Current Update as of February 27, 2005
Inspired by The Edgar Cayce Institute for Intuitive Studies
Edited by HENRY REED, Ph.D.
(Hampton Roads Publishing)
One Excerpted from book
An After-Death Communication Occurs Unexpectedly during Therapy
"The beginning of knowledge is the discovery of something we do not understand."
Becky excitedly described to me what she experienced. "I saw my mother," she said, a broad smile across her tear-stained face. "I told her, I love you, and she said, I love you too. Then she hugged me. I could actually feel her arms around me."
But at the time of this experience, Beckys mother had been dead for five years.
Becky wasnt describing a dream. She was sitting in my office when she had the experience. She said she felt the touch of her mothers arms and was joyful to see her mothers smiling face, but only she and I were there and her eyes were closed. Her mothers warm, familiar embrace seemed vibrant and alive, but her mother was dead.
Her sense that she felt the touch of her deceased mothers arms was unusual enough, but the life change that resulted was remarkable. "Ive been an atheist my whole life," she said, "but Im sure now there really is a life after death. I used to worry about dying, and I felt so much pain when my mother died. I know now, though, that my fear and grief were based on something I didnt understand. I know that everything is OK and that I need to remember this when I feel life is getting me down." Her grief reduced dramatically and remained resolved in the months that followed.
When Becky came to my office that day for help to alleviate the deep sadness she was feeling over her mothers death, I was able to use a new form of therapy I had discovered to help reduce her grief. The method was available to me because I had learned how to use it through a long journey that began with a session in which it occurred by accident and progressed through identifying how I could help a patient experience it at will.
The story of that discovery follows.
My Skeptical Behavioral Scientist Training
The radical behaviorist movement was at its peak in the 1960s and was nowhere stronger than among a group of professors at the University of Kansas in Lawrence, where I was an undergraduate psychology major. Radical behaviorism asserted that only observable behaviors are worthy of scientific consideration. The practice of inferring private, mental events in people may be appropriate for mind readers and other nonscientific thinkers, but it had no place in a science of psychology. We were confident that inferences about inner states are unnecessary because understanding the relationship between observable behaviors and environmental variables is all that is needed to understand peoples problems and provide treatment.
I carried that behaviorist, scientific underpinning into my masters degree studies at Illinois State University and through my work in community mental health for three years. I became adept at counting behaviors while manipulating the environment to evaluate how the counts changed. Finally, I ended my formal studies at Baylor University in Waco, Texas, in the comfortable familiarity of a cognitive-behavioral paradigm, the most widely accepted scientific psychological model of the early 1980s that continues to dominate psychology today.
No matter how my perspectives broaden, the instincts and skepticism of the scientist will never leave me. Anything I believe must be verifiable.
After completing my Doctor of Psychology (Psy.D.) at Baylor, I accepted a position at a Chicago-area Veterans Administration hospital working with post-traumatic stress disorder veterans, a focus that was to become my career. The first seven or eight years of using the cognitive-behavioral model with these traumatized vets were grueling for me and for my patients. The half-dozen professional staff on the unit all felt the same. The prevailing cognitive-behavioral model for treating victims of psychological trauma was "exposure therapy." We repeatedly exposed patients to reminders of their traumatic experiences in a safe, supportive environment so that, over time, their intense emotional responses might decrease in intensity.
While the approach made sense from a theoretical point of view, and we did get some modest results, the therapeutic changes were minimal and didnt appear to hold up over time.
A New Technique Dramatically Reduces Trauma and Grief
Then, in the late 1980s, psychologist Francine Shapiro, Ph.D., discovered a radical new therapy technique she named eye movement desensitization and reprocessing, or EMDR. In EMDR therapy, the psychotherapist, usually sitting before and slightly to the side of the patient, moves his or her hand, with the index and next finger extended, left and right in front of the patient on the same level as the patients eyes. While focusing on the psychotherapists hand and keeping the head stationary, so only the eyes move left and right rhythmically, the patient attends to a disturbing thought, feeling, sensation, or image.
During a set of eye movements, the patient experiences a spontaneous, natural reprocessing of the thought, feeling, sensation, or image. After a number of sets of eye movements, patients typically report psychological breakthroughs that normally would take months to achieve. The procedure is now being used for a wide variety of disorders, from multiple personality disorder to the post-traumatic stress disorders I worked with.
