EMDR – treatment to PTDS and every day upsetting experiences

Further to my last blog on EMDR,  I’ve put together some further information incorporating some answers to the frequent questions I’m asked….

What is EMDR?

EMDR is an abbreviation and it stands for (Eye Movement, Desensitisation and Reprocessing). It is a psychotherapy founded by Francine Shapiro in 1987. More recently Francine has said that the term “Reprocessing Therapy” would more clearly describe this complex therapy. EMDR helps people to heal from the symptoms and emotional distress that are the result of a disturbing / upsetting experience. Shapiro describes EMDR as helpful in reducing or eliminating disorders that originate following a distressing experience.

What Issues is EMDR Useful to Treat?

Although it’s a relatively new therapy in the field of psychology, it continues to grow rapidly in popularity, due to treatment effects, positive research studies and outcomes, and its developed procedures and protocols. It is also adaptable so that very young children can also access the therapy.

EMDR is used in the NHS and is cited in the NICE guidelines (which are the National Institute for Health and Care Excellence) as a recommended therapy for treatment of Post Traumatic Stress. EMDR can be used for any trauma or disturbing life experience that is causing emotional distress in the here and now, enabling people to heal from the symptoms. Examples of major traumatic events could be Serious Road Accidents, Violent / Serious Assault, Sexual Abuse, Terrorism, Military Combat, Serious Neglect, Witnessing Death). These events can often be a cause of P.T.S.D., which is an anxiety disorder caused by frightening or distressing events. Some common symptoms or trauma may include: Sleep disturbance and nightmares, irritability, anger and oppositional behaviour, Intrusive memories and thoughts, withdrawal and avoidance of people, places and things, anxiety and panic, Hypervigilance, racing heart, headaches, stomache aches.

EMDR can also treat other disturbing event that have caused us upset and lead to psychological disturbance, (for example being bullied or teased by parents, peers, at school at work, feeling fearful or frightened, feelings of isolated, embarrassing situations) and in treating everyday memories which cause low self-esteem, powerlessness etc. Sometimes disturbance can come from multiple traumatic or disturbing situations or everyday events.

Studies have shown that by using EMDR therapy people can experience the benefits of psychotherapy that once took years to make a difference. It is widely assumed that severe emotional pain requires a long time to heal. EMDR therapy shows that the mind can in fact heal from psychological trauma much as the body recovers from physical trauma. When you cut your hand, your body works to close the wound. If a foreign object or repeated injury irritates the wound, it festers and causes pain. Once the block is removed, healing resumes. EMDR therapy demonstrates that a similar sequence of events occurs with mental processes. The brain’s information processing system naturally moves toward mental health. If the system is blocked or imbalanced by the impact of a disturbing event, the emotional wound festers and can cause intense suffering. Once the block is removed, healing resumes. Using the detailed protocols and procedures learned in EMDR therapy training sessions, clinicians help clients activate their natural healing processes.

How Does it Work?

EMDR is based around the AIP Model (Adaptive Information Processing Model).   Francine Sharpiro, who founded EMDR, created an information processing theory to explain how EMDR works. We are said to all have a physiologically-based information processing system, which processes our numerous experiences and stores our memories in a way that we can easily access them. Our memories are stored in a useful way and linked in “networks” that contain similar thoughts, sensations, emotions and images. When we experience a new situation the memory is merged or integrated with old memories, new associations are made, which can develop our learning.

In the event of us experiencing or hearing about an upsetting, negative or traumatic situation, the information processed may be incomplete, as a result of the strong feelings the event creates and some dissociation may occur. As a result of incomplete information processing the event does not connect / associate fully or merge with other healthy memories or event already stored or processed. The memory is dysfunctional / not usefully stored, with some parts of it being unprocessed. This can result in the memory being triggered by similar situations or the event being thought about regularly. We can experience feelings of reliving it, intrusive thoughts about self, strong emotions and physical sensations.

I Don’t Understand – Can you Explain Differently?

How we store and process our memories can be likened to an office worker or administrator at work. Part of their role is to develop an effective and useful filing system, where documents are stored in the correct place, with similar items and can be located easily and quickly when needed.

On the whole the filing system works very well but occasional they may have some documentation which doesn’t quick fit with their system, or is incorrectly labelled or handed to them incomplete or in a non-understandable form. The administration will do their best to store the documentation correctly but may find information difficult to locate, being mixed with unrelated paperwork or being place in their top drawer (and keeping making an appearance every time the drawers opened.

Going back to our own memories ………….. EMDR processes the different elements of the event to reduce and alleviate the distress caused by images, thoughts, emotions, physical sensations. The processing helps the disturbing / unprocessed memory to merge / link with other processed / healthy / adaptive information or memories. Once this occurs new learnings develop and the event is stored in the appropriate place with other healthy, adaptive memories. An effective treatment results in negative beliefs being changed to more helpful ones, distress being relieved and bodily symptoms reduced.

What will I Expect from Sessions?

