October 20, 2023 • 35 mins
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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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Dr. Elizabeth Barlow (00:01):
Welcome to the Kindermind podcast, where
we're devoted to opening upconversations and destigmatizing
mental health.
We'll bring you interviews withpractitioners in the field of
mental health, researchersuncovering new knowledge and
best practices for treatingmental health disorders, and
individuals sharing their mentalhealth journey.
Thanks so much to all of ourlisteners for joining us today
(00:23):
on the Kindermind podcast, wherewe're exploring EMDR treating
trauma for veterans and firstresponders.
We're joined today with guestspeaker Lisa Duez LCSW.
Lisa, thank you so much forjoining us to be on the show
today.
Lisa Duez, LCSW (00:37):
Oh, thank you so much for having me.
Dr. Elizabeth Barlow (00:39):
Yes, so I am.
I feel like I say this a lotlately I don't know enough about
the topic and I think thatmight actually be a good thing,
because I like to learn and Idon't like to think I know
everything, because that's justnot who I am.
So I will admit, I am atherapist that doesn't know
enough about EMDR.
I have referred clients to EMDRbecause I know that it is a
(01:00):
very helpful thing for folks whoare experiencing things like
post-traumatic stress disorderand overcoming childhood trauma,
things like that.
To start, can you tell us whatEMDR is?
Yes, absolutely.
Lisa Duez, LCSW (01:13):
It is such an interesting story.
Let me just tell you reallyquickly.
Francine Shapiro she's sincepassed on she developed EMDR in
the 80s.
Now I might get the story wrong, I might not.
She was either watching, I thinkshe was walking, and when she
was walking she was thinkingabout something.
And then she started to see howher eyes move a little bit and
(01:33):
she figured out that when shewas thinking about something and
when she was using bilateralstimulation either by her eyes,
that you could her memoriesbecame a little bit less taxing
on her.
So she figured out becauseshe's a neuroscientist and she
had that training and she didsome this is good enough to
(01:54):
strike this, but she did thehomeless population and she
figured out this whole eightphase protocol called the
adaptive information processing,where the hypothesis is that
memories are storedmaladaptively, just in fragments
in our mind and they createobstacles to when we actually
reprocess stuff.
So EMDR, because of thebilateral stimulation, uses the
(02:16):
left brain and the right brainto talk to each other and so you
can actually move memories fromthe amygdala of your brain,
which is that fight, flutter,fear, more to that, I call it
the big brain, where you're inthe front and understand what
has happened to you, but youalso understand that it's not
happening now and you canfunction.
Dr. Elizabeth Barlow (02:35):
That sounds phenomenal and as you
were speaking, I was thinkingabout how useful that could be
for our clients and our folksout there who have those
repressed memories or they stillhave, like you said, fragments
of the memories, but they'recausing really awful side
effects and consequences laterin life.
(02:56):
Definitely, yeah.
So what led you to specializein EMDR therapy?
Lisa Duez, LCSW (03:02):
I think when I back by so long ago I think I
was just when it first startedto become something that was
trained I just became veryinterested in it just because I
was very interested in the brainanyway.
And then when somebody was likeyou can move the memories and
blah, blah, blah blah and I waslike what sign me up?
And so since then I've justbeen not exclusively doing EMDR,
(03:24):
but doing EMDR is my mainlegality and I just really it
just works and I just I findthat you can be very creative
with it once you know it andit's just it's a very powerful
tool.
I will say that Okay.
Dr. Elizabeth Barlow (03:39):
So I'm going to go off the cuff here
because I'm trying to like takewhat I just learned from you
about EMDR and think about it inlike real world application,
because I know that it is verysuccessful for veterans really
also combat veterans, firstresponders, folks who are seeing
lots and lots of things that wedon't typically see on a normal
(04:02):
day and they're forced toreally process these things very
quickly and then move on, andwe 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 experienceda lot of trauma either recently
they were in combat or it's beenyears since they've been in
(04:25):
combat what is your process forusing EMDR to help them?
Lisa Duez, LCSW (04:32):
Yeah, so it is.
So most of those folks havePTSD, although they probably
have other things.
But when their brain isoperating in the past, when
they're in the present andthey're trying to just do their
life, when they're completedservice, it's difficult for them
to just turn it off.
I would say so.
Emdr in itself is an eightphase process.
(04:54):
So you don't come in to a EMDRclinician and right away do EMDR
.
You come in and we do a littlebit of treatment planning, we do
some resourcing where weactually install coping skills,
and then the person comes backand they do EMDR and they can
work on.
What's nice about EMDR is youcan work on past stuff.
You can work on present thingsthat are bothering you.
(05:15):
You can actually also do workon future things.
Let's say, if you have, I'lljust use the one I did last week
where somebody had a big testcoming up, and so you actually
can help them do.
How are they good?
Keeping control of theiremotional response in a test,
it's really cool.
But with the vets we can goback as far as we need to,
(05:37):
because those memories, eventhough they happened so long ago
, are still very much alive andthey very much dictate their day
to day.
Dr. Elizabeth Barlow (05:44):
So that's really interesting to hear that
it can be used for past, presentand future and, knowing the
trauma that veterans have mostlyexperienced in the past and
really first responders, theymight even be experiencing that
right now and if they're stillfirst responders, they're most
(06:04):
likely going to experience thatin the future as well.
What are some of the uniquechallenges that veterans and
first responders face when itcomes to receiving mental health
treatment or even with EMDR?
Is there anything that kind ofcomes along in that process?
That's a challenge?
Lisa Duez, LCSW (06:21):
Yes, of course.
So it's funny because I'm apolice wife.
My husband is a police officer.
Yeah, he's been a policeofficer, for he's actually
retired.
So I should stop saying he's apolice officer, because it's not
anymore and that just happenedlast week, so I'm getting used
to it.
But the culture of a firstresponder and the veterans
culture or the military cultureis something like where you
(06:41):
signed up for this might happen,deal with it, you might see
stuff, you might have to beinvolved in something that
you're not going to like andyou're going to have to handle
it.
So that's been the previousculture.
The culture now is turningtowards a little bit more of a
wellness culture, which I am so,so happy about.