Experience has taught me that EMDR does two things better than any other approach. First, it rapidly and completely uncovers past traumatic events that are repressed or partially remembered. It is very common for a patient to say something like, "I can see the whole thing very clearly now" or "I felt like I was back there again." This experience by itself does very little to help the patient resolve the traumatic experience and, in fact, patients generally feel very distressed when they fully uncover a traumatic memory.
Once the traumatic memory is fully accessed in this way, however, the second strength of EMDR is that it allows the patient to process the memory so that the reliving component of the memory is eliminated, and the patient can then remember the traumatic event in a more abstract way. It is clear that this processing can only occur if the traumatic event is first uncovered and fully accessed.
No one is quite sure how it works, although it is apparent that it speeds up mental processing and is similar to the rapid eye movements (REMs) people experience in dream sleep. It is well known that during dream sleep, our brains process information at a higher rate than when we are awake. It has been assumed that this increased processing during sleep causes the rapid, back-and-forth eye movement. Having a fully awake person purposefully shift the eyes in the same way, as in EMDR, seems to cause the brain to process information more rapidly and efficiently. Thus EMDR draws upon the persons own natural ability to heal.
A number of studies have looked at the effects of EMDR on brain functioning. Levin, Lazrove, and van der Kolk (1999), for example, used neuroimaging to study the effects of EMDR. It was found that when subjects accessed a traumatic memory prior to EMDR, deep structures in the brain that represent the sensory and emotional components of the traumatic event were activated in isolation. After EMDR treatment, however, areas of the brain that hold the memory in a more abstract or symbolic manner were also activated. These findings support the consistent clinical observation that prior to EMDR, when people access a traumatic memory, they feel they are reexperiencing the event; after EMDR, they are able to remember the event in a more abstract and emotionally detached manner. I know of no other psychotherapeutic technique that can demonstrate such a clear change in brain function and an accompanying dramatic shift in perspective reported by the patient.
EMDR Is Not Hypnosis
I am frequently asked if EMDR is similar to hypnosis. Professionals trained in both EMDR and hypnosis, including me, believe that the techniques involve two very different types of mental processing. The best way to explain the differences is to use this analogy. Consciousness is like an internal movie projector that ceaselessly projects mental images onto the minds screen. Hypnosis gets a person into a relaxed, focused state so the projector slows down. Because the projector is slowed, hypnosis can be used to go back to places on the film where forgotten or repressed memories are thought to exist. While hypnosis can assist in retrieving memories, the problem is that a person in a hypnotic state is also very suggestible and may unknowingly put an event on the screen that in reality never occurred. False memories, as they are now called, can seem very real to the person after the hypnosis.
EMDR, on the other hand, accelerates information processing in the brain so it speeds up the consciousness projector. When people suffer from repeatedly experiencing a traumatic memory, their projectors are, in essence, stuck in time and keep replaying the moments when the event occurred. EMDR speeds up the projector, unsticking it to allow it to run smoothly. The traumatic event then ceases to intrude in an unwanted way into consciousness.
At the same time, EMDR does not increase the suggestibility of the subject, so false memories are not a problem with EMDR. In fact, I have used EMDR to undo false memories. Tim, for example, had an alcoholic mother who was prone to fits of rage. For years, he was very troubled by a vague memory of feeling smothered and having difficulty breathing in his mothers presence. While under hypnosis with another therapist, he developed an image in which his mother was holding a pillow over his face with the clear intent of trying to kill him.
When I used EMDR with Tim, he immediately went back to the time he felt smothered and clearly remembered that his mother was preparing to take him outside on a very cold day and was bundling him up in his snowsuit as he lay in his stroller. His mother had tied a scarf tightly around his face, which caused him to have some difficulty breathing. Without any suggestion from me, Tim discovered what really happened and, from that moment on, was no longer distressed by the memory. Had he discovered that his mother was trying to kill him, more EMDR would have been required to get his "stuck projector" running smoothly again.
EMDR Has Begun to Make Its Way into Mainstream Practice
EMDR is rapidly making its way into mainstream mental health. Over 30,000 professionals have been trained in EMDR therapy worldwide, and the number is growing. EMDR training is only available to people who are already recognized by their state as independent providers of mental health services.
