Trauma and the use of EMDR as a trauma-based psychological treatment

 

When a person experiences a sudden and unpredictable distressing traumatic event, she/he may feel overwhelmed at the time emotions such as the panic, fear and distress. Their brain may be unable to fully process the information at that moment as occurs with a normal memory. The emotionally distressing memory seems to become frozen in time as the sensory information has been unable to be effectively processed on a neurological level and filed appropriately in the brain.

 

Consequently, when a person experiences a trigger which automatically recalls the distressing memory, the person can also re-experience what they saw, heard, smelt, tasted or felt, and this can be quite intense and upsetting. Often the memories, thoughts and feelings are so distressing, the person tries to avoid thinking about the recalled event to avoid re-experiencing the upsetting emotions.

 

The person may also adapt safety seeking and avoidant behaviours to try to ensure he/she is not re-traumatised by those sensations and memories. This may include avoiding the scene of the accident, for example, and taking detours even though it may be a much longer route, or avoiding busier times or driving at night if the accident occurred in the dark.

 

A person may find that the distressing memories and images/sights/sounds automatically come to mind when something reminds him/her of the traumatic event, or sometimes the memories just seem to intrude without apparent warning or an identifiable trigger. These are called flashbacks. These upsetting experiences can interfere with the person’s every day functioning and quality of life.

 

If the distressing experiences persevere for more than 3 to 6 months, are significantly disruptive to everyday living and quality of life and are severe they may warrant a diagnosis of post-traumatic stress disorder and may require trauma-based psychological intervention, such as EMDR.

 

What is EMDR?

EMDR is an effective psychological intervention used as a treatment for various traumas. It is recognised by the NICE guidelines as an effective psychological technique for post-traumatic stress symptoms and is widely used in NHS settings. A combined approach of cognitive behavioural therapy and EMDR has been shown to have very positive results in the treatment of trauma.

 

How does EMDR work?

The person is asked to focus upon the most upsetting aspect of the traumatic memory and the negative thought or belief the person has about her/himself in relation to the traumatic memory. The person is asked to score the level of emotional disturbance related to the memory and where it is located in the body.

 

The alternating left-right stimulation of the brain with eye movements, using guided right to left hand movement or tapping by the therapist during EMDR, seems to stimulate the frozen or blocked information processing system, allowing the person to safely revisit and reflect upon the memory and release the trapped uncomfortable feelings.

 

In the process the distressing emotion-laden memories seem to lose their intensity, so that the events themselves are less distressing and seem more like ‘ordinary’ memories. The effect is believed to be similar to that which occurs naturally during REM sleep (Rapid Eye Movement) when a person’s eyes rapidly move from side to side whilst he/she is asleep.

 

During REM sleep the brain is reprocessing and making sense of and sorting through the events, experiences, information of the day and appropriately filing it in memory. EMDR triggers a similar reprocessing effect but working on a specific event, namely the trauma. The trauma is reflected upon and reworked and placed in a different area of memory where it will not be re-triggerd and neither will the negative emotions be recalled and relived with such intensity. EMDR helps reduce the distress of all the different kinds of memories, whether it was what a person saw, heard, smelt, tasted, felt or thought.

 

Research and evidence suggests that EMDR works for relatively recent isolated traumas and also for deep-seated repeated traumas, such as childhood sexual abuse which occurred many years previously.