What is EMDR and how can it help patients deal with trauma?

EMDR (Eye Movement Desensitisation and Reprocessing) is a type of therapy that can help people suffering from PTSD as well as less complex traumas. In her latest online article, highly-revered chartered and clinical psychologist Dr Kerry Ashton-Shaw explains this therapy in detail, including how it works and its benefits over other types of therapy.

What is EMDR?

EMDR stands for eye movement desensitization and reprocessing. It is a therapy that was specifically developed to treat trauma, originally PTSD or post-traumatic stress disorder.

The therapy is a non-talking therapy. This may sound strange as people expect to talk during therapy, and part of EMDR is talking. But when we're actually reprocessing the trauma, we're using a different part of the brain, not where the language centres are located. We might use eye movements, tapping, or sounds to get what is called bilateral stimulation, which is stimulating both sides of the brain.

What happens during an EMDR session?

There are several different parts to EMDR. Like most therapies, the first part is getting to know the therapist a bit. We then usually do something called stabilisation, to make sure the person feels ok before we start the reprocessing stage of the therapy.

Once you get to the reprocessing stage, you will already know the therapist quite well. You will already have had an assessment with the therapist, and they will have done some practice with you so you know what the eye movements feel like.

During the reprocessing session, the therapist will talk less, and ask you to think about a particular part of the trauma. You will be asked to think a particular thought and notice what is going on inside your body.  

We will then do some eye movements which will help with reprocessing the trauma. We feel the trauma and go into it, and the eye movements help to reprocess it.

For example, imagine you have been in a car crash and are suffering from some post-traumatic stress. It can sometimes feel like there is a part of your brain that doesn’t know the car crash is over, and still suffers from this fear and stress. Even though you know it is safe, when you get back into the car, you can still feel really anxious. EMDR can help the two parts of the brain join up:

• The part of the brain that is still going through the trauma.
• The part of the brain that knows you are safe and is ok.

The eye movements help the brain and body calm down and realise the trauma has passed. It can be for a simple trauma, like a car crash, or for more complex trauma, e.g. trauma brought on by chronic stress.

Again, the therapist doesn’t say a lot, and the patient just focuses on the changes in the body. Sometimes they can feel the memory moving on or becoming less vivid. Sometimes people notice thoughts or feelings coming up, so we just notice them and go with them.

We do a little bit of eye movement, maybe 25 to 30 eye movements, we take a breath, we notice what we’re feeling, and we go back to doing some eye movements.

At the end of the session, the therapist will always make sure the patient is “back in the room.”

What age groups benefit most from EMDR therapy?

EMDR can be used across all age groups: adults, older adults, and teenagers. In children, the way in which the therapy takes place varies depending on the child’s age.

For younger children, we often use a story to help the EMDR. Take for example a 4 or 5-year-old child who has developed a phobia of needles after getting blood tests done. I won’t talk to them directly about their experience. Instead, I might talk to them about a dog who needed to go to the vet and was really scared, and explain how the dog overcame this fear. While we tell this story we might do some tapping, often done by the parent.

Sometimes we might use a child’s protocol with adults. The best form of treatment depends on each individual.

What is the difference between Eye Movement Desensitisation and Reprocessing (EMDR) and Trauma Focused Cognitive Behavioural Therapy (TF-CBT)?

They are both therapies addressing trauma, but Trauma Focused CBT is a talking therapy. It is a lovely way of working, and some people prefer it. I find it tends to take longer, and means you need to talk about the trauma.

In contrast, with EMDR you will be focusing on your thoughts but also on your feelings and body sensations. With EMDR your therapist doesn’t have to know what the trauma is that you are reprocessing.

For example, I could be working with someone on their trauma, but I don’t know the details, but we can still work on it. EMDR also tends that things start to go a bit quicker, especially when we get to the reprocessing stage.

Dr Kerry Ashton-Shaw is a committed consultant and chartered clinical psychologist based in Liverpool. If you would like to book a consultation with Dr Ashton-Shaw you can do so today via her Top Doctors profile.