To date, there have been 18 scientifically controlled studies of the efficacy of EMDR. Overall, these studies support the value of EMDR. In addition to reducing post-traumatic stress disorder problems, it is also effective in the treatment of grief, phobic and panic disorders, sexual dysfunction, dissociative disorders, performance difficulties, and chronic pain. EMDR is still in its infancy and other applications will certainly be found.
The weight of evidence for its effectiveness has prompted official endorsements of EMDR by the American Psychological Association Division 12: Clinical Psychology (1998), International Society for Traumatic Stress Studies (2000), Northern Ireland Department of Health (2001), United Kingdom Department of Health (2001), Israeli National Council for National Health (2002), and U.S. Veterans Administration/ Department of Defense (2004).
The most important testimony for the effectiveness of EMDR, however, is that we have seen it work repeatedly and reliably with thousands of our patients.
A Near Tragedy Teaches Me about EMDR Firsthand
A colleague and I on the post-traumatic stress disorder unit were preparing to complete the formal certification training at Dr. Francine Shapiros EMDR Institute in Watsonville, California, when a very distressing event forced me to experience the power of EMDR before my training. My two-year-old son nearly asphyxiated when a piece of food lodged in his throat. He first began choking and we werent sure what was happening; then he stopped breathing and started turning blue. A successful Heimlich maneuver dislodged the food and he survived the ordeal, but the image of my son, blue, frantic, and dying before my eyes became an intrusive image that disturbed me often for two weeks after the incident.
When I explained my distress to the colleague who was planning to go through EMDR training with me, he suggested he use the technique as we understood it then to help my mind reprocess the troubling memory. We did several sets of eye movements while I focused on the incident. In ten minutes, the image had lost its distressing nature for me, and my anxiety over it had decreased dramatically. It seemed too good to be true. The effect appeared to be due to my own inner processing of the memory, a source of healing I had learned in my behaviorist training as being inconsequential. But that was only the first rock to dislodge from the foundation of certainty about behaviorism I had stood upon since my earliest days at the University of Kansas.
We Begin Using EMDR Therapy with Remarkable Results
My colleague and I completed the EMDR training and began using it in our post-traumatic stress disorder unit at the Veterans Administration (VA) hospital to see the effects it would have on our unique patients. The results were dramatic. Often we achieved in a single session changes in patients that we had not been able to approximate after years of conventional psychotherapy. It was a heady time for us. Regularly, one of us could be seen scurrying down the hall into a colleagues office to excitedly describe a successful session with a patient, doing a high five in triumph.
In 1992, Dr. H. Lipke and I published "Case studies of eye movement desensitization and reprocessing (EMDR) with chronic post-traumatic stress disorder" in Psychotherapy. We were elated for our patients and for ourselves as professionals earnestly seeking ways to make a difference in our patients lives.
EMDR proved especially powerful in healing grief. People who experience grief, especially traumatic grief, generally feel a variety of intense emotions. Initially, survivors often experience shock and numbing. Then, more chronic feelings of anger, guilt, and sadness surface; they may be crying one moment and full of anger or rage the next. A primary task for the psychotherapist is to create a supportive psychological environment in which patients can openly express these feelings and work through them.
By working through these feelings, patients are usually able to eventually achieve some level of acceptance of their loss and improved ability to get on with their lives. Generally, the loss is never fully resolved; reminders of the loss can trigger periods of sadness, guilt, or anger throughout the patients life. Over time, however, these episodes usually decrease somewhat in frequency and intensity.
If, for example, parents have a child who is hit and killed by a car while playing in the street, the parents will likely experience all three of these emotions (sadness, guilt, anger) very intensely at different moments. At times, they will be enraged at the driver who killed their child; at other times, they will feel intense guilt for having allowed their child to play in the street or for not watching their child more closely. In their most despairing moments, they will feel the cold clutch of intense sadness at their loss and the painful feeling of disconnection from their child.
It is my belief that at the core of grief is profound sadness. The core sadness is so painful that the patient unconsciously but effectively shrouds it in guilt and regret and gets stuck on "What if?" questions. What if I could have prevented her death? What if I had been a more loving friend? Both the guilt and sadness are often avoided by anger or rage-at God, the doctors, the commanding officer, or anyone else available as a target. The doctors should have been more attentive. Our lieutenant had no business putting us in that dangerous position. However powerful they seem when acted out, the layers of guilt and anger are only defenses the patients mind uses to keep from feeling the painful sadness at the core.
