How EMDR can help police officers exposed to graphic images and incidents
Eye Movement Desensitization and Reprocessing (EMDR) is an integrative therapeutic approach that can help a police officer who has experienced a traumatic event find a way to deal with distressing memories
There’s an old expression that “there are some things you just cannot unsee.” While that may be true, there is clear evidence that with the assistance of a practitioner of Eye Movement Desensitization and Reprocessing (EMDR) — an integrative therapeutic approach for dealing with distressing memories — cops can put much of that trauma behind them.
Whether it is bearing witness to the death of a child or of a fellow police officer — or some other heinous tragedy — cops frequently are exposed to incidents and images that haunt them for a long time to come. Having experienced either a one-time traumatic event, or by having seen multiple traumatic things over time, some individuals can suffer from nightmares, flashbacks, and other symptoms of PTSD. And sometimes, a traumatic memory can become frozen — stuck — in the brain, where it can continue to be triggered by reminders.
According to one retired police officer who experienced a traumatic event and the doctor who treated him, EMDR can help.
On November 18, 1974, Pat Monaghan and his partner — Mike Draeger — were en route to an officer-needs-assistance call when their patrol wagon collided with another responding squad. Their vehicle was resting on its passenger side when the gas tank ruptured and exploded. Both men escaped the burning vehicle, but Mike was engulfed in flames.
Monaghan and other responding officers attempted to put the fire out, but the gasoline-soaked uniform kept reigniting. Both men were rushed to the hospital. Monaghan was soon released, but a little more than a month later, Draeger succumbed to his injuries — he had second and third degree burns covering 68 percent of his body.
Monaghan had physically recovered, but he struggled to help his partner’s widow and young children while his own grief and trauma went untreated. He was haunted by the image of his partner’s injuries and the smell of his burns. Monaghan had flashbacks of his incident, and for a long time his grief was unresolved.
“Sometimes our eyes are forced to see more than our souls can take,” Monaghan said. “With training we know our assignments and auto pilot many times take over. But what happens when the incident is outside the norm — like graphic injuries that are disturbing and difficult to get out of one’s mind? What about when we know the victim — a friend or colleague? Or when a victim is a child or elderly — a reminder of our children or parents?”
So how does one who has experienced severe visual trauma cope?
Of course, today when an officer experiences severe trauma, there are peer support services and other avenues through which one can seek healing. Back in 1974, there were no support services. In fact, the effects of post-trauma stress were just being learned from returning Vietnam veterans — and Monaghan ended up forming his agency’s peer support group. However, sometimes even “talking through the trauma” is not enough. This is where EMDR comes in.
“Talking helps, but does not seem to get to the part of the brain where the memory is ‘frozen’,” Dr. Roger Solomon told PoliceOne. “This is why distressing events continue to be experienced and relived, despite telling the story or talking about it. These experiences are living in ’trauma time‘ and may be continually be re-experienced. Eye Movement Desensitization and Reprocessing therapy is a therapeutic approach that goes 'beyond words' to resolve the memories that get stuck.”
“It was in 1991 that I had EMDR, 13 years after the incident,” Monaghan said. “It’s never too early or too late for treatment. EMDR made my life more manageable, and I was able to gain control of those intrusive thoughts and images. If you can replace that traumatic image with something positive, that can help.”
According to Solomon — a police psychologist and psychotherapist who is on the senior faculty of the EMDR Institute and who provides basic and advanced EMDR training internationally — the therapy targets the past memories underlying present problems, present situations that trigger symptoms, and lays down a positive future template for adaptive behavior.
“EMDR is compatible with elements of other clinical approaches. However, it is a distinct form of psychotherapy, which directly addresses the physiologically stored memories,” Solomon said.
In short, EMDR therapy is comprised of eight phases and a three-pronged methodology to identify and process:
A) Past memories of adverse life experiences that underlie present problems
B) Current situations that elicit disturbance
C) Enhance the ability to deal with adverse circumstances in the future.
