EMDR is a Mindfulness-Based Trauma Therapy

EMDR (Eye Movement Desensitization and Reprocessing) is essentially a mindfulness-based trauma therapy (see my article: How EMDR Therapy Works).

EMDR is a Mindfulness-Based Trauma Therapy

Both EMDR and mindfulness are present-oriented and nonjudgmental using dual awareness to process disturbing memories. Both down-regulate the sympathetic nervous system (SNS) which reduces the emotional charge and the vividness of the trauma.

Here are the qualities that EMDR and mindfulness share in more detail:

Shared Mechanisms of EMDR and Mindfulness

• Dual Awareness and Waking Memory: EMDR uses bilateral stimulation (BLS) and mindfulness uses attentional anchors, like mindful breathing. Both mechanisms enable the brain's working memory to multitask which strips away the vividness of traumatic memories.

• The "Observer" Stance: EMDR's core prompt, "What are you noticing now?" or instructing the client to "stay to with it" is active mindfulness. It shifts the brain away from identification with trauma and treats thoughts and bodily sensations as transient phenomena.  

• Adaptive Information Processing (AIP): Both practices engage the brain's natural capacity to heal. Just as mindfulness promotes "decentering" (stepping back from negative thoughts), EMDR removes the "splinter" of dysfunctional memory networks so the mind can integrate them adaptively.

Integration in Therapy

• Stabilization: Therapists use evidence-based mindfulness strategies, like grounding and containment exercises to build distress tolerance before dealing with traumatic memories.

• Somatic Awareness: Both frameworks require deep body awareness which helps clients to track physical sensations without spiraling (see my article: The Mind-Body Connection: What is Somatic Awareness?).

Mindfulness exercises for EMDR stabilization (Phase 2) are somatic and sensory tools designed to anchor you in the present, manage distress and prevent emotional flooding before trauma processing begins:

Key EMDR stabilization exercises include:

• Relaxing Place Exercise: You identify a real or an imaginary place that brings you a deep sense of peace.  Then, you focus on vivid sensory details: sight, sound, texture and temperature. EMDR therapists often pair this with bilateral stimulation to neurologically reinforce the feeling of calm and safety (see my article: What is the Relaxing Place Exercise?).

A Relaxing Place Exercise

• The Container Exercise: This exercise helps you to mentally store overwhelming emotions, body sensations and traumatic memories. You picture placing distressing thoughts into a secure container, like a locked chest or vault, closing it and leaving it safely put away until you are ready to process it again with your EMDR therapist.

• The 5-4-3-2-1 Grounding Technique: This sensory awareness exercise pulls you out of traumatic memories or dissociation by bringing your focus to the present room. You actively notice: 
• 5 things you can see
• 4 things you can physically feel or touch
• 3 things you can hear
• 2 things you can smell
• 1 thing you can taste

• The Butterfly Hug: This is a self-administered bilateral stimulation technique where you cross your arms over your chest, placing hands on opposite shoulders or collarbones, and giving alternating gentle taps on your right and left sides or focusing on a calm thought to self soothe when you feel triggered (see my article: What is the Butterfly Hug?).

EMDR Butterfly Hug

• Dual Awareness: One Foot in the Present and One Foot in the Past: This is a mindfulness practice where you learn to observe a distressing emotion or memory while simultaneously keeping your awareness on your body in the present moment. You might tell yourself something like, "A memory is coming up, but that happened in the past and I'm safe in this room right now."

Get Help in EMDR Therapy

EMDR therapy is a mindfulness-based therapy to overcome trauma.

Get Help in EMDR Therapy

If you have been unable to work through traumatic memories on your own or in traditional talk therapy, you could benefit from working with a licensed mental health professional who is an EMDR therapist.

Rather than suffering with unresolved trauma, seek help in EMDR therapy so you can free yourself from your traumatic history and live a more fulfilling life.

About Me

I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), IFS, Somatic Experiencing and Certified Sex Therapist.

