{Trigger Warning: this episode discusses the experience of strangulation and suffication}

JANILEE”

Welcome, friends. You found Just Janilee at the corner of “Am I crazy?” and “No, you're not. Here's the science to prove it.” Today we are talking about EMDR and Ketamine.

So this is the Just Janilee episode that's linked with the main episode we did on therapy {episode 7} and and it is released a little bit late. So apologies, but thank you for your patience. And what we're going to do today is we're going to go over EMDR and Ketamine, because they are the most new therapies that are out there that maybe we know a little bit less information about. In the show notes for this episode, the very top link will be to a YouTube video that talks about just different types of therapy from a very educational perspective. So you can go there, you can watch that. But we're going to dive in and we're going to spend most of today talking about EMDR and not as much time talking about Ketamine.

The main reason for that is that EMDR is not quite as new as Ketamine. And so  the newer treatment is the less papers there are to explain what is going on.  So I will tell you that from my personal experience, I first did EMDR, I want to say like five years ago and before I did it, like I do with most things—because I am who I am—I did a lot of research into EMDR. And there is like everything else in life, there are some people who swear by it and some people who think that it's complete hoax. What I was looking for when I was looking into it was side effects. And I was very surprised to find that for the majority of the papers that I was looking into, even meta analyses,  there weren't a lot of side effects that were negative.  Most of the negative feedback was simply, “This didn't work for me.” And that's to be expected with any type of therapy, whether EMDR, Ketamine, talk therapy, even like ECT, which is electroconvulsive therapy, sometimes referred to as shock therapy, every type of therapy, it's going to work differently for different people because we are different people. We're all individual in our own way, so none of that is surprising. And so I was surprised simply by the lack of negative side effects. And so I thought, for me, it was worth a try.

So, like I mentioned, we're starting out with EMDR. There's a bunch of papers linked in the show notes. Per usual, I wanted to address something here and now because I've researched a couple of episodes in the future and depending on the specificity of a certain topic, it can be harder to find papers that are not behind paywalls. So sometimes I will pay the fee to be able to access a certain paper so I can do the research, so I can explain what it means. But because it's behind a paywall, I can't share a link that everyone can use, which I try to do most of the time. So I still am going to link every paper that I use, but if it is behind a paywall, I put that in parentheses after the title of the paper. Just so you can be aware. Just go straight to our Vilified Pod website, which Villifiedpod.com just FYI, you can know straight from the website if it's going to require money to get the full paper, but for all papers, you can read the abstract. Which is basically just the summary of what the paper is. All right, so let's jump into it.

EMDR is an acronym. It stands for eye movement, which is the EM, and then Desensitization, which is the D and Reprocessing, which is the R. EMDR, or eye movement, desensitization and Reprocessing. So the first paper I'm looking at for this one, it's more of a summary one, which I always like to try and find. Sometimes I go and get just kind of the first papers that come out with it. Most the time I try and get papers that are more recent in time, like within the last ten years or so. Just because it's going to have the most up to date information. But sometimes it's helpful to go back in time because they can be the most simplified examples and explanations of the topic we're trying to understand.  This paper is  nine years old,  based on the year this episode is being recorded. So this episode is recorded in 2023, and this paper is from 2014. A little bit older than I wanted, or that I usually like to go, but it's free to everyone and it's a pretty good explanation and summary of what EMDR is. So.  It is by Francine Shapiro. And like I do with all of the articles, I always like to cite where they come from. So Francine Shapiro, she works for the Mental Research Institute. So it's not like the NIH or the NMHI (National Mental Health Institute), but it is someone like the person who wrote this paper has a PhD.  I was introduced to EMDR first through the book The Body Keeps the Score, which we mentioned a lot on this podcast. And there is a certain lecture that Van der Colt, the author of that book, gave on YouTube where he talks about how he heard of EMDR and immediately {Van der Colt} thought, “This is total crap.” And then he had a group of people that actually looked into it and researched it, and he was surprised by what the results were, that there is some efficacy to this. Right? So even though his team doesn't work specifically for these accredited institutions where I like to get papers from. That doesn't mean that there isn't anything to be gained from papers that come from other resources. This is, like I mentioned, from 2014. It's only a couple of pages long. If you wanted to check it out, it's, I think, seven pages. But two of those are just all of the references that were used. So, yeah, two pages of references. That's how you know it's a well researched paper.

So I'm just going to start at the top here, if you wanted to follow along. And I'm just going to go through it. So let's see what we got here. The abstract, it's at the top in the gray background, and it just tells you about the sections of the paper. One thing that I thought was interesting is that EMDR was actually introduced back in 1989 with a randomized controlled trial. It is a very good type of study that helps reduce bias. And so that first trial was published in 1989, and that was before I was even born. {But not before Larissa was born.} However, it wasn't really until around 2010, or a little before, or a little after, when it started to be something that you could actually find treatment for. So before then, it was very often just something that you could do if you were willing to take part in a scientific study. And if you weren't, then you were just stuck with regular DBT {dialectical-behavioral therapy}, cognitive behavioral therapy {CBT}, talk therapy or no therapy. So things have definitely changed. Just even in the event of my life,  over the span of my lifetime, so much has changed in the fields of mental health. And that is a good thing and that is wonderful. If you read on the first page, it talks about kind of the results of that trial—where it came from and everything. But I wanted to spend most of today {on the} table that's on the bottom of page two that is super helpful.

It talks about the eight phases of EMDR therapy or treatment, just taking like a cultural bias. If you hear EMDR, what are you thinking of? Most of the time you're going to be thinking of, okay, so there's a therapist moving their hand and the client is just watching their hand move, and it's super weird and like, “What's the point of it? Okay, well, that's dumb. Okay, moving on. Right?” But there's more to it than just that active part of it. The active part of it is it is weird and it is what's the word I'm looking for? Unusual. Something that we're not very much exposed to and so it can be uncomfortable to experience. And it was for me as well.

