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Betsi Cadwaladr University Health Board

North Wales Child and Adolescent Mental Health Service

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Eye Movement Descnsitisation and Reprocessing (EMDR)


What is EMDR?


Eye Movement Desensitisation and Reprocessing (EMDR for short) is a relatively new therapy established within the last 15 years.  It is an extremely effective treatment for people – children as well as adults - who have had traumatic experiences.


It is also helpful for a variety of emotional and behaviour problems in adults and children.


How does trauma affect us?


Everyone has traumatic experiences during their lives.  The effects can be physical, psychological or a mixture of the two.  Most recover quickly, some do not.  Sometimes the effect of a trauma can stay with us and affect our lives long after the event.  Specialist help may be needed to aid recovery.


The effects on children


Sometimes the traumas experienced are easy to see – death, or a road traffic accident, for example.  But it is not always that easy.


Sometimes you know what they are but your child does not.  The traumas may have taken place so early in life that they are not remembered or the child may have pushed them out of their minds or “forgotten” them.


When children do not remember they often show the effects through behaviour.


These are often signs of ‘Emotional Stuck Points’ - or ESPs


For example they may not laugh, play or smile much.  They may be too obedient and willing to go with any adult.  They may be unable to stand up for themselves or protest when badly treated.  Sometimes parents know something is very wrong but are not aware that anything traumatic has happened.


‘Emotional Stuck Points’ tend to be less clear-cut than specific traumas.  EMDR can be used to improve self-esteem and help with depression, anxiety, non-co-operation or anti-social behaviour such as lying and stealing.


Why is traumatic experience so special?


This seems to have something to do with the way the brain processes information when traumas occur.


Let’s think about how ordinary memories are formed.  Usually, when something happens, your eyes, ears and other senses are the first to respond.  This body of information is then stored as memories.  These usually have a story-like quality, and contain your impressions and interpretations as well as facts about what happened.


When something dangerous happens your body and brain respond in a different way.  Your body recognises the emergency and takes protective action; its messages to the brain seem to be put into an emergency store, often without going through the normal memory processing.


These experiences – with the original sound thoughts and feelings – are recorded in your brain in the raw unprocessed form.


Sometimes the brain does not process them in the normal way to form ordinary memories.  They are even stored in a different part of the brain.


How are traumatic memories different?


Traumatic memories seem to become locked into the brain in their “raw” form.  When these memories are recalled they can be very upsetting.  Sometimes they can be recalled out of the blue causing flashbacks, nightmares and outbursts. They can make it very difficult to deal with ordinary stressful situations in the calm and reasonable way that we normally would.


How can EMDR help?


EMDR is an approach that seems to help ‘unblock’ the brain’s processing so that traumatic memories can become “ordinary” memories.  We do not know precisely how this treatment works.  It may have something to do with the alternating left-right stimulation of the brain – or with REM sleep in which the eyes often move from side to side.  These eye movements may help to process the unconscious material.


EMDR involves asking the child to think about the upsetting events after which he or she is asked to look at the therapist’s finger and follow it back and forth for about 15 to 30 seconds.


Other types of left-right stimulation such as hand taps or drumming might be used if a child finds the eye movements difficult.  After a few seconds of eye movements or other right-left stimulation, the therapist stops, asks the child to notice if anything has changed about the image.


The therapist then asks the child what comes up next in his or her mind.  Typically something shifts and the child reports a new image, thought, feeling, or physical sensation.  Then the child is asked to hold this in mind and follow another set of eye movements, hand taps or sounds.  Sometimes upsetting thoughts and feelings come up and need to be dealt with.  The procedure continues (unless the child gives the STOP signal – see below) until the event no longer seems upsetting for the child.


Feeling safe


When upsetting experiences and feelings are being worked with it is very important that the child feels safe and in control at all times.


The therapist will usually set up a “safe place” with the child before starting to use EMDR to work on upset feelings or memories.  This procedure involves the child imagining a place where he or she feels safe and happy, and using eye movements to “install” a strong image of this.  This safe place is a relaxation technique.  


It can be a refuge for the child during EMDR or between sessions at any time.


The stop signal


This gives the child control and helps him or her to feel safe. The child is asked to raise a hand if they want to stop.  This informs the therapist that the child wants to ‘stop immediately’. The child is told that it is important to remember “it is your own brain that will be doing the healing and you are the one in control”.


Finally


The information given here does not replace advice given by your therapist.  Please discuss it with your therapist, who will be able to give you more detailed information.