Understanding EMDR Therapy by Rachel Sewrey
What is EMDR therapy?
It sounds very scientific and a little scary right? I wanted to write this article to hopefully de-mystify EMDR and make it feel less scary as it has huge benefits in therapy.
EMDR stands for Eye Movement and Desensitization Reprocessing. Again, this feels very scientific and I had images of my head being wired up to lots of machines to be reprogrammed when I first heard of this therapy. I can tell you now that this is not the case, no machines involved (however some therapists do like to use a gadget called a Bi Lateral Stimulator which aids the client if the eye movement reprocessing or tapping is unsuitable).
EMDR was first developed by Francine Shapiro back in 1987. She first became aware whilst out walking in a park that eye movements appeared to decrease negative emotions associated with her own traumatic memories. In her work she identified that eye movements had a desensitizing effect, and soon realized that other people had the same response with these eye movements. This is what started her work to develop EMDR therapy. In 1989 controlled studies were published in the treatment of PTSD. EMDR was found to be highly effective in reducing the symptoms of PTSD and today is widely used due to its effectiveness.
How does EMDR work?
The scientific answer is that EMDR facilitates the accessing and processing of traumatic memories. In layman’s terms this means that when a trauma occurs, the brain takes a snapshot of the incident, but because the brain and body have been triggered into survival mode, it shuts off the supply of oxygen to the top of the brain which is where we have our thinking brain. The stress hormone cortisol is released and the brain then struggles to process these memories in a logical order as it would in a normal memory. Everything from that traumatic incident gets mis-filed. This is the reason PTSD sufferers can be triggered at any time. These mis-filed memories can be anything from a picture in the mind to a smell, taste, sound or even a feeling that the brain associates with the original trauma. It is important to point out that trauma does not have to be a life-threatening event, it can be anything that a person deems different from their everyday life, such as rape, domestic abuse, being in a narcissistic relationship, getting stuck in a lift, witnessing an event, etc.
Phases of Therapy
The first phase; the assessment phase. The therapist will work with you identifying presenting symptoms, medication, and history, and drawing up a treatment plan that works for you.
Phase two; is working to give you coping strategies or as the therapist may call it resourcing you with techniques so that you can use them on yourself if you feel you are being triggered at any time. This helps stop any re-traumatizing happening (this is the main advantage of EMDR therapy as other therapies can re- trigger trauma by revisiting the event without resourcing the client with safe coping mechanisms). It gives you the knowledge you can talk about or remember the event without experiencing the side effects.
Phases three- five; this is the preparation phase. The therapist will talk to you about the event. They will not want specific details, but are looking for what emotions you feel when thinking about the trauma. Are there any physical symptoms you are experiencing, such a pain in a specific area of the body? This helps the therapist to understand how the trauma is affecting you. You will be asked what negative images or beliefs you have due to the event. Then what the positive would look like if the issue were to be resolved. This is sometimes called the target event. You will be asked to focus on the image, negative thought, and body sensations while simultaneously engaging in EMDR processing using sets of bilateral stimulation. These sets may include eye movements, (eyes focusing on a finger or object whilst it moves from side to side in a set pattern), taps, or tones. The type and length of these sets is different for each client. At this point, you are instructed to just notice whatever spontaneously happens. After each set of stimulation, you will be asked to let your mind go blank and to notice whatever thought, feeling, image, memory, or sensation comes to mind. Depending upon what you report the therapist will choose the next focus of attention. These are repeated numerous times throughout the session. If the client becomes distressed or has difficulty in progressing, the therapist follows established procedures to help the client get back on track, using the previously taught resourcing methods. When you report no distress related to the targeted memory, you are asked to think of the preferred positive belief that was identified at the beginning of the session. At this time, you may adjust the positive belief if necessary, and then focus on it during the next set of distressing events.
Phase six; the therapist will take you through a guided bodyscan. This is to help you to identify what may be happening in the body, as it is known that we store physical effects from trauma within the body. For example, tightness in the chest, an upset tummy, heavy feet, or a bad headache etc.
Phase seven; the therapist will start to close the therapy session, they may ask you to keep a journal of anything that may arise in relation to new memories of the traumatic event, and physical symptoms. It is normal to feel quite tired after a session of EMDR therapy. It can help to remind you to use the resourcing techniques that were previously taught to help calm yourself.
Phase eight; this is known as the re-evaluation phase as this is happens the beginning of the next session to identify the progress made, if you need any more re-processing, and if there were any new target events that you would like to work on.
What has happened to these traumatic memories?
As stated before, the brain mis-files the traumatic event and is unable to make sense of them. The eye movement or tapping has a bi-lateral stimulation affect getting both sides of the brain working at once, promoting blood flow to the whole brain. This in turn helps the brain to take these memories and make sense of them, file them away safely as just a memory with no associated effects. You will be able to revisit these memories as you would an ordinary everyday memory.
EMDR has proven effective in the management of not just PTSD/CPTSD but also anxiety, depression, and addiction. Before the pandemic it was thought that EMDR therapy had to be performed with the person in next to the therapist, however, it has been shown to be just as effective being delivered online. This means it does not have to be limited to the therapy room alone, great news with this “new normal” we are living in.
If you would like to know any more information or are interested in having some EMDR therapy please contact me at https://theeaves.org.uk/practitioners/rachel-sewrey/