Oh, yeah, one more thing I wanted to mention before we jump into this table here, the eye movement part. This actually came, the idea of this came from scientists that were looking into sleep. If you have ever heard of the stages of sleep, oftentimes you'll hear the term REM sleep. Like, oh, you're tired because you didn't get enough REM sleep. REM is actually an acronym that stands for Rapid Eye Movement. So when studying the way that we sleep, why is Rapid Eye movement so helpful? Right?  It's an interesting term. It's an interesting thing to think about. I remember when I was first introduced to this topic, I wanted to understand it. So after a therapy session, I'm sitting in my car and I was parked next to a bush, and I thought about what the point of REM sleep and EMDR and how they link? And I came up with this kind of image in my head that I thought can help. Throughout the course of the day, we notice so many things that we just don't remember the next day. And I was trying to think of an example because I work well with examples, and I looked at the bush next to my car. And I noticed way that the leaves were moving.  And I remember the way they were moving here and now because I had a kind of little bit of an epiphany, I guess you could call it at the time. Because I remembered I passed so many bushes and trees, and I don't remember the exact way that the leaves were moving. But if the leaves had been moving towards me, I would have responded by trying to protect myself, by running away or this or that. Right? But they weren't. And so my brain just decided that it wasn't important information and I didn't need to keep it. And so when you're in your REM sleep, I picture it as your eyes are reading through the book of what your day was and discarding the majority of the stuff because it's not that important. And everything else that is important, like, I don't know, a weird conversation you had with a coworker or things that were meaningful to you. Like a stranger complimenting your shirt. Whatever your brain thinks that you might need, it keeps in  not too far back. It doesn't track. It doesn't keep it in the deep memory that it just slowly moves there over time. But the things that are unresolved, the things that the brain can't figure out where it goes, those are things that we usually think about right before we go to bed or right as we're trying to fall asleep or sometimes when we're doing meditation. When we allow our brain to relax enough to review the information that it's been given rather than constantly taking in new information. And so I thought that was an interesting kind of comparison of where EMDR and the idea of it even came from was seeing the physiological benefits. Remember, physiological, being in the body, like our body rests better when we get REM sleep. Well, what's so important about REM?

So all of that, we'll jump into this table here at the bottom of page two. And when we get to the desensitization, which is the phase number four, we'll go a little bit deeper into the desensitization part, which is where you do follow, like, fingers back and forth.  I'm like doing it here, but just gently. Episodes aren't on video yet, so you can't see it. We'll get there. We'll get there. All right, let's jump in. So, table one, it's an overview of the eight phase eye movement, desensitization, and reprocessing EMDR therapy treatment. So this is something that I thought was weird. When I told my therapist I wanted to do EMDR, she started by doing other stuff. I thought that was weird, but it's normal. So phase one is history. Taking this, I feel like, is pretty standard in most forms of therapy. You go and like Larissa and I talked about in the main Therapy episode, episode seven, you go to a therapist and they're like, “Yo, who are you? What's up? Tell me your life. Tell me why you're here. If you want to tell me what you did today.” You just get to know a person, right? The clinical side of it is, while that's happening, the therapist will identify suitability. So if they think EMDR will work for this patient or not. And they will also identify processing targets from the events in the client's life according to standardized three pronged protocol. The three pronged protocol is simply their procedures, so there's purpose and procedures, columns in procedures, it says questions and techniques to identify.

The first one is past events that have laid the groundwork for the pathology, which is things that have happened in the past that have formed the way that we act in the here and now.

Number two is current triggers. So things that happen in our everyday life that cause us to overreact, where we react in ways that our body feels that are necessary, but doesn't necessarily need that much of a reaction based on the situation and three, future needs. So that's kind of a little bit of drawing a conclusion about where this treatment might go, what we think that we might need in the future, those sort of things. Like I mentioned, this is kind of stuff that usually is {specific to} the client. If you go in for therapy, you're not going to be aware of it unless you ask your therapist. I'm grateful for my trauma-informed therapist because I sure did ask them a lot of questions, and they let me in on their process. Which I found fascinating, and it worked, and it helped me, which I'm now sharing all of this information with you, so it helps you too.

All right, step number two preparation: prepare the clients for EMDR processing. This is an interesting one. That's like the purpose of it, which I feel like is pretty standard, but if we look at the procedures, there's education regarding the symptom sorry, the symptom picture. So basically, “Hey, this is EMDR. This is how it might work. Is this something that you want to do? This is how it's going to work.” Like, “Let me explain it to you. And but the second thing listed there are the procedures, the metaphors and techniques that foster stabilization and a sense of personal control.” From a strictly clinical viewpoint, I don't know if I would know how to interpret this. The only way I know how to understand this is based on my own personal experience. And EMDR has a lot of visualization in it. And like we've mentioned in the main episode, EMDR does not work well for Larissa because visualization doesn't really help her understand or process things. But visualization works well for me, because for me, I feel like I can let my brain do what it needs to do and it doesn't need me to tell it what to do. And there's no right or wrong, it's just the way it is. So with this, what it looks like is creating what my therapists call the “Safe Space.”  

Now, EMDR, it is based on the idea of following fingers as they move back and forth in front of your eyes. But there is also EMDR that can happen where you hold it feels almost like a text message, like a vibration in your hand. So you're like holding these two balls in your hand and they just vibrate like “Left hand, right hand, left hand, right hand, left hand, right hand.” And so that was what I like to do is have my eyes shut and just hold on to those so I could feel it and when it happens and you're in your head. So for me because I close my eyes and it works even if you're not closing your eyes.  The idea of EMDR is to have you so focused on the hand moving or the pulses that you're feeling in your hands or whatever else, that your brain can detach from your present reality and delve back into something that it can't take on in any other environment. It can bring things up, that it can't process while you sleep, that it can't process in other situations because it doesn't know how to handle it.  And so when that happens, you can get overwhelmed and explaining what this process was like, which is part of step two as well. My therapist helped me form a safe place, which is basically a place where if I had nothing to do, no phone, no internet, no nothing, and I just had to wait for half an hour, so I would feel most relaxed. Where would I feel most at peace. And we've mentioned this just a little bit in past episodes. A lot of people, when they imagine these sorts of scenarios, it revolves around nature, because that is, you take away anything man made, anything electronic, anything that humans created, and you're left with nature. And so if it's not that, right, sometimes it can be meditation room, which is very man made, because gongs aren't found in nature or whatever. But whatever it might be for you, maybe it's just a specific memory. Here's a fun thing. If you've ever had the Percy Jackson and the Olympian series by Rick Ryardon, there is nectar and ambrosia that demigods eat and drink that help them heal from wounds inflicted by these mythological creatures. But the nectar and ambrosia, they taste different based on whatever these people like, right? And so, like, the main character, Percy, he tastes his mom's homemade blue chocolate chip cookies. And I always loved the idea that you heal better from wounds when you're reminded of something that is just so dear to you, right? So it's this idea of finding a place that tastes like my mom's blue chocolate chip cookies. Or I love water. Me, generally, I love water. And so I'm hearing a waterfall or I'm watching a river, and I'm putting my hand in, feeling the water run over my fingers. Whatever it is for you. It's finding this place where you, you can just breathe and relax and it's this safe place to come back to because we're delving, like the process of EMDR. It delves and it attempts to bring up these difficult things because we're in a safe place where we can handle it. So important distinction here, I feel like that's long enough on number two.