I have helped many individual adults and couples over the years.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

 

Understanding Why An Emotional Block Might Be Preventing You From Crying

If you have ever felt like your tears of sadness are "stuck", you know the frustration of feeling an emotional block (also known as emotional numbing). This often happens when your nervous system feels overwhelmed and enters into a self-protective "freeze" response.

Trauma Responses: The Freeze Response

You might feel the intense pressure of a lump in your throat, but your mind perceives this type crying as a potential threat to your emotional survival and safety. This "freeze" response is known as a trauma response. 

What Are the Reasons Why Your Tears Might Feel "Stuck"?

• Your Nervous System "Freeze" Response: When you experience prolonged stress or intense trauma, your sympathetic nervous system (SNS) can become overloaded. Instead of triggering a fight-or-flight response, your body reacts with a survival mechanism called dissociation (also known as a dorsal vagal shutdown).  Your brain reduces the intensity of your emotions to protect you from being overwhelmed by them. This response acts like a "circuit breaker" that cuts off power to your tear ducts (see my article: What is Trauma-Related Dissociation?)

Trauma Responses: The Freeze Response 

• Emotional Exhaustion and Burnout: Crying is an active biological process that requires emotional energy. If you have been trying to "hold it together" for months or even years, your emotional reserves can become depleted. The sadness is there, but your body might not have the stamina to release the tears.

Emotional Exhaustion and Burnout

• Unconscious Conditioning and Safety Walls: If you grew up in a household where there were rules that you shouldn't cry or you were punished for showing emotional vulnerability, these experiences can teach your brain to suppress tears. If you might ahve been given the message that you had to be "independent" when you were a child so you had to keep your emotions suppressed. In addition, forcing yourself to "power through" can leave you with no room to pause, soften, feel your feelings and cry.  

Being Scolded For Crying as a Child?

• Mental Health Conditions: Even though depression is usually associated with sadness, it frequently shows up as emotional blunting or anhedonia. This can make you experience your feelings as "flat" which makes tears inaccessible.

How to Safely Release Blocked Emotions in Experiential Therapy

You can't force an emotional release by trying to force yourself to cry because when you put that kind of pressure on yourself, your nervous system tightens up even more. In order for you release pent up emotions, you need to have a sense of safety so your body can gently release the emotions.

When you are dealing with "stuck" emotions, traditional talk therapy can be too much of an intellectual process that keeps you in your head. You might gain intellectual insight into your problems, but you don't get an emotional release.

The most effective therapies for processing trauma and releasing "stuck" emotions are mind-body oriented therapies, also known as Experiential Therapies (see my article: Why is Experiential Therapy More Effective For Healing Trauma Than Traditional Talk Therapy?).

The following are some of the main types of Experiential Therapy:

• Somatic Experiencing (SE): SE was developed by Dr. Peter Levine. SE treats emotional numbness as trapped survival energy from past stress or trauma. An SE therapist helps you to slow down so you can track subtle sensations (warmth, tingling, tightness) rather than asking you to only talk about what you're experiencing. By slowly introducing small amounts of "stuck" energy at a time (a process called "titration" in SE), your nervous system gently "thaws out" of its freeze response without becoming overwhelmed (see my article:  What Are the Benefits of SE to Heal Trauma?).

Somatic Experiencing Therapy

• Eye Movement Desensitization and Reprocessing (EMDR): While EMDR is usually associated with the bilateral stimulation process it uses, it is deeply rooted in how the body stores distressing memories. During the processing phase of EMDR, you focus on a particular memory or, if you are stuck in a freeze response, you focus on the physical feeling of numbness and where you feel it in the body. Then you follow either a physical or tactile bilateral stimulus. EMDR can help you to process "stuck" emotional information. Over time, this can lead to a somatic discharge like crying or a deep sense of physical relief when your body and mind feel safe enough to do it (see my article: How Does EMDR Therapy Work: EMDR and the Brain).

