Back into life - EMDR with primary withdrawal after trauma
“Where I am? I am somewhere between heaven and earth, but I don't know where exactly." "My therapist waited for my anger, but it just isn't there...nowhere” – “I can't imagine anything helpful when I feel bad, I just don't have the energy... it's all too much for me." – “I just want to give up...” Reaction to traumatic events can vary a lot. This is true even when a PTSD has been diagnosed. Contrary to the 'classical' hyper-arousal response to traumatic memories there is also a different pattern of response that is characterized by a lack of an increase in heart rate, and very different pattern of neural activations, despite having a severe case of acute and subsequent PTSD'[l] and may go along with (peri- and posttraumatic) dissociation, emotional numbness, exhaustion, withdrawal and depression. The above statements belong to people with this pattern of response who have experienced subsequent difficulties already in the stabilization phase of their trauma-therapy. First, I will present an understanding of this symptomatology, the hypothesis being a predominance of the dorsal vagal system (see: Polyvagal Theory  and activation of the early withdrawal reflex (or: fear-paralysis reflex). This goes along with particular cognitive and especially emotional and physical features. Second, I will present a way to work with this condition, taking into account that the completion of "interrupted action." In this case does not imply an outward (fight or fight response) but an inward orientation withdrawal). EMDR with an adjusted protocol and tactile bilateral stimulation provides the way to process and pull through this interrupted (or unsatisfied) organismic withdrawal and the fear mostly associated with this process. Returning from this deep and primary withdrawal from life brings back the energy and the patient turns back towards life; vagal predominance subsides and the stuck impulse to withdraw releases. 1. Ruth A. Lanius, James W. Hopper, Ravi 5. Menon, Individual Differences in a Husband and Wife Who Developed PTSD After a Motor Vehicle Accident: A Functional MRI Case Study. Am J Psychiatry 160:4. April 2003, p. 668. 2. Porges. S.W. (2001). The Polyvagal Theory: Phylogenetic substrates of a social nervous system. International Journal of Psychophysiology, 42, 123-146. Learning objectives: 1. Recognize dorsal vagal predominance and primary withdrawal after trauma, 2. Understand the different orientation of interrupted action/ trauma scheme, 3. Know how to help withdrawal-patients to stabilize and process with adjusted EMDR-protocol and tactile or auditory bilateral stimulation. New and unique: Identifying this withdrawal-type of traumatic reaction and scheme, understanding it with the help of Polyvagal Theory and development of EMDR- adjusted protocol and way to process this.
Original Work Citation
Mueller-Schwefe, R. (2010, June). Back into life - EMDR with primary withdrawal after trauma. In Experimental use of EMDR. Symposium conducted at the 11th EMDR Europe Association Conference, Hamburg, Germany
“Back into life - EMDR with primary withdrawal after trauma,” Francine Shapiro Library, accessed July 30, 2021, https://emdria.omeka.net/items/show/19901.