EMDR and Attachment Focused EMDR
Eye Movement Desensitisation and Reprocessing, usually known as EMDR, is a powerful psychotherapy technique which has been successful in helping people who suffer from trauma, anxiety, panic, disturbing memories, post-traumatic stress and other emotional problems. EMDR can be a rapid type of therapy, which can provide lasting relief, and is one of the treatments of choice for PTSD in the NICE guidelines (2005).
When would we suggest EMDR for you?
Since its inception, EMDR has been helping people conquer their symptoms of PTSD. While it has been widely utilized by therapists, with great success protocols to address developmental trauma have been a great addition to this already effective therapy. The original model has been adjusted to become applicable to a greater population of people dealing with relational and developmental trauma and CPTSD. The AF-EMDR model tackles the foundation–the attachment style–to then heal trauma.
What's happening in our brains when things get 'stuck'
After a distressing or traumatic event, you may feel overwhelmed, which may lead to your memory network becoming “stuck” or “frozen” on a neurological level. This can mean that when you recall the event or situation, you can feel as if you are re-experiencing what you saw, heard, smelled, tasted or felt, and these sensations can be very intense. Sometimes people will do anything to avoid experiencing the painful memory, sometimes people are reminded or “triggered” by something into remembering, and sometimes people are subjected to involuntary intrusive thoughts, in “flashbacks” or dreams. If any of these symptoms persist, they can cause significant emotional distress for you.
What are the symptoms often helped by EMDR?
- High anxiety and lack of motivation
- Memories of a traumatic experience
- Fear of being alone
- Unrealistic feelings of guilt and shame
- Poor and disrupted sleep
- Difficulty in trusting others
- Relationship problems
How does EMDR work?
The psychotherapist will ask you to revisit the traumatic moment or incident, recalling feelings surrounding the experience, as well as any negative thoughts, feelings and memories. This will be a gentle process and done in a manageable way for you: you will go at your own pace. The therapist will use bilateral stimulation such as eye movement, buzzers, audio or tapping. The more intensely you focus on the memory, the easier it becomes for the memory to come to life. As quick and vibrant images arise during the therapy session, processed by the eye movements, painful feelings become replaced by peaceful, loving and resolved feelings.
In the process the distressing memories lose their intensity, so that the memories are less disturbing and seem more like “ordinary” memories. The effect is like what occurs naturally during REM sleep (Rapid Eye Movement) when your eyes rapidly move from side to side. EMDR helps reduce the distress of memories, whether it was what you saw, heard, smelt, tasted, felt or thought.
EMDR therapy can help clients replace their anxiety and fear with positive images, emotions and thoughts.
What can I expect from my EMDR sessions?
EMDR is more than just the eye movements. It is a comprehensive therapeutic approach involving principles, protocols and procedures with the goal of reducing distress in the shortest amount of time. Your psychotherapist will spend time getting to know you and your history, both generally and about the traumatic event(s) itself. You are welcome to ask any questions you may have about your treatment.
Your psychotherapist will also spend time doing breathing and grounding exercises with you, and a guided visualisation called “a safe or pleasant place.” This will prepare you for the processing of the traumatic event, and you will practice these exercises regularly.
You will select an image that represents the distressing event and then think about negative and positive thoughts, your feelings, the amount of distress you feel and where you feel it in your body. The therapist will then begin the bilateral stimulation, after each set of BLS, you can say what came to mind or what you noticed during the eye movements. During the BLS you may experience the distressing event quite intensely to start with, but this distress will reduce as the EMDR processes the memory.
Your therapist will continue with the BLS until your distress reduces as much as possible. Your therapist will then ask you to think about your positive thoughts and check whether there is any part of your body where you still feel distress. Before the end of the session, your therapist will give you time to feel calm again, using the safe-pleasant place exercise or relaxation techniques.
Attachment Focused EMDR
Attachment focused EMDR was developed by Laurel Parnell and, while using the main mechanisms of EMDR such as bilateral stimulation, dual attention and adaptive information processing, it also incorporates a great deal of resource development which helps people with traumatic childhoods feel safe in working with distressing memories.
Attachment-Focused EMDR works in a very similar way to standard EMDR. Just like standard EMDR, Attachment-Focused EMDR works on difficult, distressing memories using bilateral stimulation. In AF-EMDR, however, the focus can be more on memories that occurred much earlier in life and which serve as feeder memories to later PTSD, CPTSD and other problems later in life. Attachment-Focused EMDR is informed by Attachment theory. Attachment theory was initially proposed by John Bowlby and later developed further by his colleague Mary Ainsworth, and looks at how early relationships with our closest caregivers contribute to our experience of the world, our emotional development and our interactions with others.
AF-EMDR incorporates an understanding that with developmental trauma the lack of safety, and security in childhood leads to adaptive strategies that can persist into adulthood, ultimately causing significant distress. Using Resourcing, Tapping, Bilateral Stimulation, and visualization, trauma can be integrated and reprocessed so that it no longer has a profound negative effect on the present. With AF-EMDR, clients will visualize and internalize a peaceful place using their imagination. Often individuals with developmental trauma have never had a safe place so we use imagination to create one. Imagination can impact the brain in the same way as lived experience, thereby creating new neural pathways. Clients can return to this space whenever they need to during therapy and outside of sessions. AF-EMDR also uses an imagined support team to assist the client. Through imagination, the support team can provide experiences that the client may not have had, or not have had enough of. With EMDR, a client will be exposed to bilateral stimulation through eye movement, sound, tapping or sensors, while exploring troubling memories. Using resourcing, clients will be able to add and deepen the ability to feel soothed, comforted, guided and protected. Because AF-EMDR can also help people gain a sense of internal regulation, interpersonal relationships can also be positively affected.
EMDR is not a form of hypnotism
You will always remain conscious and in control.
What to expect after your session of EMDR
Clients are often tired after an EMDR session. It is good to rest after a session, if possible.
The processing may or may not continue after the session. If new insights, thoughts, memories and dreams occur, you can make notes of them and bring them to your next session.