How EMDR works as a trauma therapy

Trauma is an emotional response to being harmed or witnessing harm to others. When a memory is too traumatic for the brain to process, it doesn’t get stored in the memory properly and as a result, we can experience distressing symptoms like flashbacks and intrusive thoughts. EMDR (Eye Movement Desensitisation and Reprocessing) is a proven trauma therapy that can help people process traumatic memories so they can begin to heal. Our clinical lead, Paul O’Donnell, explains how EMDR works and why it’s his go-to therapy for clients suffering from trauma.

How EMDR works

EMDR is recognised by NICE (National Institute for Health and Care Excellence) and the World Health Organisation (WHO) as a treatment for PTSD, and it is also often used to help with anxiety, depression, OCD, and phobias. So how does it work?

“In an EMDR session, I tell the client that I’m going to ask them to follow my fingers with their eyes and I’m going to go side to side from left to right. This is what we call bilateral stimulation or BLS,” says Paul. “This can sometimes feel a bit bizarre for someone who is embarking on EMDR for the first time. That’s why it’s important to take a thorough client history, build up a relationship, and give the chance to ask ?questions.”

Bilateral stimulation activates the memory network. Traumatic memories and the thoughts, feelings, and physical sensations that accompany them are often linked to something in our past which may seem unrelated. EMDR helps clients with trauma join the dots and understand why they are feeling as they do.

“When I’m doing an EMDR session with a client as a part of trauma therapy, I will work with them to figure out what their traumatic memory is linked to,” Paul explains. “Typically, I will start with the earliest memory, what we call the ‘touchstone memory.”

On identifying the touchstone memory, Paul does something called a float back, which means inviting the person to think about the trauma. He asks specific questions about what thoughts, emotions, and bodily sensations are coming up. Clients are asked to tap into their senses and to pay attention to whether there is anything they can smell or taste. This takes the client back to what they experienced in the moment.

“I ask clients to sit with those thoughts, emotions, and sensations and I make sure they understand there is no right or wrong way for them to be feeling. Then I invite them to let their mind float back to a time when they may have felt similar to how they do now,” says Paul. “Often you will get these chain of events that arise, a potential link between what happened in the past and the most recent event.”

How EMDR helps with the processing of traumatic memories

The way EMDR aids processing of traumatic memories is what makes it so effective as a trauma therapy. The bilateral stimulation is said to re-enact the REM stage of sleep which is when the brain processes things which have happened that day. When memories are too traumatic, this crucial stage of processing does not happen.

“When a memory is so traumatic that it can’t be processed at the time, it doesn’t get stored properly,” explains Paul. “It just sits there and festers until something else happens down the line which brings that old memory back to life.”

Talk Works works closely with emergency services organisations, and Paul often sees this happening with the clients he sees.

“I work with individuals in emergency services who have done the job for many years. They come in and tell me that they have seen everything and have managed to cope well with events they’ve attended, seeing their role as real privilege to be able to support others in their time of need. But then they get this one job. It’s no more challenging than any other job, but for some reason, now they can’t eat or sleep. What is usually going on is that there’s something from that event that is linked to a memory from the past that is buried. They perhaps didn’t talk about it, but went straight to their next job. The human brain is not designed with repeated trauma in mind.”?

Helping trauma sufferers gain a different perspective

A common issue with clients experiencing trauma is that they have maladaptive thoughts about their experience and this keeps them stuck. For example, someone has a car accident where they were hurt and their passenger was hurt, and they tell themselves ‘it was all my fault’, even though they know on a logical level that it was not their fault.

Bilateral stimulation helps to ?process the trauma that is keeping them stuck.

“When a client is going through bilateral stimulation, I will ask them to tell me what they notice. They might have a temporary sickly feeling in their stomach, or they may say they have a headache. This is the processing taking place. Trauma is often kept in the body,” says Paul.

After just a few rounds of bilateral stimulation, a client can start to think about the traumatic event differently. Going back to the example of the car accident, a person might start off saying it was all their fault, then after a little while, they can begin to have a different perspective. They might remember that it was dark and anyone would have struggled to see around that corner. This is adaptive thinking and when this comes through, processing is starting to take place.

“What we might also do is ask people to rate the SUD or subjective units of disturbance. When the client thinks back to the event, how disturbing is it for them on a scale of 0 to 10? 0 being neutral and 10 being the worst thing you can imagine. I have witnessed ?a client ?go from 10 to 0 in 10 minutes,” says Paul.

Having trained in EMDR three years ago, Paul is a definite advocate of its use in trauma therapy.

“Since training in EMDR, I don’t think anything comes close. It’s the rapid turnaround and the fact that I’ve seen clients who were so mentally disturbed from the trauma that I didn’t think EMDR would work, but it just did. It still astounds me that I might see someone who tells me they can’t function and a few sessions later, they are saying that life is great.”

The golden rule of EMDR

Though EMDR can be transformational, there are some golden rules to follow. Therapists must make sure that clients are grounded and stable before commencing treatment.

We spend at least a few sessions giving clients the tools to stay grounded, like breathing techniques and visualisation. It’s not always possible to tell how traumatic the processing of memories is going to be for someone, so we always aim to make sure they are functioning within their window of tolerance,” says Paul.

For anyone who is suffering from trauma and feeling nervous or even bewildered about trying EMDR, Paul has this message.

“I always encourage honesty and I tell clients that if the thought of it is worrying, they just need to tell me and we can talk about their concerns. The worst case scenario for someone suffering from trauma is that they stay the same. And I can’t think of a time where someone has stayed the same after EMDR. I have lost count of the number of people it has helped.”