EMDR : Getting Past Your Past

Afoot and light-hearted I take to the open road,
Healthy, free, the world before me,
The path before me leading wherever I choose.

Walt Whitman – Song of the Open Road

What is trauma?

Traumatic experiences can leave you struggling to function and enjoy life – stuck in stress responses, unable to relax and feel safe, vulnerable to being ‘triggered’, hijacked by flashbacks, your confidence self-esteem and resilience undermined, feeling out of touch with your emotions, finding it hard to think clearly or take the actions you might need to, going around in circles, feeling powerless or unable to trust relationships or the world at large.

Sometimes you solve one problem and another pops up and takes its place – life becomes dispiriting, exasperating, an exhausting joyless slog. The rut deepens sapping your hope.

Image credit: https://upliftconnect.com/wp-content/uploads/2016/07/rorschach-test.jpg

You survive – but perhaps without important parts of yourself and your life feeling intact and robust. You develop coping mechanisms, sometimes healthy – sometimes less so – sometimes creating problems of their own – as you try and numb distressing thoughts, feelings, or memories, or avoid what you have learned to fear or just get through each day.

In recent years there has been a huge amount of research going on around the impact of both one-off traumatic experiences – acute or incident trauma – and chronic, complex and developmental trauma, and there is now a large body of evidence about its wide ranging impacts – and – even more importantly – approaches to successful treatment and resolution and post-traumatic growth.

Psychological trauma is not a mental illness – is a type of injury that occurs as a result of an overwhelming experience. Not all bad and distressing experiences result in lasting trauma, and not all trauma arises from events that seem traumatic – but when the stress caused by the traumatic experience exceeds an individual’s ability to cope with and/or integrate the feelings, sensations or thoughts involved in that experience – it pushes you way beyond your window of tolerance and leaves you feeling unsafe, unable to cope. The impact can be particularly significant if, in those moments when you are most vulnerable, you also feel alone, with no-one you can turn to that you can trust and that can cope with the intensity of your fear and shock, if you are used to being ‘the strong one’, the hero, self-sufficient, or if you feel responsible or ashamed in some way – as is so common in the experience of survivors.

Trauma can also have a lasting and far reaching impact on your functioning if it happens early in your life when your brain is still rapidly developing and adapting to your environment, and especially when your trusted adults play a part in the trauma.

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Picture credit: https://www.childtrends.org/publications/how-to-implement-trauma-informed-care-to-build-resilience-to-childhood-trauma

There is no quick fix, one-size fits all approach to resolving trauma. But addressing it can take you from simply surviving to living again. It can also help with medically unexplained symptoms where these are somatizations of trauma, or symptoms associated with being stuck in stress responses.

Time can be a healer, but when trauma does not easily resolve on its own EMDR can be a powerful tool to help us move forward.

EMDR is the NICE recommended treatment for trauma, PTSD and an increasing range of mental health conditions https://www.nice.org.uk/search?q=emdr and there is an ever-growing body of research into its use as a mental health treatment https://www.emdr.com/research-overview/.

How does EMDR work?

EMDR works by a combination of facilitated graduated desensitisation, whilst using dual attention to stop important parts of the brain from shutting down due to associated stress, so that the traumatic experience can be put in the past where it belongs, instead of being re-experienced over and over again as if it was happening now.

EMDR breaks the vicious circle of overwhelm and harnesses the natural healing mechanisms we have in REM sleep to rebuild your confidence and capability to withstand and integrate remembering and still being able to go on with living.

You don’t have to talk about the details of your experiences, and this therapy doesn’t involve challenging ‘negative thoughts’ or ‘faulty thinking’, or completing homework worksheets. Feeling and thinking in ways that make it challenging to feel relaxed and happy are not seen as the cause of distress – they are a symptom – a consequence of the body and brain being unable to recover on its own from the overwhelm caused by the traumatic experience. The eye movements you will make with your therapist will enable experiences to be processed so that you can move on. Research suggests that outcomes are often sustained and integrating EMDR treatment into psychotherapy can accelerate trauma recovery significantly.

What does an EMDR session involve?

There are some similarities and some important differences between an EMDR session and a standard traditional psychotherapy session.

We will most likely follow a structured protocol and sessions may be more directive, with more questions and activities than a traditional psychotherapy session.

