Sam Way on trauma, PTSD and EMDR

00:01

Host: Welcome to In Conversation With. This is Season 3, Episode 12. I’m your host, Langdon Auger, and my guest today is Sam Way. Sam is one of our admins for the Mental Health Radio group. Thank you, Sam, for all that you do there.

Sam: No, thank you for having me.

Host: No problem. Today, we’ve talked and we want to discuss trauma, the development of PTSD and CPTSD, the differences between the two, and EMDR as an effective treatment. Just before I get anywhere, what is EMDR?

Sam: EMDR is eye movement desensitization and reprocessing.

Host: Okay. Are you ready?

Sam: Yeah.

Host: Let’s get started right off the hop, because I know this is a very important topic, and I know you’re a very good expert about it. I want to make sure we get everything covered in the time we have. I’m going to start with the hard one right off the bat. What is trauma?

01:13

Sam: I think a lot of people misunderstand what trauma is and define it as a single event. Trauma isn’t actually what happens to you. It’s what happens inside your body as a result of what happened to you. It’s not the event itself. Gabor Maté, who’s a Canadian physician, is an expert in this field. He coined that definition, and also talks about how trauma settles in your nervous system and brain. That’s the actual trauma.

Host: Trauma can be almost anything. It’s how it settles in your body.

Sam: Trauma can be absolutely anything. It can be somebody honking a horn behind you. It can be physical abuse, emotional abuse, psychological abuse, war, bombs going off. It can be separation.

Host: And it can happen at any age as well?

Sam: Yes. It’s most impactful in your nervous system at younger ages especially, because you don’t have the cognitive function to process it yet.

Host: With a child, something that happened as childhood trauma might have been buried a while ago. You might be reacting to it without realizing that trauma is present.

Sam: A hundred percent. A lot of trauma is pre-verbal, and you carry it forward your whole life, especially if you don’t process it out properly. In childhood, you don’t have the tools to do that.

03:00

Host: I know with my age group, and you’re a little younger than I am, we never knew how to handle it. It wasn’t even defined when we were kids. We either stuffed it down and dealt with it the best we could, and moved on. As we get older, it may just be starting to resurface.

Sam: Absolutely. I think it’s always been there. We didn’t realize it. We didn’t have the knowledge or the language for it.

Host: How does it affect the person experiencing it? I understand that’s a very broad question, but it’s something that needs to be discussed, I think.

Sam: Ideally, when you suffer trauma, you get a physiological reaction. Depending on what it is, say a bomb goes off in a war, or you’re in a horrible car accident. First, you’re either going to freeze or go into total panic mode, which is your amygdala initially reacting. That’s the fear centre of your brain. It’s the most primitive part of your brain, and it’s trained to keep you safe and alive.

Sam: Its reaction time is about a quarter of an eye blink. That’s the first thing that goes. From there, it settles into your body, into your nervous system. You could go into panic mode. Your heart rate and breathing are going to increase drastically in severe cases.

04:35

Sam: Your body is going to start shaking uncontrollably. That’s actually your brain trying to release the trauma through your body. That’s what drives me crazy now. Our health professionals, especially EMS, are trained to give you a shot to calm you down, thinking they’re making you more comfortable. What that’s doing is stopping your body from naturally releasing the trauma and allowing you to recover. That’s something we really need to reform.

Sam: Typically, in an ideal situation, a few minutes to maybe 20 minutes later, depending on the event, you should start to recover. That’s when your thinking brain kicks in, your cerebral cortex takes over and says, ‘Okay, it’s over. We’re done. We’re safe. We’re fine.’ Either the threat is gone or we have people here helping us, and you start to recover. Your heart rate regulates, your breathing slows, the panic goes away. Then the last step would be that your brain forms a memory. That’s also a protection mechanism. It’s like, ‘Okay, this is done. This is over. This is how we’re going to protect ourselves from this happening again.’

06:22

Sam: That’s ideally what happens. If that regulation doesn’t happen, that’s where you develop PTSD or complex PTSD. PTSD is the standard post-traumatic stress disorder, which they now call post-traumatic stress injury. It isn’t actually a disorder, it’s an injury. That’s the most common one, and it’s the one we see with or associate with war veterans and natural disaster survivors. It’s usually caused by a single event.