Where it's hey, the firstresponders often have support
(07:04):
from their department.
They have peer teams, they havewe have EMDR a retreat, what
you would call it where we doreally intensive EMDR with first
responders in Virginia, whereit's more now of hey, this job
is difficult, let's get you sometools, so that's better.
(07:25):
I think the military is on thattrend too.
Some of my clients that aremilitary have talked about how
they are talking to them aboutPTSD.
They're talking to them aboutwhat might happen instead of
just saying, yeah, it doesn'thappen.
So the other part of the otherpart that's a little bit unique
to first responders and vets isthe concept of moral injury.
(07:48):
I know everybody knows whatmoral injury is because it's
been around forever.
But what we have found is it'sa little bit more prevalent in
people that have had to dothings in a capacity where they
may have a judgment againstthemselves about it, like
somebody who had to hurt someonein a very bad way.
(08:09):
They would never do that ifthey were under some other
circumstances.
Someone had to someone thatmaybe had to obey an order that
resulted in something negative.
So they have this extra layerof trauma.
That's the trauma itself andthen the judgment, their own
judgment, of how they wentthrough the trauma.
Did they do a good job?
(08:30):
Did they fight for their fellowbuddy?
What did they do?
So that's the second layer inthis particular type of client.
Is that moral injury part of it?
Now that it's not present inother people, but I see a higher
propensity in the vets andfirst responders for sure.
Dr. Elizabeth Barlow (08:49):
Absolutely so.
Thinking about the process thatyou go through with your
clients with EMDR, can you tellus what a session typically
looks like for a veteran orfirst responder seeking
treatment?
Lisa Duez, LCSW (09:01):
Sure.
Dr. Elizabeth Barlow (09:01):
So after we've done.
Lisa Duez, LCSW (09:02):
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 startthe second part of it, which is
the actual EMDR session.
So it looks like this, a littlebit like hey, we come up with
targets that's done previouslyto the session, and we come up
(09:24):
with cognitions towards thetarget.
So let's say somebody was in acar accident and so the target
would be the car accident, thenegative cognition would be we
pair with a negative cognition,because trauma is always about
how you feel.
How is it, how does it affectyou?
So the negative cognition mightbe I feel unsafe.
(09:45):
So we've come up with a numberwith that like how unsafe do you
feel?
On the scale of one to 10, justto baseline it.
And then we ask the person tocome up with a picture.
We ask the person to rememberthe cognition.
We ask the person to figure outwhere they feel it in their
body.
Sometimes people feel it intheir chest or in their guts,
and then we would ask them whatemotions they feel.
(10:07):
And then we go ahead and we dobilateral stimulation, and that
is done a lot of different ways.
It started out as just eyemovement.
So you would see old time EMDRtherapists moving their finger
in front of somebody's face Ifyou look on YouTube.
But now we actually have neurotech tappers, that buzz left,
left and then we have we can doit with sound waste and so any
(10:30):
kind of bilateral stimulationwhere one side of the body is
activated and then the otherside of the body is activated so
you can tap your knees, you cando butterfly taps.
There's all different kinds ofways to do it.
I guess they just never changedthe word I, because now we do
it all kinds of ways and then westart that we stop it for a
little bit and then we saywhat's coming up and they might
(10:52):
say this is what I saw, and thenwe just write back into it and
then eventually and it justdepends on the person, because
this is where it gets a littletricky Sometimes people will
need to continue to repress usthat memory at the next session.
But sometimes the memory issufficiently repressed and at
that point we install what'scalled a positive cognition.
(11:13):
So I movement, desensitizationis the first part and then the
repress is the second part.
So for the example of somebodywanting a car accident or
something.
You want to feel unsafe.
You want to feel safe.
So we actually again pair thememory with a positive and we do
some more scaling and weactually help that person
(11:36):
install we call it installingpositive cognition and make sure
that the body is feelingthere's no more distress.
You do body scan and the personis done.
Sometimes that takes onesession, sometimes that takes
two sessions, sometimes it takesthree sessions.
It really depends on the memoryand the person.
Dr. Elizabeth Barlow (11:54):
Oh, wow, that's really fast.
That's a lot, isn't it?
Yeah, no, that's awesome.
So, in a nutshell, what are thegoals of reprocessing the
trauma and therapy and like toget?
Lisa Duez, LCSW (12:07):
it.
I always tell clients it's sofunny, but I always tell them
that Will Smith, the minderasure thing from Ben and Black
, yes, you remember that I'vebeen like we don't have that, we
don't have that we're justgoing to do that.
So that is not this.
I said we just make it so thatyou can, so that the memory I
was used, the analogy of thememories not driving the bus
(12:27):
anymore.
So you still have the memory onthe bus, but the memory is in
the backseat or on the roof orall the way in the back and it's
not like top of mind.
So when you think about it it'snot going to cause you distress
.
You are going to be able tothink about it and be like, oh
yeah, that happened to me.
But it's not going to be likethat happened to me and I want
to go through the roof right now.
It's just, yeah, that happenedto me.
Dr. Elizabeth Barlow (12:48):
And so it's adaptively processed
instead of and I love that it'sso fast, because you think about
therapy and repress memories ormemories that are causing you
harm, and you think it's goingto be like a long, hard journey.
But yeah, I was able to reallydo that and couple it with, like
neuroscience and tap into thosefragments and reprocess those.
(13:11):
That's awesome.
Lisa Duez, LCSW (13:14):
Yeah, I think it's just because that it's
always I'm not got other beliefsthat you have to go through
trauma, or trauma has to gothrough your body, because your
body stores your trauma infeelings and stuff like that.
So EMDR is like a bottom-upModality, in that your feelings
come first and then you figureout what your feeling is.
Okay, that's that thing in mygut, what is that?
Oh, that's my anchor.
(13:34):
So, as EMDR does, bottom-upprocessing that's what we're
working more towards is isgetting it out of you that way,
from like your, from almost likeyour primal brain, because
that's where it's stored, andthen making more sense of it in
more of your Cognitive, yourlike what is that?
The prefrontal cortex, whereit's like more.
(13:55):
Okay, this is what happened tome.
