Jane Chugg-White CBT

Eye Movement Desensitization Reprocessing (EMDR)

This is a summary of some of the core elements of EMDR. Please don't hesitate to contact me for an informal chat and/or signposting to other resources if you would like further information about EMDR.

EMDR is recommended by the NHS in their guidelines as an evidence based effective treatment for Post Traumatic Stress Disorder although it can be used for some anxiety related issues and in the treatment of phobias. It was originally devised by Francine Shapiro. It involves a very specific set of procedures which include eye movements to help the brain to process information relating to traumatic events.

When a traumatic event is experienced, the brain does not process it in the way that a non traumatic event would be processed. Imagine that each of us has a filing cabinet of memories in our brain. If we want to remember a certain event in the past, or someone asks us about an event in the past, or something reminds us of an event in the past, for example; your last holiday; providing this didn't involve serious trauma we can 'retrieve' the file marked 'my last holiday' and bring it into our present consciousness, talk about it, and then file it away again, and get on with our day without any problems.

With a traumatic experience the part of the brain that processes information becomes overwhelmed and the processing procedure becomes interrupted. The trauma memory often becomes fragmented, it might be difficult to remember the events in order, there may be blanks in the memory. The memory also stays very 'alive' and 'present' and it won't seem to go into the past no matter how hard the person tries. This is because the traumatic event remains un processed. The brain attempts to wall the information off, but it is a bit like an overfull cupboard, every time the door is open, something falls out. Reminders in the present can cause parts of the memory to fall out of the 'cupboard door' and intrude into the present so that the person can feel as if the trauma is happening all over again. The person can have intrusive images, or feelings, or nightmares.

EMDR treatment through a very specific set of procedures allows the brains processing system to 'fire up' again and to process the traumatic information. It involves taking the memory out from behind the 'wall' or the 'cupboard'; and with the help of the EMDR treatment and support from the therapist, the person can be helped and supported to make a narrative of events, and to process the events of, and thoughts and feelings about the traumatic event which then enables full processing to occur so that this event/memory can be filed in the same way as other memories are filed in the filing cabinet; in the same way that the only way to deal with an overfull and untidy cupboard is to take everything out; sort through it piece by piece, and put things back in order. It may seem unthinkable for a traumatic event or even feel disrespectful to the event to think about making order, or meaning from it, but the therapy supports the person to make their own individual sense and order of the trauma, so that the person is able to live their lives free of being controlled by the extremely debilitative effects of PTSD. 

This is a simplistic way of describing this therapy, but hopefully helpful in order to have an understanding of the process and rationale for the treatment. It is not an easy process to undertake, but PTSD is an extremely debilitating illness, and EMDR has a good evidence base for recovery. Throughout the treatment support will be very present, and coping strategies and resources are built up beforehand. The client also always remains in control; you will never be asked to do anything you don't want to do, or talk about anything you don't want to talk about. One of the enormous benefits of EMDR treatment is that it is not necessary to talk about every detail of the trauma for it to work. (Some people find it helpful to talk through the details, but for others they might prefer not to, and either decision will be supported and respected).

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