Number three is the assessment. So assess the target for EMDR processing by stimulating primary aspects of the memory. So we elicit the image, negative belief currently held, desired positive belief, current emotion and physical sensation, and baseline measures. So this is something that happened every single time we did EMDR. Sometimes I'd come in and my therapist would almost always ask me, “Is there anything that you would like to do?” Like, “Anything that you would like to focus on?” And if I had something specific, like a current trigger in my life, I remember a current trigger I had at the time was I couldn't respond to emails. Like responding to work emails gave me such bad anxiety that I would literally have a meltdown. And so that was like, I'm like, “I need to work on this trigger because it is certainly impacting my everyday life.” But sometimes I'd walk in and say, “Whatever, let's work on something else.” And so my therapist would look in her notes and find, “Okay, we were working on this thing last time and so. I just want to brace you going forward.”  

I was thinking about the EMDR experiences I had and I thought it would be helpful if I found one specific one that I could kind of walk you through so that we're having like the clinical side of it, but then also the application side. Right. What I try and do in these Just Janilee episodes is: “Here's all the clinical science information.” But applying it to real life application as well. So like the corner of “Am I crazy?” And “No, you're not. Here's the science to prove it.” So here's the science side, but the “Am I crazy?” Like addressing that vulnerable feeling and how can we actually apply these clinical things that you're telling us to be something that feels better. Does that make sense? I hope it does. I don't know why I'm asking. Because you can't answer and Larissa is not here. But that's the idea.

So I picked one that I felt helped me explain it the best. And so I'm going to share my experience while we go through these clinical steps. But I just wanted to kind of a TRIGGER WARNING. If this is a difficult topic for you, I am going to be talking about a situation where  I was nearly suffocated and it's a very deep and very visceral thing for me. And I don't want this to be something that is hard for you to listen to. And if it is, please just be aware of that, of what the topic is, of what the subject matter is going to be going forward. And I was thinking I don't want to exclude people who are going to have a hard time listening to this. So  what I decided is on the transcript on the website, if you go there, the parts where I'm explaining what might be triggering, they will be in a orange/reddish orange, kind of color because the editor's notes are left in red text. So it'll be orange, reddish color. It'll just have trigger warning next to it  so that you can skip that part but still be able to read the actual transcript of the episode. So you don't have to be left out if suffocation is something that it could be triggering to you.

With assessment, you access the target for EMDR processing by stimulating primary aspects of the memory. Okay, so let's take that clinical phrase, let's break it down just a little bit, access the target. So, I feel like that's pretty self explanatory. But if we read the second half by stimulating primary aspects of the memory, I feel like that helps us with what the target is. So the target is usually—if we look at the procedures here, it's the negative belief currently held desired positive belief. So we have all of these memories and as we talk about this episode has actually already been released. But in identifying emotions, there's a difference between a feeling and an emotion. And we have to be able to complete the process of feeling the emotion and having an actual action result. And so when we're identifying the target, we're basically looking at what is that emotional wave and at what point were we not allowed to complete this process. And now we're going to allow ourselves to complete this process so the target can change based on what it is that we're focusing on.  

For me. All I knew as a client in this situation was I get really  this is actually something I did EMDR for after COVID-19 happened because wearing a mask I could not wear a mask without having a panic attack because it reminded me of, literally, previous times in my life, and it happened multiple times when I could not breathe and I'd put a mask on and I'd start to hyperventilate and not be able to breathe. And so I come into therapy, I'm like, “I can't breathe when I wear a mask. And I have to wear a mask everywhere because there's COVID. What do I do?” So we found “Okay, well, what is distressing?” “Well, there's this memory I have of not being able to breathe when I was younger.” “Okay, so that is how we identified the target.” See how that works? Start with the trigger of  number two. In the first step, the current triggers, we start with the trigger. And it was affecting my everyday life. I had to wear a mask. “Okay, well, when you think about it, when you think about wearing a mask, what comes to your mind? What are you afraid is going to happen?” And for me, what came to my mind was a past experience where I couldn't breathe. And so we identified the target.

Now, if we look at the procedures here, I think this is interesting because when I was looking at EMDR, I didn't look at this eight step process. I just wanted to see what people thought of it. I wasn't so much interested in how it worked. So I find it interesting to look at it now after having gone through EMDR, because  these are exactly the things that my therapist would ask me, like, we would do EMDR, and she would be like, “Okay, so what's the negative belief that you currently hold about that?” And she would say those words, and then, “What do you want to believe instead?” And so  very simply, in this situation, the negative belief that I currently held was that anything that restricted my breathing would lead to death.  And what do I want to believe instead? That I have the ability to stop myself from suffocating when wearing a mask. Basically, the desired belief was, “I want to believe that wearing a mask isn't going to lead to me passing out. It isn't going to suffocate me.” It's so simple, but it is helpful. Like, currently, my current belief is “That if I wear a mask, I have a panic attack and I can't function.” And my desired belief is “I can wear a fucking mask without losing my effing mind.” Okay. Well, what emotion do you feel? So we're moving on to the current emotion and physical sensation.  What do you feel like when you think about it? And all of a sudden, I'm tightening my shoulders right now, just thinking about it. My shoulders go up. I start to kind of curl in a little bit in the fetal position. And being doing therapy either through video or in person, I didn't know how to answer these questions, but my therapist was like, “Hey, I noticed your shoulders went up.” “Oh, yeah, they are doing that. And I'm breathing a little bit faster. Okay. And my pulse is starting to race a little bit.” I'm so, like, “You know, physically, I'm not feeling that great, and emotionally, like, I'm starting to cry a little bit because I'm worried.” Worried, that's an emotion. Okay. I just, okay, so you basically figure out baseline measures where you're starting.

