In my therapy practice I offer a range of different psychotherapeutic approaches and techniques so that I can use the most appropriate tool from my toolbox to help a client with their own individual issues. Good psychotherapists are committed to continuous professional development and undertake additional courses each year to keep their skills up to date and to stay abreast of new methods, models, techniques and research in the world of psychotherapy. Perhaps you have been seeking therapy or are just interested in what is available?
If you have ever checked out various therapist websites you are probably bewildered by the strange sounding therapies and techniques they offer. Whilst hypnotherapy is now very common, other evidence-based therapies such as EMDR are less well known. I trained in using this form of therapy a few years ago, when I felt I needed an extra tool in my toolbox for dealing with distress in a fast and effective way. In this blog I am talking about EMDR and how it can be invaluable in helping people overcome serious distress.
So what is EMDR?
EMDR stands for Eye Movement Desensitisation and Reprocessing. It is a powerful psychological treatment method that was first outlined in the 1980’s by Dr Francine Shapiro, a clinical psychologist. Shapiro developed the EMDR therapeutic approach based on specific principles, protocols and procedures with the goal of reducing distress in the shortest period of time.
Substantial research has demonstrated the benefits of EMDR in treating psychological trauma and (PTSD) Post Traumatic Stress Disorder. It is now commonly used to help the victims of large-scale catastrophes around the world including experiences of war and natural world disasters. However, it is also used to help people overcome the distress experienced from childhood abuse or neglect, assaults, surgical trauma, road traffic and workplace accidents. For example, train drivers who witness fatalities on the line are treated with EMDR as it can relieve their distress quickly and effectively. It can also be used to help people experiencing emotional distress with other issues including anxiety, phobias, grief, divorce, illness, performance anxiety, self esteem or any distress from the past, which is still impacting on day-to-day life.
So how does it work?
Being involved in a distressing event can feel overwhelming and the brain may be unable to process this information in the same way as it would an ordinary memory. The distressing memory seems to become frozen on a neurological level. Recalling the distressing memory, which can sometimes be triggered when you least expect it, can cause you to intensely re-experience whatever you could see, hear, smell, taste or feel at the time of the event. Sometimes the memory is so disturbing that you avoid thinking about it so you don’t have to experience the distress. In PTSD, people experience flashbacks and nightmares that are as intense as the actual incident that created the distress.
EMDR aims to identify and process dysfunctional and unhelpful behaviours, emotions, cognitions and memories arising from recent or past trauma and distressing life experiences. The theory behind the treatment proposes that unprocessed traumatic or distressing information produces dysfunctional reactions. These unprocessed memories are stored in separate unconnected memory networks in the brain. In EMDR, bilateral stimulation allows you to make connections between these neuro-networks causing spontaneous insight and change, resulting in learning and relief of emotional distress.
For example, let’s suppose someone was bullied at school and instead of the brain making sense of that experience and letting it go, the distress experienced is stored in a separate memory network along with all the emotion, beliefs and physical sensations that were there at the time. When something happens perhaps 20 years later that the brain interprets as being similar in nature (perhaps a boss at work makes a negative comment) the brain makes sense of it by linking to the old memory and all the associated feelings come flooding back. This person may not understand why the boss being negative triggers such a distressing reaction in them because it is happening automatically and is beyond their control. In EMDR, that old memory can be processed appropriately as you learn what you need from it and let the rest go. The original memory is transformed and stored in this reconsolidated form so the person can’t be triggered any more.
The treatment phase of the EMDR protocol can seem a little strange when you first encounter it. Alternating eye movements (or sometimes tapping or sounds) are used to stimulate the brain into reprocessing the frozen or blocked information that is being triggered and creating the distress. This bilateral stimulation allows you to re-process the distressing memories more appropriately, so they lose their intensity and can be stored in the same way as normal memories. The effect is believed to work in the same way as we naturally process ordinary memories during REM (Rapid Eye Movement) or dream sleep when your eyes move rapidly and repeatedly from side to side. After treatment, past memories no longer cause you distress, allowing you to respond adaptively in the present and in the future.
What happens during EMDR treatment?
In my therapy room, I start with a history taking session during which I assess your readiness for EMDR and develop a treatment plan. Working together, we identify possible targets for EMDR processing. These include recent distressing events, current situations that elicit emotional disturbance (triggers) and related historical incidents.
I always ensure that every client has adequate methods of handling emotional distress and good coping skills before any processing work takes place. Hypnotherapy techniques can be great for doing this effectively and the bonus is that you learn and practice some valuable skills that can be used in everyday stressful situations, as well as during or between sessions.
Once an initial target has been identified, it is processed using EMDR procedures. This usually involves you identifying a specific visual image related to the memory, beliefs about yourself in that situation, and the associated emotions and body sensations. There are other ways of using EMDR where you don’t have to openly share distressing information with the therapist, so before any processing starts we decide together which way of working would be most beneficial for you.
When the processing stage begins you are asked to focus on aspects of the memory whilst simultaneously moving your eyes back and forth following my fingers as they move across your field of vision for 20-30 seconds. You may be asked instead to listen to alternating tones or use a tapping device, which you hold in each hand to experience the bilateral stimulation, which enables the processing to take place. You are then asked to relate whatever thought, feeling, image, memory, or sensation comes to mind. This is repeated numerous times throughout the session. As the memory is adapted appropriately you will notice things changing and the associated distress subsiding until it disappears. Depending on the complexity and severity of the distress, it may take several sessions to process the old memories in a fully adaptive way.
After EMDR processing, clients generally report that the emotional distress related to the memory has been eliminated, or greatly decreased, and that they have gained important cognitive insights. Usually they cannot recall the old memory in the same distressing way again. Importantly, these emotional and cognitive changes generally result in spontaneous behavioural and personal change, which can be further enhanced.
When I first experienced EMDR I was blown away by it’s effectiveness. I have since used it very successfully for treating many clients including people suffering from the effects of phobias, anxiety, relationship distress, and road traffic accident traumas.
I have completed all 4 parts of an EMDR Association approved course and supervised practice in Eye Movement Desensitisation and Reprocessing. Training on an approved course is restricted to mental health professionals who hold current registration to provide psychotherapeutic services (such as British Psychological Society membership). I am pleased to be able to offer this service to my clients alongside my other services.
If you are interested in EMDR there is a link on my website to find out more: http://www.mindmakeoveruk.com/links.html
I am Susan Tibbett, a Chartered Psychologist and Hypnotherapist based in York. You can reach me at: http://www.mindmakeoveruk.com