The use of EMDR has been recommended by the Department of Health’s National Institute of Health and Clinical Excellence (NICE) in the guidelines they issued on Post Traumatic Stress Disorder in 2005. This reflects the evidence for its effectiveness which has been collected from clinicians and researchers.
I am a qualified EMDR therapist and since February 2017 have been successfully working using EMDR to work with clients. I also completed the Child Level 1 training in July 2019 which means that I am able to work using EMDR with children, young people and adults (please note I currently only work with children aged 8 and upwards.
What is EMDR?
EMDR stands for Eye Movement Desensitisation and Reprocessing. It is a therapy used to help people recover from distressing events and the problems they have caused, like flashbacks, upsetting thoughts or images, depression or anxiety.
EMDR is recognised by the National Institute for Health and Care Excellence (NICE) as a treatment for post-traumatic stress disorder (PTSD), and the World Health Organisation (WHO), which also recognises it as an effective treatment for children.
Emotional trauma and the brain
When an individual is traumatised, he/she may experience such strong emotions that their brain becomes overwhelmed. The brain consequently is unable to cope with, or process information as it usually does. Distressing experiences become ‘frozen in time’. Such events are stored in the brain in their original ‘raw’ form and can then be repeatedly remembered as ‘action replays’ or intrusive memories. As a consequence, the person repeatedly relives the original unpleasant event/s. Remembering in this way may feel as bad as experiencing it the first time because the images, sounds, smells, and feelings don’t change or process. Such memories have a lasting negative effect on the way a person sees themselves, the world and other people. It can have a profoundly negative effect on all aspects of their lives.
What happens during EMDR?
Normally, when we receive sensory information it passes through an emotional filter in our brain called the Amygdala, which is located in the Limbic system of the brain. This information then passes through another structure, the Hippocampus. The Hippocampus processes information for time and space properties and allows it to pass to the left hemisphere of the brain. This experience is then stored in memory and something new is learned. However, when incoming sensory information is emotionally-charged, for example because of a traumatic event or other very disturbing experience, it gets stuck in the Central Nervous System in the right hemisphere of the brain. This stuck information does not get processed. When reminders of the event occur, the stuck memory is triggered and is emotionally re-experienced in the present. This accounts for flashbacks, intrusive thoughts and nightmares that are common symptoms of PTSD.
How does EMDR work?
EMDR seems to directly influence the way that the brain functions. It helps to restore normal ways of dealing with problems (i.e. information processing). Following successful EMDR treatment, memories of such events are no longer painful when brought to mind. What happened can still be recalled, but it is no longer upsetting. EMDR appears to mimic what the brain does naturally during dreaming or REM (Rapid Eye Movements) sleep. EMDR can be thought of as an inherently natural therapy which assists the brain in working through distressing material utilising a natural process, this is called Adaptive Information Processing. EMDR therapists help clients reprocess their traumatic memories by using a process that involves repeated left-right (bilateral) stimulation of the brain while noticing different aspects of the traumatic memory. It is believed that the bilateral stimulation of EMDR creates biochemical changes in the brain that aid processing of information. Theorists suggest that the mode of action occurs in the Limbic System, where the Amygdala and Hippocampus are located.
Who can EMDR help?
EMDR is best known for its effectiveness in treating post-traumatic stress disorder (PTSD). It is widely used by the NHS, charitable organisations and private sector, and the Ministry of Defence use EMDR to help service personnel with PTSD.
EMDR can also be used to help treat a variety of mental health problems like depression or anxiety, especially where a difficult life event has been involved. EMDR can be useful for people who have witnessed or experienced an event like a car accident, a violent crime, sexual or emotional abuse, bullying, a social humiliation or the sudden loss of a loved one, and are struggling to recover.
I have also worked effectively with those who have experienced OCD and vicarious trauma working with police officers, hospital workers, doctors, teachers, social workers and other counsellors.
EMDR is suitable for adults, young people and children. Younger children can find it difficult to fully engage with some types of talking therapies, so EMDR can be an effective, simpler alternative. See our page about EMDR and children to find out more.
Sessions with me
I work using EMDR according to the protocols set down by Dr Francine Shapiro, who is the founder of EMDR, and EMDR UK & Ireland. Basically, this means that there are various phases before we reach the desensitisation stage.
Stage 1: history taking – where I try to really understand what’s been going on for you and how you are currently being affected.
Stage 2: Preparation – this stage involves me teaching you something about the brain, body and trauma. Also we work on relaxation and grounding and coping techniques. We may also do something called resourcing which is aimed at helping you to access more positive experiences, thoughts, and images before moving on through the remaining EMDR phases.
Stage 3: Assessment – this is basically assessing what we are going to work on (the target memory) examining images, thoughts, feelings and bodily sensations connected with that memory.
Stage 4: Desensitisation – this is the stage where the bilateral stimulation (BLS) comes into play. All of your senses become involved as you process the disturbance you are targeting. After each set of BLS we check in but don’t analyse what’s going on. This is where your brain is working to defragment/unlock those frozen memories.
Using state of the art equipment which includes a lightbar, pulsators, and headphone during this phase helps me to carry out the BLS using different stimuli in a professional and standardised manner. The lightbar, pulsators and headphone can be used together or separately, depending on what you prefer.
Stage 5: Installation – we will work to install some positive thoughts around the situation.
Stage 6: body scan – this is about checking your body for any residual sensations related to the memory.
Stage 7: Closure – The end of the session will depend on if we completed up to stage 6 or if we were still processing a memory we would explore to find a holding space often called a container to contain any distressing material that might come up between sessions.
Stage 8: Reevaluation – At the beginning your next session we would reevaluate your disturbance level regarding the target from the last session and see where we go from here, or if in the last session the work had been incomplete we resume at stage four.
On a more technical level
Distressing events can leave you feeling overwhelmed and your brain may be unable to process what has happened and store it in the same way as a standard event. Thus the distressing memory becomes frozen on a neurological level. When you recall the distressing memory you might feel that you are actually experiencing it all over again and this can be very intense. Sometimes people just try to avoid thinking about the distressing event so that they can avoid experiencing these feelings. Often there is a trigger that sets off the distressing memory and re-experiencing, or sometimes it can just hit you, or pop into your mind.
Part of the reprocessing of memories in EMDR is based on eye movements or taps in a left-right stimulation of the brain which seems to stimulate the frozen or blocked information processing systems. The eye movements replicate REM (Rapid Eye Movement) that occurs naturally when we sleep. REM sleep begins with signals from an area at the base of the brain called the pons. These signals travel to a brain region called the thalamus, which relays them to the cerebral cortex – the outer layer of the brain that is responsible for learning, thinking, and organising information. Thus EMDR therapy aims to replicate REM in order to learn, think and organise information around the distressing event/memory and store it in a different, more manageable way.