What is EMDR?
EMDR stands for eye movement desensitisation and reprocessing. It is possibly one of the most groundbreaking therapies to be discovered and developed in the last thirty years. Discovered by Francine Shapiro in 1988, it is now recognised as an evidence based treatment by the most reputable of therapists globally.
Shapiro realised that when she recalled traumatic memories that she developed rapid eye movement that was uncontrolled. By taking control of the eye movements she was able to change her response to the memory. This response was developed to treat PTSD. Indeed, she did so successfully and today we have EMDR. Research has shown that EMDR is equally as effective as CBT and is used to treat trauma in adults and children alike.
Trauma and memory
When we have an experience most of the experience is at least introduced by sensory input. Our eyes and ears are the first sensory experiences to record the memory. We process the experience and the memory is then stored away in the brain with all of our other memories.
Trauma however is sometimes processed quite differently. Because the experience is essentially a psychologically emergency situation, we deal with the sensory natural responses that take place such as fight or flight. Our minds then place our memories about the trauma into “temporary” storage, as if to be processed properly later.
The trauma can however be so extreme that we forget that the memory is in “temporary” storage and hasn’t been dealt with either rationally or emotionally. It’s a bit like baking some bread. The dough has been prepared but it hasn’t been allowed to either rise or bake. Every time the memory resurfaces it can feel as though we are reliving the entire experience as a brand new experience all over again. The memory has not been processed, rationalised and carefully assigned a place in our catalogue of memories. Unless we consciously recognise that our memories are stuck in the brain in this unprocessed state, they will remain trapped in our temporary memory stores and will be experienced as the raw, fresh memories every time we draw on them.
EMDR and reorganisation of memory
EMDR is the mechanism by which a memory is drawn out of the temporary storage and reprocessed to prepare it and place it in proper storage together with other memories. The event is not forgotten but placed in a more rational context. This makes the memory itself valuable as a resource rather than an experience in constant replay.
How EMDR works
No one is exactly sure how and why EMDR works. There has however been sufficient evidence and peer based reviews of the evidence to satisfy the criteria for classification as an evidence based treatment. One thing that is clear is that the left to right eye movement involved in the therapy is a catalyst for recovery. Some theories suggest that the eye movement which is similar to that of REM while asleep is what takes place when we process our experiences while asleep.
What happens during treatment?
The patient is asked to recall the memory while moving their eyes in a left to right movement sometimes following the therapists finger. In some cases where the eye movement is difficult for a patient to maintain, such as with children other left to right stimuli are used. Stimuli such as drumming hand tapping can work equally well. After a few seconds the therapist will ask the patient to stop and take a break. This is sometimes in the form of a deep breath. An enquiry as to what comes to mind next will follow. Usually a different and new image will come to mind. Which the therapist then asks the patient to hold. They then start with the eye movements, tapping or drumming again for a few seconds.
There may be multiple uncomfortable or distressing feelings and thoughts that need to be processed. The treatment will continue until that patient decides that it’s time to stop and provides a stop signal.
Preparation for EMDR
Because the therapy involves dealing with traumatic experience and recalling the memories can be like reliving it all over again, some preparation needs to take place. The patient and the therapist will work together to create a safe place for the patient. This is important, should things become a little too much for the patient. Hand signals to request an immediate stop are also prepared and where the patient is an adult some further reading may be offered.
Is it for me?
EMDR is usually used as a tool with other forms of therapy. It is offered to a client only when the client is ready. It is also not a fix all for all therapy situations. That said when it is used as part of a treatment programme its exceptional success can bring quick relief to those that have struggled with long term trauma that has been otherwise difficult to mange.