EMDR Therapy

• Internal Family Systems (IFS) Parts Work Therapy: In IFS an inability to cry due to a trauma-related freeze response is viewed as a protective strategy rather than a "broken" emotional system.  From an IFS perspective, this freeze response shields you from being overwhelmed by grief, fear or overwhelming sadness. In traditional psychotherapy the freeze response is often viewed as a symptom to eliminate, but in IFS the freeze response is appreciated as a protective aspect of the client. An IFS therapist uses the process called "unblending" to help the client to step away from the freeze response so that they can access Core Self, which is a part that is compassionate and curious to get to the underlying emotional wound that the emotional numbing protects (see my article: IFS Therapy is a Gentle Evidence-Based Trauma Therapy).

IFS Parts Work Therapy

• Accelerated Experiential Dynamic Psychotherapy (AEDP): An AEDP therapist treats the freeze response with a safe relational environment that gently helps to "thaw out" the nervous system. One of AEDP's primary goals is to "undo aloneness" where the therapist uses attachment-oriented affirmation ("I am here with you" or "We are doing this together") to build a secure base. When the brain registers true relational safety, the nervous system naturally begins to release it's survival-driven emotional numbing. The AEDP therapist also uses moment-to-moment tracking of the client's somatic cues. She will bring awareness to these somatic cues ("I notice that your jaw seems tight" or "I notice that your breath seems shallow. Can we slow down so we can see what's happening there?" Similar to IFS, AEDP recognizes that emotional numbing was once an adaptive defense when it wasn't possible to express emotions. So, she helps the client to process the emotional numbing. When the client begins to "thaw" from the emotional numbing, the therapist shares the emotional burden, validating the client's feelings and keeping the client anchored within their "window of tolerance" so that this energy can be discharged in a way that is manageable for the client (see my article: What is AEDP and How Does It Heal Trauma?).

What Are the Benefits of Integrating Experiential Therapies Like EMDR, IFS, AEDP and SE?

When an Experiential Therapist integrates EMDR, IFS, AEDP and SE (or any combination of these therapies), it means she is practicing an integrative trauma-informed "bottom up" approach to healing trauma.

Rather than using an intellectual top-down approach of talking about trauma conceptually, as would be done in traditional psychotherapy, the Experiential Therapist targets how trauma is held in the mind and in the nervous system. 

By using a combination of Experiential Therapy, the trauma therapist builds a complete plan that addresses the cognitive, emotional, relational and physical layers of your trauma. 

Get Help in Experiential Therapy

Whereas traditional psychotherapy is a "top down" approach, Experiential Therapies are a  "bottom up" approach to healing trauma.

Get Help in Experiential Therapy

The bottom-up approach of Experiential Therapy is often more effective than a top-down approach because because trauma, intense anxiety and emotional stress are stored in the lower brain regions and the autonomic nervous system which rational thoughts and traditional talk therapy cannot access.

If you are struggling with unresolved trauma, seek help in Experiential Therapy so you can heal your trauma and lead a more fulfilling life.

About Me

I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), IFS, Somatic Experiencing and Certified Sex Therapist.

I have helped many individual adults and couples over the years.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Also See My Articles:

EMDR Therapy - When Talk Therapy Isn't Enough 

Somatic Experiencing - A Mind-Body Oriented Therapy to Heal Trauma 

AEDP: How Does AEDP Process Emotions? 

IFS: How Are Emotions Processed in IFS Parts Work Therapy? 

Getting Help in Trauma Therapy: What Are Traumatic Memories?

People who seek help in trauma therapy often want to know how traumatic memories differ from standard memories.

What Are Traumatic Memories?

Let's start by defining traumatic memories.

Traumatic Memories

Traumatic memories are vivid, deeply distressing recollections of overwhelming or life threatening experiences.

Unlike regular autobiographical memories, the brain processes and stores traumatic memories as a separate cognitive entity as compared to standard past narratives.

How Are Traumatic Memories Different From Standard Memories?

Ordinary memories function like a cohesive story with a clear beginning, middle and end. However, when a traumatic event occurs, the brain's survival mechanisms alter how the information is stored in the brain:

• Lack of Narrative Structure: Traumatic memories are often highly fragmented, disorganized or temporarily missing from conscious recollection.

