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All about EMDR: What is it and how can it help you?

Fed up with persistent painful feelings after past trauma? Struggling with your mental health? You may be wondering if Eye Movement Desensitisation and Reprocessing (EMDR) could help. But what is it, how does it work, and how can you access it? Let’s break it down.

What is Eye Movement Desensitisation and Reprocessing (EMDR)?

Eye Movement Desensitisation and Reprocessing (EMDR) is a highly effective psychological therapy developed to treat trauma. It can help you successfully process – and heal from – distressing memories and feelings.

First developed in the late 1980s, dozens of randomised controlled trials have since shown EMDR to be highly successful and faster than many other treatments.

EMDR involves alternating left-right brain stimulation while you process distressing memories. This left-right stimulation (known as bilateral stimulation) helps the brain reprocess stuck or frozen information. Such bilateral stimulation has traditionally been conducted via eye movement (hence the name Eye Movement Desensitisation and Reprocessing). To achieve this, your therapist may move his or her fingers back and forth or use a light panel that you follow with your eyes, whilst you process distressing memories. Sometimes though, an EMDR therapist will achieve bilateral stimulation via sounds playing left to right through headphones. Or via touch – for instance through tapping, or using mechanical pulsators you hold in each hand.

Here at The London Psychiatry Centre, as long-standing experts in delivering EMDR, we prefer to use eye movement. This is because research has shown it to be more effective in reducing the intensity of distressing memories than a technique like listening to clicks through headphones. We deliver standard hand-movement EMDR, or via a light panel that the patient tracks with their eyes. EMDR can also be offered online and it is equally effective.

Why might I be suggested EMDR?

Internationally recognised as a swift, effective first-line treatment for trauma, EMDR is endorsed by the NHS; the National Institute for Health and Care Excellence (NICE); the World Health Organisation; and many other bodies.

EMDR is most famous as a treatment for post-traumatic stress disorder (PTSD).

However, in the years since it was developed, it has also been used to treat problems such as:

• Depression
• Anxiety disorders (including obsessive compulsive disorder)
• cPTSD
• Addictions
• Behavioural issues
• Dissociative disorders
• Relationship problems
• Personality disorders

What happens during an EMDR session?

An early session with your EMDR therapist will likely focus on determining if EMDR is right for you and preparing you for the process. You can expect:

• Questions about your personal history: what you have struggled with and what has led you to seek EMDR; the mental, emotional, and physical health issues you may be dealing with; what support you currently have; any medication you may be taking, and so on.
• If your therapist feels that EMDR is a good fit for you, then he or she will explain the process and the logic behind it.
• A space for you to ask questions about EMDR and talk through any worries you might have.
• Relaxation and other grounding exercises guided by your therapist.

After you and your therapist feel that you are ready, a process of Eye Movement Desensitisation and Reprocessing can begin. Here’s how it works:

• You will be asked to pick an image that represents an important upsetting event – a kind of ‘worst moment snapshot’ that is embedded with feeling.
• Your therapist will then ask you to think about negative and positive thoughts linked to the image, the feelings you’re feeling, and where those emotions are in your body.
• Then, your therapist will start the visual (or auditory or tactile) stimulation while you are holding that memory picture in your mind. So while you are focusing on the memory snapshot, you will be following your therapist’s visual stimuli with your eyes. This process is known as a ‘set of stimuli’.
• EMDR is tailored to your needs. Often, one set of stimuli will involve about 25-30 left to right movements, lasting up to around 30 seconds. But this really depends on what is effective for you.
• After every set of stimuli, your therapist will want to know what you noticed, how you felt, and what came to mind.
• During the bilateral stimulation, the traumatic memory may feel intense at first. But usually, these uncomfortable feelings will fade as the memory is reprocessed.
• Sets of stimuli will usually carry on until your distress is lowered as much as possible within the session.
• A typical EMDR session can vary widely depending on what comes up and how you’re getting on.
• Before you leave the session, your therapist will work to help you feel calm again with the use of relaxation techniques.

How does EMDR work?