Unlike many other psychological therapies there isn’t a need for speaking in detail, the healing comes from the client own internal processing, rather than the therapists insights. EMDR typically looks are three periods of time (past present and future) The Past being the disturbing memory / events. The current is situations in the here and now which are causing distress. The future we look at the skills and attitudes required for positive future actions.

The EMDR process / protocol is split into eight phases.

Phase 1 is the history taking sessions, where we will discuss you readiness for treatment and develop a treatment plan. Together we discuss the possible “targets” the situations you would like to work on (these could be past occasions or current). We will discuss the skills and behaviours you would like / need for future situations.

Phase 2 preparation, helps you to prepare for the more active phased of EMDR. I will help you to handling possible emotional distress during and in between sessions. This may involve using imagery and relaxation techniques. Often phase 2 and phase 1 may be run alongside each other. It’s very important that a client can self soothe and can use the grounding / relaxation techniques independently during and in between sessions before the active phase commences.

Phase 3 – 6 , these are the active phases of the process where the target is identified and processed. These phases include Assessment, Desensitisation, Installation, Body Scan.
You will identify a visual image of the memory, a negative belief about self and identify related emotions and body sensations. You are asked to identify a positive belief (how you would like to believe about yourself). Rating scales are used for both the positive belief and how strong the negative emotions are.
The image, negative though and bodily sensations are focussed upon, whilst the therapists instructs the client to move their eyes from side to side are another form of bilateral stimulation (taps on knee, hands, tappers). The client is to notice whatever happens (there may be some change to a thought, feeling, image, memory or sensation or there may be no change). The therapist supports the client when they feel stuck of in times of heightened distress. This process continues until no distress is reported. At this point the ratings of positive thought and emotion level are checked. If there is no distress and the positive rate still fits and is rated high, and there are no unusual physical sensations. The therapist helps to link these to the target with further bilateral stimulation. If distress / uncomfortable sensations are found processing would continue.

Phase 7 – is the Closure Phase. The client is reminded to log any memories or thoughts between sessions that may be disturbing. The therapist and client take some time to complete some grounding / relaxation exercises. If there are disturbances between sessions it indicates that the processes is continuing and the mind continuing to heal by itself, client is recommended to use calming / safe place techniques. Sometimes if clients are resistant in therapy the information is processed in between sessions. Some clients feel emotional between sessions and others do not. After a session some people feel tired, therefore it’s advised to plan some relaxed time after the session, to have a bit of quiet time or go for a walk.

How Many Sessions will I need?

This is unique to the individual and circumstances, as well as childhood difficulties, number of trauma and age on onset, current situation and support. Multiple traumas and complex history of abuse of poor attachments may require more long term work and more intensive preparatory work in phase 2, before active processing starts. The amount of preparation will vary from person to person and dependant of the client’s ability to self soothe. Some studies showed that 90% of single trauma victims no longer had PTSD after 3 x 90 min sessions. Another study showed that after 6 x 50 min session 100% of single trauma and 77% multiple trauma victims were free from PTSD. In another 77% of combat veterans were free of PTSD in 12 session.

With EMDR it’s recommended that you have regular sessions and commitment to attendance is required. EMDR is most effective when the full protocol has been completed. Usually 6-12 sessions are need on average.

Side Effects

With any type of psychotherapy emotions may increase for a while after the session as distressing or unresolved memories emerge. High levels of emotion or physical sensations may occur during the session and process can continue after the session in the form of dreams, memories and feelings.

Will I re-live the Trauma?

Unlike some therapies, in EMDR you are not asked to re-live the trauma for long periods of time. The high levels of intensity only last for a short amount of time and reduce quickly. You will have learnt tools to help relieve any distress if it becomes too intense.

Difference between Hypnotherapy and EMDR
(As cited for the American Journal of Hypnosis)

Although some of the tools and techniques used in EMDR can to likened to those from other therapies, including Hypnotherapy there are distinct differences to the these therapies.

Typically when practicing hypnotherapy the client is helps to be taken into an altered state of mental relaxation. In EMDR mental relaxation is not typically attempted. In fact, attempts are often made to connect with an anxious or disturbing mental state or feeling, whilst the client very much is guided to stay in the here and now.

Also in hypnosis the client develops a highly focused state of aroused receptivity. In EMDR clients maintain a dual focus on past and present – focusing on both positive and negative currently held beliefs, as well as the emotional arousal brought about by imaging the worst part of a disturbing memory.
One of hypnotherapies effects are to utilize the client’s imagination, to think out of the box and to help perceive things in a different way. In EMDR the client is helped to feel grounded and asked about current feelings and body sensations, to prevent drifting away from reality.


EMDR although a fairly recent psychotherapy is growing in popularity, this is partly due to the recommended therapy status by NICE, and many research studies taken place and also the practitioner and client feedback of the effectiveness of the therapy to reduce or eliminate feelings associated with memories, painful situations.
If you have any further questions on EMDR or any of the psychotherapies I offer you can email me on julie@symmetrytherapy.co.uk

EMDR Video

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