in childhood (a way of measuring cumulative trauma) the poorer the outcomes for health and well-being later in life.

Further, health risks for a range of adverse conditions rose as well with an increasing number of ACEs reported. These conditions include:

  • Alcoholism and alcohol abuse
  • Chronic obstructive pulmonary disease (COPD)
  • Depression
  • Fetal death
  • Health-related quality of life
  • Illicit drug use
  • Ischemic heart disease
  • Liver disease
  • Poor work performance
  • Financial stress
  • A risk for intimate partner violence
  • Multiple sexual partners
  • Sexually transmitted diseases
  • Smoking
  • Suicide attempts
  • Unintended pregnancies
  • Early initiation of smoking
  • Early initiation of sexual activity
  • Adolescent pregnancy
  • Risk of sexual violence
  • Poor academic achievement

Many other studies show that adverse experiences in childhood correlate to depression later in life. A study done in the UK showed that adult depression could be traced back to “poor parenting, poor physical care, parental conflict, overcrowding, and social dependence.”

In the US, however, western medicine likes to think of mental illnesses like depression as a physical condition of the brain, a disease of brain chemistry that should be chemically medicated away.

Happily, my clinical experience as an EMDR therapist has shown me that depression can be remedied. Alleviated. And, many times, eliminated. What you can do is trace depression back to the childhood experiences that so traumatized the brain that it “froze up” while storing those memories, in a way that has prevented healing.

Goal: shift psychological memory to objective memory

Lucille hadn’t been able to change her perspective by herself. The thoughts about what she witnessed as a child (the drugs, alcohol, sex, and violence) were not always in her conscious awareness. But they always affected her thought process and the lens through which she saw the world and the people around her.

She was very depressed and, like many depressed individuals, didn’t think that she would ever get better. She had tried therapy before—” too many times,” she told me in our first session.

In talk therapy, she had learned to recognize her negative, automatic thoughts and tried to change them and understand where they came from. It didn’t help. It didn’t change or stop the thoughts. Insight wasn’t enough.

She had also tried radical acceptance. That didn’t work either. When I asked her about meditation, she gave me her angry look, and I knew that Zen Buddhism wasn’t going to be the cure for her suffering.

Most people believe they ARE their histories. This is an understandable assumption, but I find it is simply not true. Your history is merely something that has happened to you. You are much more than that.

It is possible to have had an experience, even a traumatic one, that you have “digested” so well that it doesn’t trigger you anymore. You can recall difficult memories and think about them as events that happened in the past.

Recalling memories without the intensity of emotions is what we call an objective memory. It’s there, and we’re pretty neutral about it. We accept it and are still able to focus on other things.

A more troublesome type of memory is called psychological memory. Those memories behave very differently. These have an emotional charge to them that we can still feel. They feel very present – like they just happened. And they make us focus on ourselves, on our own experiences.

Psychological memories can be both draining and distracting. Imagine how much energy goes into dealing with memories that you just can’t get out of your mind, sometimes years later. Or memories that are triggered and pop up, unwanted, at random times all day long.

When you are struggling with phantoms from the past like this, you cannot live fully in the present. In EMDR, we process these psychological memories in a way that transforms them into a proper objective memory. Many clients report that after EMDR treatment, the traumatic memory doesn’t seem personal anymore—as if it’s gone from being about them to being something they read about in a news feed.

This shift in perspective will allow you to stop identifying with your memories and discover who you really are.

Converting psychological memories into objective memories is one of the core goals of EMDR. When the traumatic memories underlying your ruffled mental state are processed in this way, relief arrives, sometimes at long last.

Changes affect your overall health

We have been taught for decades that our genes determine everything about us, including our brain chemistry and behavior. But a great deal of recent scientific research is showing the opposite—that we, through our minds, can affect the expression of our genes.

That means that therapies like EMDR can ultimately change which genes are turned on or off, change the strength of connections between neurons, and change patterns of interconnections in the brain. That shift can affect states of not only mental disorders but physical conditions as well, such as we saw in the bulleted list above (e.g., heart disease).

If the mind affects gene expression, then for better overall health (as well as mental health), it becomes important to clean up the mind by processing our unprocessed memories.

Off the hamster wheel, for good

When we were done with Lucille’s EMDR therapy (which only took a few months), she was surprised to discover who she really was—a lovely woman. She was able to be much more present. To think clearly. To see other people’s perspectives. To be kinder, and less angry.

The rumination had stopped—that vicious thinking cycle that had occupied most of her inner life before EMDR—stopped. Getting off the hamster wheel after so many years was more than a life-changing experience. It gave Lucille the life she had never had.

Lucille experienced more meaning in life. It wasn’t just about her and her negative thoughts and feelings. There was a whole world out there that she discovered for the first time.

She was able to forgive her parents, too. Everything that happened in her childhood belonged in the past now. It had become a neutral, objective memory. Simply a fact. Lucille was able to respond to what was happening in front of her, right now, and not to events that happened 20 years ago.

She didn’t know she had this in her. As an adult, she had always been depressed or angry. Her EMDR experience transformed her life. And it made me, again, so appreciative about being an EMDR therapist and being able to help people change their lives this much.

Rotem Brayer is a certified EMDR therapist and an EMDR consultant in training practicing in Denver, Colorado. He divides his time between helping refugees to improve their mental health and maintaining a private practice.

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