Counselling, Psychotherapy, EMDR and Supervision
EMDR Therapy: An Overview
EMDR is an acronym for ‘Eye Movement Desensitisation and Reprocessing’. It is a powerful psychological treatment method that was developed by an American clinical psychologist, Dr Francine Shapiro, in the 1980s. As a Senior Research Fellow at the Mental Research Institute, she published the first research data to demonstrate the benefits of the therapy in 1989. Since then a wealth of research has been conducted demonstrating its benefits in treating psychological trauma arising from experiences as diverse as war, childhood neglect or emotional, sexual or physical abuse, natural disaster, assault, surgical trauma, road traffic accidents and workplace accidents and it is increasingly used to help people overcome these painful life events or experiences.
EMDR has also been found to be of benefit to children as well as adults. Its effectiveness as a treatment for PTSD has been recognised in the NICE treatment guidelines. (Click this link: NICE Guidelines March 2005
EMDR is a complex and powerful therapy. Therapists always have a background in mental health before undertaking
training in EMDR. You are strongly recommended to consult only legitimate clinicians who have undergone a full
bona-fide EMDR training. I am an accredited EMDR practitioner, attend ongoing training and receive regular specialist
supervision for this aspect of my work with clients.
Trauma and Post-Traumatic Stress Disorder (PTSD)
When a person is involved in a distressing event, s/he may feel overwhelmed and their brain may be unable to process the information like a normal memory. It is normal to be very anxious, distressed and to go on to experience symptoms such as flashbacks, nightmares and panic attacks, as well as being physiologically highly aroused and “jumpy”. In time these symptoms will fade away for most people as the mind’s own natural healing mechanism quickly processes it. Sometimes (in roughly 1 in 4) the symptoms do not go away and the person may have full-blown PTSD or some of their symptoms may persist. Why this happens to some people depends on a number of factors (and is not related to the person being “weak”) but how it happens is due to a disruption of the way the brain processes information. The distressing memory seems to become frozen on a neurological level and is frozen in time. When a person recalls the distressing memory, the person can re-experience what they saw, heard, smelt, tasted or felt, and this can be quite intense.
Sometimes the memories are so distressing that the person tries to avoid thinking about the event to avoid re-experiencing the distressing feelings. Some find that the distressing memories come to mind when something reminds them of the upsetting event, or sometimes the memories just seem to just pop into mind. Some people may be constantly fearful, angry or ashamed; others may be unable to sleep, may be “on edge” all the time, be unable to concentrate and have memory difficulties. These experiences may happen all the time or may be triggered by reminders of the event; some people therefore avoid anything that might remind them of the trauma.
How EMDR works
The essence of the approach is to stimulate the brain’s information-processing system through alternating left-right
stimulation of the brain with eye movements, sounds or taps which seems to stimulate the frozen or blocked
information-processing system. In the process, the distressing memories seem to lose their intensity, so that the
memories are less upsetting and seem more like ‘ordinary’ memories. The effect is believed to be similar to that
which occurs naturally during REM (Rapid Eye Movement) sleep when our eyes rapidly move from side to side.
EMDR helps reduce the distress of all the different kinds of memories, whether it was what you saw, heard, smelt,
tasted, felt or thought.
What happens during therapy?
EMDR is not simply the use of eye movements. Rather it is a comprehensive therapeutic approach with principles, protocols and procedures with the goal of reducing distress in the shortest period of time. At initial meetings, your therapist will spend time getting to know your history. This generally includes understanding the kind of distress and difficulties you are experiencing, if you have physical problems, if you are taking medication and explore the support you have. If your therapist feels EMDR is appropriate for your difficulty, then s/he will describe the EMDR model to you and explain the theory. You can ask your therapist questions and express any concerns you may have. Your therapist will spend some time doing some relaxation exercises with you, which could include ‘safe or pleasant place’ exercises, guided visualisation, deep muscle relaxation, breathing retraining etc. Once you and your therapist feel that you are sufficiently prepared, you can then target a distressing memory with the eye movements or other forms of left-right alternating stimulation, such as sound or taps, while being invited to recall particular events and thoughts. This process will be described in detail before embarking on the process. During the eye movements you may experience the distressing event quite intensely to start with, but this distress generally reduces as the memory is processed with EMDR. Your therapist will continue with the eye movements until your distress is reduced as much as possible. Before the end of the session, your therapist will give you time to feel calm again, using the safe-pleasant place exercise or relaxation techniques. This procedure is repeated, targeting each distressing
memory before eventually focusing on future desired targets.
For further information about EMDR and the stages of EMDR therapy, go to www.emdrassociation.org.uk
Who can benefit from EMDR?
As indicated above, this treatment has been found to be beneficial for processing painful experiences of many kinds, as well as the particular difficulties arising from PTSD. Like many therapists, I find that integrating EMDR treatment into a course of therapy is of great benefit to many clients. However, EMDR is contra-indicated if a client is suicidal or currently self-harming. It does not work if a client is taking tranquilisers (e.g. benzodiazepines) or using cocaine.