WHAT IS EMDR?
EMDR is an acronym for Eye Movement Desensitisation and Reprocessing. It is a form of psychotherapy that was develop in the 1980s by a clinical psychologist named Dr. Francine Shapiro.
The idea behind it is to allow people to recover from symptoms they have suffered as a result of severe emotional distress or any number of disturbing life experiences (aka trauma).
If your body can recover from the physical aspects of a traumatic experience, then so can your mind.
If you break your leg, or cut your arm, your body will begin to repair itself. With EMDR, the proposal is that the same can be done with psychological trauma too.
EMDR works because of how the brain deals with trauma. For many people, when they experience a traumatic event (I mean REAL trauma, not when your favourite team loses the cup final) our brains are overwhelmed by the seriousness of it and they simply can't process the memory of the event in the same way it does with more mundane memories.
It becomes stuck in an endless cycle. In lay terms, the brain simply doesn't know how to sort it out so it ends up playing on repeat. EMDR aims to deal with these memories that are 'stuck' in psychological limbo and allows the brain another chance to process them, so they don't keep repeating themselves.
HOW DOES EMDR WORK?
EMDR is an eight-phase treatment that can take many months to complete. For the sake of this, we will talk about the therapist and the 'client'. The phases work like this.
- The patient's history and personal treatment plan are discussed. This allows the therapist to target the areas that EMDR can potentially help.
- Before EMDR begins, a 'safe place' is identified. This is a memory or image that promotes a sense of positivity, comfort and security. The place is used to close a session or help to tolerate parts of distress that arise.
- Using a target created in Stage 1, a snapshot of that is identified and becomes the focus for the distress. It is known as a negative cognition, which can be a negative feeling they believe to be true, especially if they focus on the target. A positive cognition is also identified, which can be a positive self-statement like "I am safe".
- Phase 4 is key. This is where the client will be asked to focus on the negative cognition they have thought of and, at that same time, the disturbing emotion it generates. The therapist will then ask them to follow a moving object, a pen or the therapist's fingers, with their eyes (not their head - this is the 'Eye Movement' part of EMDR) whilst it moves from side to side within the client's field of vision. After a number of moves, they will be asked to identify what they feel or what came to mind. They may then be asked to focus on this memory and the movements begin again. If not, then they will continue to focus on the original one. The level of distress will be monitored by the therapist during this phase.
- The fifth stage is known as the Installation Phase and allows the clients to talk about the positive cognition, if it's still valid as it may have changed after Phase 4. If not, another positive cognition may be needed.
- The therapist will ask if there are any areas of the client's body that are in pain, distress or discomfort. If there are, then they will be asked to concentrate on that part and new sets are issued.
- The therapist will debrief the client with any appropriate information and support.
- This will be a re-evaluation of the time since the last session, i.e. have any disturbing images surfaced (or resurfaced) since the last session. This is done to ensure the relevant historical events have been processed and often takes place at the beginning of the next session (rather than the end of the current one).
The main thinking behind EMDR really occurs in stage 4. Whist the client is following the object, it is believed that the biological mechanisms begin to process the memories and the internal associations with more positive memories, allowing the trauma to be transformed on an emotional level. Transformation is key.
It is not intended that the traumatic memory is forgotten or hidden, more that the experience that one they based them now has positive connotations, rather than negative ones. The trauma has been 'Desensitised' and 'Reprocessed', hence the name.
WHO IS EMDR FOR?
EMDR is recommended, primarily, for those with Post Traumatic Stress Disorder. One of the main symptoms of PTSD is the unnerving replaying of the traumatic event. It causes the person living with PTSD to relive the trauma over and over again, through flashbacks whilst they are awake and nightmares whilst they are asleep.
Sadly, this can't be resolved in one session. It just doesn't work like that.
The focus of EMDR isn't to overwrite the memory or make the person pretend it never happened, but simply to retrain the brain to be desensitised to the anxiety and distress it has caused.