Okay, moving on to step number four. It's desensitization. So this is the process experiences toward an adaptive resolution. Adaptive resolution is  being able to function. It's allowing that emotional arc to complete itself. So standard I'm reading now under procedures, standardized protocols incorporating eye movements, taps or tones that allow the spontaneous emergence of insights, emotions, physical sensations and other memories. So I forgot about the tones. So eye movements, taps or tones. The taps were the things that I was holding in my hands that would vibrate left, right, left, right. You can also do it: I had one specific memory, not this one, but a different one where it was so hard that I had the pulses in my hand. But my therapist also ended up tapping my knees because I needed that double effect there. You can also do tones where you're hearing something in your left ear then your right, your left ear then your right ear.  There's a lot of ways to do it, but you incorporate these things where you do it for a specific amount of time. Now therapists know what to look for when they have EMDR training. They're kind of waiting for you to process this or that and you do it a couple of times.

So for me, it's usually about like 30 to 60 seconds of just letting your brain do what it does. And it's hard, right? And we've talked before about like, you have to have someone home. They have to have that Mohawk of self awareness neurons. But letting your brain just do what it does, like meditation, you just take what comes up without judgment. But unlike meditation, you don't have to have everyone home.  Your brain can literally say “There's no one home.” And that can be the problem that we solve. And so I do like that aspect of this as well. So this is step four. And like I mentioned, we were going to go a little bit deeper into the EMDR, like how it works and why it works. So if we go I'm jumping down a little bit for people following along on page three heading called EMDR Therapy Approach. So under here it talks about how I'm just going to read a quote:

“Unlike CBT, which involves extended focused attention on disturbing event EMDR, reprocessing sessions promote an associative process that clearly reveals the intricate connections of memories that are triggered by current life experiences.”

So what does that mean? It's saying, EMDR, you don't have to keep revisiting the issue over and over and over and over again. You visit that one traumatic memory, figure out at what point in that emotional arc you were stunted, and then you finish that. Whereas talk therapy, you tend to go back to the same traumatic events over and over again. That is something you can say held true for me. Back on page two here {in the graph}, it says one of the components used during the reprocessing phases is composed of dual attention stimuli in the form of bilateral eye movements, taps or tones. The eye movements have been the subject of great scrutiny and were called into question a decade ago by an meta analysis of studies evaluating treatment effects with and without this component. However, guidelines published by the International Society for Traumatic Stress Studies indicated that no conclusions were possible because the studies evaluated in the meta analyses were fatally flawed owing to the use of inappropriate populations, insufficient treatment doses, lack of power. Since that time, 20 RCTs (randomized controlled trials) have indicated positive effects of the eye movement component. Twelve RCTs demonstrate an immediate decrease in arousal, negative emotions and or imagery vividness. And the remainder report additional memory effects, including  increased attentional, flexibility, memory retrieval and recognition of true information.

So score that part for a second here. Break it down. It's explaining not necessarily how it works because remember, this is a summary document payment, but it is explaining the effects, what happens. So it's decrease in arousal, so that's how reactive you are. Decrease in negative emotions, less vivid imagery. It's how do I phrase this? It's being able to exist in two places at once. It's being able to exist in your traumatic memory and relive those events either as the victim or as a bystander different perspective than you had when you experienced it, because you are also existing in the current time and place. You are existing in the here and the now.

And for me, I relied heavily on the constant reminders that I was not actually being suffocated, that I could breathe, because when this traumatic event happened, I wasn't following these fingers back and forth. I wasn't hearing these tones in my ears. I wasn't feeling these taps, and my hands are on my knees. So those things are constant reminders, and you can change the speed and you can change the intensity, but most of the time, it would be like, “Boom, boom, boom, boom, boom, boom,” every couple of seconds. So you can't go very long in existing this memory without a reminder. Like, don't forget, you're also existing in the here and now. And so it reduces the intensity of revisiting this experience.  

Now, what happens  when the brain just does its thing? Like I mentioned, it happens in brains sometimes. “Where's your brain going?” I'm like, “I don't know. I'm still forming the image around what happened.” Or sometimes it doesn't start with a memory. Sometimes it starts with a belief you have about your self. Another simple example is I used to believe that I wasn't allowed to sing when I was happy. And when I let my brain do what it did, I have like, 16 I don't know how many, but it was a lot of memories that instantly flooded into my mind. I basically just sat there and was like, “All right, brain, I'm not allowed to sing? What you got to say about that?” And my brain just threw all of these memories at me, and every single one of them was my mom saying, “Stop singing. You're being annoying. Be quiet. Shut up. I don't want to hear that. You sound terrible. You can't harmonize worth crap.” Like, all of these things that I was not necessarily cognitively aware of when I just let my brain do its thing. All of these memories come up. And so that was like, a spontaneous emergent of insight, as the article here puts it, and then you view that situation differently.

