Individuals who have suffered severe childhood trauma may, as a result of it, later suffer from Post-Traumatic Stress Disorder (PTSD), or similar condition. Some professionals advocate a relatively new technique which aims to address this; it is known as Eye Movement Desensitisation and Reprocessing (EMDR).
WHAT IS EMDR?
The therapist administering EMDR will first examine the issues related to the individual’s psychological difficulties and, also, help him/her develop strategies to aid in relaxation and deal with stress. After this, the therapist encourages the individual to recall particular traumas, whilst, simultaneously, manipulating his/her eye movements by instructing him/her to follow the movements the therapist is making with a pen, or similar object, in front of the individual’s face). The theory is that this will facilitate the individual to effectively reprocess his/her traumatic experiences, thus alleviating psychological distress.
THIS SOUNDS A LITTLE ODD; WHAT IS THE RATIONALE BEHIND EMDR AND HOW, EXACTLY, IS IT THOUGHT TO WORK?
My first reaction to hearing about this particular therapy was that it sounded somewhat strange. However, the rationale behind EMDR is that disturbing memories from childhood need to be PROPERLY PROCESSED by the brain in order to alleviate symptoms associated with having experienced childhood trauma (eg PTSD, as already mentioned); this is because the view is taken that it is the UNRESOLVED TRAUMA that is the cause of the psychiatric difficulties the individual who presents him/herself for treatment is suffering. Those professionals who recommend the therapy believe that the EYE MOVEMENTS INDUCED BY THE THERAPIST IN THE INDIVIDUAL BEING TREATED LEAD TO NEUROLOGICAL AND PHYSIOLOGICAL CHANGES IN THE BRAIN WHICH AID IN THE EFFECTIVE REPROCESSING OF THE TRAUMATIC MEMORY, and, in this way, ameliorates psychological problems from which the individual had been suffering.
WHAT ARE THE STAGES INVOLVED IN EMDR THERAPY?
These are briefly outlined below:
1) The first stage is the identification of the specific memory/memories which underlie the trauma.
2) Next, the individual is asked to identify particular negative beliefs he/she links to the memory (e.g. ‘I am worthless’)
3) Then, the individual being treated is asked to replace the negative belief with a positive belief (e.g .’ I am strong enough to recover’ or ‘I am a person of value with potential to have a bright future’ etc)
4) In the fourth stage, the therapist moves a pen (or similar object) in various, predetermined motions in front of the individual’s face and he/she is instructed to follow the movements with his/her eyes (e.g repeatedly left and right). Whilst this is going on, the therapist instructs the individual to simply, non-judgmentally observe his/her own thoughts, letting them come and go freely and without trying to influence them in any way – just to accept them, in other words, and let them happen.
5) This procedure is repeated several times.
Each time the process is undertaken, the therapist asks the individual being treated to rate how much distress he/she feels – this continues until his/her self-reported level of distress becomes very low. Similarly, each time the process is undertaken, the individual is asked to report how strongly he/she now feels he/she believes in the positive idea given in stage 3 (see examples provided above); therapy is only concluded once the level of reported belief becomes very high.
N.B. The therapy is actually more involved than this, so the above should only be taken as a brief outline. There are, too, different variations of the procedure outlined above which can be employed within the EMDR range of therapies available.
EMDR CAN HELP UNBLOCK TRAUMATIC INFORMATION HELD IN THE BRAIN AND HELP US TO HEALTHILY INTEGRATE IT INTO OUR LIFE STORY AS A WHOLE :
When we suffer severe trauma we are not able to fully mentally process what it is that has happened to us and the trauma becomes mentally entrenched – in other words, what happened to us becomes locked or ‘stuck’ in our memory network. The effect of this may include us experiencing various symptoms such as irrational beliefs, painful emotions, anxiety and fears, flashbacks, nightmares and phobias. It may well also cause blocked energy and greatly reduce our self-efficacy.
When we experience events that trigger memories of the trauma, images, sounds, physical sensations and beliefs which echo the original experience of the trauma cause our perception of current events to be distorted.
EMDR (Eye Movement Desensitization and Reprocessing) can unblock this traumatic information and thus allow us to healthily mentally integrate it with our other life experiences and our life story as a whole.
Trauma can occur in the form of SHOCK TRAUMA and DEVELOPMENTAL TRAUMA. Shock trauma consists of a sudden threat which is overwhelming and/or life-threatening – it occurs as a single episode such as a violent attack, rape or a natural disaster. Developmental trauma, on the other hand, refers to a series of events which occur over a period of time. These events GRADUALLY ALTER THE PERSON’S NEUROLOGICAL SYSTEM to the point that it REMAINS IN THE TRAUMATIC STATE. This, in turn, can cause an interruption in the child’s long-term psychological growth. Experiences which can lead to developmental trauma include abandonment by a parent, long term separation from a parent, an unsafe environment, an unstable environment, neglect, serious illness, physical and/or sexual abuse or betrayal by a caregiver.
The effects of developmental trauma include damaging the child’s sense of self. self-esteem, self-definition and self-confidence. Also, the child’s sense of safety and security in the world will be seriously undermined. This makes it far more likely that the individual will experience further trauma in life as an adult as his/her sense of fear and helplessness remain unresolved.
EMDR works by allowing the locked or ‘stuck’ traumatic information to be properly, mentally processed. This leads to the disturbing information becoming psychologically resolved and integrated.
HOW DOES EMDR ACTUALLY WORK?
EMDR is based on the idea that it is our memories which form the basis of our PERCEPTIONS, ATTITUDES and BEHAVIOURS. Because, as we have already established, traumatic memories fail to be properly processed they lead to these perceptions, attitudes and behaviours becoming DISTORTED and DYSFUNCTIONAL. In effect, the trauma is too large and too complex to be properly processed so it remains ‘STUCK’ and DYSFUNCTIONALLY STORED. This often leads to MALADAPTIVE ATTEMPTS TO PROCESS AND RESOLVE THE INFORMATION CONNECTED TO THE TRAUMA SUCH AS FLASHBACKS AND NIGHTMARES (Sharpio, 2001).
When this problem occurs it is EMDR which is being increasingly turned to allow effective processing and mental healing to occur. I will look in more detail at what EMDR involves in later posts.
WHAT DO EVALUATION STUDIES OF EMDR THERAPY SUGGEST ABOUT ITS EFFECTIVENESS?
A recent meta-analysis of evidence (ie an overview of a large number of particular, individual studies of EMDR) supported the claim that it is effective, as have other meta-analyses. However, some researchers have suggested that it is not the EYE MOVEMENT PART of the therapy which is of benefit, but only the act of repeatedly recalling traumatic memories which is the effective component (based on the idea that these repeated mental exposures, under close supervision and in a supportive and safe environment, of the traumatic memories alone facilitate their therapeutic reprocessing).
In response to this criticism, its exponents (and there are many professionals who are), regard the EYE MOVEMENT COMPONENT of the therapy as ESSENTIAL in giving rise to the NECESSARY NEUROLOGICAL CHANGES which allow the EFFECTIVE REPROCESSING OF THE TRAUMA; these proponents also emphasize that the therapy only requires short exposures to the traumatic memory/memories, thus giving it an advantage over therapies which utilize far more protracted exposures.
Research into EMDR is ongoing.
David Hosier BSc Hons; MSc; PGDE(FAHE).