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Bilateral Stimulation in Wilderness Therapy: Treating Trauma, Grief, and Shame in Adolescent Boys

As my training in EMDR was coming to a close, I had an interesting conversation with one of the primary facilitators, Frank. He described his efforts to bring EMDR treatment into public schools. He spoke with conviction about the need for and potential benefits of this treatment for children, and he lamented the opposition he’d encountered. Some of the students were very resistant, and this paled in comparison to parents who thought the protocol looked a lot like hypnosis. Though frustrated by this, Frank smiled as he described the solution he’d devised. Proudly, Frank displayed a toy ball that flashed when he slammed it against the table. “It’s the same thing!”, he exclaimed. “They can stare at this and get the same benefits!” Intrigued, I thought of my upcoming work at Blue Ridge Therapeutic Wilderness. “What’s the difference in that and staring into a campfire?”, I asked Frank. “Nothing!”, he said. I explained my future work environment, and Frank encouraged me to explore my campfire idea. That idea has since developed into a collection of techniques centered around bilateral stimulation.

As stated by EMDR Institute, Inc., “EMDR (Eye Movement Desensitization and Reprocessing) is a psychotherapy that enables people to heal from the symptoms and emotional distress that are the result of disturbing life experiences.”  In sessions, clients shift patterns of avoidance and explore their memories and interpretations of past events. In between sets of eye movements, the therapist checks in with the client to follow how they are reprocessing the events and guide the client further. Typically, through EMDR, negative beliefs about self decrease and, following this, positive thoughts and perspectives are strengthened.

The “D” in EMDR stands for desensitization. For a person to engagein desensitization, they have to face the painful or fear-inducing thought or memory. To increase our chances of success, I start the process with a deep breathing technique combined with mental imagery that is designed to increase a person’s sense of control and ability to manage intrusive thoughts. This provides a tool that helps to lower the student’s fear and resistance to the rest of the process

I often follow this breathing technique with bilateral stimulation in the form of sound. This seems to be the easiest way to introduce the concept and begin working. Students tend to be very accepting of bilateral sound, and it provides an important entry point. Students hold their painful thoughts and memories in mind while breathing deeply and listening to sounds that alternate from left to right and back and forth. Tracking the movement of sound is an important part of this process much like the following of fingers during the eye movements of traditional EMDR. As new realizations emerge, I assist students in processing and incorporating what they find.

wilderness therapy

After this introduction to bilateral stimulation, visual stimuli are introduced in the form of fire, which, in the wilderness environment, carries a great sense of importance. Considering the value of the periphery in visual stimulation, I have evolved the original campfire idea into two fires on either side of the student in their peripheral field of vision. Two fires flicker independently of each other, and I find this effect helpful in providing alternating stimulation. For this, I use fat wood or heart pine, which is harvested in the same or similar forests to the ones in which our students live their daily lives. There’s a sense of connectedness to the land that comes along with this. In addition to the flames, the scent of the pine creates a ceremonial space around the work that is being done. This scent triggers memories and is helpful in bringing students back to their important emotional work in each session. At this point, the process begins to become sacred to the student.

Having experienced some benefits of bilateral stimulation in processing their pain, and having begun to treat their work as an important and sacred process, students are then ready to engage in eye movement or traditional EMDR without resistance. At this point, I continue to use peripheral fires while leading students through sets of eye movements in a traditional EMDR protocol; guiding them to follow specific thoughts and realizations as they arise. In addition to reprocessing painful or traumatic memories, we also work on identifying and integrating positive beliefs related to the student’s strengths and sense of capability.  As sessions come to a close, I discuss with students and field instructors the possibility of the student continuing to process material from the session, and we identify specific coping skills that will be used in the following days. The breathing technique taught earlier is often an important coping skill at this point.

wilderness fire

Through this process, EMDR is adapted to the population and the setting of wilderness therapy with very good results. In one example of this, a student who had been extremely suicidal prior to entering treatment disclosed his shame related to his sexuality and worked through this to the point of exclaiming “I’m good enough!” When asked, “good enough for what?”, he replied, “good enough to live!”

It’s important to note that other activities involved in wilderness therapy, such as hiking, also include bilateral stimulation. Another student, who had been consumed by anger and grief after his father’s passing stated during a session that he was angry at his father. While doing EMDR work, he found loneliness predated that anger. He continued to trace his emotions back and found that his loneliness was a result of the large presence his father had in his life. From there he acknowledged his father’s wisdom, and, eventually, he arrived at a sense of love for his dad. The next day, while hiking, the student continued to process material from the session. He thought of his father’s compassion, and he later reported that his heart “exploded” with love. This explosion of love was later instrumental for this student in forgiving his mother and himself and healing that relationship. I wish I could show others the light that came on in this boy’s eyes, and I hope to continue to help adolescent boys heal in this way for a long time to come. I’m truly honored to do this work.

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