Eye Movement and Desensitisation and Reprocessing (EMDR)

EMDR (Eye Movement Desensitisation Reprocessing Therapy) is a brief therapy that focuses on managing continuing distress that feels ‘stuck’ for some one. It can be helpful in treating distress that an individual may experience from a range of areas, such as trauma (including post-traumatic stress disorder). Examples may include something like:

• Being in a car accident and struggling to get rid of the upset you feel from this;
• Witnessing something upsetting (such as someone being assaulted or something else that has really upset you);
• Being a victim of a physical or sexual assault;
• Feeling really anxious all of the time;
• Feeling upset about things that happened to you as a child;
• Unresolved grief;
• Panic attacks;
• Phobias.

It was developed by a respected American Clinical Psychologist and Researcher, Dr Francine Shapiro. Dr Shaprio made the chance observation that eye movements can reduce the intensity of disturbing thoughts and feelings under certain conditions. Dr Shapiro studied this scientifically and in 1989 reported success in using EMDR in treating victims of severe trauma.

Since then EMDR has developed rapidly, and has been widely researched. It has been adopted by the UK as a recognised effective therapy for trauma, and is recommended as part of NICE (National Institute for Health and Care Excellence) guidelines.

How does EMDR work?

When an individual encounters a distressing event, you can experience such strong emotions that it is thought to overwhelm the brain. The brain consequently is unable to cope with, or process information as it does ordinarily. Distressing experiences become ‘frozen in time’. It can have a lasting negative effect on the way a person sees themselves, the world and others. It can affect parts or all of their lives, including their ability to work or study.

EMDR seems to directly influence the way that the brain functions. It helps to restore normal ways of dealing with problems (i.e. information processing). Following successful EMDR treatment, memories of the distressing event are no longer painful when brought to mind. What happened can still be recalled, but it is less upsetting. EMDR appears to mimic what the brain does naturally on a daily basis during dreaming or REM (Rapid Eye Movements) sleep: EMDR can be thought of as an inherently natural therapy which assists the brain in working through distressing material.

Is EMDR effective?

Research studies have shown that EMDR can markedly accelerate the healing process after a distressing experience and that the effects are long lasting. In fact, there are now more scientifically controlled studies on the treatment of stress and trauma disorders with EMDR than with any other form of psychological treatment. EMDR is highly effective, often preferred by clients and generally of shorter duration than other treatment methods.

What will it involve?

A therapist will spend some time with you talking about your difficulties and how they may relate to your past experiences. They will plan some sessions and develop some relaxation skills with you, before moving on to assess what you may benefit from looking at. Sessions tend to be weekly.

Part of this early stage of the intervention is to check that EMDR may be a good therapy for you to try. If the therapist thinks it may fit with your needs then you will start to look at the memories from your past that may need processing.

You will be asked to describe a frozen image which best describes that memory. The therapist will then work with you to try and process that image. You will be asked to explore with the therapist to what extent that image is disturbing you now, as well as looking at how it can be dealt with. The focus here will be on installing positive beliefs.

How many sessions will it include?

It can be difficult to say as it all depends on your level of distress, how many memories appear important to you and how quickly the processing starts to work for you. We are all different and so you cannot say for sure. However, it is important to remember that the therapy is completed at your pace. Generally session numbers can range from 4 to 12, and it is something that is assessed as we go along.

Can someone come in with me during the sessions?

It is a therapy that does not work well with observers, mainly as it can be distracting for the client and you may also be surprised at what memories you recall. You may not necessarily want those memories disclosed to others.

Will it involve homework?

No. EMDR does not ask you to complete out of session work. However, you may find that between sessions your brain continues to process your memories and you may recall things that you had forgotten. At most you would be asked to just jot down on a piece of paper anything that you found came to mind and it can be talked about at the next session. You will be encouraged though to use your relaxation skills to manage any distress that may emerge following the session.

Is it confidential?

The therapist will keep a brief note of what you covered in the session, but these notes are kept by the therapist and will not appear in your medical records. They are aids to help the therapist remain focused on what you discussed and how it can be used to plan a future session.

All EMDR therapists receive supervision for their practice. They will be discussing clients with their supervisor, but this will not include names or identifying details. The supervisor will ask the therapist to audio record occasional sessions to assist with their therapy practice. This is about ensuring the therapist is being supervised to aid with the effective delivery of the therapy. You may be asked if the session can be recorded and you are free to decline this. If you agree, the therapist would just discuss how the recording will be used and when and how it will then be safely destroyed, and using the CCATS Data Protection Policy. Any audio recordings that you agree to will not be kept for longer than required, and will be used solely for the purpose of supervision. Yet, it is your choice to agree to this or not and there is no pressure to do so. Your needs are the most important here. Indeed, if you are at all concerned you must decline it as there can be no distractions (e.g. additional worries) happening for you. You do not have to give a reason as to why you are declining any audio recording.

What if I attend and then decide not to engage?

You may attend and then find that you do not like the idea of the therapy, that it does not suit you, or that it is the wrong time for you to be doing this. You do not need to provide an explanation to the therapist; you would just indicate that you will not be attending another session.

Who will be doing the therapy with me?

We have a range of experienced therapists at CCATS, some of whom are working toward their accreditation and some who are already accredited EMDR therapists. To be an accredited EMDR therapist you have to have engaged with over 25 clients using EMDR, to have engaged in regular supervision with a Consultant EMDR Therapist, and to have had your therapy observed by your supervisor. All accredited EMDR therapists are members of the EMDR association for UK and Ireland. Other experienced therapists in the CCATS team who are yet to be accredited, have all engaged in the required EMDR training, and are now working toward accreditation.

CCATS staff trained in EMDR:

*Acknowledgements to EMDR extra for providing a summary of EMDR and its history.