Sam: Symptoms include a sense of threat afterwards, where the panic doesn’t go away, avoiding triggers, so you don’t want to return to places that remind you of the event, visual flashbacks, which are huge and awful, hallucinations, and emotional dysregulation. There could be extreme anger or depression, and you have no control over it. It’s not like, ‘Hey, it’s over, snap out of it.’ You can’t.

Sam: Complex PTSD is a little less known, but actually very common. Even a lot of therapists miss it, unfortunately. That’s from recurring events. Quite often you see it with ongoing psychological or emotional abuse. Often the victims don’t even realize they’re subject to it. For a lot of people, myself included, that’s your normal. You don’t know any other world, so you think everything’s fine. It’s not.

07:55

Sam: With complex PTSD you also have the sense of threat, as with regular PTSD, and avoidance of triggers. Quite often they’re more emotional. That’s where you see people-pleasing characteristics, where you want to avoid getting anybody angry or upsetting them. You don’t want anybody yelling or lashing out, so you avoid those triggers. Flashbacks come in the form of emotional flashbacks as opposed to hallucinations. Instead of seeing visions of things, it’s familiar feelings. Those can come back without warning.

Sam: With CPTSD, because of its nature, quite often you see a lot of shame and self-abandonment. That’s because you think you’re at fault for causing the harm and the events. It’s not true, but that’s what your brain does to you. That’s what you’ve convinced yourself of.

Host: Somehow I’m at fault.

Sam: Absolutely. You absorb everything. With self-abandonment, you want everybody around you to be happy so there’s no chaos. You just want quiet, you want peace, so you do what everybody else wants, even if you don’t want to, as long as it keeps the peace and keeps the chaos at bay. Then you’ll typically see a lot of social anxiety. That stems from psychological abuse in a lot of cases. You’ll see lessened self-worth, not wanting to be around crowds because you feel like nobody likes you or you don’t fit in, and fear that someone could get angry or upset and lose control, and then you’re back in chaos and craziness again. You’ll see a lot of that as symptoms.

10:30

Host: I can check off a few different boxes about that. Most of mine are from childhood. My mother used to sneak upstairs when I got sent to my room for whatever I did wrong at that moment or that hour. You had to go upstairs and lie on your bed. Then she’d sneak up and see if you were lying on it. She’d take five minutes to walk up the stairs, but every now and then there was one step that made the littlest creak. You’d be prepared for it, so you’d get back on your bed.

Host: My mother’s been gone for over 10 years now, and I still have that recurring dream of her sneaking upstairs. I’m trying to hear a stair creak. It’s still there. I still have that dream.

Sam: Yeah.

Host: There are your emotional flashbacks. When is it going to end, though? That’s the whole thing. Why do some people develop PTSD and CPTSD, and what’s the major difference between the two?

11:43

Sam: We kind of covered the differences between the two. Why some people develop it and some people don’t is still a bit of a mystery, honestly. There’s speculation that it’s a combination of things, including trauma exposure. The more trauma you’re exposed to, the more reactive you’re going to be to it. If you don’t have the opportunity to process it out, you’re just going to be more subject to that.

Sam: Again, going back to the EMS thing, when they give you that shot and don’t allow you to process the trauma, you have a substantially higher risk of developing PTSD during that event than if they would just let you shake.

Host: It’s probably not entirely covered in their paramedic training. It might be for newer people nowadays, because it’s become such a bigger deal lately. The guys who took me in had no idea that it might have been a trauma-related thing. They were treating the moment and what it was, and what they needed to do to get me in the ambulance and take me into Calgary. That’s Western medicine.

Host: Do they get paid for the shot as well?

Sam: Well, they get to charge for it, right?

Host: Oh yes, that’s true. I never thought of it that way. I know Western medicine is a moneymaker. Some of those ambulance rides are awfully expensive.

Host: I’ve also had a heart attack. Anyway, that’s another topic altogether.

