Dr Pamela Lawson (CPsychol)North London Counselling Psychology and Psychotherapy

EMDR and PTSD. words image

Post Traumatic Stress Disorder (PTSD)

Post Traumatic Stress Disorder (PTSD) is a term which first came into usage in the 1970s to describe the psychological issues affecting US soldiers returning from the Vietnam War. It was officially recognised as a disorder in 1980 by the American Psychiatric Association. Trauma, of course, has long been acknowledged as having a significant impact on the human psyche. The term PTSD acknowledges this impact, particularly the neurobiological changes to both the central and autonomic nervous system, and the detrimental effects these changes have on human behaviour and functioning.

If you have been diagnosed with PTSD or are suffering from PTSD-like symptoms, as a result of a traumatic or distressing experience, your daily life is probably very challenging. You may be noticing any of the following symptoms:

- nightmares
- flashbacks
- intrusive thoughts
- hypervigilance
- avoidance of places or things which remind you of the event
- feeling numb or detached
- memory lapses around the event
- loss of interest in life
- low mood or negative thoughts
- anger and irritability
- panic attacks.



Eye Movement Desensitization and Reprocessing (EMDR)

EMDR is an evidence-based treatment for PTSD endorsed by the National Institute for Health and Care Excellence (NICE) and the World Health Organisation (WHO) among other bodies. It is specifically designed to help clients process traumatic or distressing experiences thus enabling the symptoms and emotional pain to be healed. It is based on a concept called Adaptive Information Processing (AIP) which uses bilateral stimulation in the form of eye movements or tapping to reprocess dysfunctional memories.

The AIP model proposes that the information related to a traumatic experience can sometimes be incompletely processed, resulting in the related sensations, emotions and distorted thoughts being stored like a 'live wire'. These 'live' associations are then easily triggered again and again, greatly undermining normal day-to-day life. EMDR is thought to alleviate this ongoing mental and physical distress by reprocessing the dysfunctionally stored components of the distressing memory.

The EMDR therapist employs a standardised protocol where the client engages a dual process by simultaneously attending to disturbing material whilst focusing on a therapist-directed external stimulus. Whilst the exact mechanisms are unknown, EMDR is understood to access the memory network where traumatic memories are dysfunctionally stored and enables new, adaptive associations to be made. EMDR thus aims to reduce subjective distress and strengthen adaptive beliefs related to the traumatic experience. It has been found to be as effective as Trauma-Focused CBT for the treatment of PTSD with the added advantage that the client does not need to describe or examine their experience at length.

EMDR has considerable power and is recognised as an effective and efficient tool for treating traumatised populations. For this reason, EMDR is widely used by medics and clinicians working in war zones and areas affected by natural disasters. Some of the most extensive EMDR research has been on its effectiveness with combat veterans in the US, where it is validated by the American Psychiatric Association and the US Department of Veteran Affairs and Defense.

Whilst EMDR therapists can treat many cases of PTSD in 5-12 sessions, more complex presentations will require much longer work where EMDR is combined with talking therapy over a period of months and sometimes years. So, whilst EMDR is both a powerful and effective therapeutic tool, it is not a magic wand; but even in the most complex presentations, EMDR can often provide some relief or alleviation through resourcing and other grounding techniques.

Finally, whilst EMDR was initially developed in 1989 to treat PTSD, it is now used to treat a range of conditions including depression, anxiety, phobias, OCD, attachment disorders, chronic pain, acute stress and more. The EMDR field is full of therapists applying this ground-breaking technique to an ever wider range of presentations with exciting and encouraging results. Please see below for a list of references and websites which you can peruse for more information.

Websites:
https://ptsduk.org
https://emdrassociation.org.uk
https://emdr-europe.org
www.emdr.com
www.emdria.org
www.ptsd.va.gov
https://isst-d.org
https://estd.org

References:
Trauma and Recovery by Judith Herman
The Body Keeps the Score by Bessel van der Kolk
The Body Remembers: The Psychophysiology of Trauma and Trauma Treatment by Babette Rothschild
Eye Movement Desensitization and Reprocessing (EMDR) Therapy (3rd Edition) by Francine Shapiro
Attachment-Focused EMDR: Healing Relational Trauma by Laurel Parnell
EMDR Toolbox: Theory and Treatment of Complex PTSD and Dissociation by Jim Knipe
Waking the Tiger: Healing Trauma by Peter Levine

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