EMDR
EMDR, Eye Movement Desensitisation and Reprocessing therapy was discovered and established in the 1980s by Francine Shapiro.
Whilst out walking she noticed that some disturbing thoughts she’d been having had suddenly disappeared and that when she deliberately brought these thoughts to mind they weren’t as upsetting as they were before. She noticed that as these thoughts came to mind she was spontaneously moving her eyes back and forward. She developed this idea, testing it out on colleagues, helping them to move their eyes left to right by getting them to follow her moving fingers. People had the same good results and so she continued to develop and research the technique.
In the intervening years, numerous research studies have been done and EMDR has been found to be an effective way of clearing disturbing memories from both recent and distant events. It is now widely used across the world and recommended as an effective treatment in the NHS.
How are significant events stored in our memories?
Through life, as events happen, they are stored in our memory. The event itself is stored, together with the linked emotions, physical sensations, people involved, the situation, sounds, tastes, smells and the belief we have about ourselves as a result of the event.
When memories are positive, we often don’t think of them much. When we try, we can recall some positive events, such as being hugged or praised by a parent or teacher, friendships or achievements and we often come up with a picture of the situation as well as a good feeling in our bodies and a belief that we are lovable, secure or competent. Sometimes, these good feelings can come up without us recalling the initial event as they might be triggered by being in a similar situation or interaction with someone. We may feel good about ourselves without knowing why.
When the memory is a negative one, the same thing happens, but the linked feelings and physical sensations are negative; eg feeling scared, unhappy, lonely, unwanted, shaking, sweating, feeling sick. Again, these negative reactions may come up from deliberately recalling a difficult event or they might be triggered by a sound, smell, person or situation which is either the same or similar to the original negative event. It can feel like we’re in a time capsule where images, feelings and physical symptoms appear with such intensity it feels like we’re right back at the time of the event.
We may or may not realise what the link is, hence we may be terrified of lifts without ever having had a bad experience in one. For instance the link may be the feeling of being out of control, which may link to a past experience of feeling out of control while waiting for medical results, rather than anything to do with lifts. The situations are really different, but the feeling having of no control is the same. In another example, we may feel frightened when we talk to our boss at work, even though they are objectively nice. The link may be that your boss has a beard which is visually similar to that of a teacher who shouted at you at school. These links are known as associative channels.
Why do unwanted or difficult feelings or memories pop up?
Under normal circumstances with day to day events and moderately difficult experiences, we go to bed, sleep, dream and process the events of the day. In the morning things tend to feel a bit better, hence the phrase “sleep on it”. This processing happens during REM sleep or dream sleep. For instance, if someone shouts at me in the supermarket because I’ve jumped the queue by mistake, I might feel shaken and upset afterwards, but by the next day I’ll have processed it and although I’ll still remember what happened, it won’t feel particularly upsetting as I’ve put it aside in my memory as something that happened but it is in the past and needn’t affect me now.
When there is overwhelming trauma, we produce more cortisol than normal, which interferes with the information processing. The elements of the traumatic experience are stored as fragments of memory, rather than being integrated as one whole experience in the context of our lives. Each fragment is stored independently: stimuli eg sudden movements, noises or smells; feelings eg fear or shame; physical sensations eg sweating, tense or frozen; beliefs about yourself eg I’m not safe, I’m not wanted. As we sleep and dream, we have nightmares, which wake us up and stop the processing completing.
These fragmented memories can be activated by reminders of the trauma or triggers, which bring up the linked feelings and physical sensations and make us feel like we are still in danger, or another overwhelming sensation, sometimes with a clear memory of the traumatic event where it feels like we’re back reliving it, other times there is the sense of danger without necessarily knowing why.
What happens during EMDR processing?
During EMDR we recreate the natural processing which happens in REM or dream sleep by using left to right stimulation, either by moving your eyes left to right by following alternating lights or a moving object, by feeling vibrations by holding buzzers, using sounds by wearing headphones or by tapping on your chest or legs. As you are awake and in the relative safety of the therapy session, with your therapist to guide you, it is possible to recall the incident with it’s linked feelings, sensations and beliefs about yourself and process the event until it becomes more of a normal memory, where you can still recall the event but when you do you also bring to mind more positive aspects of the event, yourself or others involved. This goal is called adaptive resolution. When this happens, things which previously triggered you no longer have such a negative impact and you are able to face these situations with more confidence.
For each problem that you want to address in EMDR there may be a number of memories that come to mind as being significant, as well as some that don’t immediately pop up. For instance, if you have a phobia of travelling on buses, a key memory might be:
Being a passenger in a bus crash
The impact of the crash
Lying on the floor of the bus
Thinking that no one was going to come and help
Aspects of the bus crash may link to earlier memories such as:
Feeling scared on a roller coaster as a child
Falling over and cutting your knee at school and no one coming to help you
Other memories of a key person who was involved in the bus crash
As these memories are linked in different ways by situation, emotion, physical sensation etc, it may be that processing one memory will also have a positive impact on another.
During EMDR processing memories from the recent and perhaps more distant past are processed until you are able to imagine and then actually travel on buses without fear.
Frequently asked questions about EMDR
Do I need to talk about what happened?
After a traumatic event, some people want to talk it through in detail, while others would rather not think or talk about it. Either is fine. For EMDR processing to work, the memory needs to be activated, but only for a short time. As you do the left to right movements, visually, using sound or touch, the feelings tend to change quite quickly as the processing happens. There is no need to tell your therapist the details of what happened if you don’t want to.
What if I don’t want to think about what happened?
After a traumatic event its natural to want to block it out and not think about it. Unfortunately it tends to keep popping up anyway, which is why we come to therapy. For EMDR processing to work you do need to bring up the memory, but only for the briefest time. There is research which shows that people who are scared of spiders and who are exposed to subliminal pictures (going across the screen so fast that they are unaware that they have seen them) make fast recoveries. This shows that while we do need to have the event in mind it can be at an unconscious level, without re-experiencing the full impact of what happened.
What type of problems can EMDR help with?
EMDR works by making links between our current symptoms or difficulties with events that have happened in the recent or distant past. These links are often out of our awareness and we don’t need to know the route cause before we start. Sometimes the cause is clear, such as a major event like an accident or an attack and EMDR is probably best known for helping with such events. It is on the NICE guidelines as one of the two recommended treatments in the NHS for PTSD. EMDR has been used for numerous difficulties; anxiety and panic attacks, bereavement, depression, as well as interpersonal difficulties such as problems in relationships at home or work. EMDR can also help with working towards goals like weight loss, stopping drinking, or improving confidence in social situations or giving presentations.
Websites and books about EMDR
Detailed information on EMDR from the UK EMDR Association
An explanation of what EMDR is, with links to videos as well as some research papers and articles about EMDR in the media
A short video explaining EMDR from people who’ve experienced it
A 3 minute video produced by the UK EMDR Association
Leaflet on EMDR from Get Self Help
A brief leaflet explaining how EMDR works
A book which you can use yourself, or in conjunction with therapy by Laurel Parnell, one of the world’s leading EMDR therapists. It describes how to use your imagination and life experiences to bring up feelings such as feeling loved, strong, resourceful, wise, confident, or calm, together with how to use simple hand taps on yourself to help strengthen these feelings
Written by Francine Shapiro, who developed EMDR therapy, this book describes the theory and practice of EMDR, with numerous case studies to explain the concepts