I'm fine.
Dr. Elizabeth Barlow (13:58):
Okay, I'm my, my it's so cool and my
wheels are turning and I'mthinking the other week I was
talking to Amy on the show aboutconversion disorder and that,
like you mentioned, our bodystores trauma.
So I'm assuming like EMDR wouldbe a really great go-to for
someone who's going throughConversion disorder and has all
(14:22):
of these physical ailments andthings that cannot be explained,
to really Refrainwork that,rewire that and try to get that
out.
Lisa Duez, LCSW (14:30):
I've actually done a converse public
conversion disorder clients.
Somebody had non-epilepticseizures and then someone just I
can't remember the other one.
But a lot of times you'll haveclients that'll have migraines,
just other different physicalailments, and then you'll start
to reprocess and EMDR therapistwhen my thing is, when I can
tell that they're sleepingbetter, I'm like okay, this is,
(14:52):
we're getting here, we'regetting somewhere.
So you definitely, it'sdefinitely connected.
Dr. Elizabeth Barlow (14:56):
Yeah, I wonder if I could try it for my
migraines.
I don't know, might be worthlooking into.
I'll tell you so I could workso thinking about, like your
experience and you like yourpassion for EMDR and like what
you do.
I'm sure you've got somesuccess stories.
Do you have one you can sharewith us?
Lisa Duez, LCSW (15:18):
Yeah, I thought of one today, a cool one.
I had a vet and he came to mewhen he was in his 70s, or maybe
a little later, but goes toshow you one thing and it's
never too late for healing.
And so he had a trauma thathappened to him in 1945, or were
two, right when the war hadended and he had to liberate
(15:41):
concentration camp, and so justthose memories of seeing those
people in that state, eventhough he was there to help,
just the whole chaotic part ofthat Experience for him.
And then there was also part ofa helicopter crash that he had
or somebody that he knew hadpassed, but this was in 2017 and
(16:02):
he carried that all that time.
Oh, wow, from 1945 to 2017.
And he's just.
I heard this stuff and I want totry it because I'm tired and it
worked, and now he hadsufficient enough time to
sufficiently resolve it on hisown.
This is, I did what I had to do, but we were able to help him
(16:24):
out with, with both of thosetargets just the people that he
saw and helped, and then thecrash where his buddy died.
So that was that one alwaysyeah, 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 (16:44):
Absolutely , and that's so awesome that you
were there to help him throughthat, when he was ready and able
to go through that, so that'sso amazing.
That's a great story.
That would be my go to.
I know if that would.
Lisa Duez, LCSW (16:56):
yeah, that's my go to.
I've another, a couple more goto, but that is the go to.
That is like I, yeah, he it'sbecause 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 duringthat time.
So we, we had to learn, learnthrough history books, and he's
here telling me everything andI'm like, oh my gosh, it was
(17:17):
quite, quite a privilege to workwith him.
Dr. Elizabeth Barlow (17:18):
I For sure .
So one of the common thingsthat I know, I hear and I'm
going to make an assumption,many other people here as well
is decrease in access to mentalhealth care, not just for the
general public, which is a thing, but really also for our
veterans and our firstresponders.
So how can veterans and firstresponders access EMDR therapy
(17:41):
and what should they look for ina qualified EMDR therapist?
Lisa Duez, LCSW (17:46):
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 EMDRtherapists.
There's another professionalorganization called Mdrea it's
the International EMDRAssociation.
So there's many therapists onMdrea that will put their name,
(18:08):
their bio, who they work withand you can just go in there,
find a therapist and search andthen you can always recommend,
if you can possibly do it, to doa consultation with a therapist
and just find out, like becauseyou know how fit is with people
.
And then I think also just withpolice departments around the
(18:28):
country they are doing moreoutreach.
I know in Virginia we have apretty extensive peer network
that police officers and peerswork together and then police
officers are really gravitatetowards EMDR because they don't
have to talk too much and mostpeople you don't have to tell
the story in EMDR, you just haveto come up with a picture.
(18:49):
And then also with the VA, emdris utilized along with a lot of
other therapies but EMDR it'san evidence-based treatment that
is researched, that it works.
I know if the VA is using it.
It's definitely it's one of thetop tier.
Dr. Elizabeth Barlow (19:08):
Okay, and thinking about police officers,
first responders, veterans, likeour group of people who really
go out and serve us every singleday.
They have their own type ofculture, they have their own
type of background.
Can you share the importance ofcultural competence and really
understanding, like the uniqueexperience and background of our
(19:31):
first responders and veteranswhen it comes to providing EMDR
as a therapist?
Lisa Duez, LCSW (19:37):
Yeah definitely .
They have their own they're.
You think about it.
I adore my co-workers, butthey're not on the same level as
people that are battle buddiesor people that are in a first
responder squad.
That these guys, they know thatthey have to have each other's
backs Right, that if somethinggets really bad they have to
have each other's backs.
So they have they need for whatI, in my opinion, they
(20:02):
definitely need that trust.
They need that rapport building.
They need you to accept themthe way they are, with their
quirkiness and the rubber meetsthe road and some of their
stories and the fact that theyare also healers.
In a way, they're just healers,probably with a little bit more
authority than a therapist, andthat they do.
(20:26):
They do want to do the samework that we do, in that we help
people.
So they want a little bit moreacknowledgement of that and they
need a little bit more of aless formal relationship.
Expect that they're going tocuss.
Expect that they might come inwith their guns trapped to their
belt.
Expect that you're going to beyou know.
(20:48):
They're going to want to get toknow you like on a like, on a
casual level, instead of thatbuttoned up therapist throwing a
lot of DSM diagnosis at themand they just want to know hey,
can you help me and how are wegoing to do this?
And then they want to do thework.
They're very committed and theywant to do the work.
They want to succeed andthey're very motivated and
they're a lot of fun to workwith.
They're just it's an honor towork with some of them.
(21:10):
They really have been.
They're a fun group.
They have a lot of trauma, butthey are.
They're very, they're a littleself-deprecating and I'm like,
listen, no, don't be doing thatto yourself, you know.
So it's cool, I love it.
