Deciding to come to therapy is the first courageous step in looking after your mental health but understanding the different types of therapy can be tricky. Being able to understand how different types of therapy may help with unresolved trauma, specific mental health struggles, or even a general improvement in your quality of life, can help you to make informed and empowered choices about the journey that lies ahead.
Speaking openly about your experiences and attending therapy currently has positive associations in the media, especially since many prominent public figures have come forward with their experiences. Recently Prince Harry has spoken about his own therapy and specifically EMDR (Eye Movement Desensitisation and Reprocessing).
What can it treat?
EMDR has a fascinating history related to it’s discovery by Francine Shapiro to treat unresolved trauma and PTSD (Post-Traumatic Stress Disorder), and is now supported by hundreds of research trials. Since it’s discovery it has been applied, adapted, and researched to treat many other mental health difficulties such as anxiety disorders, stress, depression, sleep difficulties, addictions, grief, and pain. However, it’s interesting to note that many mental health difficulties have connections to traumatic life experiences.
How does it work?
Research has suggested traumatic memories are stored in a different way to normal memories meaning that the memories can be triggered by multi-sensory reminders (smell, taste, sensations, places, words, images), appear fragmented, and may feel as if they are happening again in the present (typically called a flashback). You might find yourself becoming easily angered or emotional, and wanting to avoid any reminders. The memories, images or sensations can pop up unexpectedly as intrusive thoughts, nightmares, flashbacks or images.
EMDR aims to ‘process’ specific trauma memories that are intrusive, distressing, and disrupt everyday functioning with the end result of reducing the distress and impact and allowing the memory to be stored away like other memories. By revisiting and processing the memory, the distress reduces and a new meaning or positive belief can be added (e.g I am safe, I have choices, it’s not my fault).
You could think of it like the wardrobe analogy below from Dr David Trickey, and you can see more examples here.
Explanation of trauma memories and therapy - depicted by Dr David Trickey, consultant clinical psychologist
What happens in EMDR?
There are eight stages to EMDR therapy:
History taking- together we understand what needs to be addressed from the past, the difficulties you are experiencing in the present, and what you would like to develop for your future well-being.
Preparation- in this phase we settle into our therapeutic relationship, share important information, and build coping strategies so that you feel ready and safe to start the trauma processing. Coping strategies include developing a calm or safe place image, finding ways to feel grounded or relaxed when big emotions come along, and making the most of the strengths you already have.
Assessment- we identify the specific memories that we need to work on and the meanings and emotions attached to them. We also identify a positive alternative belief that we work towards.
Desensitization- use of eye movements, taps or tones aid memory processing (called bilateral stimulation) and reduce the distress connected to the memory.
Installation- once the distress associated with the trauma memory has reduced, we increase the strength of the new belief e.g. I am safe, I have choices, I am valued.
Body Scan- we check for any remaining distress held in the body and whether we need to do further processing.
Closure- this is a time for us to discuss the events of the session, your insights and reflections and how you are feeling. We often use strategies to feel calm and relaxed to complete the session. These are the skills we developed in phase 2.
Re-evaluation- every session we re-evaluate our progress and the aims for the session.
You can read more about these stages on the Emdira website.
It is important to say that during the therapy you will remain fully awake and in control. Your therapist will be with you every step of the way. By identifying distressing memories, you can learn how to process them and heal from past wounds in a safe environment with guidance.
Lola Perez-Gavino has also made this helpful short animation to explain how EMDR works.
Animation by Lola Perez-Gavino, Clinical Psychologist, at www.mindmadeeasy.com
What is the mechanism of change?
There are several different theories about how EMDR works and the mechanism of change. One theory is that EMDR divides an individual’s attention between the memory and another stimulus such as finger movements or tones from headphones (bilateral stimulation). Another theory has suggested that eye movements are similar to those we experience during REM (rapid eye movement) sleep. However, more recent neurobiological studies have pointed to the similarity between the eye movements in EMDR and those we use when walking forwards and orienting to our surroundings. Seeing as walking forwards is usually incompatible with fear (most people freeze or retreat from fear unless highly trained), the eye movements are thought to reduce the fear associated with the traumatic event being held in mind. However, it is also essential that the memory is updated with the new more helpful information. If you are interested in the different theories and the research including neurobiological and brain imaging studies, you can find this and more on the EMDR Institute FAQ page. Ultimately, EMDR helps to process traumatic memories and emotions by changing the related physiological and neurological responses leading to positive or neutral associations.
What other trauma-focused therapies are available?
We also offer other evidence based trauma focused therapies such as Cognitive-Behavioural Therapy for Trauma. One of the differences with EMDR is that it does not involve divulging as much information, which can be helpful for those who are processing particularly difficult traumas or do not feel comfortable disclosing intimate details of their situation. It is always a good idea to talk through the different options either by scheduling an enquiry call or in your initial consultation.
what is it like to receive EMDR?
One of our clients shares her experience
“I was unaware of the EMDR and had tried CBT, but did not find it suited me, personally. When the EMDR process was explained, I did approach it with a certain amount of scepticism, but was willing to give it a go. During the process I felt calm and safe and allowed myself to be open to the process. I felt a physical sense of release, during the re-living and processing of some of the events that had taken place during my accident. I felt it was a positive experience and gave me the tools to boost my confidence, to re start working and carrying out routine daily tasks, like travelling on public transport. I also noticed my sleep was improved, as flashbacks were reduced. Panic attacks were less and more manageable. I still use some of the techniques to help reduce anxiety if in a pressured situation.”
How can I enquire and access EMDR?
If you would like to talk to us about EMDR, trauma therapies we offer, or accessing therapy with our practice more generally, we’d love to hear from you. You can find all of our contact details here, or schedule a free call.
Blog post written by Dhanisha Vora & Dr Natalie Bodart