Kinder Mind
Kinder Mind
Exploring EMDR: Treating Trauma for Veterans & First Responders
Prepare for a deep exploration of the brain's uncharted territory with our guest, Lisa Duez, LCSW. Lisa, specializes in Eye Movement Desensitization and Reprocessing (EMDR) therapy and decodes the complexities of this unique therapeutic approach. She breaks down how EMDR can reconfigure fragmented memories, often the root cause of impediments in a person's life. A captivating journey awaits as we delve into EMDR’s potential in treating physical ailments and trauma, particularly among veterans and first responders.
Lisa recounts the inspiring story of a veteran's healing journey. This client found solace and release from an incident dating back to 1945, all thanks to EMDR therapy. Lisa further highlights the hurdles veterans and first responders often face while seeking mental health treatment. She emphasizes the crucial role of cultural competence in providing EMDR therapy. So, if you're intrigued by the human mind's capabilities and the transformative effect of innovative therapy methods, this conversation with Lisa Duez, LCSW is a must-listen.
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Welcome to the Kindermind podcast, where we're devoted to opening up conversations and destigmatizing mental health. We'll bring you interviews with practitioners in the field of mental health, researchers uncovering new knowledge and best practices for treating mental health disorders, and individuals sharing their mental health journey. Thanks so much to all of our listeners for joining us today on the Kindermind podcast, where we're exploring EMDR treating trauma for veterans and first responders. We're joined today with guest speaker Lisa Duez LCSW. Lisa, thank you so much for joining us to be on the show today.
Lisa Duez, LCSW:Oh, thank you so much for having me.
Dr. Elizabeth Barlow:Yes, so I am. I feel like I say this a lot lately I don't know enough about the topic and I think that might actually be a good thing, because I like to learn and I don't like to think I know everything, because that's just not who I am. So I will admit, I am a therapist that doesn't know enough about EMDR. I have referred clients to EMDR because I know that it is a very helpful thing for folks who are experiencing things like post-traumatic stress disorder and overcoming childhood trauma, things like that. To start, can you tell us what EMDR is? Yes, absolutely.
Lisa Duez, LCSW:It is such an interesting story. Let me just tell you really quickly. Francine Shapiro she's since passed on she developed EMDR in the 80s. Now I might get the story wrong, I might not.
Lisa Duez, LCSW:She was either watching, I think she was walking, and when she was walking she was thinking about something.
Lisa Duez, LCSW:And then she started to see how her eyes move a little bit and she figured out that when she was thinking about something and when she was using bilateral stimulation either by her eyes, that you could her memories became a little bit less taxing on her. So she figured out because she's a neuroscientist and she had that training and she did some this is good enough to strike this, but she did the homeless population and she figured out this whole eight phase protocol called the adaptive information processing, where the hypothesis is that memories are stored maladaptively, just in fragments in our mind and they create obstacles to when we actually reprocess stuff. So EMDR, because of the bilateral stimulation, uses the left brain and the right brain to talk to each other and so you can actually move memories from the amygdala of your brain, which is that fight, flutter, fear, more to that, I call it the big brain, where you're in the front and understand what has happened to you, but you also understand that it's not happening now and you can function.
Dr. Elizabeth Barlow:That sounds phenomenal and as you were speaking, I was thinking about how useful that could be for our clients and our folks out there who have those repressed memories or they still have, like you said, fragments of the memories, but they're causing really awful side effects and consequences later in life. Definitely, yeah. So what led you to specialize in EMDR therapy?
Lisa Duez, LCSW:I think when I back by so long ago I think I was just when it first started to become something that was trained I just became very interested in it just because I was very interested in the brain anyway.
Lisa Duez, LCSW:And then when somebody was like you can move the memories and blah, blah, blah blah and I was like what sign me up? And so since then I've just been not exclusively doing EMDR, but doing EMDR is my main legality and I just really it just works and I just I find that you can be very creative with it once you know it and it's just it's a very powerful tool. I will say that Okay.
Dr. Elizabeth Barlow:So I'm going to go off the cuff here because I'm trying to like take what I just learned from you about EMDR and think about it in like real world application, because I know that it is very successful for veterans really also combat veterans, first responders, folks who are seeing lots and lots of things that we don't typically see on a normal day and they're forced to really process these things very quickly and then move on, and we know that can have a really negative, lasting impact on them. So when you are working with, let's say, a combat veteran with EMDR and they have experienced a lot of trauma either recently they were in combat or it's been years since they've been in combat what is your process for using EMDR to help them?