So going back to the original example of me suffocating, I envisioned this experience as it was happening down to the exact color of the couch. It was this really ugly blue and green couch that had a couch cover on it most of the time. And I hated that couch cover because every time someone stood up, the couch cover just got moved wrong, and I had to go fix it, and the couch cover was off. And I remember that the material felt like a weird combination between wicker and plastic and. It's, see it's, it still affects me, right? And so I have to, like, let myself breathe because I'm putting myself a little bit in this situation. Again,  I'm just visualizing the little things that are happening there without addressing the big thing yet. And the little details kind of kept coming. I remember I was wearing this one specific hoodie that I wore all the time about a specific sport team that I liked and how one end of the strings that come out of the hood part one end had a knot tied on it and the other end didn't. And I remembered that I was laying on my back on this couch and there was no pillow under my head, and I had—it's still hard to talk about. I'm powering through for you guys because this is essentially what is happening with EMDR here. I was laying on my back and laying on top of me was my mother. And for context, the reason that is such a huge thing is I was around eleven or twelve and my mother weighs over 400 pounds. I don't know the exact amount, but it's a lot. And that is a lot of pressure on a very small body. And so when I'm doing this EMDR and I'm feeling…I'm feeling everything…I'm feeling the couch underneath my hands and wishing that my neck had the support of a pillow. I'm feeling this tightness in my chest and I'm struggling to breathe and it's almost like that EMDR—those pulses in my hands allowed me to hit pause and step back. And instead of being that person laying on the couch that was being suffocated, I could now see this 400 pound woman laying on top of a twelve year old girl and I could just see that something wasn't quite right here at all. And even though I'm looking on this scene, I can breathe a little bit easier in the here and now. Remember existing two places at once. I can breathe better in the here and now  because I'm not the one on the couch in the past. And so it's allowing me to view the situation in a way I never experienced it before as a bystander rather than the victim. And so I get myself in a safer place. Remember that safe place? Super important. I mean, that's step two of this process get myself in that safe place. And then I hit play, right? So, like, these these happen in, like, 60 second intervals. And so I'm like, “Okay, I'm ready to go back and press play for another couple of seconds.” So I go in, and I hit play. And another detail, I'm like, “All right, brain, I'm here. I'm watching this scene play out. What do you got to tell me about it?” And I remembered I could hear myself pleading. And it was a weird situation because I heard myself pleading as a bystander. But I also had this gut punch that reminded me of what it felt like to be pleading. And I just kept saying over and over again, “Mom, get off me. I can't breathe. Mom, I can't breathe.” And I remembered getting quieter, quieter. Now, not all of the details came back. I don't remember the situation that caused this memory. A lot of memory loss comes with trauma. But I heard the angered tones. And there's this quote by Maya Angelou: ”People don't necessarily remember what you did or what you said, but they'll always remember how you made them feel.”  And that's exactly what I was remembering in that moment. I didn't remember the exact words, not all of them, but I heard the tones, and so then “Ooof,” Stop. Right? We had, like, that 30 or 60 second moment. The pulse has stopped. I no longer exist in that memory. It's on pause again. I'm in the present. I discuss. I'm like, “Okay,” so this is therapist like, “All right, what happened?” “Well, this is what happened for those 30 seconds.” “Okay. You doing okay?” “Yeah.” “All right, let's go back. We'll hit play again.” “Okay.” So I put myself back in that bystander situation. I'm looking at the situation where this child is getting crushed under 400 plus pounds, and the child is pleading, saying, “I can't breathe. Please get off me.” And the mother is saying, no words yet, but, like, mean and angry. And I hit play. And all of a sudden, some words started to come through, and I remembered, “Not until you promise not to leave. Not until you promise not to leave.” And then I felt desperation, and so I'll pause the EMDR again, and I'm like, “All right, so this is what happened.” The therapist is like, “What do you think that means?” I'm like “Oh, hold on. Okay, so the the mother on this child is saying, not until she promised not to leave. And this child is feeling desperation,” and it's like, “Oh, yeah. I didn't want to promise I wouldn't leave because I knew that I'd be held to my word. And walking away and going outside and getting away from my mother when she antagonized me was how I liked to deal with my emotions, because there wasn't as much response, there wasn't as much anger that came back to hurt me because it couldn't be held against me. I just left, right?” And so all of this is happening, and I'm realizing, “Okay, this picture is coming together more, and I'm remembering I didn't want to promise I wouldn't leave because I really wanted to be by myself, to feel these emotions. Okay. All right, I'm ready to dive back in again.” All right, start feeling the pulses, and let's hit play again. And then I let this scene keep playing, and I focus. This time, instead of on the mother crushing the child, I focused on the child, the me in the situation. And I saw an expression that if you see on any face because, remember, this isn't me. I'm the bystander in the situation. It was pitiful, and it was helpless, and it was desperate. And I connected again to that feeling that I'd had of desperation and…and then I started seeing black spots in my eyes. (And it just my shoulders are so tight right now, you guys, you can't even see it. Okay, hold on. I got it.  Okay, stretch it out my neck a little bit. Rolling my shoulders.) So I start seeing the spots that are appearing on the edges of my vision. And all of a sudden, I kind of realized that part of what's scaring me so much about not being able to breathe is the fact that I can't move.  I don't have agency in this situation.  And I am starting to black out. I'm starting to lose consciousness. I'm starting to get desperate. And so pause. The EMDR session again. And I was like, “Hey, therapist, guess what? I just realized I can't make a choice. I'm stuck. This is being forced upon me. It's something that I can't do.  What's bothering me about this situation being suffocated physically is not pleasant. And I can see the paleness of that face, and I can see the desperation and the fear in that child's eyes, and I can see this child getting crushed by 400 plus pounds. But I realized that part of what was scaring me about wearing a mask it was the helplessness,” but I wasn't quite done. So we go back in again a little bit and I think this was the last time. I don't remember exactly how many times that this was a couple of years ago, but we hit play on that memory just one more time, and I realized that I'm starting to not be able to talk and that my voice is getting higher.  I have to take a deep breath. Now I can breathe. I have all this air. We're good. But I started to notice that I can't do these things. And I start to realize, like, “I'm starting to black out. I am not able to breathe.” And the child me caved. And when I realized, like, that this child was caving immediately because it was me judging myself, I was like, “WOW, you're just going to cave? You're going to give in that easily? You're just going to say, yeah, okay, I promise I won't run away.” And… And… I was angry about it. So EMDR starts I'm like, “Dude, freaking caved.” And then I was like, “Hold on. I viewed, like, 90% of that situation from a bystanders perspective. Not being able to interact and not being able to change what happened. But if that were to happen to anyone else, would I really get mad at someone,  at anyone for saying that they wouldn't run away so that they didn't lose oxygen?” 

