Russian Doll’s Brain

In the second episode of Russian Doll, the Netflix series just nominated for a “Best Comedy” Emmy, the camera focuses on a strip of light-emitting diodes atop a tripod. Russian Doll, the acclaimed Netflix series, tells the Groundhog Day-like story of Natasha Lyonne’s character Nadia Vulvokov, who keeps dying and coming back to life at her 36th birthday party. The show is a puzzle-box, packed with Easter eggs and clues, so it’s easy to overlook this brief detail. Let’s pause here, though, as the green light zips backs and forth across the device.

The shot widens to show us Nadia’s friend Ruth, a very Upper West Side therapist. Ruth asks, “Are you back at that Touchstone Memory?” The camera cuts to her patient, a middle-aged man we will never see again after this exchange. “Yes,” he says with difficulty, “I’m there back outside the school.” Ruth prompts him to continue: “You see the man’s shadow. How does that make you feel?” “Frozen, powerless.” After a beat, Ruth asks, “Is that belief true now?” “No,” he says, “I know how to ask for things now.”

The moving light and the language Ruth uses are part of a therapy called Eye Movement Desensitization and Reprocessing, or EMDR, which was developed for patients with trauma and offers a way of reading Russian Doll. Nadia’s problems—most pertinently her dying, but more broadly her tendency to push away people who care and to numb herself with drugs and liquor—have formed as a response to something traumatic that happened long ago. To solve them, she must excavate her own Touchstone Memory, the earliest memory pertaining to the trauma.

Coming to terms with the past isn’t a novel theme, but Russian Doll is unusual for situating it in a therapeutic framework instead of a moral one. Nadia’s journey into her past isn’t about giving or receiving forgiveness or righting wrongs. She simply wants to stop suffering. To do so, Nadia, like Ruth’s patient, needs to change the way she remembers the past. She needs to reprogram her brain.

***

The goal of EMDR is to eliminate somatic or psychic suffering by “processing” a traumatic memory and replacing the negative emotions and thoughts associated with it (feeling “frozen, powerless,” for instance) with a more adaptive cognition (“I know how to ask for things now”). The protocol consists of eight discrete phases: history taking, preparation, assessment, desensitization, installation, body scan, closure, and reevaluation. Central to the process is the patient recalling a traumatic memory while receiving stimulation to alternating sides of the body. Some therapists use visual stimulation, such as having the patient track the therapist’s hand or a light like the one in Ruth’s office. Other therapists deliver the stimulation by tapping the patient’s knees, playing alternating aural tones, or having the patient hold paddles that vibrate one at a time. According to EMDR’s developers and practitioners, bilateral stimulation activates the two hemispheres of the brain in a way that mimics REM sleep, when our dreaming brains process our experience into memory.

The theories that explain why EMDR works, like the protocol itself, are the product of one woman, Francine Shapiro, who dropped out of an English PhD program when she was diagnosed with cancer and spent the next ten years taking continuation classes on stress-reduction and wellness before enrolling in a non-accredited psychology program. In Getting Past Your Past, her 2013 self-help book that explains and the principles of EMDR and extends their utility beyond PTSD sufferers to, basically, everyone, Shapiro recounts that it was a “chance observation” that led her to develop EMDR. While walking in the park, troubled by her thoughts, Shapiro noticed that moving her eyes from side to side as she looked around lessened her feelings of distress. Shapiro’s first experiments were informal, on herself and her friends. In 1987, the first randomized controlled research study of EMDR was conducted with combat veterans and victims of sexual abuse diagnosed with PTSD. PTSD, at the time, had been in the DSM for less than a decade and was considered difficult to treat. The results of Shapiro’s study were positive and published in the Journal of Traumatic Studies in 1989 to a great deal of excitement and some skepticism. Shapiro published the textbook on EMDR in 1995.

Today, EMDR is recognized by the American Psychological Association and the Department of Defense as an evidence-backed, clinically-effective treatment for PTSD, though it has not entirely shed its reputation as woo-woo. In 2009, Scientific American ran an article titled EMDR: Taking a Closer Look that called into question whether bilateral stimulation had any meaningful effect and concluded it did not. According to the authors, the flashing lights and buzzing paddles were just window dressing on what is essentially prolonged exposure therapy, where a patient becomes desensitized to a traumatic memory through controlled exposure; they implied the theories and mental model Shapiro constructed to explain EMDR’s efficacy were just-so stories and that any benefit a patients experienced was indistinguishable from those available through cognitive behavioral therapy

In his book on trauma The Body Keeps The Score, psychiatrist and researcher Bessel Van Der Kolk recalls that when he first learned of EMDR “it sounded like yet another of the crazes that have always plagued psychiatry.” When, however, he watched a woman whose life was imploding from childhood sexual abuse try EMDR and experience dramatic relief—not just of PTSD symptoms but also of compulsively self-destructive behavior patterns— Van Der Kolk was persuaded that the therapy might be “a way to help people revisit their traumatic past without becoming retraumatized.” His Trauma Clinic conducted a National Institute of Mental Health-funded controlled study which found that patients receiving EMDR experienced greater improvements than both those in the placebo group and those treated with Prozac. Additional studies involving brain imaging have documented how EMDR changes the brain of people with PTSD by enlarging the hippocampus, the brain’s memory control center. Van Der Kolk acknowledges that “we don’t yet know exactly how EMDR works, [yet] the same is true of Prozac,” and asserts that “clinicians have only one obligation: to do whatever they can to help their patients get better.”