In preparation for your session its likely we will begin by establishing a detailed history, making an assessment – which may involve filling in some questionnaires and identifying a treatment strategy with you. We will broadly discuss what traumatic experiences you have endured, how it affects you, and what improvements you hope to see after treatment.

This approach might feel unfamiliar at first – try not to worry – we will proceed with your trauma recovery in a structured way, moving through three broad stages.

Stage 1

In the first stage of trauma recovery we will use sessions to work together to build a strong foundation of healthy coping and emotional regulation skills and together with a therapeutic alliance in which you feel secure and confident, so that EMDR treatment has the best possible impact.

We may use some EMDR techniques to strengthen and expand your coping resources so that you can feel confident going into the treatment and also get a feel for what future sessions might be like. Our aim will be to help you achieve a feeling of safety and stabilisation in the here and now, and to start to overcome the emotional dysregulation that so often arises from traumatic experiences. We will work together to ensure that you feel as safe and secure in your body, your mind, your relationships and your life as you can right now, and reduce the frequency with which everyday here and now events ‘trigger’ flare ups of your trauma symptoms.

We will need to establish trust between us, and that you have functional coping mechanisms and you are able to abstain from using substances and alcohol for the duration of your treatment, and that your current life and support systems are relatively safe and stable. This may take a little time – and that’s ok. When you are ready we can move towards the next stage.

Stage 2

In stage two we begin to approach your traumatic experiences, using the new tools, resources and support systems you have created, and using EMDR desensitization techniques to begin to reduce the intensity of symptoms caused by remembering. The desensitisation phase of EMDR can release old distress – part of getting ready to put things in the past where they belong. You might feel some strong emotions, or you might find that you feel numb and ‘zoned out’ at times. Try not to worry, we will have laid the groundwork in stage one for you to feel safe to express and cope with this – we will go at your pace and we can return to stage one skills at any time if you feel overwhelmed or something changes in your life that means your capacity to cope is reduced temporarily (eg relationship or work difficulties).

When working on desensitization, we will typically begin by identifying some key memories – these might be the ones which are the earliest, the ones you find most salient, and the most recent, and decide in which order to approach them. We will target each memory in turn in a structured way and keep checking in along the way about how the distress is reducing and the memory is changing. Finally we will check back to ensure the last traces of the distress associated with the memory are processed.

You may find during this stage that you experience some spontaneous new insights and realisations that accelerate your progression with recovery, and that there is a positive impact on levels of distress associated with other memories we are not directly working on. You may find that old beliefs about yourself that you associate with these experiences, feeling powerless, ashamed, culpable and unsafe also start to fade in intensity. It’s also common that the memories feel less ‘charged’, and unpleasant physical sensations associated with recall also weaken somewhat. Once you start to experience some positive effects we will often use EMDR techniques to consolidate or ‘install’ them.

Before we end a session we will take time together to ensure that you are feeling sufficiently safe and grounded to return to whatever you’re doing after our appointment. You may be invited to explore additional mind-body practices at this time to support your wellbeing and recovery.

In the days following your appointment you might find that processing continues, particularly at night during dreams – that’s normal – just keep a note and we can pick it up next time we meet. We will spend some time in our next session checking back to make sure that what we worked on is now resolved.

In this stage of treatment we will balance this steady pace with maintaining momentum so that you don’t become stuck in reliving traumatic memories, or in avoidance. This part of your treatment may only last a few months. When you are ready we will move on to stage three.

Stage 3

Stage three of trauma recovery is all about integration and moving on. We will work together to help you come to terms with what you have experienced, to liberate your future from your past. We will work on your goals, overcoming your fears, facing healthy challenges and change and re-establishing a feeling of being part of the world. Then its your time to fly!

How we will meet

Finding the right EMDR therapist is really important. You may wish to have a free initial phone consultation to give you an opportunity to find out how we might work together.

Our one to one sessions can be conducted face to face in the consulting room in Egerton.

We can get started quickly and work longer term if you need to.

Session fees for one to one EMDR sessions are £150. Sessions usually last between 90m – 2hrs. If we agree we need a longer session, we will pre-agree a pro-rata fee.

Book your free consultation

I offer a free initial phone consultation to give you an opportunity to find out how I can help you.

Simply enter your details into the form and I will contact you to discuss your requirements in more detail.