The grief therapy we had been practicing before we began using EMDR therapy sought to reduce the immobilizing pain of grief by helping our patients peel off the shrouds of anger to reveal the guilt, then peel off the layers of guilt to reveal the sadness, then talk out their sadness to help them work through it. That process took years of frustration and seemingly endless therapy appointments. With EMDR, we could help patients rapidly process through all of these layers, sometimes in a single session.
Core-Focused EMDR Accesses the Core Sadness
EMDR had proven to be such a reliable, effective procedure for uncovering and alleviating traumatic grief that I felt comfortable with encouraging patients more strongly to go to the core sadness immediately and stay with it. I was able to bypass the overlying guilt and anger that preoccupied normal therapy sessions for months or years and go directly into the sadness in one session. When we were able to process the core sadness fully, guilt and anger tended to vanish without even being directly addressed. It demonstrated that guilt and anger serve only to protect patients from experiencing the deep sadness. I also found that patients responded better when they closed their eyes briefly after a set of eye movements, so I instructed all patients to close their eyes. I termed my direct approach to the underlying sadness "core-focused EMDR." The results were very successful and occurred even more rapidly than with standard EMDR.
Dennys case is an example. Denny, a combat veteran, lost a good friend during an intense firefight in Vietnam. His friend had been in Vietnam only a short time and Denny had taken it upon himself to show him the ropes. During this firefight, his friend raised his head above the barricade from which they were firing, was shot in the temple, and died instantly.
Denny finished telling me the story in a rage. "If that damned lieutenant hadnt ordered us where we knew we shouldnt have been, hed still be alive." He said he had told his friend repeatedly before this battle to keep his head down, and he felt very guilty, turning his anger on himself, because he hadnt warned him again before this firefight. "I could have saved him. Why didnt I tell him again?"
I asked him whether he felt any sadness about his friends death and he said he did feel some, but "only to a small degree." When I started the core-focused EMDR, I ignored the guilt and anger, telling him to pay attention to the sadness. I did a set of EMDR eye movements and his sadness increased quickly. He began to sob. I stayed with the sadness, administering more sets of eye movements until the sadness was at a peak. He cried and shook his head. "Stay with that feeling," I told him and administered more eye movements.
Finally, with additional core-focused EMDR, his sadness began to decrease. After several more sets, I asked him, "How is your sadness now?"
"Its pretty well gone," he said, smiling weakly. "I feel much better about it."
"What about your anger and guilt feelings?" I asked.
He thought for a moment. "Gone," he said. "I just feel like it happened and theres nothing I could do about it. No one could have told him enough times to keep his head down. It wasnt my fault."
Once the core-focused EMDR had addressed Dennys sadness, the guilt and anger disappeared. They were no longer needed to conceal the deep sadness at the root of all the emotions.
EMDR Lets Us Make a Difference in Our Patients Lives
EMDR had proven to be a wondrous gift to our patients and us, and core-focused EMDR was taking our patients to their core problem, healing it in even more dramatic fashion.
The years that followed were filled with accomplishment and victories. We honed our skills and, in partnership with our patients inner resources, made a difference in their lives. Our inpatient unit was one of the first in the country to use EMDR consistently and successfully. It seemed that we had a vista from which we could survey the known psychological terrain with confidence and optimism.
Then one day, during an otherwise normal session with a patient, the core-focused EMDR took me and the patient into a realm I didnt know existed.
A Patient Has an After-Death Communication in My Office
On the day I first discovered the induced after-death communication (IADC) phenomenon, I was in a psychotherapy session with Sam. I handed him a box of Kleenex as tears trailed down his face, dropping from his chin to his shirt. I had worked with Sam, a 46-year-old patient at the VA Hospital, on other traumatic memories of his Vietnam War experience, but he had avoided bringing up this one because it was too painful.
While in Vietnam, he had developed a very close relationship with Le, a ten-year-old orphaned Vietnamese girl. She had made Sams base camp her home after both of her parents were killed. She helped with daily chores on the base and in return was given food, shelter, and companionship. The other American soldiers watched out for her, but Sam and Le developed a special relationship. Le reminded Sam of his two younger sisters, helping him maintain a sense of his own humanity amid the dehumanizing brutality of war.
