Helpful for those who find no relief in CBT?
 

Hi, would it be at all accurate to say that EMDR might be of little use to someone who finds the founding ideas of CBT to be flawed, i.e.-that a given subject is an agent in their own life, that 'changing' one's mind is precisely what chronic GAD *prevents*. After four years of CBT, I've gotten no closer to alleviating anxiety at all.
I state this here not as a grievance against CBT per se, but to ask a more difficult question: If one's anxiety is highly *resistant* to many techniques of well-being (psychiatric, psychotropic meds, CBT, Gestalt psychotherapy, to name only three with which I am familiar), is EMDR an advisable therapy. Given the prohibitive cost of EMDR, can anyone advise vis-a-vis whether EMDR makes a radical epistemological break with previous treatments of trauma & anxiety or whether it emerges from a particular school/technique? I've had chronic GAD for eighteen years and am looking for miracles. Is EMDR advisable given that scenario? I don't expect concrete responses, but any feedback would be greatly appreciated. Thank you very much.

Re: Helpful for those who find no relief in CBT?
 

There are no controlled studies on the use of EMDR with GAD, only a few case reports that found it helpful. In my clinical experience, GAD is one of the more difficult applications for EMDR, because the target selection is challenging. Often GAD (Generalized Anxiety Disorder, for the uninitiated) seems to emerge from very early life experiences that were less than reassuring. So experiences of vicariously experiencing and incorporating parental anxiety, never feeling quite secure and protected, never feeling attached and loved, are good ways to incubate GAD. Those early experiences CAN, in my clinical experience, be modified with EMDR, but its not a quick fix, and the clinician has to be skillful and creative in identifying targets. Just exactly how does a client bring to mind a memory of events he/she can't remember? Hypothesized early neglect experiences can't be vividly brought to mind, but certain strategies help pull the hypothetically key neural networks to conscious mind.

Example: a client may be able to remember the linoleum on the kitchen floor where he learned to walk, or a photo album may trigger memories, or a bit of old fabric. Or sometimes I ask the client to turn their attention to the place where a memory would be if there were one, of being held or longing to be held. Sometimes I ask the client to imagine tomorrow coming and being in the situation where anxiety typically emerges, and then just process the symptoms. What emerges can be very subtle, not clear memories like we often find in EMDR, just whiffs and snippets.

I don't know that EMDR is any more expensive than CBT. And given that it tends to go faster, its sometimes more cost effective.

In my opinion, EMDR is more likely to help than CBT because it gets at the viscerally held experience.

Re: Helpful for those who find no relief in CBT?
 

I have had excellent results using energy work to heal GAD. If applied skillfully, most people will notice improvement immediately. Sometimes that improvement is quite dramatic after only a few sessions.

I use EMDR also but have not tried it with GAD particularly so I can't comment on that, but I do know that energy work can be quite helpful and that clients can use it as self-help between sessions (whether the sessions are EMDR sessions or energy work or CBT or any other treatment) as well.

Take care,

Carol Ann

Re: Helpful for those who find no relief in CBT?
 

You could try hypnosis. It will allow you to experience the thoughts and feelings you had long ago while continually co-creating them so that they are more useful for you (age regression).

John