Veterans and first respondersdefinitely one of my favorite
populations to work with.
Dr. Elizabeth Barlow (21:28):
Yeah, I love my salty veterans
especially and, like you said,they're going to cuss I love it.
Lisa Duez, LCSW (21:32):
I do too, cause it's like you.
Dr. Elizabeth Barlow (21:33):
There are no false pretenses, like you
know who you are getting and youknow who you are talking to.
Like they just yeah and theywant it.
Yeah, and they want the sameattitude.
Lisa Duez, LCSW (21:43):
I think they're going to show you who they are.
Dr. Elizabeth Barlow (21:45):
They want to know who you are.
Lisa Duez, LCSW (21:46):
They don't want to know who you are.
Dr. Elizabeth Barlow (21:50):
And they will call you on your mess.
Lisa Duez, LCSW (21:51):
So don't try to pull one over.
Dr. Elizabeth Barlow (21:54):
Yes, and I think one of the greatest
things about this group ofpeople that we're talking about
is that they are helpers andthey're lifesavers and they're
just selfless.
And I think one of the biggestchallenges with this group of
people are is that they arehelpers and they are lifesavers
and they're selfless.
So it always reminds me of thatsituation when you're on the
(22:16):
plane and they're like secureyour oxygen mask first.
That's not going to happen ifyou're a first responder or a
veteran, because they're justcalled to serve.
That's just what they do.
They're going to make sureeverybody on that plane has
oxygen before they do.
What if you could get to standon a soapbox right now and
really inspire someone who mightbe out there really dealing
(22:38):
with trauma?
That just doesn't have to bedealing with that trauma.
It just doesn't have to bedealing with that trauma anymore
because EMDR exists.
What would you say to thatperson?
Lisa Duez, LCSW (22:47):
Oh my gosh.
First of all, I would tell themthat they are very brave and
very courageous.
That's the first thing I wouldsay, Because in this that trauma
therapy and therapy in generalis no joke.
It is hard work if you do itright.
That would just tell them thatthey're very brave to understand
that they need help.
Asking for help in itself ishard, and then just the whole
(23:11):
nonsense of or not nonsensestrike that part, the whole
thing about taking back theirown story, that something might
have happened to them but theyget to choose how to heal from
it.
And so I would just tell themthat they just generally and I
think I would say this toanybody is that you deserve to
be healed, you deserve to liveyour best life, and part of that
(23:32):
, I think, is going through whatyou went through on your own
time and in your own terms, andI think EMDR and other therapies
help to do that.
Dr. Elizabeth Barlow (23:42):
Absolutely .
And if I could piggyback onthat, I would hop on my soapbox
and say that it's not admittingthat there is something wrong
with you.
It is not admitting that youare not strong enough and you
are not capable of just pushingthrough and just being big
enough to overcome what you'vegone through.
(24:02):
It's not about being enough.
There are things that happenthat we are not built or wired
to really be able to handle, andwe experience these things.
So then when those things getstored in our library of
experiences, they come up againbecause they were so horrible
and they were so challenging forus to even process.
(24:24):
So it's not about admittingdefeat.
It's not about admitting you'reweak.
It's about how do I make whatI'm going through go away,
because I don't have the toolsto do that for myself, because
I'm experiencing these things.
This tool is out there for youto use.
So I would encourage anyonelistening who needs a tool to
overcome some really crappystuff that they went through.
(24:46):
This is a great tool for that.
Lisa Duez, LCSW (24:48):
This is so, yeah, because you deserve to
feel safe.
Absolutely you deserve to feelsafe yeah, absolutely,
absolutely.
Dr. Elizabeth Barlow (24:56):
Thank you so much for joining us today,
lisa, and telling us more aboutEMDR.
Are there any key takeaways ormessages that you'd like to
share with our listeners?
Lisa Duez, LCSW (25:06):
I don't think so.
Just I think there I'm anadvocate.
I will shout at the top of theroof is that you've got to go to
therapy If you need to.
You deserve it.
Therapy is your brain is justas important as your leg or your
foot or something to fix,because it's just super
important.
Dr. Elizabeth Barlow (25:23):
Absolutely .
You have physical health, yougot mental health that same
thing, just different parts ofthe body, and they're both very
necessary.
I heard that you are in theworks planning an amazing
conference next year for helpingprofessionals and that there is
an early bird pricing going onright now.
Lisa Duez, LCSW (25:41):
Yes, there is.
Thank you so much for let metalk about it.
I am in Virginia Beach,Virginia.
The Clinician ConnectionConference is also going to be
in Virginia Beach, Virginia.
We have a fantastic oceanfronthotel and I will tell you that
the weather in Virginia in Aprilis very nice not too hot, not
too cold, great for beachwalking.
(26:03):
The Clinician ConnectionConference is just putting
together those topics thatclinicians really need to learn
about eating disorders,spiritual trauma, working with
law enforcement officers, plussome really good speakers to get
you motivated to be a clinicianand do the work that we do.
The website iswwwclinicianconnectionnet and we
(26:24):
have, as she said, an earlybird special.
I think it's $2.50 right now,but I think it goes up in a
little bit, so you might want tojump on it Absolutely.
Dr. Elizabeth Barlow (26:35):
And for those of you listeners who enjoy
our exploring abuse, fates,spiritual Religious Abuse and
Counseling podcast with ChrisConley LPC.
Chris will be a speaker at thisconference.
You'll get the opportunity tomeet him and please mention that
you heard him on the podcast ifthat's your first time hearing
from him.
Lisa Duez, LCSW (26:56):
Yeah, I can't wait to hear him speak.
Dr. Elizabeth Barlow (26:58):
Yes, it's going to be great, so I'm
excited to go.
I think it's going to be a lotof fun Again.
Lisa it was great spending timewith you today learning more
about EMDR.
Thank you to all of ourlisteners for checking out the
Kind of Mine podcast again thisweek.
Please stay tuned.
Our next episode drops nextFriday.
Thanks so much.
Lisa Duez, LCSW (27:17):
Thank you so much for having me, you, you,
(30:21):
you you, you, you, you, y y m y.