• Sensory-Heavy Integration: Traumatic memories are often intensely loaded with sensory data. You might remember a specific smell, a sharp sound, a visual fragment, but you might lose track of the timeline or context.

• The Current Experience: A standard unpleasant memory is recalled as a past experience. However, certain traumatic memories feel like they are happening now rather than being something that occurred in the past. When this occurs, you can feel like you're being emotionally hijacked in the moment--even though it's a memory from the past (see my article: What is Emotional Hijacking?).

How Do Traumatic Memories Manifest?

Because traumatic memories are often stored dynamically in the nervous system, they can surface in certain distinct ways:

• Intrusive Flashbacks: You might have intrusive flashbacks where you have a sudden, involuntary re-experiencing of the event triggered by everyday sights, sounds or smells that are similar to the original trauma.

Traumatic Memories

• Somatic/Bodily Memories: The body can retain physical tension, chronic pain, a racing heart or gastrointestinal distress when you are triggered. This can occur even if you are not consciously thinking about the trauma. 

• Emotional Flashbacks: You might experience a sudden emotional wave of intense fear, helplessness, anger, shame or despair that feels completely disproportionate to your current safe surroundings (see my article: What Are Emotional Flashbacks?).

• Nightmares: Repetitive, disturbing dreams can replay certain aspects of the traumatic event.

How Can You Heal From Traumatic Memories?

Traumatic memories are often "stuck" in a raw, "unmetabolized" state and traditional talk therapy usually isn't sufficient to process these memories.

Trauma therapies are specifically designed to help the brain move the fragments out of survival mode and integrate them into standard autobiographical memory. 

Common evidence-based trauma therapy include:

• EMDR (Eye Movement Desensitization and Reprocessing): EMDR uses bilateral stimulation to help with processing traumatic memories so these memories lose their charge (see my article: How Does EMDR Therapy Work?).

Traumatic Memories

• SE (Somatic Experiencing): SE focuses on releasing the traumatic energy trapped in the nervous system (see my article: What is Somatic Experiencing?).

Traumatic Memories

• IFS (Internal Family Systems Parts Work Therapy): Traumatic memories are healed by establishing a compassionate internal relationship between your Core Self and the wounded parts of your psyche. This gentle, non-pathologizing approach treats trauma as a system of protective and wounded internal parts of you (see my article: What is Internal Family Systems (IFS) Parts Work Therapy?).

Traumatic Memories

• AEDP (Accelerated Experiential Dynamic Psychotherapy): AEDP heals traumatic memories by processing overwhelming emotions within a safe therapeutic relationship to rewire the brain's trauma response (see my article: What is AEDP and How Does It Heal Trauma?).

Get Help in Trauma Therapy

If you are experiencing emotional trauma, waiting to get help in trauma therapy can cause the trauma to become more entrenched. This can lead to more severe psychological, physical and relational complications over time.

Get Help in Trauma Therapy

Rather than waiting or struggling on your own, seek help from a licensed mental health professional who is a trauma therapist so you can overcome your trauma and live a more fulfilling life.

About Me

I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), IFS, Somatic Experiencing and Certified Sex Therapist.

As a trauma therapist, I have helped many individual adults and couples over the years.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Also See My Articles:

Reacting to Your Present Circumstances Based on Your Traumatic Past

What is Complex Trauma? 

What is the Difference Between Trauma and Posttraumatic Stress Disorder (PTSD)? 

How Can Unresolved Trauma Affect Your Relationship? 

 

How Does Experiential Therapy Achieve Psychological Breakthroughs?

In my prior article, How is Experiential Therapy Different Than Traditional Talk Therapy?, I began a discussion about why Experiential Therapy is more effective than traditional talk therapy.

Experiential Therapy Achieves Breakthroughs

In the current article, I'm focusing on how Experiential Therapy achieves psychological breakthroughs.

First, it's important to understand what types of therapies come under the umbrella of Experiential Therapy.