***

In Russian Doll, Nadia isn’t in therapy, but her problem is similar to many of us who seek therapy out: she wants to get to the bottom of why she can’t break out of a repetitive, involuntary, and painful pattern. She wants to move on. Part of what makes Russian Doll such a delicious viewing experience is that it invites and sustains multiple simultaneous interpretations for Nadia’s repetitions that sit together like, well, Russian dolls.

You might have your own idea about the striking use of split-screens and colored lights throughout the series, or the fact that Nadia must pass through a door with a neural-looking blue light on it each time she regenerates — but even so, you might be willing to see a nod to EMDR. Nor do you need to believe that Nadia and her counterpart in death Alan are literally two halves of the same mind (as Nadia suspects when she stabs him in the thigh to see if she will feel it) to recognize the left-brain/ right-brain dynamic of their partnership. Russian Doll is about more than EMDR therapy, yet Shapiro’s model deeply informs the show’s depiction of memory, behavior and recovery from trauma.Throughout the series, video gaming and computer programing layer with an EMDR-informed model of the brain to suggest a relationship between the cycling, memory, and trauma. In a tweet, Lyonne mentioned that the work of programmer and writer Ellen Ullman, and in particular her novel The Bug, was “inspo” in Russian Doll’s writers room. In that story, an emotionally disconnected computer programmer is tormented by a bug that keeps making his program crash as his personal life unravels and memories of his alcoholic father resurface. In The Bug, computer memory and human memory are linked by analogy, by elision, and by pun. Russian Doll teases this connection, using video games and programming as analogies for the role of memory in the human mind.

The video game Nadia has designed and which she plays in Alan’s apartment presents one way to understand Nadia’s situation: as a game in which a character, unable to successfully accomplish a task, dies and respawns, over and over until the player learns how to overcome the obstacle. At the same time, that layered, looping structure resembles the way we dream. During sleep, our brains process the day’s experiences. Useful lessons are retained and shifted from working to long-term memory storage, extraneous details (beta fish and party extras, perhaps) are discarded, and we wake up calmer and more able to cope with or address what troubled us the night before. We might dream as many of fifteen versions of the same dream in a night, each iteration slightly altered as the mind works through a problem until resolution is reached.

Shapiro, in Getting Past Your Past, imagines the mind as a dense thicket of memories encoded in neurons. These memories network by associative links that operate below the conscious level and, like computer code, invoke automatic responses when tripped. When Nadia lashes out at Alan for displaying the family photos she keeps stashed under her bed, it’s not really Nadia steering; she’s on auto-pilot, and trauma charted the course.

It’s heavy to consider the ways our responses, even our personalities, are dictated by the worst moments in our past. What’s the point of trying a #30daychallenge or #lifehack or getting #sober to fix your life when you are doomed by neural wiring to replay your maladaptation and trauma? Yet Russian Doll, for all its darkness, isn’t bleak. Getting Past Your Past is a self-help book. The past can’t be changed, but memories can. Brains can be rewired. Nadia can get free.

***

If memories are the code that dictate the way we respond in the present by priming us to react in certain learned ways, traumatic memories are buggy. They crash the system. While most daily experiences—good, bad, and ugly—are processed by our brains during the night, some are so overwhelming, so primally charged with danger, that our brains don’t process them. They just glitch. Instead of processing the traumatic experience through dreams, we wake up from nightmares or develop insomnia. Each time we remember, our stress response activates as if we were right back in that moment, and we experience panic attacks, flashbacks, or somatic symptoms. Walk into a deli, for instance, and you are instantly back to the time your mother shamed and frightened you in her convertible full of watermelons; you dissociate or you get a panic attack or a nosebleed—or, in Nadia’s case, you die.

As Nadia’s sleuthing brings her closer to a way out of the cycling, visions of herself as a young girl begin to appear. Nadia tells Alan that this child self is “lost, trapped between the past and the present.” In Getting Past Your Past, Shapiro explains that traumatic memories are “frozen in time”: “if someone who was raped a year ago or molested 50 years ago has PTSD, the past is present. When they think of the incident, it can feel as though it’s happening all over again.”

It’s worth pausing to note that EMDR, in Russian Doll, is more metaphor than road map. In real life, Nadia Vulvokov might not be a good candidate for the therapy. It can be dangerous for substance abusers and complicated for patients whose traumas are multiple and in the distant past. When associative links to a traumatic past are scattered everywhere—mirrors, delis, girls whose parents are blowing up their lives, Emily of New Moon, lost cats, roast chicken, literally anyone who might want to get close to you—and have had a few decades to take root, the process of reprocessing all those memories is difficult and the therapy may be less effective.

For Nadia, the pain of transformation is worth it. Shapiro writes in Getting Past Your Past, “Whatever happened in childhood helped forge who you are today. As a child, you had no control and no choice, but things are different as an adult.” It’s an optimistic, even comforting, message that though we may be formed by our traumas we are not doomed by them. Revisiting the past, for Shapiro, is “not about assigning blame. It’s about liberation.” Our final vision of Nadia, fused by sleight of hand out of another left/ right split screen, is of her carrying a torch out of a tunnel, a look of cautious, private triumph on her face. She is finally free of the cycling but also of the trauma responses that have been controlling her. She has changed. In order to get here, Nadia has had to let go of the guilt and shame associated with the memory of her mother and replace it with a more adaptive belief about being a survivor who wants to live. She has had to dislodge a mirror fragment that is large and sharp and brings up blood. Trauma, it is often said, leaves a psychic wound. Yet the brain is a physical organ. It can be changed. It can heal.

Joanna Petrone