Dr. Elizabeth Barlow (35:00):
Antonio with music by PAX Minerva.
Welcome to the Kindermind podcast, where
we're devoted to opening upconversations and destigmatizing
mental health.
We'll bring you interviews withpractitioners in the field of
mental health, researchersuncovering new knowledge and
best practices for treatingmental health disorders, and
individuals sharing their mentalhealth journey.
Thanks so much to all of ourlisteners for joining us today
(00:23):
on the Kindermind podcast, wherewe're exploring EMDR treating
trauma for veterans and firstresponders.
We're joined today with guestspeaker Lisa Duez LCSW.
Lisa, thank you so much forjoining us to be on the show
today.
Lisa Duez, LCSW (00:37):
Oh, thank you so much for having me.
Dr. Elizabeth Barlow (00:39):
Yes, so I am.
I feel like I say this a lotlately I don't know enough about
the topic and I think thatmight actually be a good thing,
because I like to learn and Idon't like to think I know
everything, because that's justnot who I am.
So I will admit, I am atherapist that doesn't know
enough about EMDR.
I have referred clients to EMDRbecause I know that it is a
(01:00):
very helpful thing for folks whoare experiencing things like
post-traumatic stress disorderand overcoming childhood trauma,
things like that.
To start, can you tell us whatEMDR is?
Yes, absolutely.
Lisa Duez, LCSW (01:13):
It is such an interesting story.
Let me just tell you reallyquickly.
Francine Shapiro she's sincepassed on she developed EMDR in
the 80s.
Now I might get the story wrong, I might not.
She was either watching, I thinkshe was walking, and when she
was walking she was thinkingabout something.
And then she started to see howher eyes move a little bit and
(01:33):
she figured out that when shewas thinking about something and
when she was using bilateralstimulation either by her eyes,
that you could her memoriesbecame a little bit less taxing
on her.
So she figured out becauseshe's a neuroscientist and she
had that training and she didsome this is good enough to
(01:54):
strike this, but she did thehomeless population and she
figured out this whole eightphase protocol called the
adaptive information processing,where the hypothesis is that
memories are storedmaladaptively, just in fragments
in our mind and they createobstacles to when we actually
reprocess stuff.
So EMDR, because of thebilateral stimulation, uses the
(02:16):
left brain and the right brainto talk to each other and so you
can actually move memories fromthe amygdala of your brain,
which is that fight, flutter,fear, more to that, I call it
the big brain, where you're inthe front and understand what
has happened to you, but youalso understand that it's not
happening now and you canfunction.
Dr. Elizabeth Barlow (02:35):
That sounds phenomenal and as you
were speaking, I was thinkingabout how useful that could be
for our clients and our folksout there who have those
repressed memories or they stillhave, like you said, fragments
of the memories, but they'recausing really awful side
effects and consequences laterin life.
(02:56):
Definitely, yeah.
So what led you to specializein EMDR therapy?
Lisa Duez, LCSW (03:02):
I think when I back by so long ago I think I
was just when it first startedto become something that was
trained I just became veryinterested in it just because I
was very interested in the brainanyway.
And then when somebody was likeyou can move the memories and
blah, blah, blah blah and I waslike what sign me up?
And so since then I've justbeen not exclusively doing EMDR,
(03:24):
but doing EMDR is my mainlegality and I just really it
just works and I just I findthat you can be very creative
with it once you know it andit's just it's a very powerful
tool.
I will say that Okay.
Dr. Elizabeth Barlow (03:39):
So I'm going to go off the cuff here
because I'm trying to like takewhat I just learned from you
about EMDR and think about it inlike real world application,
because I know that it is verysuccessful for veterans really
also combat veterans, firstresponders, folks who are seeing
lots and lots of things that wedon't typically see on a normal
(04:02):
day and they're forced toreally process these things very
quickly and then move on, andwe 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 experienceda lot of trauma either recently
they were in combat or it's beenyears since they've been in
(04:25):
combat what is your process forusing EMDR to help them?
Lisa Duez, LCSW (04:32):
Yeah, so it is.
So most of those folks havePTSD, although they probably
have other things.
But when their brain isoperating in the past, when
they're in the present andthey're trying to just do their
life, when they're completedservice, it's difficult for them
to just turn it off.
I would say so.
Emdr in itself is an eightphase process.
(04:54):
So you don't come in to a EMDRclinician and right away do EMDR
.
You come in and we do a littlebit of treatment planning, we do
some resourcing where weactually install coping skills,
and then the person comes backand they do EMDR and they can
work on.
What's nice about EMDR is youcan work on past stuff.
You can work on present thingsthat are bothering you.
(05:15):
You can actually also do workon future things.
Let's say, if you have, I'lljust use the one I did last week
where somebody had a big testcoming up, and so you actually
can help them do.
How are they good?
Keeping control of theiremotional response in a test,
it's really cool.
But with the vets we can goback as far as we need to,
(05:37):
because those memories, eventhough they happened so long ago
, are still very much alive andthey very much dictate their day
to day.
Dr. Elizabeth Barlow (05:44):
So that's really interesting to hear that
it can be used for past, presentand future and, knowing the
trauma that veterans have mostlyexperienced in the past and
really first responders, theymight even be experiencing that
right now and if they're stillfirst responders, they're most
(06:04):
likely going to experience thatin the future as well.
What are some of the uniquechallenges that veterans and
first responders face when itcomes to receiving mental health
treatment or even with EMDR?
Is there anything that kind ofcomes along in that process?
That's a challenge?
Lisa Duez, LCSW (06:21):
Yes, of course.
So it's funny because I'm apolice wife.
My husband is a police officer.
Yeah, he's been a policeofficer, for he's actually
retired.
So I should stop saying he's apolice officer, because it's not
anymore and that just happenedlast week, so I'm getting used
to it.
But the culture of a firstresponder and the veterans
culture or the military cultureis something like where you
(06:41):
signed up for this might happen,deal with it, you might see
stuff, you might have to beinvolved in something that
you're not going to like andyou're going to have to handle
it.
So that's been the previousculture.
The culture now is turningtowards a little bit more of a
wellness culture, which I am so,so happy about.
