EMDR therapy for trauma, what is it?

What is EMDR therapy?

Eye Movement Desensitisation and Reprocessing (EMDR therapy) is a relatively new therapy.  However there are now thousands of studies and a recent study (Cost-effectiveness of psychological treatments for post-traumatic stress disorder in adults), found that EMDR therapy was the most cost-effective treatment for Post-Traumatic Stress Disorder (PTSD) in adults.  However EMDR therapy is also very useful for treating depression, anxiety, alcohol use disorders, other addictions and there is some growing evidence that it may be helpful in treating long covid.

I use EMDR therapy extensively in my practice.  I have found EMDR therapy to be very helpful, not just in dealing with single incident trauma, but also helping people to unpack developmental trauma, I have undertaken additional EMDR therapy training to become and EMDRAA “Accredited Practitioner”.  You can see my profile on the EMDRAA website here.

Many people may not feel they have experienced trauma, but developmental trauma can be as simple as not having your needs met in childhood.  The insights and deeper understanding that clients often develop during the reprocessing stage of EMDR never cease to amaze me.

How does EMDR work?

EMDR was developed by Francine Shapiro in 1987 and is guided by the Adaptive Information Processing (AIP) model.  AIP posits that our brains are generally good at adaptively processing information.  However, if events happen at an early age and we don’t have people around us who can help us understand and process what is happening or if the event is so traumatic that we are unable to process the memory, then the memory can become stuck in our brain in an unprocessed state.  When these memories are triggered by a current event the emotions, thoughts, beliefs and physical sensations can be re-experienced and symptoms of PTSD or other mental health conditions can be displayed.  This is commonly known as being “triggered”.

When people are traumatised by an event they often don’t want to talk about it.  EMDR doesn’t require a lot of talk about traumatic events, however we do need to get an idea of the traumatic events in order to reprocess them.  Reprocessing of memories generally involves “bilateral stimulation”, which is often eye movements, but you may have seen images of Prince Harry with his hands crossed across his chest, this is one form of bilateral stimulation that can be used in EMDR.  

The idea of the reprocessing is that we hold a traumatic event in our working memory at the same time as our working memory is taxed, thus we can’t hold onto the memory in the same way and it starts to be processed.  We don’t know exactly what will happen during this process, but often thoughts, emotions, feelings or new memories come up.  As the memory is reprocessed it generally starts to change, people often report that it is less clear, or that they can’t see the images of the memory as clearly or it’s like watching a movie as the memory is now more distant.  After reprocessing the memory will generally be less triggering and hold less emotional distress.

What are the 8 stages of EMDR therapy?

Some people who know about EMDR are keen to leap straight into the magic moving finger stage of “reprocessing”.  It’s important to understand that EMDR is an 8 phase process, each of these stages is important in ensuring that people are properly prepared before reprocessing begins and that memories are properly processed to completion.  The EMDR International Association provides a good summary of the 8 stages of EMDR in the image below.t 

What happens during an EMDR session?

The amount of time required for EMDR processing depends greatly on the client.   Once we get to the reprocessing stage of  EMDR therapy, there are three prongs that we work on:

(1) we generally start by processing past events that have been integral in the development of dysfunctional thoughts, this includes forging new associative links with adaptive information;

(2) then current circumstances that elicit distress are targeted, and internal and external triggers are desensitized;

(3) imaginal templates of future events are incorporated, to assist the client in acquiring the skills needed for adaptive functioning.   

Some clients require significant preparation before processing can begin, there are often protective parts that we have developed to keep us safe.  Often these protective parts need to be better understood in order for reprocessing to be able to proceed.  New memories may also be uncovered adding to the reprocessing work that needs to be completed. 

At a minimum 12 sessions will generally be required, however more commonly 20 sessions are needed and often more where there is complex trauma related to difficult childhood experiences.  Please get in touch if you feel you would like to experience EMDR.

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