Lisa Duez, LCSW:Yeah, so it is. So most of those folks have PTSD, although they probably have other things. But when their brain is operating in the past, when they're in the present and they're trying to just do their life, when they're completed service, it's difficult for them to just turn it off. I would say so. Emdr in itself is an eight phase process. So you don't come in to a EMDR clinician and right away do EMDR. You come in and we do a little bit of treatment planning, we do some resourcing where we actually install coping skills, and then the person comes back and they do EMDR and they can work on.
Lisa Duez, LCSW:What's nice about EMDR is you can work on past stuff. You can work on present things that are bothering you. You can actually also do work on future things. Let's say, if you have, I'll just use the one I did last week where somebody had a big test coming up, and so you actually can help them do. How are they good? Keeping control of their emotional response in a test, it's really cool. But with the vets we can go back as far as we need to, because those memories, even though they happened so long ago, are still very much alive and they very much dictate their day to day.
Dr. Elizabeth Barlow:So that's really interesting to hear that it can be used for past, present and future and, knowing the trauma that veterans have mostly experienced in the past and really first responders, they might even be experiencing that right now and if they're still first responders, they're most likely going to experience that in the future as well. What are some of the unique challenges that veterans and first responders face when it comes to receiving mental health treatment or even with EMDR? Is there anything that kind of comes along in that process? That's a challenge?
Lisa Duez, LCSW:Yes, of course. So it's funny because I'm a police wife. My husband is a police officer. Yeah, he's been a police officer, for he's actually retired. So I should stop saying he's a police officer, because it's not anymore and that just happened last week, so I'm getting used to it.
Lisa Duez, LCSW:But the culture of a first responder and the veterans culture or the military culture is something like where you signed up for this might happen, deal with it, you might see stuff, you might have to be involved in something that you're not going to like and you're going to have to handle it. So that's been the previous culture. The culture now is turning towards a little bit more of a wellness culture, which I am so, so happy about. Where it's hey, the first responders often have support from their department. They have peer teams, they have we have EMDR a retreat, what you would call it where we do really intensive EMDR with first responders in Virginia, where it's more now of hey, this job is difficult, let's get you some tools, so that's better. I think the military is on that trend too. Some of my clients that are military have talked about how they are talking to them about PTSD. They're talking to them about what might happen instead of just saying, yeah, it doesn't happen.
Lisa Duez, LCSW:So the other part of the other part that's a little bit unique to first responders and vets is the concept of moral injury. I know everybody knows what moral injury is because it's been around forever. But what we have found is it's a little bit more prevalent in people that have had to do things in a capacity where they may have a judgment against themselves about it, like somebody who had to hurt someone in a very bad way. They would never do that if they were under some other circumstances. Someone had to someone that maybe had to obey an order that resulted in something negative. So they have this extra layer of trauma. That's the trauma itself and then the judgment, their own judgment, of how they went through the trauma. Did they do a good job? Did they fight for their fellow buddy? What did they do? So that's the second layer in this particular type of client. Is that moral injury part of it? Now that it's not present in other people, but I see a higher propensity in the vets and first responders for sure.
Dr. Elizabeth Barlow:Absolutely so. Thinking about the process that you go through with your clients with EMDR, can you tell us what a session typically looks like for a veteran or first responder seeking treatment?
Lisa Duez, LCSW:Sure.
Dr. Elizabeth Barlow:So after we've done.
Lisa Duez, LCSW:As I mentioned, it's a eight phase process. So we do the first few phases, one through three, kind of separately, and then we start the second part of it, which is the actual EMDR session. So it looks like this, a little bit like hey, we come up with targets that's done previously to the session, and we come up with cognitions towards the target. So let's say somebody was in a car accident and so the target would be the car accident, the negative cognition would be we pair with a negative cognition, because trauma is always about how you feel. How is it, how does it affect you? So the negative cognition might be I feel unsafe. So we've come up with a number with that like how unsafe do you feel? On the scale of one to 10, just to baseline it. And then we ask the person to come up with a picture. We ask the person to remember the cognition. We ask the person to figure out where they feel it in their body. Sometimes people feel it in their chest or in their guts, and then we would ask them what emotions they feel. And then we go ahead and we do bilateral stimulation, and that is done a lot of different ways. It started out as just eye movement. So you would see old time EMDR therapists moving their finger in front of somebody's face If you look on YouTube. But now we actually have neuro tech tappers, that buzz left, left and then we have we can do it with sound waste and so any kind of bilateral stimulation where one side of the body is activated and then the other side of the body is activated so you can tap your knees, you can do butterfly taps. There's all different kinds of ways to do it. I guess they just never changed the word I, because now we do it all kinds of ways and then we start that we stop it for a little bit and then we say what's coming up and they might say this is what I saw, and then we just write back into it and then eventually and it just depends on the person, because this is where it gets a little tricky Sometimes people will need to continue to repress us that memory at the next session.