Where it's hey, the firstresponders often have support
(07:04):
from their department.
They have peer teams, they havewe have EMDR a retreat, what
you would call it where we doreally intensive EMDR with first
responders in Virginia, whereit's more now of hey, this job
is difficult, let's get you sometools, so that's better.
(07:25):
I think the military is on thattrend too.
Some of my clients that aremilitary have talked about how
they are talking to them aboutPTSD.
They're talking to them aboutwhat might happen instead of
just saying, yeah, it doesn'thappen.
So the other part of the otherpart that's a little bit unique
to first responders and vets isthe concept of moral injury.
(07:48):
I know everybody knows whatmoral injury is because it's
been around forever.
But what we have found is it'sa little bit more prevalent in
people that have had to dothings in a capacity where they
may have a judgment againstthemselves about it, like
somebody who had to hurt someonein a very bad way.
(08:09):
They would never do that ifthey were under some other
circumstances.
Someone had to someone thatmaybe had to obey an order that
resulted in something negative.
So they have this extra layerof trauma.
That's the trauma itself andthen the judgment, their own
judgment, of how they wentthrough the trauma.
Did they do a good job?
(08:30):
Did they fight for their fellowbuddy?
What did they do?
So that's the second layer inthis particular type of client.
Is that moral injury part of it?
Now that it's not present inother people, but I see a higher
propensity in the vets andfirst responders for sure.
Dr. Elizabeth Barlow (08:49):
Absolutely so.
Thinking about the process thatyou go through with your
clients with EMDR, can you tellus what a session typically
looks like for a veteran orfirst responder seeking
treatment?
Lisa Duez, LCSW (09:01):
Sure.
Dr. Elizabeth Barlow (09:01):
So after we've done.
Lisa Duez, LCSW (09:02):
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 startthe second part of it, which is
the actual EMDR session.
So it looks like this, a littlebit like hey, we come up with
targets that's done previouslyto the session, and we come up
(09:24):
with cognitions towards thetarget.
So let's say somebody was in acar accident and so the target
would be the car accident, thenegative cognition would be we
pair with a negative cognition,because trauma is always about
how you feel.
How is it, how does it affectyou?
So the negative cognition mightbe I feel unsafe.
(09:45):
So we've come up with a numberwith that like how unsafe do you
feel?
On the scale of one to 10, justto baseline it.
And then we ask the person tocome up with a picture.
We ask the person to rememberthe cognition.
We ask the person to figure outwhere they feel it in their
body.
Sometimes people feel it intheir chest or in their guts,
and then we would ask them whatemotions they feel.
(10:07):
And then we go ahead and we dobilateral stimulation, and that
is done a lot of different ways.
It started out as just eyemovement.
So you would see old time EMDRtherapists moving their finger
in front of somebody's face Ifyou look on YouTube.
But now we actually have neurotech tappers, that buzz left,
left and then we have we can doit with sound waste and so any
(10:30):
kind of bilateral stimulationwhere one side of the body is
activated and then the otherside of the body is activated so
you can tap your knees, you cando butterfly taps.
There's all different kinds ofways to do it.
I guess they just never changedthe word I, because now we do
it all kinds of ways and then westart that we stop it for a
little bit and then we saywhat's coming up and they might
(10:52):
say this is what I saw, and thenwe just write back into it and
then eventually and it justdepends on the person, because
this is where it gets a littletricky Sometimes people will
need to continue to repress usthat memory at the next session.
But sometimes the memory issufficiently repressed and at
that point we install what'scalled a positive cognition.
(11:13):
So I movement, desensitizationis the first part and then the
repress is the second part.
So for the example of somebodywanting a car accident or
something.
You want to feel unsafe.
You want to feel safe.
So we actually again pair thememory with a positive and we do
some more scaling and weactually help that person
(11:36):
install we call it installingpositive cognition and make sure
that the body is feelingthere's no more distress.
You do body scan and the personis done.
Sometimes that takes onesession, sometimes that takes
two sessions, sometimes it takesthree sessions.
It really depends on the memoryand the person.
Dr. Elizabeth Barlow (11:54):
Oh, wow, that's really fast.
That's a lot, isn't it?
Yeah, no, that's awesome.
So, in a nutshell, what are thegoals of reprocessing the
trauma and therapy and like toget?
Lisa Duez, LCSW (12:07):
it.
I always tell clients it's sofunny, but I always tell them
that Will Smith, the minderasure thing from Ben and Black
, yes, you remember that I'vebeen like we don't have that, we
don't have that we're justgoing to do that.
So that is not this.
I said we just make it so thatyou can, so that the memory I
was used, the analogy of thememories not driving the bus
(12:27):
anymore.
So you still have the memory onthe bus, but the memory is in
the backseat or on the roof orall the way in the back and it's
not like top of mind.
So when you think about it it'snot going to cause you distress
.
You are going to be able tothink about it and be like, oh
yeah, that happened to me.
But it's not going to be likethat happened to me and I want
to go through the roof right now.
It's just, yeah, that happenedto me.
Dr. Elizabeth Barlow (12:48):
And so it's adaptively processed
instead of and I love that it'sso fast, because you think about
therapy and repress memories ormemories that are causing you
harm, and you think it's goingto be like a long, hard journey.
But yeah, I was able to reallydo that and couple it with, like
neuroscience and tap into thosefragments and reprocess those.
(13:11):
That's awesome.
Lisa Duez, LCSW (13:14):
Yeah, I think it's just because that it's
always I'm not got other beliefsthat you have to go through
trauma, or trauma has to gothrough your body, because your
body stores your trauma infeelings and stuff like that.
So EMDR is like a bottom-upModality, in that your feelings
come first and then you figureout what your feeling is.
Okay, that's that thing in mygut, what is that?
Oh, that's my anchor.
(13:34):
So, as EMDR does, bottom-upprocessing that's what we're
working more towards is isgetting it out of you that way,
from like your, from almost likeyour primal brain, because
that's where it's stored, andthen making more sense of it in
more of your Cognitive, yourlike what is that?
The prefrontal cortex, whereit's like more.
(13:55):
Okay, this is what happened tome.
I'm fine.