This is another detail I forgot to mention as we did it, but the breaths were getting more and more shallow. The breath, like, I wasn't able to fill my lungs up as much, and it almost felt like  a balloon. Almost, but, like, being squeezed out from the bottom. And so it's like you're breathing into the balloon, but when you breathe out, you lose part of the balloon. The balloon gets smaller, and then the balloon gets smaller again, and the balloon gets smaller again. And I have very little balloon left. I can barely take an intake of breath.  How is this going to show up? How is this going to affect things? And so we move on to this installation step here. We're going to enhance the validity of the desired positive belief. Okay, well, we have to go back. The negative belief was, “I can't wear a mask without having a panic attack.” And the positive belief was, “I would like to believe that I can wear a mask without having a panic attack.” Okay, so we're going to enhance the validity of that, and we're going to fully integrate the positive effects within the memory network. And so what this whole experience did was it allowed me to re experience this. And yes, it was intense, and yes, it was really hard, and yes, I felt like a child trapped under my 400 plus pound mother again. And she was controlling me again for that therapy session, but it wasn't as bad. I can revisit it now. And as I am not going to edit out, it still affects me and I still struggle to breathe. And I'm definitely going to be taking some deep breaths when we're done doing some box breathing and everything,  but I can do it without stopping recording of a podcast. I didn't have to stop recording the podcast to go have a panic attack. It's still rolling. We're still going here, right? So it's not as intense.

The idea for me in my situation was to go through an entire process to the point where a situation isn't emotionally charged, not positively, not negatively, it's just neutral. I'm not completely detached from that emotion, from that situation, yet that's something that, again, only comes in time. There are some memories, like the first example that I'll use when people ask me like, oh, how bad was your mom? And I'm like, “Oh yeah, you want to open that box? You want to dip your toe in that water? You want to open that can of worms? I have a story that I'll tell you,” and I'm so emotionally detached from that story. I can tell it like it wasn't even happening to me, like it happened to someone else, because that situation is no longer emotionally charged. Because I've completed the emotional arc for that situation. So when we're doing EMDR and we're in this installation phase, you need to enhance the validity of the desired positive belief. It's a super valid thing to want to believe that you can wear a mask without suffocating. And for me, that came in separating out the powerlessness from the physical sensation of not being able to breathe and realizing that they were two separate things.

If you are wondering how this situation turned out, for me, what I ended up realizing, and it was after there were multiple near completed blackouts, anyway,  not important, but there are multiple events that I had to process to get to this point. BUT by the time that COVID ended, I was able to actually walk into a store and buy myself something. I remember I walked into a store to pick up a prescription and I left. And I felt so proud of myself.  Because I was able to wear a mask the whole time, realizing that for me, that was a huge victory. And the way I was able to do it was by going into this memory, by processing it with EMDR, by looking on it as a bystander, I realized I couldn't talk. My ability to talk lessened and lessened and lessened. And so when I started to get panicky, why wearing a mask? I would just talk to myself. I would just keep a steady stream of words under my breath just walking down the aisle: “Hey, look at that. Frozen pizza. Yeah, I feel like I want to eat some frozen pizza. Oh, cauliflower crust. I don't know. We have to have, like, really good ingredient ingredients to be able to do that. Right?”  Taking a purposeful breath. “Okay. Yeah, I'm doing okay. Yeah. Back to the pizza. Cauliflower crust. I think I just want to go, like, full crust. Is that a stuffed crust? I don't know. Maybe I don't want a frozen pizza. Maybe I want to just order from a hot pizza place. Okay.  Look at that. Are those frozen waffles?  Yeah, I do like frozen waffles. Blueberry frozen waffles. Win win.”  Now, if you'd passed me in the store when I was doing that, you probably thought I was crazy. But what mattered to me was I could go into a store wearing a mask and leave without having a panic attack. I didn't care if people thought I was crazy for talking to myself. I could do something that I wasn't able to do before. And that's valid right now. When we do the body scan, (it's helpful to when you dive back into these situations, you're looking at it in all these ways) very often, after EMDR would end, we would do this body scan of like, “How are you feeling?” And I'd be like, “Oh, yeah, I'm fine.” My therapist is like, “Really? Are you clenching your jaw?” “Oh, yeah, I am.” “Are your shoulders still tight?” “Oh, yeah, they are,” right? It's just tuning back in with your body to be in the fully present moment again. It's focusing in on where you are here and now. It's feeling the ground underneath your feet. It's feeling the arm of the couch. It's realizing that your brain is going to have to figure this out and that we're going to have to pick this up next week. And this isn't a resolved issue yet, but for here and now, I went through that and I relived that, and I learned something from it, and I'm okay.  I'm here. I'm alive. I'm okay, right? Concentration on and processing of any residual physical sensations. I roll my shoulders. Are they still tight? Yeah. Well, what can I do about that? Okay,  what other physical sensations need to be resolved here? What other things am I holding from that situation that I don't want to be taking with me into the rest of my day.

Now, these last two are interesting, so seven here: Closure. You want to ensure the client's stability at the completion, right? You don't want to leave them hanging on. So in addition to resolving those physical sensations, you want them to feel like they're in charge and in control of their life again in the here and the now.  Even if I was able to get rid of the physical sensations, my therapist didn't want me leaving the situations feeling like I was helpless, right? Like that helpless feeling. I didn't go into therapy with that helpless feeling. I went into therapy pissed off that I couldn't breathe with a mask on when my brain logically knows that it does not restrict my ability to breathe. But my brain was also telling me it did. But I know that my brain is wrong. I was pissed off. I was frustrated. Am I going to be leaving this therapy session feeling helpless and hopeless? Maybe a little, but can I manage it until the next session? Am I stable enough to make it through another week of my life? How much is this going to be something that I carry with me? Right? It is something and this compartmentalization is huge for trauma survivors. Is this something I'm going to be able to compartmentalize away? Am I going to be able to function? Now.