It has been well established through numerous randomised controlled trials and work in clinical practice, that EMDR works. But there are different theories about how it works.

One popular theory is that the brain can store traumatic memories differently to how it stores ordinary memories. With ordinary memories, the brain stores them efficiently and networks them, connecting them to other memories and sensory information smoothly. But during traumatic events, there’s a disconnect between what you see, hear and feel and what your brain stores in memory using language. The upsetting memories become ‘stuck’ or ‘frozen’ – stored in a way that doesn’t facilitate healing. So, the brain never receives the message that the danger has passed. In everyday life now, sights, sounds, or sensations associated with the original event can serve as ‘triggers’, prompting a person to relive the upsetting event over and over again. Sometimes the intensity of these flashbacks can cause a person to ‘shut down’, ‘zone out’ or dissociate from them. They might even feel less aware of why they have developed dysfunctional coping mechanisms or feel shut down.

Alternating left-right brain stimulation through eye movements (or in some instances through sound or touch) appears to help the brain to successfully process the frozen memories. In this way, they lose their power, becoming more like ‘ordinary’ memories. This bilateral stimulation might resemble that which happens automatically during Rapid Eye Movement (REM) sleep.

Another theory has to do with working memory. The idea is that although a person can do multiple tasks at the same time in different working memory ‘domains’ (verbal, visuospatial), each domain has a finite capacity. So when a person is using visuospatial working memory by recalling a traumatic memory, and a strenuous visuospatial task (tracking movements rapidly with your eyes) is added, the working memory struggles to retain and process everything all at once. The vividness of the distressing memory is dimmed down because of the competition for working memory energy. Consequently, when this memory signal is reintegrated into long-term memory again, it is ‘filed’ in a downgraded, less intense, less emotionally-charged form.

Fay Kalapoda, BABCP Accredited CBT therapist and EMDR Europe Accredited Practitioner at The London Psychiatry Centre says: “Regardless of ongoing scientific debate about precisely how it works, it is well-established – through decades of randomised controlled trials and clinical practice – that EMDR does work. It works in dimming the intensity of painful memories, significantly reducing trauma symptoms, and helping patients to move on with their lives.”

Who should not do EMDR?

EMDR may not be suitable for people who have problems such as:

• Severe dissociative identity disorders
• Current active psychosis
• Severe cognitive impairment (e.g. dementia)
• Certain medical conditions that aren’t stabilised (e.g. recent strokes or heart attacks)

Sometimes clients with one of the above issues will be suitable for EMDR, but need particularly careful preparation. Consultation with medical health practitioners may be appropriate too. At The London Psychiatry Centre, as a highly medically-informed practice, we offer medical services including cardiac screening.

The best way to determine if EMDR is right for you is to have a consultation with an experienced EMDR therapist.

Can I do EMDR remotely?

Yes, you can absolutely do EMDR remotely. Some patients want in person EMDR; others find online EMDR fits better around their other commitments. Online EMDR is just as effective as face-to-face EMDR.

How can I get EMDR?

If you’re interested in getting EMDR, a starting point can be talking to your GP. You may be able to access EMDR on the NHS. However, availability might vary by region, as could the number of sessions offered and the symptom threshold you may need to meet. Keep in mind that EMDR waiting lists can be long. If you don’t want to wait, you can access a private EMDR therapist.

Here at The London Psychiatry Centre, we have decades of experience in providing EMDR. As go-to experts in the treatment, we have successfully delivered EMDR for survivors of the 9/11 and 7/7 terrorist attacks, the Thailand Tsunami, and a host of other extreme events including the Iraq and Afghanistan wars. In addition, we are highly experienced in delivering EMDR for ‘non life-threatening’ traumas such as:

• Divorce
• Litigation
• Car accidents
• Sexual assault
• Historic childhood sexual, physical or psychological abuse
• Infidelity

So you’re in safe hands.

Whatever your painful memories are, you don’t have to suffer anymore. Swift, evidence-based treatment can help you move beyond them, to the life that’s waiting for you.

Make an appointment by calling 020 7580 4224 or email info@psychiatrycentre.co.uk