Each time Sams unit returned from his patrols in the jungle, Le would pick him out of the group, run to him, and give him a hug. Other soldiers in Sams unit became accustomed to seeing them together talking about their lives before they met. Le particularly enjoyed his stories about life in America. After several months, Sam decided to adopt Le and bring her home.
Orders came from headquarters, however, that all orphaned Vietnamese children on the base were to be sent to a Catholic orphanage in a distant village. Sam was devastated. A few days later, Sam, in tears, helped load Le and the other orphaned Vietnamese children onto a flatbed truck to take them to the orphanage.
Just as they got all of the children onto the truck, shots rang out and bullets zipped past the truck. Risking their lives, Sam and the other soldiers quickly pulled the children off the truck to the relative safety of the ground. The shooting stopped as quickly as it had started, and they began to put the children back onto the truck. Nearly all of the children were back on the truck when Sam realized he didnt see Le. He walked to the back of the truck and saw her lying face down with a spot of blood on her back. Sam rolled her over and was horrified to see that her front torso was blown open from a bullet that had entered her back. Sam sat on the ground, holding her lifeless body, and cried. Other soldiers eventually had to pull Sam away and take Les body to bury her.
The incident was Sams psychological undoing.
For the remainder of his tour in Vietnam, he numbed the pain of his profound loss with anger and rage, volunteering for dangerous patrols to kill any enemy he could find or be killed himself. After Vietnam, he returned to the States and fathered a daughter, but then avoided her for years because she triggered anger, guilt, deep sadness over Les death, and gruesome images of Les dead body. For nearly 28 years, Sam spent most of his days secluded in the basement of his home, separated physically and psychologically from his family.
To help him open up and work through the grief that was dominating his life, I decided to use core-focused EMDR. Sam sobbed quietly from the overwhelming pain of his grief. I asked him to focus on his sadness while I administered the first set of eye movements. As I expected, the sadness that had held him isolated in grief for 28 years increased notably. I gave him more sets of eye movements and his sadness began to decrease.
While tears ran down his face, I administered a final eye movement procedure and asked him to close his eyes. Neither of us was prepared for what happened next. The tears that had been flowing from his closed eyes suddenly stopped, and he smiled broadly. He giggled softly. When he opened his eyes, he was euphoric.
"When I closed my eyes, I saw Le as a beautiful woman with long black hair in a white gown surrounded by a radiant light. She seemed genuinely happier and more content than anyone I have ever known." Sams tear-reddened face glowed. "She thanked me for taking care of her before she died. I said, I love you, Le, and she said I love you too, Sam, and she put her arms around me and embraced me. Then she faded away."
Sam was ecstatic and absolutely convinced that he had just communicated with Le. "I could actually feel her arms around me," he proclaimed.
As Sams psychologist, I wasnt sure what to make of what he was telling me. I assumed that the agony of his grief had somehow produced a hallucination based on fantasy or wishful thinking. I had never witnessed or heard of such a response during psychotherapy.
After Sam left my office on that day, the image of his smile showing through his tears and his assertive statement that he felt he had communicated with Le played repeatedly in my mind. I sat in the quiet of my office trying to understand what had happened.
Sam experienced a grief hallucination, I thought. I had heard of these. But that wasnt sufficient to explain what I had witnessed. The creativity had been remarkable. I had not seen that spontaneous imagination in any patient and had never read about anything similar in the literature. If that was a hallucination, then his mind had miraculously created an experience that was completely healing. During my clinical rotations on wards with the chronic and severely mentally ill, no patient ever reported a hallucination that was so positive and healing.
Something in Sam flowered in an instant, without direction from me, reversed the sadness in which he was immersed, and brought him a notable feeling of release from intrusive images, anxiety, and depression that had consumed him for 28 years.
I left the VA hospital building that day still feeling puzzled by what had happened. I wondered whether I would ever in my professional career see such a remarkable scene again. Probably not, I thought. Sams experience was one of those events a psychotherapist would see once in a professional lifetime and I could just file it away as a one-time aberration. But I also felt concern that if Sam had hallucinated, the intense stress of his traumatic memories had somehow compromised his ability to differentiate reality from fantasy. That worried me.
Copyright © 2005 by Allan L. Botkin, Ph.D. & R. Craig Hogan, Ph.D.
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