Dr. Elizabeth Barlow (13:58):
Okay, I'm my, my it's so cool and my
wheels are turning and I'mthinking the other week I was
talking to Amy on the show aboutconversion disorder and that,
like you mentioned, our bodystores trauma.
So I'm assuming like EMDR wouldbe a really great go-to for
someone who's going throughConversion disorder and has all
(14:22):
of these physical ailments andthings that cannot be explained,
to really Refrainwork that,rewire that and try to get that
out.
Lisa Duez, LCSW (14:30):
I've actually done a converse public
conversion disorder clients.
Somebody had non-epilepticseizures and then someone just I
can't remember the other one.
But a lot of times you'll haveclients that'll have migraines,
just other different physicalailments, and then you'll start
to reprocess and EMDR therapistwhen my thing is, when I can
tell that they're sleepingbetter, I'm like okay, this is,
(14:52):
we're getting here, we'regetting somewhere.
So you definitely, it'sdefinitely connected.
Dr. Elizabeth Barlow (14:56):
Yeah, I wonder if I could try it for my
migraines.
I don't know, might be worthlooking into.
I'll tell you so I could workso thinking about, like your
experience and you like yourpassion for EMDR and like what
you do.
I'm sure you've got somesuccess stories.
Do you have one you can sharewith us?
Lisa Duez, LCSW (15:18):
Yeah, I thought of one today, a cool one.
I had a vet and he came to mewhen he was in his 70s, or maybe
a little later, but goes toshow you one thing and it's
never too late for healing.
And so he had a trauma thathappened to him in 1945, or were
two, right when the war hadended and he had to liberate
(15:41):
concentration camp, and so justthose memories of seeing those
people in that state, eventhough he was there to help,
just the whole chaotic part ofthat Experience for him.
And then there was also part ofa helicopter crash that he had
or somebody that he knew hadpassed, but this was in 2017 and
(16:02):
he carried that all that time.
Oh, wow, from 1945 to 2017.
And he's just.
I heard this stuff and I want totry it because I'm tired and it
worked, and now he hadsufficient enough time to
sufficiently resolve it on hisown.
This is, I did what I had to do, but we were able to help him
(16:24):
out with, with both of thosetargets just the people that he
saw and helped, and then thecrash where his buddy died.
So that was that one alwaysyeah, 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 (16:44):
Absolutely , and that's so awesome that you
were there to help him throughthat, when he was ready and able
to go through that, so that'sso amazing.
That's a great story.
That would be my go to.
I know if that would.
Lisa Duez, LCSW (16:56):
yeah, that's my go to.
I've another, a couple more goto, but that is the go to.
That is like I, yeah, he it'sbecause 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 duringthat time.
So we, we had to learn, learnthrough history books, and he's
here telling me everything andI'm like, oh my gosh, it was
(17:17):
quite, quite a privilege to workwith him.
Dr. Elizabeth Barlow (17:18):
I For sure .
So one of the common thingsthat I know, I hear and I'm
going to make an assumption,many other people here as well
is decrease in access to mentalhealth care, not just for the
general public, which is a thing, but really also for our
veterans and our firstresponders.
So how can veterans and firstresponders access EMDR therapy
(17:41):
and what should they look for ina qualified EMDR therapist?
Lisa Duez, LCSW (17:46):
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 EMDRtherapists.
There's another professionalorganization called Mdrea it's
the International EMDRAssociation.
So there's many therapists onMdrea that will put their name,
(18:08):
their bio, who they work withand you can just go in there,
find a therapist and search andthen you can always recommend,
if you can possibly do it, to doa consultation with a therapist
and just find out, like becauseyou know how fit is with people
.
And then I think also just withpolice departments around the
(18:28):
country they are doing moreoutreach.
I know in Virginia we have apretty extensive peer network
that police officers and peerswork together and then police
officers are really gravitatetowards EMDR because they don't
have to talk too much and mostpeople you don't have to tell
the story in EMDR, you just haveto come up with a picture.
(18:49):
And then also with the VA, emdris utilized along with a lot of
other therapies but EMDR it'san evidence-based treatment that
is researched, that it works.
I know if the VA is using it.
It's definitely it's one of thetop tier.
Dr. Elizabeth Barlow (19:08):
Okay, and thinking about police officers,
first responders, veterans, likeour group of people who really
go out and serve us every singleday.
They have their own type ofculture, they have their own
type of background.
Can you share the importance ofcultural competence and really
understanding, like the uniqueexperience and background of our
(19:31):
first responders and veteranswhen it comes to providing EMDR
as a therapist?
Lisa Duez, LCSW (19:37):
Yeah definitely .
They have their own they're.
You think about it.
I adore my co-workers, butthey're not on the same level as
people that are battle buddiesor people that are in a first
responder squad.
That these guys, they know thatthey have to have each other's
backs Right, that if somethinggets really bad they have to
have each other's backs.
So they have they need for whatI, in my opinion, they
(20:02):
definitely need that trust.
They need that rapport building.
They need you to accept themthe way they are, with their
quirkiness and the rubber meetsthe road and some of their
stories and the fact that theyare also healers.
In a way, they're just healers,probably with a little bit more
authority than a therapist, andthat they do.
(20:26):
They do want to do the samework that we do, in that we help
people.
So they want a little bit moreacknowledgement of that and they
need a little bit more of aless formal relationship.
Expect that they're going tocuss.
Expect that they might come inwith their guns trapped to their
belt.
Expect that you're going to beyou know.
(20:48):
They're going to want to get toknow you like on a like, on a
casual level, instead of thatbuttoned up therapist throwing a
lot of DSM diagnosis at themand they just want to know hey,
can you help me and how are wegoing to do this?
And then they want to do thework.
They're very committed and theywant to do the work.
They want to succeed andthey're very motivated and
they're a lot of fun to workwith.
They're just it's an honor towork with some of them.
(21:10):
They really have been.
They're a fun group.
They have a lot of trauma, butthey are.
They're very, they're a littleself-deprecating and I'm like,
listen, no, don't be doing thatto yourself, you know.
So it's cool, I love it.
Veterans and first respondersdefinitely one of my favorite
populations to work with.
