Introducing EMDR: Eye Movement Desensitisation and Reprogramming

When I began practising this relatively new therapy, clients were sceptical. But here’s what three said after a few sessions (reproduced with permission):

• ‘It’s tangible, not airy fairy, I can see it’s really making a difference.’

• ‘I can’t believe it works, but I feel a lot calmer now!’

• ‘difficult at times . . . it had a very dramatic effect on me. It helped me to process outstanding memories.’ 

EMDR is especially helpful for people who have:

• stark and unhappy memories of a neglected or abused childhood.

• recurrent flashbacks and nightmares from accidents, attacks, sexual abuse and similar traumatic experiences.

In 1987, an American therapist, Dr Francine Shapiro, made a chance discovery: whilst walking, she noticed that troubling thoughts diminished as she moved her eyes from side to side. Without understanding the neurobiology of what was happening, she successfully developed a simple treatment based on this chance discovery to treat Vietnam War veterans suffering Post Traumatic Stress Disorder. EMDR is now recognised by the National Institute for Clinical Excellence (NICE) as a recommended means of treating PTSD.

REM

There may be parallels with Rapid Eye Movement sleep, which we know accompanies dreaming. When disengaged from daytime functioning, the brain processes recent experiences, filing them away, making connections with previous learning. People who do not get REM sleep lose out on this digestion process.

Fight or Flight

Usually, experiences are digested, put into perspective and filed away as part of normal brain processing. But if our senses are overwhelmed by any traumatic, threatening event, our rational brain shuts down: the threat is thrust into our primitive reptile brain as if a video recording were lodged there. Anxiety increases to make us take action, and we prepare to fight or flee. The video images stay there, so that if anything remotely similar occurs in the future, they are triggered: anxiety rises and we go into the same survival mode.

Rubberbanding

The first EMDR therapists worked with Vietnam veterans who dived for cover if a door slammed. The trauma of shellfire had led these men to equate any loud noise with extreme danger. Our reptile brain is so clever that it generalises. Unfortunately, modern life is full of loud noises – but since his rational brain has never processed the original memory, the ex-soldier has no means of distinguishing a car backfire from an artillery explosion.

EMDR has proved itself very successful in helping veterans to reprocess traumatic memories. It is as if the brain is helped to do what it does best – digest, file away, make connections, get events in context.

Ever wondered why certain bosses terrify you? It could be that they are so like some bullying teacher that you rubberband to the feelings of child helplessness every time they speak to you.

Big Ts, Little ts

Therapists have always known that we are taken back to the pain of early memories by events that are similar – we dislike a boss because he is sarcastic and bad-tempered like our father; we are frightened of water because we nearly drowned as a toddler; goodbyes may be hard if we lost a loved one in childhood. A lesser experience has the same impact on us as the original hammer blow. Indeed, life is full of trauma – not the wartime or cataclysmic Big Ts, but the lesser ts, ie situations we faced which emotionally overwhelmed us. If these accumulate – say regular episodes of parental misattunement, criticism, lack of nurture and encouragement or emotional neglect – the results can be just as wounding.

Little t experiences happened when

• We were emotionally unsupported
• We did not have the information to understand what was happening
• We were faced with events to which a child of our age should not have been exposed

EMDR has been found to be as effective with the little ts as the Big Ts.

Installing Resources

The therapy does not involve hypnosis. But as EMDR can activate intense emotional memories, it would be irresponsible for any therapist to plunge a client into trauma work without some careful preparation. So, it is necessary first to establish a long-remembered ‘Safe Place’ through a structured visualisation procedure. This is reinforced and embedded by a series of slow eye movements.

These ‘resources’ are places to go mentally when life is tough. For some people, a few sessions involving careful visualisation and installation of such good memories is enough to bring real improvement.

A similar process can ‘install’ good memories of times when the client felt:

• good about themselves
• supported and valued
• emotionally connected with someone important to them in childhood.

Further EMDR processing of ‘Big T/Little t’ memories is sometimes unnecessary once these resources have been installed.

An EMDR Processing Session

A typical processing session will identify a recent or past event that is troubling. Through normal counselling, we arrive at the key, early scene (the Touchstone Memory) -  the prototype of the recent  experience. We establish the key negative thought that you came to believe about yourself at that time. (Such negative thoughts get stimulated every time a similar experience occurs, putting us into a cycle of destructive thinking.) Then we induce eye movement simply by following my hand movements in front of your face. Whatever comes to mind we go with – the brain begins to make connections, clearing out similar bad memories, linking them up with more recent, moderating sensations and thoughts. In The Adult comes to the rescue of the Child.