EMDR (Part 1/4)

This is the first of a series of four articles I wrote on EMDR therapy.

I believe that, grosso modo, I have outlined the basic tenets of EMDR therapy. I will begin with Van der Kolk’s work first. What I think he is onto is many of the basic tenets of primal therapy but in a less organized fashion. For example, he states rightly that for trauma to be resolved there has to be a high level of arousal since the trauma was stored under conditions of that level of arousal. He emphasizes that traditional therapy focuses on reducing arousal either through the use of tranquilizers or in attempting the calm the patient’s arousal level, also known as anxiety. The question is can his therapy produce the same arousal? Bereft of reliving the trauma I don’t think so.
We control every session in terms of vital signs. During a reliving of the early trauma, and that means pre-birth and birth, which is not in the parlance of EMDR therapists, we see body temperatures climb three degrees (F) in minutes; systolic blood pressure over 200 and heart rate exceptionally high, as well. We have done salivary cortisol studies (stress hormone) on before and after therapy with reduction in levels after one year of therapy; plus four separate brainwave studies where we found, inter alia, changes in the power distribution between left and right hemispheres, which is what Kolk wants to achieve.
We have done several EEG studies on hemispheric laterality. Early in our therapy there is a change in the right hemisphere amplitude. Long term changes, on the contrary, affect the left hemisphere. In an eighteenth month follow-up of fifteen patients there was a statistically significant increase of left hemisphere activation. More important, increased left temporal activation was significantly correlated with the patient’s improvement. (As measured by blind ratings by therapists) What the researchers concluded was that there was an overall greater harmony of the two brain hemispheres. Another conclusion was that with a slight shift in power to the left side there was better control of own’s feelings and impulses.
Some conclusions of our EEG laterality studies: 'Several studies have been done on hemispheric amplitude asymmetry in primal patients. This author (Hoffman, E.) found that primal therapy initially affected the right hemisphere the most, while long-term changes primarily showed up on the left side, in an 18 months follow-up study of 15 primal patients at the New York Primal Institute, a statistically significant increase of relative left hemisphere activation was found for the anterior temporal areas. Increased left temporal activation was significantly correlated with the patients' improvement in therapy as rated blindly by their therapist.
In a recent long-term EEC brain-mapping study at the LA Primal Center a similar significant increase of left temporal activation was found in a group of patients after therapy. In most patents, following one year of therapy, alpha amplitudes were nearly symmetrical in the right and the left temporal] lobes.
Neuropsychologist Rhawn Joseph writes:
"Thus. the left and nght halves of the brain and the mind can, in fact, be influenced and overwhelmed by these limbic unconscious forces simultaneously, independently. These impulses can be transmitted “first through the unconscious mental system maintained by the right brain to be acted on because the limbic system maintains rich interconnection with both halves of the brain.... Whereas these impulses are almost complete; they are foreign to the language-dependent conscious mind, and the left half of the brain. The right brain, being more involved in emotional functioning, is able to discern and recognize these limbica!ly induced feeling states and desires for what they are."

Thus, higher amplitudes in the right hemisphere, as we see in most normals, may indicate that this side of the brain is closer to and more integrated with feelings originating deeper in the brain. If upshooting Primal Pain interferes with left hemisphere functioning we may expect mental disturbance of a psychotic dimension accompanied by larger amplitudes on the left side. This is exactly what several studies have shown. Our hypothesis was that both hemispheres can be differentially influenced by deep unconscious, limbic/
brainstem forces. The right side is more attuned to deep-lying stored feelings. Remember, it is this side that develops earlier and is more responsive to very early emotional imprints. We have found that intrusions of painful imprints impact the right side more than the left. When there is long-term stored trauma the right side of the brain is called upon for the heavier work; it is activated during recall and reliving. It then shifts some of the burden to the left side for control and integration, hence the enhanced harmony. When someone is awash in old pain and cannot integrate there is a right side dominance.
In my book, “The Biology of Love,” I discuss arousal levels and their importance. The point of all this is that Dr. Kolk is on the right track but it is doubtful that any therapy other than a complete neurophysiologic reliving can accomplish that. Secondly, every reliving of a certain trauma, such as being left alone for days after birth (perhaps due to the illness of the mother) produces the same vital signs as the session before. It is one way of many that we can verify the veracity of the reliving. It is accompanied by a later developed, articulated feeling of hopelessness. In these cases the vital signs drop significantly. One can feel hopeless long before one has the cortical wherewithal to articulate it.