For some, the idea of EMDR might seem too good to be true – for those with PTSD, anxiety or who have suffered trauma, it can sometimes seem that nothing will help. Here, Dr Jane McNeill Clinical Partner London and Chartered Psychologist, looks at what EMDR can be used for and how it works.
EMDR (Eye Movement Desensitisation Re-Processing) is a therapeutic approach designed for working with traumatic or distressing memories. EMDR is recommended by the National Institute for Health and Care Excellence (NICE) and the World Health Organisation (WHO) as the front-line treatment for PTSD (Post Traumatic Stress Disorder) alongside other emotional and behavioural problems. The NHS uses EMDR to treat children and adults who have had traumatic experiences which are continuing to cause them psychological difficulties.
At some point in our lives, we may experience traumatic events which can lead to increased stress. The effects can be felt psychologically, physically or in combination. The majority of people recover, but some do not. Some people continue to be significantly affected by the trauma long after the event has passed. In these cases, specialist help may be necessary to help recover.
We can understand why the effects of Trauma last so long by looking at the way the brain processes information. Generally, when something happens, our senses are the first to respond: our eyes, ears and other senses capture information which together are stored as memories. Memories are made up not only of facts but also contain feelings, interpretations and narratives.
In a situation which signals danger, we respond in a different way. Almost immediately, our body and brain recognise there is an emergency and take immediate action. The messages sent to the brain are put into an emergency store without going through the normal memory processing. These experiences, often with the original sounds, smells, images, thoughts and feelings, are recorded in the brain as raw, unprocessed information. They are stored in the limbic system, in an isolated memory network which is unconnected from the cortex where we use language to store our processed memories.
Traumatic memories with their emotions, sensory and physical information seem to get stuck in the brain in this raw, unprocessed form. When recalled, these memories can be very distressing and can pop into our minds when we might not be expecting or wanting them to. This can cause flashbacks, nightmares and distressing episodes. They can make it very difficult to cope with ordinary stressful situations in a way we might normally expect to.
The process of EMDR seems to unlock the brain’s processing so that the traumatic memories become like other non troubling memories. Dr Francine Shapiro developed Eye Movement Desensitisation Re-Processing in the 1980’s by using the brain’s natural healing processes.
After a thorough assessment, you will be asked specific questions about a disturbing memory and then eye movements rather like those we make in REM (rapid eye movement) sleep are recreated by asking you to follow the therapist’s fingers from side-to-side across your visual field. Following a short set of eye movements, you will be asked to report back any experiences you have noticed during the eye movements. This can be distressing and at any time the client can ask the therapist to stop. It is vital that the client feels safe and in control at all times. The “stop” signal involves the client raising their hand and this signals the therapist to stop immediately.
Alternatives to eye movements are available which include hand taps, or sounds which share the bi-lateral nature of the eye movements. With repeated sets of eye movements, taps or sounds, the memory changes and becomes much less distressing. This process can take place over the course of one session or more than one session. Through continued processing the memory becomes a neutral memory of an event in the past. Brain scans show movement from the limbic system over to the hippocampal area of the brain which is consistent with where we store processed memories without the emotional intensity of trauma memories.
EMDR is not hypnosis and with the stop signal you can stop the process at any point. You are at all times awake and in control. As a result, most people find EMDR extremely beneficial and find it enables them to resolve past traumas. However, EMDR is not suitable for everyone and it does require the client to able to tolerate strong emotions at the beginning of the processing. That said, these distressing emotions are short-lived and with the installation of the Safe, Calm or Special Place this can aid the client to experience the difficult feelings and emotions which may occur.
Another part of EMDR is the development of a “special place” for the client. This involves the client imagining a place where they feel safe, relaxed and comfortable. This place is “installed” using the left-right eye movements. This is also used as a relaxation technique and can be a calm place the client can imagine being in, either in the EMDR session, or between sessions when feelings can feel overwhelming.
How long does treatment take and what evidence is there that it works?
EMDR sessions generally last between 60 and 90 minutes. The NICE guidelines specify that between 8-12 sessions are necessary for the treatment of simpler traumas. For multiple or complex traumas, more sessions may be required. EMDR is recommended by the NICE guidelines for the treatment of PTSD, The Ministry of Defence, The American Psychiatric Association, The United States Department of Defense and other numerous international health agencies. It is estimated that over 2 million individuals have benefitted by this approach. For more information about EMDR, please see http://www.emdria.org and https://www.gov.uk/government/news/treating-ptsd-in-the-armed-forces
If you are interested in finding out how EMDR can help you, or a loved one, please contact Clinical Partners on 0203 326 9160 or use the contact us form to request a call back.
Clinical Partners is the UK’s largest private partnership of psychiatrists, psychologists and psychotherapists providing nationwide mental health care for children, adults, families and businesses.