EMDR - How does EMDR work?

Eye Movement Desensitization Reprocessing Therapy (EMDR) is a rapid and highly effective, evidenced-based psychotherapy. It was originally developed by American psychologist Dr Francine Shapiro in the 1980s to help people suffering from trauma as a result of exposure to either natural disasters, rape, road traffic accidents or childhood abuse.

EMDR is not only effective in the treatment of Post Traumatic Stress Disorder (PTSD), it is also used to treat a variety of other psychological difficulties including general and specific performance anxieties, chronic pain, phobias, OCD, dissociation and depression. Furthermore, EMDR offers flexibility in that it is routinely used in conjunction with other more traditional talking therapies such as Cognitive Behavioural Therapy (CBT).

We all process information in our brains as we see, hear, feel, smell and taste the world around us. We learn through our senses. However, when a person encounters a traumatic event that feels threatening to their safety, the brain's natural information processing system can sometimes break down. As such, the traumatic event goes unprocessed and fails to be properly integrated with other memories. Essentially, the experience becomes frozen in time with all the thoughts and raw feelings that were present at the time the event was occurring.

EMDR helps to re-integrate traumatic memories, thoughts and feelings by purposefully activating the central nervous system (CNS) and the brain's information processing system. This is achieved through 'bilateral stimulation': alternating attention between the two hemispheres of the brain so that it transfers information between them, thus ensuring the traumatic experience becomes 'just another memory'. This allows natural healing to take place.

During the EMDR process, the client brings together cognitive, sensory and emotional responses to a disturbing memory which become set as the 'target' for treatment.

The psychologist then asks the client to follow the path of their fingers as they move repeatedly from right to left - moving the eyes from side to side and stimulating both brain hemispheres. An electronic device displaying lights, sounds and tactile stimulation can also be used to stimulate the brain. The client is encouraged simply to allow whatever comes to mind, without critical evaluation. There are often links to old memories, bodily sensations and strong emotions as well as spontaneous and rapid insights as the processing takes place. The aim is to allow the client to process the memory until the disturbing associations are no longer present and the memory, when brought to mind, does not generate any distressing reactions.

EMDR is a client-led therapy in that the client is always conscious and in control of what is happening. EMDR is not a form of hypnosis. The client is able to stop treatment at any stage.

EMDR is not a one-session cure although it may be quicker than some traditional talking therapies.

The National Institute of Clinical Excellence (N.I.C.E) recommends EMDR as a treatment of choice for Post Traumatic Stress Disorder (PTSD).

Compassion Focused Therapy

Compassion-Focused Therapy (CFT), also known as Compassionate Mind Training (CMT), has been developed to help people who experience high levels of shame and self-criticism. These can be common characteristics of clients who experience other emotional difficulties including social anxiety, eating disorders, general anxiety and depression. People with high levels of shame and self-criticism are often highly disapproving of themselves and have difficulties in being kind to themselves, feeling self-warmth or being self-compassionate.

CFT was developed by a clinical psychologist, Professor Paul Gilbert, for people who typically come from harsh backgrounds where bullying, neglect, abuse or lack of affection in their family was common. These individuals often experience problems with managing their emotions and can easily perceive others to be critical and rejecting of them and, in turn, can become self-disliking and self-critical. Individuals prone to high levels of shame and self-criticism often find it difficult to soothe themselves or generate feelings of safeness and warmth.

The key principles of CFT are to motivate the individual to care for their own wellbeing, to become sensitive to their own needs and distress, and to extend warmth and understanding towards themselves. The client is encouraged to employ these self-soothing actions as they engage in various imagery tasks while documenting their self-attacking thoughts.

Compassion can be thought of as a skill that people can train in. Through regular practice and adopting a compassionate attitude, people are able to alter their physiological reactions to stress.

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© 2011 Dr Stephen Bainbridge
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