This step eight, this reassessment for me, I feel like it often happened both within at the end of an EMDR session, but also at the beginning, it was kind of this making sure that there's progress going on here, making sure that this is something that you want to talk about.  Very often with the way that the brain works, these neural networks, sometimes I would come in the next session and I would have moved on past this helpless feeling. And now I just want to deal with the fact that I couldn't send emails. I would just bounce around here and there, everywhere, and that was okay. But over time, I ultimately saw that a lot of these things intertwined. My belief about my mom very related to my fear of wearing a mask. They don't seem related, but what's at the core of both of them is my mom. Whether by physically crushing me or by verbally and emotionally demoralizing me, {she was} reinforcing that I don't deserve to exist. And that's crushing. But I can handle that. I can deal with that in a way that I couldn't do it before because there were too many different ways it was being reinforced. And so you see patterns about yourself occur over time with the more EMDR that you do.

So I want to talk just a little bit here about how much EMDR do you need? Well, it depends if you have one traumatic event. A lot of the research says that eight to twelve sessions is enough. And by that I mean let's say that you had a car accident. Let's say that you had an unexpected or even unexpected death of someone you cared about. What if you were raped? It works for everything. It's not like this is a therapy that only works for certain people. It only works for events that are traumatizing for you. Like, for example, the first one I gave a car accident, I can get a fender bender and walk it off. And I remember when I had a friend that got an offender bender and that crushed them and they kind of were debilitated and couldn't function for a couple of weeks. And I thought that was weird. And I took a step back and I realized that this is probably traumatic for them. Not traumatic for me, I've been in enough, but traumatic for them.  And so it doesn't matter what the situation is, what matters is how traumatizing it is for you. For one traumatic event, whatever it is, it could be not getting into a program that you applied for. It could be losing a friend. It could be being betrayed by someone. It could be someone sharing information about you that you weren't expecting to be made public. Like, I mean, whatever's traumatizing for you, that's what's traumatizing for you. And so for those single events, eight to twelve sessions is usually what is needed.

However, EMDR is also found to be more effective for people who've been chronically traumatized. And in those instances, there's not necessarily a number of sessions. I don't currently go to therapy because insurance in America sucks. But if I did go to therapy, could I benefit from more EMDR? Yeah, most definitely does that mean that I will ever be completely done with EMDR? I don't know but did I benefit from the EMDR I had? Yeah I did and I still do and I learned things with EMDR that I can still apply to my life it doesn't mean I can do EMDR with myself but sometimes I can use certain things like the safe place or  being able to exist in the present moment and in the trauma memory right? It's helpful to be able to have someone there to talk things through especially someone knowledgeable like a therapist and that's ideal, but I definitely use skills that I learned from EMDR in other ways.  

I just wanted to cover (this episode is way longer than I thought it would be.) So  I just wanted to cover a couple of the other little stats here that they had at the end of the article. It talks about EMDR therapy being able to help support, like, multiple family members. It uses the example here of death of a loved one, right? It but it does a lot of comparison of EMDR therapy with CBT, which is cognitive behavioral therapy. And it kind of compares the two of them. And we talked about some of the benefits earlier on, but it also talks about (I thought it was interesting here) here's the quote:

“These findings have important implications for the medical community in that many chronic pain patients may actually be debilitated by unprocessed memories encoded with the original somatic perceptions.  What that means is  mind and body are connected.”

And if you read Body Keeps the Score, it talks about this as well. But it essentially is you can have chronic pain conditions  that are linked with certain childhood traumas, not necessarily childhood, but different past, unprocessed memories, remember? Somatic we've talked about before. It's how we experience things in the body so encoded within the original somatic perceptions. That's the way that you experienced the event the first time that it happened, right? And so in my example, my original encoded perception was linked to this helpless feeling with the physical inability to breathe.  Now that doesn't mean that the two didn't happen at the same time. But I was able to realize that they weren't causational, they were correlational as they happened at the same time, but they weren't causational, meaning one didn't cause the other or vice versa.

It mentions in the article here about how EMDR can actually help to treat phantom limb pain. For those following along, I'm down on page five. Now I thought this part was interesting. “Research indicated that prolonged exposures as used in CBT result in extinction, whereas brief exposures as used in EMDR therapy trigger memory reconsolidation differences.” There it goes on to state: “Extinction does not eliminate or replace the previous associations but rather results in learning that competes with the old information.” So it basically pits old memory against new memory and it's just a battle whereas this reconsolidation aspect of it and is taking in the new information and adjusting how we view things—allowing that perspective shift that we often talk about on this podcast. It's taking in new information, adjusting to this new information and not invalidating the old memory, but understanding it and being able to move it back, further back in the brain and being able to not need to dwell on it as often.

And so EMDR therapy is fascinating. And I guess this whole episode is just gonna be on EMDR because it's already over an hour, and these are supposed to be half hour episodes. I just couldn't I couldn't help sharing everything with you guys. However, every article that I researched for this paper will be on the website. It's gonna be under the show notes. So there is a paper, this one that I reference here, there is also a paper on EMDR. It talks about trauma focused cognitive behavioral therapy, specifically in the treatment of PTSD,  which is another that one is a meta analysis. Remember, meta analyses take many different scientific projects that have happened, compile all of the data, and say, “Okay, so a lot of these studies here are the trends found in all of the studies.”

All right. There's also going to be a paper up. It's a comparative paper, so it compares the efficacy, speed, and adverse effects of treating PTSD. The reason I include a bunch of these PTSD is chronically traumatized people. If you want to talk about clinical diagnoses, they're often C-ptsd or Complex PTSD. So it talks about exposure therapy, EMDR, and relaxation training in that paper. So if you wanted to learn “Okay, so there's EMDR. How does it line up to exposure therapy? How does it line up to relaxation training?” You can see those three compared.  