Experiential Therapies includes many mind-body oriented therapies such as:

• EMDR - Eye Movement Desensitization and Reprocessing

• Somatic Experiencing - also known as SE

• AEDP - Accelerated Experiential Dynamic Psychotherapy

• IFS - Internal Family Systems Parts Work Therapy

• EFT - Emotionally Focused Therapy For Couples

How Does Experiential Therapy Achieve Psychological Breakthroughs?

Experiential Therapy achieves psychological breakthroughs by:

• Bypassing the Analytic Mind: Many clients are very good at "talking about" their problems without being in touch with how they feel. This is especially true for clients who have had prior therapy. Experiential therapy uses the mind-body connection so that therapy isn't just an intellectualized experience. Instead, clients can get to the root of their problems in a more effective way by getting to unconscious issues rather than remaining on an intellectual level.

Experiential Therapy Achieves Breakthroughs

• Engaging Somatic Memories: Trauma and chronic stress are stored in the nervous system rather than just in the logical mind. Rather than focusing only on what the client thinks, an Experiential therapist emphasizes body awareness. Instead of only asking, "What do you think?", the Experiential therapist will ask, "What do you feel and where do you feel it in your body?" This helps the client to have a felt sense of their problems. This felt sense can release trapped physical tension and stress. 

• Memory Consolidation: A breakthrough requires updating old neural scripts. In Experiential therapy the brain updates the old memory with new adaptive information with the help of the therapist.

• Emotional Catharsis: Psychological shifts often require an emotional release. Examples of this include: Expressing long suppressed anger, grief and shame. 

Psychological Breakthroughs With Experiential Therapy

Rather than just gaining only an intellectual insight into their problems, clients experience a felt shift.  They can rewrite their emotional scripts through action (see my article: Healing From the Inside Out: Why Insight Isn't Enough to Heal).

Experiential Therapy Achieves Breakthroughs

For example, instead of just understanding their childhood trauma, they experience a felt sense of what has held them back and what has shifted for them in Experiential Therapy in an embodied way. This somatic and emotional alignment changes their internal representation of their world which leads to psychological and behavioral change.

Get Help in Experiential Therapy

If you have been struggling with unresolved problems and traditional therapy has been unhelpful, consider working with a licensed mental health professional who is an Experiential therapist.

The psychological breakthroughs can lead to a more fulfilling life.

About Me

I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), Parts Work (IFS and Ego States Therapy), Somatic Experiencing and Certified Sex Therapist.

I have helped many individual adults and couples over the years.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Also See My Article:

Why is Experiential Therapy More Effective Than Traditional Talk Therapy? 

What is the Difference Between Psychotherapy and Psychiatry?

Psychotherapy and psychiatry sound alike, so it can be confusing to know what the differences are and when to see a psychotherapist versus when to see a psychiatrist.

The Difference Between Psychotherapy and Psychiatry

What is the Difference Between a Psychotherapy and Psychiatry?

While the two terms might sound interchangeable, there are important key differences:

Psychotherapy

Psychotherapists tend to focus on thoughts, including unconscious thoughts, emotions and behavior.

The Difference Between Psychotherapy and Psychiatry

Psychotherapists have at least a two year Masters degree and many of them also have an additional four years postgraduate training from postgraduate institute (like the Institute for Contemporary Psychotherapy, National Institute of Psychotherapies and other institutes).

Aside from traditional talk therapy, psychotherapists who go on for advanced training also provide specialized therapy including (but not limited to):

• Eye Movement Desensitization and Reprocessing (EMDR)

Eye Movement Desensitization and Reprocessing (EMDR)

• Internal Family Systems Parts Work (IFS)

• Accelerated Experiential Dynamic Psychotherapy (AEDP)

• Somatic Experiencing

• Hypnotherapy

• Emotionally Focused Couples Therapy

• Sex Therapy (for individuals and couples)

Depending upon their skills and training, many psychotherapists can help clients to:

• Manage Stress and Anxiety

• Overcome Depression

• Develop Resilience and Better Coping Skills

Couples Therapy

• Improve Relationships

• Process Unresolved Issues, including Unresolved Trauma

• Improve Communication Skills

• Cope with Workplace Issues

• Process Unresolved Grief

• Improve Self Esteem

And many other behavioral and interpersonal issues.