Lisa Duez, LCSW:But sometimes the memory is sufficiently repressed and at that point we install what's called a positive cognition. So I movement, desensitization is the first part and then the repress is the second part. So for the example of somebody wanting a car accident or something. You want to feel unsafe. You want to feel safe. So we actually again pair the memory with a positive and we do some more scaling and we actually help that person install we call it installing positive cognition and make sure that the body is feeling there's no more distress. You do body scan and the person is done. Sometimes that takes one session, sometimes that takes two sessions, sometimes it takes three sessions. It really depends on the memory and the person.
Dr. Elizabeth Barlow:Oh, wow, that's really fast. That's a lot, isn't it? Yeah, no, that's awesome. So, in a nutshell, what are the goals of reprocessing the trauma and therapy and like to get?
Lisa Duez, LCSW:it. I always tell clients it's so funny, but I always tell them that Will Smith, the mind erasure thing from Ben and Black, yes, you remember that I've been like we don't have that, we don't have that we're just going to do that.
Lisa Duez, LCSW:So that is not this. I said we just make it so that you can, so that the memory I was used, the analogy of the memories not driving the bus anymore. So you still have the memory on the bus, but the memory is in the backseat or on the roof or all the way in the back and it's not like top of mind. So when you think about it it's not going to cause you distress. You are going to be able to think about it and be like, oh yeah, that happened to me. But it's not going to be like that happened to me and I want to go through the roof right now. It's just, yeah, that happened to me.
Dr. Elizabeth Barlow:And so it's adaptively processed instead of and I love that it's so fast, because you think about therapy and repress memories or memories that are causing you harm, and you think it's going to be like a long, hard journey. But yeah, I was able to really do that and couple it with, like neuroscience and tap into those fragments and reprocess those. That's awesome.
Lisa Duez, LCSW:Yeah, I think it's just because that it's always I'm not got other beliefs that you have to go through trauma, or trauma has to go through your body, because your body stores your trauma in feelings and stuff like that. So EMDR is like a bottom-up Modality, in that your feelings come first and then you figure out what your feeling is. Okay, that's that thing in my gut, what is that? Oh, that's my anchor. So, as EMDR does, bottom-up processing that's what we're working more towards is is getting it out of you that way, from like your, from almost like your primal brain, because that's where it's stored, and then making more sense of it in more of your Cognitive, your like what is that? The prefrontal cortex, where it's like more. Okay, this is what happened to me. I'm fine.
Dr. Elizabeth Barlow:Okay, I'm my, my it's so cool and my wheels are turning and I'm thinking the other week I was talking to Amy on the show about conversion disorder and that, like you mentioned, our body stores trauma. So I'm assuming like EMDR would be a really great go-to for someone who's going through Conversion disorder and has all of these physical ailments and things that cannot be explained, to really Refrainwork that, rewire that and try to get that out.
Lisa Duez, LCSW:I've actually done a converse public conversion disorder clients. Somebody had non-epileptic seizures and then someone just I can't remember the other one. But a lot of times you'll have clients that'll have migraines, just other different physical ailments, and then you'll start to reprocess and EMDR therapist when my thing is, when I can tell that they're sleeping better, I'm like okay, this is, we're getting here, we're getting somewhere. So you definitely, it's definitely connected.
Dr. Elizabeth Barlow:Yeah, I wonder if I could try it for my migraines. I don't know, might be worth looking into. I'll tell you so I could work so thinking about, like your experience and you like your passion for EMDR and like what you do. I'm sure you've got some success stories. Do you have one you can share with us?
Lisa Duez, LCSW:Yeah, I thought of one today, a cool one. I had a vet and he came to me when he was in his 70s, or maybe a little later, but goes to show you one thing and it's never too late for healing. And so he had a trauma that happened to him in 1945, or were two, right when the war had ended and he had to liberate concentration camp, and so just those memories of seeing those people in that state, even though he was there to help, just the whole chaotic part of that Experience for him. And then there was also part of a helicopter crash that he had or somebody that he knew had passed, but this was in 2017 and he carried that all that time. Oh, wow, from 1945 to 2017. And he's just.