13:36

Host: EMDR therapy as an effective treatment. What is it, and why is it so effective?

Sam: EMDR is a beautiful thing. I’ve actually gone several sessions with it. It’s kind of interesting. It was found by accident by Dr. Francine Shapiro back in 1987. She was going through a difficult time and went for a walk in the park. As she was walking, she was scanning, as you quite often do, and realized there was something about her eyes moving back and forth as she processed her thoughts that lessened the emotional charge.

Sam: That got her curious, so she started doing her own controlled studies in 1989, using it as a treatment for PTSD and trying to get the emotional charge out of it. By 1990 she was presenting her first trainings. She had enough evidence to show it was working, and by 1998 EMDR Canada was formed.

Host: Nice.

14:56

Sam: My personal therapist, and I’m just so tickled, is actually the current president of EMDR Canada.

Host: Oh wow.

Sam: She is amazing. That’s also why it’s been so effective for me. I’ve literally got a rock star at the helm.

Sam: With EMDR, you’re watching a light that moves back and forth and your eyes follow it. They also give you a set of what they call tappers. They’re little balls that you hold in your hands, hooked up to it, and they intermittently vibrate in your hand, left and right, left and right, as you watch this light.

Sam: What it does is slow your brain waves down to delta wave, which is like a dream state, your most subjective state. How it works, they honestly don’t really understand. They just know that it helps to rebuild your neural pathways, the ones that get damaged in trauma, and takes the emotional charge out of the experiences, out of the events.

16:08

Sam: Traditionally, this is where the therapy’s gotten a bad rap. You used CBT and DBT, your talk therapies, which help you challenge your thoughts and reframe them into something more positive and acceptable so you can deal with them on a cognitive level. That’s all fine and dandy. That’s still part of EMDR treatment. They use CBT and DBT as a lead-in to the root of the trauma.

Sam: The beauty of EMDR is that once you identify it, you don’t have to verbalize the event itself. I think that’s another fear people have about going to therapy. They’re like, ‘I don’t want to go through this again. I don’t want to talk about it. I don’t want to explain it.’ You don’t have to.

Host: My problem with therapy, sorry to interrupt, is that they begin to sound like a Sigmund Freud book. They just keep saying, ‘I’m having this real problem with…’ I don’t know, Ward, what do you think is the problem with that? ‘How do you feel about that? How do you think I feel? I’m here. Exactly. Why do you think I am here? To get you to ask me why I think of this? Is there a reason why?’ No, I don’t know. That’s why you’re here. Anyway, that’s another one altogether.

Host: There are some wonderful new therapies, and I love that there are people out there challenging things and trying something new. I heard some new stuff not too long ago from Amanda [surname unclear]. Maybe when she’s not so busy, she’ll be able to come on and talk about it. It’s so refreshing. This EMDR therapy sounds wonderful.

18:07

Host: Do you know if it’s covered under AHS or any medical plan?

Sam: It is covered, absolutely. Our specific plan definitely covers it.

Sam: Another benefit of EMDR therapy is that it’s so much faster than traditional therapies. With CBT and DBT, you had to go through every aspect of the trauma verbally and process through it. It has its place, definitely, but EMDR speeds up the process exponentially. For average PTSD, meaning single-event trauma, they can process that out in three to five sessions.

Host: Nice. It’s gone.

19:06

Sam: Complex PTSD is going to depend on how long the traumas occurred. For me, I had 55 years stacked up. Even with that, depending on the level of impact, three to 12 sessions.

Host: That’s pretty fast. Our time has gone by really fast today, and I want you to come back and do more. Are you okay? There was a little trauma there when I asked you to do it. I could tell.

Sam: I’m fantastic. If I don’t, I have the tools to cope with it now.

Host: Perfect, that’s good. Once again, this is In Conversation With, Season 3, Episode 12, for those keeping track. Sam Way has been my guest. Thank you again for all that you do in the group. Love your posts. Keep them up.

Sam: Fantastic. Thanks for having me, and you keep it up as well.

Host: No problem, and a happy Mental Health Day to you.