According to a paper published by Solomon, the eight phases are as follows:
1. History Phase: First, the current problems and circumstances are discussed — experiences that underlie the current problems are explored.
2. Preparation Phase: EMDR therapy procedures are explained, including what to expect — for example, intense emotions may arise when the memory is being processed.
3. Assessment Phase: After the memory to be processed is selected, the client is asked to identify the image that represents the worst part of the incident, and the negative, irrational belief that goes with the incident (“It’s my fault” or “I should have done more” or “I’m vulnerable” or “I’m helpless”) is then discussed. A positive belief — the goal of the session — is identified (“I did the best I could” or “It’s not my fault” or “I’m safe now” or “I have some control”). Emotions — how distressing the event is (0-10, with 10 being the worst it can be and 0 being calm) — and sensations are also identified.
4. Desensitization Phase: This is the first reprocessing phase during which memory targets are processed. The therapist uses bilateral eye movements, similar to REM or dream sleep, to stimulate the brain’s information processing mechanisms. Alternating taps on the hands can also be effective. The goal of this phase is to lower the distress, allowing the person to think about the incident without distress. For example, on the 0-10 scale, 0 would be calm. However, EMDR does not take away appropriate emotions — so not everything goes to “0.” EMDR is not a “mind eraser.” The person does not forget what happened — it becomes something that is over and in the past. The person is no longer living in “trauma time.”
5. Installation Phase: The individual’s most desired positive self-belief, for example the positive belief identified during the assessment phase, is identified and enhanced to increase its connection with the negative memory. So the person can think of the memory calmly and with an attitude that promotes resilience, (“It’s over” or I’m safe now,” or “I cannot control the situations I encounter but I can control my response to it”).
6. Body Scan Phase: The individual identifies and processes residual physical sensations to complete resolution. Since dysfunctionally stored material often manifests through physical sensations, processing is not considered complete until all negative somatic responses are eliminated.
7. Closure Phase: This period shifts focus away from the negative memory network, to neutral or positive networks. In this phase, clients are briefed about what to expect between sessions and are instructed to keep a brief log of their psychological experiences/state of mind to identify potential EMDR targets in future sessions.
8. Re-evaluation Phase: The patient is assessed on whether treatment effects have been maintained, and what else may have emerged that needs to be dealt with. Often other aspects of the memory or other distressing memories emerge. These emerging memories can also be treated.
Solomon told PoliceOne that EMDR therapy does not involve detailed descriptions of the event, direct challenging or shaping of negative beliefs or behaviors, extended exposure to the trauma, or daily homework.
“Rather than forcing the client’s attention to remain on anxiety aspects of the event, the goal is to initiate naturalistic processing by accessing the disturbing memory, stimulating the brain’s information processing system, and allowing the client’s attention to move spontaneously to internal associations during the periods of dual attention stimuli,” Solomon said.
This allows the individual to be prepared to “allow whatever happens,” and for the clinician to remain supportive of the client with as little intrusion as possible. This allows the “frozen” memory to integrate within the wider memory network.
According to Solomon, the efficacy of EMDR therapy for trauma treatment has been confirmed by more than 24 randomized controlled studies, and it has been designated effective in the practice guidelines of organizations such as the American Psychiatric Association, the U.S. Departments of Veterans Affairs and Defense, and the World Health Organization.
“Numerous studies and case reports have found EMDR therapy to be effective with a wide range of disorders,” Solomon said. “Different diagnoses require customized EMDR therapy procedures which incorporate the three-pronged protocol of past, present, and future. EMDR therapy can be integrated with a specialized treatment framework appropriate for a wide range of populations.”
Monaghan added that if a traumatic image becomes stuck — frozen in the brain — it can be difficult to cope.
“Images may continue to intrude, and there are efforts to avoid reminders, thoughts, and feelings about the event. Feelings of agitation, anxiety, or depression may be experienced. Eye Movement Desensitization and Reprocessing can help. This therapy has been used with success on first responders who may be trapped by traumatic memories — including me.”