Lisa Duez, LCSW:I heard this stuff and I want to try it because I'm tired and it worked, and now he had sufficient enough time to sufficiently resolve it on his own. This is, I did what I had to do, but we were able to help him out with, with both of those targets just the people that he saw and helped, and then the crash where his buddy died. So that was that one always yeah, that always was that one always sticks with me number one, because it just proves that you just it's never too late, it's never too late.
Dr. Elizabeth Barlow:Absolutely, and that's so awesome that you were there to help him through that, when he was ready and able to go through that, so that's so amazing. That's a great story. That would be my go to. I know if that would.
Lisa Duez, LCSW:yeah, that's my go to. I've another, a couple more go to, but that is the go to. That is like I, yeah, he it's because it was like going back in time for me a little bit, because I wasn't alive. Yeah, I was young. Sorry, I wasn't alive during that time. So we, we had to learn, learn through history books, and he's here telling me everything and I'm like, oh my gosh, it was quite, quite a privilege to work with him.
Dr. Elizabeth Barlow:I For sure. So one of the common things that I know, I hear and I'm going to make an assumption, many other people here as well is decrease in access to mental health care, not just for the general public, which is a thing, but really also for our veterans and our first responders. So how can veterans and first responders access EMDR therapy and what should they look for in a qualified EMDR therapist?
Lisa Duez, LCSW:So the best way that I know I always tell people is get on the internet, go to psychology today there's often a listing for EMDR therapists.
Lisa Duez, LCSW:There's another professional organization called Mdrea it's the International EMDR Association. So there's many therapists on Mdrea that will put their name, their bio, who they work with and you can just go in there, find a therapist and search and then you can always recommend, if you can possibly do it, to do a consultation with a therapist and just find out, like because you know how fit is with people. And then I think also just with police departments around the country they are doing more outreach. I know in Virginia we have a pretty extensive peer network that police officers and peers work together and then police officers are really gravitate towards EMDR because they don't have to talk too much and most people you don't have to tell the story in EMDR, you just have to come up with a picture. And then also with the VA, emdr is utilized along with a lot of other therapies but EMDR it's an evidence-based treatment that is researched, that it works. I know if the VA is using it. It's definitely it's one of the top tier.
Dr. Elizabeth Barlow:Okay, and thinking about police officers, first responders, veterans, like our group of people who really go out and serve us every single day. They have their own type of culture, they have their own type of background. Can you share the importance of cultural competence and really understanding, like the unique experience and background of our first responders and veterans when it comes to providing EMDR as a therapist?
Lisa Duez, LCSW:Yeah definitely.
Lisa Duez, LCSW:They have their own they're. You think about it. I adore my co-workers, but they're not on the same level as people that are battle buddies or people that are in a first responder squad. That these guys, they know that they have to have each other's backs Right, that if something gets really bad they have to have each other's backs. So they have they need for what I, in my opinion, they definitely need that trust. They need that rapport building. They need you to accept them the way they are, with their quirkiness and the rubber meets the road and some of their stories and the fact that they are also healers. In a way, they're just healers, probably with a little bit more authority than a therapist, and that they do. They do want to do the same work that we do, in that we help people. So they want a little bit more acknowledgement of that and they need a little bit more of a less formal relationship.
Lisa Duez, LCSW:Expect that they're going to cuss. Expect that they might come in with their guns trapped to their belt. Expect that you're going to be you know. They're going to want to get to know you like on a like, on a casual level, instead of that buttoned up therapist throwing a lot of DSM diagnosis at them and they just want to know hey, can you help me and how are we going to do this? And then they want to do the work. They're very committed and they want to do the work. They want to succeed and they're very motivated and they're a lot of fun to work with. They're just it's an honor to work with some of them. They really have been. They're a fun group. They have a lot of trauma, but they are. They're very, they're a little self-deprecating and I'm like, listen, no, don't be doing that to yourself, you know. So it's cool, I love it. Veterans and first responders definitely one of my favorite populations to work with.
Dr. Elizabeth Barlow:Yeah, I love my salty veterans especially and, like you said, they're going to cuss I love it.
Lisa Duez, LCSW:I do too, cause it's like you.
Dr. Elizabeth Barlow:There are no false pretenses, like you know who you are getting and you know who you are talking to. Like they just yeah and they want it. Yeah, and they want the same attitude.
Lisa Duez, LCSW:I think they're going to show you who they are.
Dr. Elizabeth Barlow:They want to know who you are.
Lisa Duez, LCSW:They don't want to know who you are.
Dr. Elizabeth Barlow:And they will call you on your mess.
Lisa Duez, LCSW:So don't try to pull one over.
