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EMDR therapy

Image by Melissa Di Rocco

EMDR stands for Eye Movement Desensitisation and Reprocessing (EMDR).

 

Who would benefit from EMDR?

 

If you have experienced a traumatic event, or series of events either recently or many years ago, you may recognise some of these symptoms……

 

•   Poor sleep or nightmares

•   Flashbacks and intrusive memories, images & sensations. Intrusive means that you have these images, thoughts and sensations when you don’t want to have them. These intrusions seem to appear from nowhere, leaving you feeling distressed and with a sense of being out of control of them

•   Feeling jumpy and on edge

•   Avoiding situations, places & people that remind you of the trauma, or anything related to the trauma

 

These are very common experiences following exposure to traumatic events, and can lead to other difficulties such as substance dependency, self harming, and problems with relationships. In addition, many people can feel either overly-emotional or very flat, unemotional and detached. It may be difficult to be around family and friends, which can make you feel isolated, as if no-one else could understand how you feel. It may feel impossible to talk about, as you are afraid of ‘triggering’ a fear response, or re-activating how you felt at the time.

 

Firstly, the theory: What do we think happens to our brains when we become traumatised?

 

On a positive note, our brains are equipped to ‘make sense of’ everyday events, including traumatic events. EMDR proposes that we are biologically programmed to overcome adversity in the following ways:

 

Within each of us is a ‘physiological information processing system’ through which new experiences and information are processed into a state where we can make sense of them. This is known as the ‘adaptive information processing’ system of the brain.

 

The day to day information we take in is stored in memory networks that contain related thoughts, images, emotions, and sensations. Memory networks are organised around the earliest related event, and in everyday ‘non-traumatic’ situations, our memory networks are organised neatly, and in ways in which we can retrieve information quickly and easily.
 

However, traumatic experiences and persistent unmet interpersonal needs during crucial periods in  our development can produce “blockages” in the capacity of the adaptive information processing system to resolve distressing or traumatic events. This means that the distressing information remains ‘live’, leaving us in a constant state of feeling under threat, and not recognising that the danger (of the original trauma) has passed. Being in this state is often called ‘the fight or flight’ response. We need the fight or flight response to help us to survive when we are under immediate threat, but it becomes problematic for us when the threat is only in our memory, and not in the actual ‘here and now’.
 

When we are able to ‘process’ the difficult material, this activates the ‘adaptive information processing’ system of the brain. The result of adaptive processing is a ‘filing away’ of the memory, which creates learning, relief of emotional distress, and facilitates the availability of adaptive responses and understanding. What must be understood here is that EMDR does not make the memory disappear, it just makes it easier to manage.  This is especially important if you have had a traumatic bereavement, you will not ‘forget’ important memories related to the loved one you have lost.

 

What is EMDR & how can it help resolve symptoms of trauma?

 

Eye Movement Desensitisation and Reprocessing (EMDR) is a therapy which has helped many people resolve the symptoms of trauma. Essentially, we need to understand that trauma related memories become ‘locked’ in a different part of the brain, and in order for them to be ‘filed away’ properly they need to be ‘processed’. This means we have to find a way to make sense of what happened before we can put the memories ‘into the filing cabinet’.

 

We cannot make the memories of the experience disappear but we can make them manageable so that eventually you can, if you choose, think about the event without being overwhelmed with distress. You will keep appropriate emotions such as sadness or anger but they will be manageable – you will be in control.

 

There are many ways of making sense of (processing) these memories. Talking about them may help but you may not feel comfortable doing that with people you know – you don’t want to upset them or let them see you upset. Writing things down, art, and drama are also ways of processing memories. Trauma-Focused Cognitive Behaviour Therapy is one way you can talk, with the help of a therapist, about what has happened and learn to make sense of your experiences.

 

EMDR is a relatively new way of helping with these problematic memories. We understand that the mind can often heal itself naturally, in the same way as the body does. Much of this natural coping mechanism occurs during sleep, particularly during rapid eye movement (REM) sleep. Francine Shapiro developed Eye Movement Desensitisation and Reprocessing (EMDR) in 1987, and EMDR uses a process called ‘bilateral stimulation’ whereby you will either use your eyes to follow movements, listen to sounds, or receive tapping from your therapist (on the back of your hand) whilst thinking about the worst part of the traumatic incident(s).  It is thought that this process of ‘bilateral stimulation’ mirrors the process of REM sleep, which stimulates your brain into processing the painful material, and thus activating the ‘Adaptive Information Processing’ part of your brain.

 

 

What will happen during EMDR therapy?

