The case study below presents a first-hand experience of how EMDR works.
I came to therapy after experiencing trauma symptoms following a trip to Turkey where I witnessed a violent failed coup d’état. Despite having triggered the emergency/security protocol while in Turkey, upon my return I was not offered counselling to debrief the incident.
The incident was considered important as the executive director and other senior managers were being briefed on my situation twice daily while still in Turkey. In that sense, I did not feel my organisation supported me in dealing with the fall outs of the incident. I had to request for help through HR and it was almost two months before I was able to see a counsellor.
Through this experience, I wondered whether other colleagues who may not have been as comfortable going to see a therapist, or afraid of the stigma attached to doing so, would have requested the support. I believe my organisation should make post-incident debriefing mandatory, as part of the incident management protocol. It would help those who may need a little bit more encouragement to seek help.
EMDR addressed my PTSD symptoms effectively. It enabled me to understand why I was reacting the way I was, rather than being left to feel weak or stupid for experiencing such distress. It has now been over six months since the treatment and I have not experienced any symptoms in that time. The changes in how I felt and the reduction of the symptoms I was experiencing was quick. I now feel that the issue is resolved and this is not something I will continue to carry with me.
(Chris, aid worker)
There are several different approaches to psychotherapy, which can be confusing if you are searching for a therapist. It is important to be aware that some therapists will state that they work with trauma but will not have had specialist trauma training. In basic terms there are three main approaches to psychotherapy: Psychodynamic, Humanistic and Cognitive Behavioural therapies.
I would describe myself as an Integrative therapist, and therefore I work with a combination of these approaches. Additional trauma specialist models include: Trauma-Focused Cognitive Behavioural Therapy (TF-CBT), Eye Movement Desensitisation Reprocessing (EMDR), Narrative Exposure Therapy (NET) and Sensorimotor Therapy. There are other models of working with trauma but further research is needed into the efficacy of these various approaches. All trauma approaches aim to help the client to create a trauma narrative, find meaning in the event, and reduce the trauma symptoms, whether through talking, drawing, play or writing. Most trauma models follow a three-step treatment programme: stabilisation, processing and integration (Herman, 1997).
EMDR: how does it work?
Francine Shapiro, PhD, Senior Research Fellow at the Mental Research Institute, Palo Alto, California and Executive Director of the EMDR Institute, California, is the ‘originator and developer’ of EMDR (Shapiro, 1989). Since then, EMDR has been adapted and reworked based on the research and contributions of therapists and researchers the world over.
Initially used as a treatment with Vietnam veterans who weren’t recovering, it has since proven successful in treating various other presentations, including anxiety, phobias, addictions, depression, complicated grief, abuse and performance anxiety. The unique feature in EMDR therapy is that it uses bilateral stimulation (BLS) whilst processing the distressing memory (Shapiro, 2005). BLS can be conducted by following the therapist’s hand as it moves from left to right, watching a light bar, or tapping.
The same can also be achieved through listening to alternating bilateral tones or holding buzzers. The BLS alleviates negative cognitions, negative emotion and unpleasant physical sensations associated with a traumatic or distressing memory. An important concept of EMDR is the ‘Adaptive Information Processing (AIP)’ theory (Parnell, 2007). This means the client begins to reformulate and update dysfunctional self-beliefs and replaces them with positive self-reflecting beliefs. Therefore, EMDR promotes our innate healing process and reformats dysfunctional information to functional, so that it becomes adaptive information processing. ‘Just as the river flows to the sea and the body heals the wound, EMDR clears the trauma and brings integration and wholeness’ (Parnell, 2007, p. 6). In discussing EMDR, Professor Gordon Turnbull states: ‘Therapists and patients were reporting that problems that had been resistant to years of psychotherapy were being resolved in a very short amount of time – sometimes within a few sessions’ (Turnbull, 2011). In my experience of working within the field of trauma for over 15 years I have never witnessed such a powerful and successful way of working with traumatised and anxious clients: ‘EMDR works effectively and helps the client return to work quickly and safely after a traumatic event’ (Dunkley & Claridge, 2012).
The EMDR protocol sets out an eight-phase treatment plan:
For more information on EMDR Treatment I encourage you to buy my new book Psychosocial Support for Humanitarian Aid Workers, available via Amazon.