Dr. Elizabeth Barlow:Yes, and I think one of the greatest things about this group of people that we're talking about is that they are helpers and they're lifesavers and they're just selfless. And I think one of the biggest challenges with this group of people are is that they are helpers and they are lifesavers and they're selfless. So it always reminds me of that situation when you're on the plane and they're like secure your oxygen mask first. That's not going to happen if you're a first responder or a veteran, because they're just called to serve. That's just what they do.
Dr. Elizabeth Barlow:They're going to make sure everybody on that plane has oxygen before they do. What if you could get to stand on a soapbox right now and really inspire someone who might be out there really dealing with trauma? That just doesn't have to be dealing with that trauma. It just doesn't have to be dealing with that trauma anymore because EMDR exists. What would you say to that person?
Lisa Duez, LCSW:Oh my gosh. First of all, I would tell them that they are very brave and very courageous. That's the first thing I would say, Because in this that trauma therapy and therapy in general is no joke. It is hard work if you do it right. That would just tell them that they're very brave to understand that they need help. Asking for help in itself is hard, and then just the whole nonsense of or not nonsense strike that part, the whole thing about taking back their own story, that something might have happened to them but they get to choose how to heal from it. And so I would just tell them that they just generally and I think I would say this to anybody is that you deserve to be healed, you deserve to live your best life, and part of that, I think, is going through what you went through on your own time and in your own terms, and I think EMDR and other therapies help to do that.
Dr. Elizabeth Barlow:Absolutely. And if I could piggyback on that, I would hop on my soapbox and say that it's not admitting that there is something wrong with you. It is not admitting that you are not strong enough and you are not capable of just pushing through and just being big enough to overcome what you've gone through. It's not about being enough. There are things that happen that we are not built or wired to really be able to handle, and we experience these things. So then when those things get stored in our library of experiences, they come up again because they were so horrible and they were so challenging for us to even process. So it's not about admitting defeat. It's not about admitting you're weak. It's about how do I make what I'm going through go away, because I don't have the tools to do that for myself, because I'm experiencing these things. This tool is out there for you to use. So I would encourage anyone listening who needs a tool to overcome some really crappy stuff that they went through. This is a great tool for that.
Lisa Duez, LCSW:This is so, yeah, because you deserve to feel safe. Absolutely you deserve to feel safe yeah, absolutely, absolutely.
Dr. Elizabeth Barlow:Thank you so much for joining us today, lisa, and telling us more about EMDR. Are there any key takeaways or messages that you'd like to share with our listeners?
Lisa Duez, LCSW:I don't think so. Just I think there I'm an advocate. I will shout at the top of the roof is that you've got to go to therapy If you need to. You deserve it. Therapy is your brain is just as important as your leg or your foot or something to fix, because it's just super important.
Dr. Elizabeth Barlow:Absolutely. You have physical health, you got mental health that same thing, just different parts of the body, and they're both very necessary. I heard that you are in the works planning an amazing conference next year for helping professionals and that there is an early bird pricing going on right now.
Lisa Duez, LCSW:Yes, there is. Thank you so much for let me talk about it. I am in Virginia Beach, Virginia. The Clinician Connection Conference is also going to be in Virginia Beach, Virginia. We have a fantastic oceanfront hotel and I will tell you that the weather in Virginia in April is very nice not too hot, not too cold, great for beach walking. The Clinician Connection Conference is just putting together those topics that clinicians really need to learn about eating disorders, spiritual trauma, working with law enforcement officers, plus some really good speakers to get you motivated to be a clinician and do the work that we do. The website is wwwclinicianconnectionnet and we have, as she said, an early bird special. I think it's $2.50 right now, but I think it goes up in a little bit, so you might want to jump on it Absolutely.
Dr. Elizabeth Barlow:And for those of you listeners who enjoy our exploring abuse, fates, spiritual Religious Abuse and Counseling podcast with Chris Conley LPC. Chris will be a speaker at this conference. You'll get the opportunity to meet him and please mention that you heard him on the podcast if that's your first time hearing from him.
Lisa Duez, LCSW:Yeah, I can't wait to hear him speak.
Dr. Elizabeth Barlow:Yes, it's going to be great, so I'm excited to go. I think it's going to be a lot of fun Again. Lisa it was great spending time with you today learning more about EMDR. Thank you to all of our listeners for checking out the Kind of Mine podcast again this week. Please stay tuned. Our next episode drops next Friday. Thanks so much.
Lisa Duez, LCSW:Thank you so much for having me, you, you, you you, you, you, you, y y m y.
Dr. Elizabeth Barlow:Antonio with music by PAX Minerva.