COUNSELLING, FIX EAST VILLAGE, FIX EAST LONDON
DULCIE FAURE WALKER TALKS US THROUGH WHY EYE MOVEMENT DESENSITISATION AND REPROCESSING (EMDR) HAS BECOME THE THERAPY OF CHOICE FOR MANY CLIENTS.
The importance of sleep is hardly a new concept, but what is its role in how we process and consolidate memories?
During sleep, particularly rapid eye movement (REM) sleep, we process emotional experiences and ‘file’ memories. However, when we have experienced something that has caused us significant stress, sadness, fear, or pain, this can be so overwhelming that we cannot process or store them properly; they remain unprocessed and ‘stuck’. This means that they are easily accessible, and more things can trigger the traumatic memory or adverse reactions (including emotional and physical responses). This can result in flashbacks, nightmares, and other symptoms associated with traumatic stress. It can also lead us to feel very triggered by things that remind us of the event or avoid certain situations altogether.
Eye Movement Desensitisation and Reprocessing (EMDR) therapy assists in accessing and processing specific memories using eye movements mimicking the process of memory consolidation that takes place during REM sleep. It was developed by Dr Francine Shapiro, an American psychologist, in the 1980s, after extensive research in this area.
EMDR has become increasingly popular over the last decade due to its excellent treatment results and is recommended by the National Institute for Health and Care Excellence (NICE). It is helpful for people who have found that other forms of talking therapy have not helped, or where there may not be a coherent narrative to the trauma, i.e., memories are unclear or fragmented. EMDR is not a form of hypnotism; you remain conscious, always awake and in control.
The stages of EMDR
1) History and treatment planning – to assess whether EMDR is the appropriate model of therapy
2) Preparation and resource building – building coping, grounding and soothing skills
3) Assessing the target memories/experiences to work through
4) Desensitisation of trauma memories
5) Installing the adaptive responses (processing)
6) Body scan – process residual somatic responses
7) Closure – containing what has been raised in the session
8) Re-evaluation – consolidate the changes
EMDR follows 8 broad phases, some of which take more than one session to complete, while several will be covered in just one session. As with any therapy, it is important for a detailed assessment to be carried out first to check that it is the right time to do this work, so Stage 1 and 2 can take a few sessions. From there on, some people report relief after 3-5 sessions and feel this is enough, while other require more time due to multiple memories to process. EMDR can also be used in conjunction with other therapies, and I find it very helpful to use alongside other longer term therapeutic approaches, such as Compassion Focussed Therapy or Trauma Focussed CBT.
How EMDR works
When you first meet with your EMDR therapist, they will spend time getting to know you and your history. This generally includes the kind of distress and difficulties you are experiencing, any physical problems, and the support you have.
Your therapist will assist you in developing a range of techniques aimed at stabilising your emotions and prepare you for the next phase of the therapy which is known as processing. This phase can be brief or can last for several weeks it depends on the level of preparation required and the complexity of the problem.
Once you and your therapist feel that you are sufficiently prepared, you will be asked to choose an image that represents the distressing event. You will then be asked to think about negative and positive thoughts, your feelings, the amount of distress you feel and where you feel it in your body.
Your therapist will then begin the alternating eye movements, sounds, or taps while you bring the image, thoughts, and body sensations to mind. The therapist will begin to apply what is known as ‘bilateral stimulation’ to enhance memory processing.
The method of bilateral stimulation is based on personal preference. I use auditory (sounds through headphones, from left to right), visual (a ‘light bar’, where you watch a light that moves back and forth) and tactile (small buzzers, or pulsars, that vibrate from left to right in your hands) methods. Other methods include eye movements following your therapist’s finger or tapping.
Your therapist will guide you through this phase and after each set of eye movements will ask you what you became aware of or what you noticed. There are no right or wrong answers; you just report whatever you are experiencing as you let you, your brain and body process the memory. The focus will be on allowing whatever ‘comes up to come up’.
Your therapist will then ask you to think about your positive thoughts and check whether there is any part of your body where you still feel distress. Your therapist will continue with bilateral stimulation until your distress is reduced as much as possible. There is the possibility of experiencing the distressing event quite intensely to start with, but this distress usually reduces as the memory is processed. Reaching a point where the memory causes less distress can happen in one session or may take several sessions.
Before the end of each session, your therapist will support you to feel calm and answer any questions you may have about the experience, along with advice on how best to look after yourself between sessions. You can spend some time doing some relaxation exercises with you, which could include ‘safe place’ exercises, guided visualisation, deep muscle relaxation, breathing retraining, etc.
Processing can continue in between sessions. Some people report that after the session they seem to recall more aspects of the events that they hadn’t thought about for a while. Some report that they dream more. Everybody is different and these are all normal reactions. It may help to keep a diary of occurrences that you think may be associated with the work you are doing in session, and discuss these with your therapist.
Just like with any therapy session, it is advised not to do anything too psychologically or physically strenuous immediately after your session, particularly as difficult thoughts may have come to your mind. This is all part of the process, and towards the end of their treatment, most people report feeling no distress at all when recalling the traumatic event. People describe a sense of feeling ‘free’ from negative thoughts and feelings associated with past experiences, that they may not have even realised had affected them so deeply. This is one of the reasons EMDR has been effective in treating behaviours that have developed in response to stress or trauma, such as substance abuse, smoking and self-harming.
If you have any questions about EMDR, or other models of psychological therapy, please get in touch.
Source:https://www.fixlondon.co.uk/blog/memory-trauma-and-emdr