And then I also have one paper. I only included one just because ketamine is such a newer thing that, like I mentioned, it's much harder,—much harder to find papers on it. But ketamine is still very controlled. It is not as common as EMDR. It is still in its early stages of being used by people. But I did find a pretty good article from just a couple of years ago—like, five years ago. And I know that can seem like a long time ago, but in terms of, like I mentioned, EMDR first came out, like, in the 1980s. Ketamine has existed for a while, but using (so this this paper, for instance,) the title of it is Ketamine and Ketamine Metabolic Pharmacology. That's not what it says. I read that wrong. Ketamine and ketamine metabolite pharmacology its insights into therapeutic mechanisms. So ketamine has always existed for a while, but what's new about the ketamine is using it to treat depression. Ketamine is essentially—for people who don't know—it's an anesthesic. So anesthesia, if you have a surgery, there's people whose professions are anesthesiologists. That's a fun word. I can't say it right now. Anesthesiologist. You know what I mean?  Literally, their job is to come in and give people anesthesia so that they black out, so that you're not cognitively aware of people drilling on your teeth or cutting open your body or whatever else that they do.  The history of ketamine, it goes back to the 1960s, but only in its’ purposes as an anesthesia. Anesthetic. (This word is giving me so much trouble today.) Its history goes back to the 1960s, but only in terms of it being used as an anesthetic being used to help treat depression. It kind of came around to be like a safer version of shock therapy, of ECT.

It's interesting as well. Some other things that are even newer than ketamine is using like mushrooms or other psychedelic drugs to have the same sort of effects.

The one thing that is consistent throughout all of these treatments, even EMDR, is the idea of experiencing things that are traumatic because the best way to heal from them and the best way to move on from them is to revisit them. But to do so in a way that we're not living there, that we're not retraumatizing ourselves, but to dissociate, to medically dissociate, whether using ketamine or any other anesthesia or any other psychedelic medication, even like EMDR. It's like, let's try and control this dissociation because visiting this memory and finding where in that emotional arc we need to complete  the emotions but without retraumatizing ourselves. That is the common thread amongst all newer therapies here. So I did include that ketamine paper in the show notes. That paper was published by the American Society for Pharmacology and Experimental Therapeutics, which is a pretty good place  to get a paper like this from because it is a medicine, it is a pharmacology drug that is being used now for psychological concerns. It even has on the very first page of this paper an entire table of contents. It talks about clinical therapeutic effects, it talks about side effects. It also has the ways that it's going to physiologically affect your body. So like {how the medication is digested} metabolism, absorption, distribution, elimination. How does this ketamine make its way through your body? Because this is introducing a foreign substance to your body, whereas EMDR is just controlling your thoughts a little bit. Anything like ketamine or mushrooms or any psychedelic like it's introducing a substance that your body doesn't create on its own, which is the foreign substance part. So it is important to talk about how it's actually physiologically going through your body, how your body is processing it. Are we going to be doing damage to the body physically by introducing this? Right. I think it's great that these things are being researched. They are so new. I only included one paper on ketamine in the Show Notes because, I mean it's it's a fascinating read and I might have to do like a Patreon only episode about going through the Ketamine paper, if that is at all wanted by anyone.  I can do that. But it's a fascinating read. It has the chemical structures and makeups of all of these things. It has a lot of  tables which can sometimes be helpful and sometimes not be helpful, depending on how they write it out and if we can understand what they mean, it gets really detailed. And so if that is something that is hard for you, I would recommend skipping down to let me find the page…page 31. It's Roman numeral four and it's conclusions.  The page number is 651. It's the 31st page in the document. But the document is just an article from like a magazine. So the article, it's on page 31 of the article, but page 651 is what it says and it's conclusions.  Like I mentioned before, it talks about how Ketamine has been used in clinical use. It says it's been used since the 1970s. I say that. I said earlier that it's been known since the 1960s. It kind of was discovered during the 1960s because they were trying to find a better anesthetic, but it's been commonly used since the 1970s. It talks about it uses a lot of language that it uses earlier on, but you can still kind of read through there. It's basically just a summary of the entire paper. It can still be a little detailed and hard to understand. So just be aware that reading the conclusions without reading the whole paper can be hard. And yes, it is a 40 page document, but again, like eight of those pages are references.  Yeah, it's such a good article and I really enjoyed going through it.  

Yeah, I'm feeling more and more like I'm going to do like a Patreon for this ketamine paper. I'll do a Patreon only episode, but that would just be a Patreon only episode of me going through the paper. If you want to go through the paper, go for it. That is what the show notes are for, my friends.  I mean my villainous friends. So thank you. Thank you for coming along. Thank you for listening to me go through my own EMDR session. I hope that you understand it a little better. I did focus on EMDR specifically because I can relate to it a little more, but also because it is more widely available. Finding places where you can have Ketamine treatment and being able to afford Ketamine treatment are further away in being accessible to more of the general population. But EMDR shouldn't be as hard to find access to.  

That has been this Just Janilee episode. I'm glad that you guys came along. The next Just Janilee episode is 8.5 and it is talking about the Physiology of Emotions. So that should be a fun one. Hope to see you back then. And this is where I do like promotional stuff, where I'm like, “Hey guys, if you want to support me and Larissa because making podcasts takes a lot of time and money, you can support us on Patreon and get behind the scenes access.” If you don't know what Patreon is, it's basically a monthly subscription. We have different tiers. We have like $5, $10, $15 and $20 tiers. And depending on how much you donate a month, you get different access behind the scenes, and access to stuff. We're such a new podcast, so we're just starting out. We don't have any Patrons yet  and no pressure at all. Like, if you can't afford it, then don't do it. It's totally okay.  Just listening is awesome. Sharing our podcast with people is also a really cool thing. What are the other things that people and podcasts say? “Like the episode, rate the episode.” Because I feel like the “Like and subscribe thing” is like for YouTube videos. So, hey, if you're listening to this on YouTube: “Like and subscribe,”  but you can also do “Like” pm whatever podcast hosting platform such as Apple Podcasts or Spotify, you can rate the show, that helps. The more ratings a show has, the more likely it is to be a recommended podcast to people, which helps us reach more people, helps us grow our Villains Club.  

Another little insight behind the scenes for you guys. Larissa and I are also working on an episode about where the name of the podcast comes from.  We accept the title of “Being the Villain.” Why? Where does it come from? I hope that you've enjoyed hearing me blab. This is what behind the scenes looks like. So thank you for listening to this very long episode of Just Janilee. And yeah, we'll see you next time. Until then, if you ever find yourself being vilified by someone, just remember, you're in good company because you're at the corner of living your life and they're not happy about it. But guess what? That's their problem. This is VILIFIED.