We feature an expert in the mental health and substance use disorder field to answer questions. This issue we talk to Patti Miller, MA, Co-Owner & Director, Midwest Center for EMDR Training about Eye Movement Desensitization Reprocessing (EMDR).
Please share about your background and what led you to work with people who experienced trauma and then become a trainer and consultant.
I am Patti Miller. I am a licensed psychologist with a clinical, teaching, and training practice located in Eden Prairie Minnesota. I came into the field in the early 1990s with an authentic want to help people who are suffering. My perspective is informed by developmental neurology, and relational experiences that determine health and wellness outcomes. I have a systems and feminist theoretical orientation. I am grateful for my marriage of 37 years, 3 amazing daughters, and grandson. I deeply value connecting, building relationships, collaborating, and learning in all contexts.
I have loved teaching clinicians to use EMDR for the past 15 years. Starting as an Approved Consultant and now, a Trainer with EMDRIA (Eye Movement Desensitization Reprocessing International Association). For context, EMDRIA was founded in 1995 and maintains the gold standard for EMDR Training and Research. I have developed advanced courses in using EMDR With Complex Trauma and Dissociation.
In 2015, I co-authored Adaptive Internal Relational (AIR) Network Therapy, a paradigm to aid in understanding dissociation and complex trauma from a neurobiological, multicultural, and relational framework. I have taught this course nationally and internationally.
What is Eye Movement Desensitization Reprocessing (EMDR)?
EMDR is a comprehensive 8-phase model of psychotherapy that was founded by Dr. Francine Shapiro in 1987. EMDR Therapy Is a method of accessing and resolving disturbing life experiences/memories that have resulted in disrupted self-beliefs, negative emotions, and distressing body sensations. It is included in the international treatment guidelines for its effectiveness in the treatment of trauma-related stress. Some organizations that name EMDR as a front-line treatment include the American Psychiatric Association, American Psychological Association, SAMHSA, and the World Health Organization.
How does EMDR Work? How does it target and process experience?
EMDR successfully treats anxiety, depression, and many other mental health challenges that also have their origins in traumatic experiences.The theoretical basis of EMDR is the Adaptive Information Processing (AIP) System. The AIP system is intrinsic. In other words, people are wired to make sense of and learn from experience. The AIP is like other automatic biological systems of healing. If environments are “good enough” we can recover and learn from the most difficult experiences. Examples of “good enough” are being believed, heard, supported, protected, and helped. Disruptions to the AIP system interfere with the ability to have resolution of difficult events. Thus, the event is stored as a trauma network with all the picture’s sounds, and body sensations that were true at the time of the event.
Present symptoms have their origins in stored trauma networks. Essentially, cues in the present environment ignite the trauma network and people experience in the present what belongs in the past. For example, a survivor of childhood abuse can grow up and be safe in their current life. They may “know that they are safe” but never “feel safe.”
People are resilient and go on to learn positive current truths about self and life. In EMDR, these are called Adaptive Neural Networks. The example above of the “knowing that safety is real” is an adaptive network. The “feeling” of being unsafe despite knowing is the trauma network. During the protocol, the stored trauma networks (of unsafety) are accessed and then, linked to the adaptive neural networks (of present safety). Bilateral stimulation in the form of eye movements, and alternating sounds of kinesthetic stimuli, while revisiting distressing memories is used. This aids in the movement of information from the right hemisphere (where trauma is stored) to the left, resulting in greater integration, presence, resolution, and calm.
How is EMDR Therapy different from other therapies?
Every modality of therapy has beliefs about what creates symptoms and assumptions about the healing process. In EMDR Therapy, understanding AIP is a core aspect of what creates symptoms. Next, healing occurs as the protocol facilitates accessing traumatic material and metabolizing it to resolution.
EMDR differs from traditional talk therapy. Once the processing phases have begun, an EMDR therapist refrains from offering insight or deepening questions. EMDR is designed to access what the clients’ brain tells us is important.
EMDR Therapy does not require homework.
Clients do not have to tell details of what happened to the therapist for EMDR reprocessing to be successful.
Can EMDR be helpful for issues such as depression, anxiety, and other mental disorders? What about addiction?
Extensive controlled research, using EMDR with PTSD and other stressor-related symptoms is clinically proven as an effective method of treatment. Hundreds of published case reports are documented to date. EMDR successfully treats anxiety, depression, and many other mental health challenges that also have their origins in traumatic experiences. Additionally, there are specific protocols that help to manage cravings for addiction and chronic pain.
Addiction requires specific support in place. The supports are put in place in the beginning phases of EMDR before any of the reprocessing phases. Clients must be resourced enough to have successful reprocessing outcomes. Supports range from medical, nutrition, 12-step or other support group, and sponsors. Some clients need an in-patient setting. EMDR gets at the underlying negative feelings, beliefs, and experiences that sustain any addiction. I have witnessed EMDR helping those in recovery sustain their sobriety. Similarly, I work with people who have had eating disorders. EMDR resolves underlying causes and helps sustain the ability to have greater emotional regulation without the substance/behaviors. Over my years of practice, I have witnessed these results being sustained over time.
Are there populations where EMDR can be very beneficial or contraindicated?
The benefits of EMDR have a positive impact on young children through senior adults. EMDR treats single-incident traumas to more complex traumas. Inadequate preparation is the main factor that contributes to poor outcomes versus any specific population. Clients who are dissociative and/or have complex trauma histories, panic disorder, or co-occurring addiction and mental health diagnoses will need specialty care and additional preparation to move into reprocessing.
Caution also needs to be taken around people who have specific medical conditions. Clinicians are advised to collaborate with client’s physicians when medical conditions are present. Examples include pregnancy and cardiac conditions.
What are ongoing developments in the field?
I am most excited about the advances in research on the brain that show the neurological impact of EMDR. There are already scans showing the efficacy and I expect this area to grow in the next generation of therapy.
What is a resource to learn more about EMDR?
The EMDRIA website is the best resource for learning more about EMDR, research, publications, and much more.
What if someone wants to become trained in EMDR?
Midwest Center for EMDR Training has information on Spring 2024 Basic EMDR Training.
Patti Miller, M.A., Licensed Psychologist. From basic to more complex adaptations, Patti is passionate about teaching EMDR Therapy from a competency and regulation-based perspective. She specializes in the treatment of Complex Trauma, Post Traumatic Stress Disorder, Other Stressor Related Disorders, and Dissociation. She continues to have an active clinical practice alongside her teaching and consulting.
Patti has co-authored an intensive training modality called AIR (Adaptive Internal Relational) Network Therapy since 2015. AIR is a phase-oriented therapy model which de-mystifies dissociation, and complex trauma symptoms, giving therapists a cutting-edge paradigm to work from. AIR Network’s foundational principles are based in the latest research on neurology, developmental neurobiology, and 30 years of working with survivors.
Patti brings her advanced knowledge and warm, casual style to the EMDR Basic Training course. More information at https://midwestemdrtraining.com.
Last Updated on January 16, 2024