What is EMDR Therapy?

EMDR (Eye Movement Desensitisation and Reprocessing) is an evidence-based psychological therapy designed to help people process distressing or traumatic experiences that continue to affect them in the present.

It is perhaps best known as a treatment for Post-Traumatic Stress Disorder (PTSD) and is recommended within UK clinical guidelines for PTSD. However, EMDR can also be used within psychological therapy when difficult or overwhelming experiences appear to be contributing to current emotional, behavioural or relationship difficulties.

Following a traumatic or overwhelming experience, memories can sometimes continue to feel as though they are happening in the present rather than belonging safely in the past. You may know logically that an event is over, while your body and emotions continue to respond as though the danger is still happening.

​

This might show up as:

• flashbacks, nightmares or intrusive memories

• anxiety or panic

• strong emotional or physical reactions to reminders

• avoidance

• shame, guilt or self-criticism

• feeling constantly alert or unsafe

• emotional numbness or disconnection

• negative beliefs about yourself

• difficulties trusting others or feeling safe in relationships

• patterns of behaviour that you understand intellectually but struggle to change

 

Sometimes there is a clear traumatic event. At other times, particularly following childhood or complex trauma, there may not be one obvious memory. Instead, there may be a collection of experiences, sensations, emotions and beliefs that have shaped how you experience yourself, other people and the world.

​

How Does EMDR Work?

Our brains are normally very good at processing experiences and integrating them into our existing understanding of the world.

​

When something is particularly frightening, overwhelming or distressing, however, the experience may not be processed in the usual way. As a result, aspects of the memory can remain highly emotionally charged and can be activated by situations in the present.

​

A smell, expression, tone of voice, sensation, relationship experience or seemingly insignificant event might therefore trigger an emotional or physical response that feels much bigger than the current situation would appear to warrant.

EMDR aims to help the brain reprocess these experiences so that they become less distressing and feel more firmly located in the past.

​

During EMDR, you are usually asked to bring aspects of a distressing memory or experience to mind while simultaneously engaging in bilateral stimulation. This commonly involves following movements from side to side with your eyes, although alternating sounds or tapping can also be used.

​

You remain awake, aware and in control throughout the process.

​

As processing takes place, memories often become less vivid and emotionally intense. New perspectives and associations can emerge, and beliefs such as "I'm not safe", "I'm powerless", "It was my fault" or "I'm not good enough" may begin to shift towards more adaptive ways of understanding the experience.

​

Importantly, EMDR is not about deleting memories or making you forget what happened. The aim is for you to be able to remember an experience without your mind and body responding as though it is happening all over again.

​

Why Do the Eye Movements Work?

We know from a substantial body of research that EMDR can be an effective treatment for PTSD, although researchers continue to investigate exactly how its different components produce therapeutic change.

One influential explanation relates to working memory.

​

Holding a distressing memory in mind requires mental resources. Performing another task at the same time — such as following a moving stimulus with your eyes — also places demands on working memory. Because our working memory has limited capacity, doing both simultaneously may reduce the vividness and emotional intensity of the memory while it is being processed.

​

Other theories focus on processes including orienting responses, attention and memory reconsolidation. EMDR was historically compared with processes occurring during REM sleep, although its effectiveness should not be understood as simply reproducing REM sleep.

​

What matters clinically is that, through carefully structured processing, the memory can begin to lose its sense of "nowness" and become something that happened then, rather than something your nervous system continues to experience as happening now.

​

What Does EMDR Feel Like?

EMDR is much more than simply moving your eyes from side to side.

Before processing traumatic memories, we spend time understanding your history, current difficulties, triggers and patterns. We also consider your ability to manage difficult emotions and what you may need in order to feel sufficiently safe and supported during therapy.

​

You will not simply be asked to describe your most traumatic experiences in detail at the first appointment.

EMDR is a collaborative process and treatment is adapted according to the individual. You remain in control throughout and we can pause processing whenever needed.

​

For some people, particularly those who have experienced complex trauma, childhood neglect or attachment difficulties, this preparation and relationship-building stage can be especially important.

​

EMDR for Complex and Childhood Trauma

When trauma has occurred repeatedly during childhood, therapy can be more complex than treating a single traumatic event.

​

There may be numerous interconnected memories alongside deeply established beliefs about yourself and other people. You may also have developed protective ways of coping — such as shutting down, avoiding emotions, becoming hyper-independent, people-pleasing, becoming highly sensitive to rejection or using behaviours to escape overwhelming feelings.

In these circumstances, I adapt EMDR carefully to the individual rather than immediately focusing on the most distressing memories.

​

My work is informed by an understanding of attachment, emotional regulation and different protective "parts" or states of the self. Where appropriate, I integrate EMDR with ideas and interventions drawn from approaches including Internal Family Systems (IFS), ego-state work, Compassion Focused Therapy and DBT.

​

The aim is not to remove the parts of you that learned to survive difficult experiences. Instead, therapy helps us understand why those responses developed, strengthen your ability to feel safe and regulated in the present, and gradually process the experiences that those responses have been protecting you from.

​

How Effective is EMDR?

EMDR has a substantial evidence base for the treatment of PTSD and is recommended by major national and international clinical guidelines.

​

Some people with a single traumatic experience can make significant progress within a relatively brief course of therapy. However, there is no set number of sessions in which somebody should recover.

​

Treatment is usually longer when experiences have been repeated or prolonged, occurred during childhood, involved important attachment relationships, or are accompanied by difficulties such as dissociation, emotional dysregulation or multiple mental health difficulties.

​

I therefore tailor treatment to the individual rather than promising that trauma can be resolved within a particular number of sessions.

​

Who Can EMDR Help?

EMDR is particularly well established for PTSD and trauma-related difficulties. It may be helpful following experiences such as:

• childhood trauma or neglect

• physical, emotional or sexual abuse

• domestic abuse

• accidents or serious injury

• assault or violence

• traumatic medical experiences

• bullying

• frightening or humiliating experiences

• traumatic bereavement or sudden loss

• witnessing distressing events

• occupational trauma

• repeated interpersonal or relationship trauma

I also use EMDR as part of a broader psychological treatment when earlier experiences appear to be contributing to difficulties such as anxiety, shame, low self-worth, emotional dysregulation, relationship difficulties and unhelpful patterns of coping.

​

EMDR With Adolescents

EMDR can also be adapted for children and young people.

Younger people do not always have the words to explain why they feel the way they do, and therapy does not have to rely entirely on lengthy verbal discussions. EMDR can be adapted according to a young person's age, developmental stage, interests and individual needs.

​

As with adults, establishing trust, safety and a sense of control is central to the work. I take time to build a therapeutic relationship and ensure that a young person understands what we are doing and feels able to tell me when they want to stop, slow down or do something differently.

​

A Different Way of Understanding Symptoms

One of the things I find most helpful about trauma-focused therapy is moving away from asking:

"What is wrong with me?"

and beginning instead to understand:

"What has happened to me, how did I learn to survive it, and what does my mind and body need now?"

Behaviours and emotional responses that can initially seem confusing often make much more sense when we understand the experiences that shaped them.

 

EMDR can help us process those experiences so that the past has less power over the present.