Most psychotherapy sessions occur at least once a week for 45-60 minutes.

Psychiatry

Psychiatry focuses on the medical side of mental health.

Psychiatrists are mental health professions who are medical doctors (MDs or DOs). They provide differential diagnoses, prescribe psychotropic medication such as antidepressants, anti-anxiety medication, antipsychotic medication and other similar medications.

In the past, psychiatrists provided traditional psychotherapy, like Cognitive Behavioral Therapy (CBT), psychoanalysis and psychodynamic psychotherapy. However, these days most psychiatrists provide medication management. 

Some specialized psychiatrists also provide Electroconvulsive therapy (ECT) for severe mental health conditions such as treatment-resistant major depression, ADHD, schizophrenia and  catatonia (a state where someone is awake but unresponsive to other people or the environment).

After the initial evaluation session, psychiatry sessions tend to be shorter in duration (15-20 minutes) to assess how a client is responding to medication management. After a client has been stabilized on medication, sessions might occur every 3-4 months unless the client needs help with medication.

Integrating Psychotherapy and Psychiatry

Clients, who need medication management, benefit from integrating both psychotherapy and psychiatric treatment and many psychotherapists and psychiatrists collaborate to integrate both treatments (see my article: Medication Alone Isn't As Effective As Including Psychotherapy).

For instance, a psychotherapist who is helping a client with anxiety will often be in touch with the client's psychiatrist to provide feedback on what she has observed in therapy sessions and to get information about medications prescribed. This is only done with a written consent from the client.

While some clients choose to only take medication, research has shown that combining psychotherapy and psychiatric treatments is most effective (when psychiatric treatment is needed) rather than just relying on medication because clients learn coping skills and strategies to deal with their mental health issues. 

Psychotherapy can get to the underlying issues that cause the mental health issues and if worked through in therapy, it's possible that medication won't be necessary for certain clients. 

In addition, when clients stop taking medication for certain mental health issues, they often go back to having the same problems they had before they took medication. For instance, if they never learned to manage anxiety symptoms or get to the root cause of their anxiety in therapy, once they stop taking the medication, they are back to where they were before they stopped taking the medication.

At the same time, there are certain mental health conditions that require medication such as schizophrenia, some forms of ADHD or bipolar disorder to mention just a few.

How to Choose Between Psychotherapy and Psychiatric Treatment

Making a decision about mental health treatment can be a big step, especially if you are new to it.

Consider what you need:

Are you looking for help with understanding yourself, improving your relationships, dealing with situational anxiety or working on unresolved trauma or are you dealing with more complex long-standing psychiatric problems?

If you are dealing with a mental health issue that requires medication (e.g., ADHD, bipolar disorder), starting with a psychiatrist is a good first step. Then, once you are stabilized on medication, you can see a psychotherapist to help you to make the behavioral changes that medication alone won't do.

How to Discover What is Right For You

It's easy to get confused about the differences between psychotherapy and psychiatry.

The Difference Between Psychotherapy and Psychiatry

You're not a broken machine that needs to be "fixed". You're a human being which means that, like everyone else, you have messy, complicated and wonderful parts of yourself. We all do.

Rather than focusing on being "perfect", the goal is developing a better understanding of yourself, practicing self compassion, finding the right tools and strategies to deal with life's inevitable ups and downs and living a meaningful life.

About Me

I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), Parts Work (IFS and Ego States Therapy), Somatic Experiencing and Certified Sex Therapist.

I have helped many individual adults and couples over the years.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Also See My Articles:

Why is Experiential Therapy Better Than Traditional Talk Therapy to Deal With Trauma? 

With Experiential Therapy, There Are No Blank-Slate Therapists 

The Mind-Body Connection: Experiential Therapy Offers a Window Into the Unconscious Mind