 

Firstly, it is important that you and your therapist really understand each other. To help with this your therapist will spend a lot of time in the first session or two talking about your background and your experiences as well as about the trauma itself. Your therapist may spend time teaching you how to relax and looking at other areas of your life which you are not happy with – some people may begin to drink a lot more, or self harm to cope with their feelings or to help them sleep. Others may cut themselves off from friends and family. It is important that all these ways of coping are discussed with your therapist, who will be able to understand why you are doing these things, and will not judge you.

 

Once your therapist has an understanding of what the difficulties are and how you are coping, you will be introduced to the EMDR technique. You will usually start with a helpful relaxation exercise called a ‘Safe Place’ in which you focus on a pleasant place while watching a target (usually the therapist’s fingers) rhythmically moving from side to side in front of your eyes. The more you do this the more relaxing you will find it and you will be able to use this after the session to help you relax in difficult situations.

 

As you move on to working on the difficult memory, the therapist will ask you some questions about the event and your thoughts and feelings at the time. You will then be asked to think about the event while watching the moving target for a few seconds. When the target stops the therapist will ask you what you are getting or noticing at that time. All you need to do is tell them whatever is coming up even if it is blank, you can’t hold the image or it changes to another image. You will be asked to just notice that and the whole process is repeated over and over again. Each time you will probably notice something different. At first the feelings can be very intense but as you persist, they usually calm down and become easier and easier. Very often people remember all sorts of details they had not been aware of before. Sometimes things come up which seem unrelated to the trauma but you will just be asked to stay with whatever is coming up at the time.

 

Your EMDR session may be long, often 1.5 hours. This is to allow plenty of time to relax and calm down at the end so that you leave the session feeling relaxed and well. You will often end a session by returning to your ‘Safe Place’.

 

The most important thing about EMDR is that you are in control of the process. At any time you can just raise your hand and stop the process. Obviously, if you can stick with it you will work through things more quickly. Most people notice an improvement in their poor sleep and intrusive thoughts first.

 

One of the benefits of EMDR is that unlike most therapies, with EMDR the less talking the better! This can be really helpful with trauma as often it can be difficult to describe to another person the details of what you have experienced. Sometimes people can drop out of therapy because of this., meaning they sadly don’t get the help they need. With EMDR, the process will still work if you are unable to talk about what you are remembering. (Obviously this can be especially helpful in something like sexual assault.) However, feedback on what you are experiencing, as you remember the traumatic event(s) will help your therapist to help you even more.

 

Some important points about EMDR

 

If you have any doubts or concerns, do talk them through with your therapist. You are in control – if you do not feel up to doing a long session of eye movements, just say so. Learning to relax and getting your life back on track are also important parts of rebuilding your life after traumatic experiences.

 

EMDR is not hypnotism, you are awake and fully in control at all times. Whilst EMDR may sound a bit off the wall, it is an evidence -based therapy for trauma, and is recommended by NICE, which means that it has independently validated rigorous evidence to support it’s efficacy, and is recommended for use in the NHS.

 

Finally, EMDR is a very powerful therapy with strict training and supervision standards . If you are seeking an EMDR therapist, ensure that they hold a full part 3 qualification in EMDR, and that they have ongoing supervision.  EMDR Training is only ever offered to suitably trained mental health professionals, Do not ever be tempted to try ‘doing it’ on other people, you risk opening up situations you are not equipped to deal with and could do harm.

 

I am interested in seeking EMDR therapy, what should I do?

 

You can contact your GP to find out if you can be offered EMDR by the NHS.  You can also visit http://emdrassociation.org.uk to find out more about trauma symptoms and EMDR. Most importantly, seek some help.

 

Why choose Nicola at Nine Wellbeing for EMDR therapy?

 

If you are seeking EMDR therapy on a private basis, Nicola is a warm and sensitive therapist who is committed to helping those who have experienced trauma to feel more in control of their lives. Nicola is a fully qualified EMDR therapist, a member of the EMDR Association, and has spent many years as a psychotherapist working with trauma and other related difficulties in specialist NHS settings.

 

Nicola’s philosophy at Nine Wellbeing is that you are not viewed as a ‘collection of symptoms’, rather you are valued as an individual, and Nicola will strive to understand how your difficulties are impacting all areas of your life. You will be offered a personal formulation as to how you are experiencing your difficulties, what has caused them, and what therapy will target, in order to help you to reduce the impact of the trauma, and help you to live your life more fully again.

 

To find out more or to book a consultation, please contact Nicola via the contact page.

 

Nicola Forshaw holds a Masters Degree in Counselling (with distinction), a diploma in Cognitive Behavioural Therapy, and a certificate in Dialectical Behaviour Therapy.  Nicola is a highly experienced trauma/PTSD therapist and is fully qualified in EMDR (Eye Movement Desensitisation and Reprocessing). She is accredited by BACP (British Association of Counselling & Psychotherapy), and is also a registered member.

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