Yesterday I attended a stimulating workshop with Bob Neimeyer a psychologist expert on bereavement and grief  who has published widely on the subject (click here for his website). It was all about managing the loss of a loved one, especially children, through finding the benefits and the meaning in the loss – not something that is easily done, especially early on. BTW, he recommended this website as an excellent resource for assistance in dealing with losses of all different kinds: www.opentohope.com.

We were asked to do an exercise that he gets his patients to do, as way of opening up a different, meaning-based dialogue around a person’s grief. We were asked to write a story, that incorporated, in no particular order, the following elements: a crying child, a talking animal, a mountain, an empty house and a sunrise. In the 8 minutes we were given the essence of the following came to me:

The Mountain was less concerned about the child’s crying. The Goat and the Mountain had been good friends for a long time.

“Without death there is no life,” the Mountain reminded the Goat.

“But the human child is in pain,” the Goat said.

“Who said pain is a bad thing?” the Mountain asked the Goat. ” It always ends, and from pain our most important growth occurs.”

“In this life or the next,” the Goat added softly.

By the time the sun rose the next morning on the empty house, the child too, like her mother, had passed over. The Goat ate grass and the Mountain just was.

While the pain of childbirth with a mother’s first child is considered to be one of the most severe pain levels a human can experience, surprisingly few women are traumatised by it. This is because they understand what the pain is and because it comes with enormous meaning – creating life.

Today I was working with one of my patients (let’s call her Sophia – Greek for ‘Wisdom’) who was sexually abused by her father. We were talking about telling her brother who was abusing drugs and alcohol and had said to his sister that he too thought he had been molested. Sophia had actually been present when he had been abused. Sophia’s fear was that the truth would bring her brother undone. She did not want to cause him emotional pain by revealing the truth of who had abused her (he only knew ‘someone’ had).

Sophia initially came to me with feelings of depression, sexual dysfunction, low self-esteem and was drinking too much. At that stage she had unclear memories of having been sexually abused as a young child. From our current vantage point, I asked Sophia about which pain was worse – the pain she had when she knew something ‘bad’ had happened in her past – but did not understand it, or the pain she had now as she was processing the abuse in full, distressing colour. Sophia had been doing it particularly tough in recent sessions as she was doing EMDR and was in the thick of recalling the detail and working through her abuse experiences. Despite the disturbing memories she was working on, Sophia did not hesitate, “I would rather have the pain of the truth, because from here I can grow and heal. I can see a way forward. The other pain was slowly destroying me and God knows where it was going to end up.”

“Which pain would you rather your brother had?” I asked gently.

“The pain of truth,” Sophia responded – again without hesitation.

The way in which the truth sets you free is by opening a pathway forward into personal growth. Without knowing, or confronting, the truth we are caught in a loop that slowly but surely spirals downwards. The pain of truth, is such a very, very different pain.

Eye Movement Desensitisation & Reprocessing (EMDR) has come a long way since I was first trained in it in 1993. Many who did not understand it thought it was just hypnosis or a passing fad. Those of us who practised it thought it was amazing. A few years later, I decided to specialise in trauma therapy because it was so good to have a treatment that actually cured many people! Such a rare outcome in psychiatry! Not to mention that it would often work in just a few treatment sessions (after detailed assessment sessions). People who had had nightmares and intrusive memories for years would come back saying things like, ‘What did you do to me?! I can’t recall it now even if I try.’

These days I’m often using EMDR to treat overweight people who unconsciously  use their weight as a way of protecting themselves from potential abusers. Grilo et al* found that 69% of people awaiting bariatric surgery (e.g. gastric banding) had a history of childhood abuse.

I tend to forget that most of my colleagues see PTSD as a largelly untreatable condition and just prescribe medications and offer their sympathies. Worse still, they may get people to talk about the trauma, which, the research shows, will aggravate their condition. This is a tragedy for sufferers who find themselves in front of an uninformed professional.

Because it was the new kid on the block, EMDR worked hard to justify itself scientifically. Now it is recognised around the world as one of only two (maybe three) effective treatments for PTSD. Here in Australia in 2007, the  Federal Goverment joined the rest of the world in only recognising EMDR and CBT as effective treatments for PTSD. Click here to download information booklet from the Australian Centre for Posttraumatic Mental Health -  ACPMH Guide for People with PTSD. On pages 14 and 17 you will see that it only recommends CBT and EMDR as other treatments have either not been adequately tested or are less effective.

I first started treating PTSD in 1984 and until EMDR came along I used CBT and imaginal flooding. It does work – but the big difference is that EMDR works more quickly with less drop-out because the uncomfortable phase ends sooner. This work can be quite gruelling for patients. The following document looks at some of the research showing that, of the two, EMDR is generally found to work more quickly, which is a big issue for (paying) sufferers: EMDR Efficacy

*Grilo et al – click here to go my research page that includes this paper (bottom of page)

This is a great article by Dr Frank Ochberg, written for the partners of sufferers, that also nicely overviews PTSD (for both the person with it, their partner and anyone else). Click on this link: Partners with PTSD

Eye Movement Desesensitization & Reprocessing (EMDR) is now considered, by most authoritative organisations around the world, to be one of only two or three treatments that are effective in treating posttrauma syndromes. In fact, just talking about traumatic experiences has been found to make people worse.

To read more on what EMDR is and how it works click on the following link: EMDR Handouts

Here is a file listing Certified Practitioners in Australia to help you find one near you.

Here you can post any questions, comments or requests you have on the site.

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