Episode 20. EMDR Therapy

Aspasia: Welcome back to another episode of 10 Minute Mood. Today I am joined by Clinical Psychologist Veena, and we talk about EMDR. A brief reminder that the information in these episodes is meant as a general guide. It’s always a good idea to check with your therapist or your medical practitioner to ensure that you are receiving care that is in line with your particular needs. 

We will be recording a deeper dive into EMDR in a later episode, so keep an eye out for that. Enjoy.  

Aspasia: Thanks for joining me today, Veena. EMDR, it’s a term that is all over the place at the moment. What’s the simplest way to explain what on earth EMDR is? 

Veena: The EMDR part stands for eye movement desensitisation and reprocessing. Not that that’s very simple or anything, but the simplest way to explain it is our brains have a natural ability to heal.

It’s much like if you cut yourself. And then your body starts to heal. And then pretty soon that cut disappears. It’s a very similar thing with your brain. 

And so, the process that that uses is this eye movement which is also called bilateral stimulation. So it’s like when you move your eyes from side to side, much like the way that you would see people who are in the middle of REM sleep, like the deep dreaming state sleep.

And their eyes move from side to side as they’re lying there deep in sleep. That facilitates the processing, the integration of memories and learning and it allows your brain to heal from things that have perhaps happened throughout the day. And so, the EMDR specifically is for memories that are quite distressing , or events that have happened that are distressing and disturbing. The EMDR can just facilitate your brain to sort of heal in a way that allows the integration to happen, the learning to happen for things not to get very stuck in the present day.

Aspasia: Can you give me a sense then of what kinds of difficulties someone might be facing in their day-to-day life where EMDR might be a good fit for them?

Is it just really big memories, like a really big traumatic event that happened in someone’s life? Or what are we talking about? 
 

Veena: It doesn’t necessarily have to be memories. EMDR can be used to treat anxiety and panic attacks, depression, stress, phobias, sleep problems, grief particularly complicated grief addictions, pain. 

It’s not just limited to things that have necessarily happened historically. It could even be things that are developing now. But components of a memory can also be targeted. If there are particular beliefs or thoughts or sensations, emotions, images those sort of components of a memory. 

Maybe some experiences have happened in your life cumulatively. So, a number of times repeatedly where you’ve been maybe subject to some sort of distress. Or it could be a specific event itself, like maybe a car accident, something like that, where your natural coping mechanisms become overloaded and then that results in this sort of frozen kind of stuck experience in your brain. And your brain just can’t process what’s happened. So when that occurs, there are often some symptoms that you might experience that impact or interfere in your ability to function day to day. And they can be symptoms along the lines of anxiety, irritability hypervigilance, , being on edge, restless,

Veena: avoiding certain places, certain things, . All of those things that might then impact how you are coping and functioning day to day. That’s what we would target. 

Aspasia: So I’m hearing there that that EMDR might be useful for someone who is dealing with a really big event that happened to them, like you said, maybe a car accident, maybe they’re the victim of a crime. But also this idea of the repeated cumulative events. I’m imagining maybe if someone experienced a lot of bullying when they were younger.

Mm-hmm. Something like that. That they might be having difficulties now in current day life that could be the result of this kind of process. Is that right? 

Veena: It could be bullying. sometimes there might be caregivers who haven’t been there for the person is a young person.

Is it the same thing as hypnosis? ’cause sometimes when we talk about this process, it sounds like someone’s being hypnotised. 

Veena: I’m not too familiar with hypnosis, but I imagine it’s not like that because actually to do EMDR what they say is you need to be enough in the present moment in order for the learning to happen. 

You are here, you’re conscious, you’re aware of things that are in front of you, and also you can access some things that have happened in the past that then allows you to integrate or process the two.

Aspasia: This leads on to what exactly happens in an EMDR session with a psychologist.

Veena: Well, EMDR therapists can be from many different disciplines.

