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Join Date: Jan 2006
Location: Seattle, WA
Effective for PTSD symptoms
Social Anxiety Background
Social anxiety has affected me since I was in elementary school. While it was triggered initially by a traumatic experience, it is something that runs in the family and I certainly had a predisposition for. Some examples of how it manifested itself over the years: avoiding certain types of social situations and friends, avoiding public speaking, avoiding the opposite sex completely, hiding in the library during lunch, the thought of just walking down certain hallways at my highschool terrified me, fear of being around large groups of people, fear and avoidance of going to parties or social gatherings, etc. My social anxiety started to get severe when I dropped out of college after one quarter because of my social anxiety. That's when I started to get uncomfortable just leaving my apartment and hit "the bottom" so to speak. Through treatment with group cognitive-behavioral therapy (CBT), Eye Movement Desensitization and Reprogramming (EMDR) for mild Post Traumatic Stress Disorder (PTSD), and medication I've been able to live the balanced life that I value and form healthy friendships and relationships.
CBT for social anxiety. EMDR worked well for dealing with some specific traumatic events from my life and resulting physiological responses, but CBT was what was effective for learning to think, act and feel differently in social situations.
My psychologist who treated me with EMDR told me about a patient of his. It was a middle aged man with no history of any mental disorders. He witnessed a shooting where someone he knew was killed and developed such severe anxiety with physical symptoms that he barely left his house anymore. He went through around a year of talk therapy with limited positive results, but then in only one extended session of EMDR all of his physical symptoms were eliminated. He literally called my psychologist and said I don't need to come back for next week's session. This is an example of a very rapid recovery from the physical symptoms of Post-Traumatic Stress Disorder (PTSD) via EMDR.
In my case, it wasn't quite so simple or fast. While I had experienced a traumatic event at a young age, I did have a history of depression and social anxiety when I pursued EMDR. I'd also already pursued treatment for social anxiety with CBT and had gone through a 20 week group.
I approached EMDR as the last psychotherapy that I was going to try before giving medication a shot. I was hoping it would finally "fix" my social anxiety. While it didn't do that (as I am currently taking medication), I did find it to be a beneficial treatment.
First of all, what exactly is EMDR?
EMDR is a psychotherapy treatment that was designed to resolve symptoms resulting from exposure to a traumatic event. The theory is that symptoms arise when a distressing event is inadequately processed and can be eliminated when that memory is fully processed.
The "processing" that takes place in EMDR causes the traumatic memory to be transformed both emotionally and cognitively because new connections are formed with more positive and realistic information. The result is that the patient is no longer distressed when accessing the memory, instead seeing it with a new perspective free of the emotional distress and physical responses.
What does EMDR actually involve?
When working with a therapist, you focuses simultaneously on 1) the image that best represents the traumatic memory, 2) the negative belief formed, and 3) the disturbing emotion or physical sensation.
As you do this you follow an object moving back and forth with your eyes, listen to sound alternating ears in headphones or hold sensors that vibrate alternating hands.
These are believed to be important in facilitating the processing of the traumatic memory, but how exactly they do this is debated.
Three supported explanations are:
1) The bilateral stimulation through eye movements (or other alternating stimulation), facilitate interaction between the brain's hemispheres, which then improves the processing of trauma-related memories
2) That eye movements (or other alternating stimulation) facilitate processing of trauma memories by activating a state similar to REM sleep.
3) The eye movements (or other alternating stimulation) in EMDR affect the orienting response, which can inhibit the avoidance response, induce an investigatory reflex and produce a relaxation response.
The EMDR process itself is finished when you form a new, more rational belief about the memory.
After successful treatment with EMDR, there is supposed to be a reduction in the distress, a shift in the negative beliefs, and a reduction in the physical symptoms.
Ok, that being said, I went through around 20 EMDR sessions with a psychologist. In that time I went through and "reprocessed" a handful of traumatic events from my childhood.
Without getting into the nitty gritty details, I wouldn't say repressed memories came to the surface, but memories that I just didn't think were important I found to be linked together and linked to certain beliefs about myself and the world. There were times when I had a significant amount of emotional release, whether that was through crying or anger. I never would have imagined I had so much emotion stored up about the events in my past.
How do I know that it worked?
Since my childhood I had a problem where I would start to feel like I was going to throw up when going to social environments. It wouldn't have to be that I was giving a speech, it could just be going to a party. There were times when I would actually throw up I was so anxious about going to a social gathering.
After treatment with EMDR I have not had the feeling again.
If for nothing else, that made it worth it.
Overall, I don't see EMDR as the main or first treatment for social anxiety. CBT and group therapy takes that role. But I'd highly recommend it for someone who is experiencing severe ongoing physiological responses (something like throwing up) to social situations.