Dr. Elizabeth Barlow (21:28):
Yeah, I love my salty veterans
especially and, like you said,they're going to cuss I love it.
Lisa Duez, LCSW (21:32):
I do too, cause it's like you.
Dr. Elizabeth Barlow (21:33):
There are no false pretenses, like you
know who you are getting and youknow who you are talking to.
Like they just yeah and theywant it.
Yeah, and they want the sameattitude.
Lisa Duez, LCSW (21:43):
I think they're going to show you who they are.
Dr. Elizabeth Barlow (21:45):
They want to know who you are.
Lisa Duez, LCSW (21:46):
They don't want to know who you are.
Dr. Elizabeth Barlow (21:50):
And they will call you on your mess.
Lisa Duez, LCSW (21:51):
So don't try to pull one over.
Dr. Elizabeth Barlow (21:54):
Yes, and I think one of the greatest
things about this group ofpeople that we're talking about
is that they are helpers andthey're lifesavers and they're
just selfless.
And I think one of the biggestchallenges with this group of
people are is that they arehelpers and they are lifesavers
and they're selfless.
So it always reminds me of thatsituation when you're on the
(22:16):
plane and they're like secureyour oxygen mask first.
That's not going to happen ifyou're a first responder or a
veteran, because they're justcalled to serve.
That's just what they do.
They're going to make sureeverybody on that plane has
oxygen before they do.
What if you could get to standon a soapbox right now and
really inspire someone who mightbe out there really dealing
(22:38):
with trauma?
That just doesn't have to bedealing with that trauma.
It just doesn't have to bedealing with that trauma anymore
because EMDR exists.
What would you say to thatperson?
Lisa Duez, LCSW (22:47):
Oh my gosh.
First of all, I would tell themthat they are very brave and
very courageous.
That's the first thing I wouldsay, Because in this that trauma
therapy and therapy in generalis no joke.
It is hard work if you do itright.
That would just tell them thatthey're very brave to understand
that they need help.
Asking for help in itself ishard, and then just the whole
(23:11):
nonsense of or not nonsensestrike that part, the whole
thing about taking back theirown story, that something might
have happened to them but theyget to choose how to heal from
it.
And so I would just tell themthat they just generally and I
think I would say this toanybody is that you deserve to
be healed, you deserve to liveyour best life, and part of that
(23:32):
, I think, is going through whatyou went through on your own
time and in your own terms, andI think EMDR and other therapies
help to do that.
Dr. Elizabeth Barlow (23:42):
Absolutely .
And if I could piggyback onthat, I would hop on my soapbox
and say that it's not admittingthat there is something wrong
with you.
It is not admitting that youare not strong enough and you
are not capable of just pushingthrough and just being big
enough to overcome what you'vegone through.
(24:02):
It's not about being enough.
There are things that happenthat we are not built or wired
to really be able to handle, andwe experience these things.
So then when those things getstored in our library of
experiences, they come up againbecause they were so horrible
and they were so challenging forus to even process.
(24:24):
So it's not about admittingdefeat.
It's not about admitting you'reweak.
It's about how do I make whatI'm going through go away,
because I don't have the toolsto do that for myself, because
I'm experiencing these things.
This tool is out there for youto use.
So I would encourage anyonelistening who needs a tool to
overcome some really crappystuff that they went through.
(24:46):
This is a great tool for that.
Lisa Duez, LCSW (24:48):
This is so, yeah, because you deserve to
feel safe.
Absolutely you deserve to feelsafe yeah, absolutely,
absolutely.
Dr. Elizabeth Barlow (24:56):
Thank you so much for joining us today,
lisa, and telling us more aboutEMDR.
Are there any key takeaways ormessages that you'd like to
share with our listeners?
Lisa Duez, LCSW (25:06):
I don't think so.
Just I think there I'm anadvocate.
I will shout at the top of theroof is that you've got to go to
therapy If you need to.
You deserve it.
Therapy is your brain is justas important as your leg or your
foot or something to fix,because it's just super
important.
Dr. Elizabeth Barlow (25:23):
Absolutely .
You have physical health, yougot mental health that same
thing, just different parts ofthe body, and they're both very
necessary.
I heard that you are in theworks planning an amazing
conference next year for helpingprofessionals and that there is
an early bird pricing going onright now.
Lisa Duez, LCSW (25:41):
Yes, there is.
Thank you so much for let metalk about it.
I am in Virginia Beach,Virginia.
The Clinician ConnectionConference is also going to be
in Virginia Beach, Virginia.
We have a fantastic oceanfronthotel and I will tell you that
the weather in Virginia in Aprilis very nice not too hot, not
too cold, great for beachwalking.
(26:03):
The Clinician ConnectionConference is just putting
together those topics thatclinicians really need to learn
about eating disorders,spiritual trauma, working with
law enforcement officers, plussome really good speakers to get
you motivated to be a clinicianand do the work that we do.
The website iswwwclinicianconnectionnet and we
(26:24):
have, as she said, an earlybird special.
I think it's $2.50 right now,but I think it goes up in a
little bit, so you might want tojump on it Absolutely.
Dr. Elizabeth Barlow (26:35):
And for those of you listeners who enjoy
our exploring abuse, fates,spiritual Religious Abuse and
Counseling podcast with ChrisConley LPC.
Chris will be a speaker at thisconference.
You'll get the opportunity tomeet him and please mention that
you heard him on the podcast ifthat's your first time hearing
from him.
Lisa Duez, LCSW (26:56):
Yeah, I can't wait to hear him speak.
Dr. Elizabeth Barlow (26:58):
Yes, it's going to be great, so I'm
excited to go.
I think it's going to be a lotof fun Again.
Lisa it was great spending timewith you today learning more
about EMDR.
Thank you to all of ourlisteners for checking out the
Kind of Mine podcast again thisweek.
Please stay tuned.
Our next episode drops nextFriday.
Thanks so much.
Lisa Duez, LCSW (27:17):
Thank you so much for having me, you, you,
(30:21):
you you, you, you, you, y y m y.
Dr. Elizabeth Barlow (35:00):
Antonio with music by PAX Minerva.
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