There can be differences amongst them and it just depends on their preference, depends on how long or short their experiences been. Typically, when you go in for a assessment initially, you’d identify some goals that you want to work towards. The therapist might recommend weekly sessions 60 to 90 minutes at a time. They could recommend that you come in twice a week. It, it just really depends. But initially there is a number of sessions taken to actually prepare to do the EMDR work. Why that’s important is that when you do the processing sessions, the actual active kind of part of the treatment, sometimes we’re not aware of how much distress that that might bring additionally, as well. So the initial part of the treatment would be just to prepare yourself for that, to ground yourself, to stabilize, so that when it comes to the active part of the treatment, which is the processing part, you’re able to, do the processing with the therapist, and then in between sessions be able to regulate yourself. 

And then depending on the treatment plan that you have with your therapist it could take a short period of time, it could take a long period of time. 

Aspasia: So it sounds like there are different phases to EMDR and just like any treatment approach, there’s the beginning part that involves assessment.

And then also getting a person ready, making sure that the right preparation’s been undertaken before there is this phase called the processing phase. Mm-hmm. Then on the other side of is , where you are understanding what happened and putting pieces together and figuring out if there’s more processing to be done or not.

The processing sessions are probably the part that people are likely to have either heard about or seen something about. They involve this bilateral stimulation mm-hmm. Process. I’m just wondering if you could speak. Briefly about what happens in a processing session. I know it differs, but what might it look like if someone came to see you?

What might they be doing in a processing session compared to a normal therapy session? 

Veena: Yeah, so you would agree with your therapist on what the bilateral stimulation will be. The one that’s typical are eye movements and whether the therapist sits near to you and facilitates the eye movements in person, or if it’s an online session, or if for whatever reason you don’t feel comfortable with the closeness in terms of proximity that the therapist is sitting with you, they might use a light bar just to help you with the eye movements.

So that’s one way. The other way to do the bilateral stimulation, they might give you some buzzes that you hold in your hands. Or they might do some tapping on your knees, or they might ask you to do what they call a butterfly hug. And that’s when you cross your arms across your chest and you tap on your shoulders. So there’s different ways that you can do the bilateral stimulation or whatever is your preference. Whatever you feel comfortable with you can discuss that with your therapist. 

And then during a typical EMDR session, you will have identified a memory or maybe an image or a sense of something, like a felt sense of something that you want to target.

And once that happens the therapist will sort of guide you. They might stay out of the way in that, there’s not a lot of talking that happens, but there will be like, sets of eye movements or tapping that happens. And in between they’ll ask you what you notice and then they’ll kind of continue. Some therapists, if you do get stuck during the processing session will , talk a little bit more just to facilitate the processing for you. But generally speaking, they stay out of the way. 

So there’s very little talking that happens. It’s not like the talk therapy that you might have experienced typically. And then at the end, they might ask what some of the insights and learnings you might have come up with throughout the processing might be.

It could be that whatever you’re working on, that could take a number of sessions to process.

Aspasia: So you might actually finish a session and it might not have completely processed a single memory which is okay. It’s pretty common. And then you might continue that in subsequent sessions. 

You said something there about the processing sessions don’t involve a lot of talking. That is really different to other kinds of therapy, and I imagine for some people that might be a really great thing because to talk in depth about the details of very painful or traumatic memories can be challenging.

Aspasia: Obviously there’s something about this therapy approach perhaps that. Makes it a good fit if you find it really difficult to, to talk in detail about those things, or you don’t want to go into that level of detail, is that right? 

Veena: Yeah, definitely. You can give just enough detail for the therapist to ascertain what might be going on, but you don’t actually have to go into the details of it. It’s not necessary, for the therapist to know exactly what happened. That is definitely an advantage for people who find it uncomfortable, or for whatever reason aren’t willing to share that information. And also if you are somebody who likes to share the details and things, that’s also okay.

It’s not like you have to go to EMDR and not share anything. 

Whatever your preference is, you can let the therapist know.

Aspasia: I’m thinking, is this something can be used with kids adolescents, older people? 

There are definite modifications to what we call the standard protocol of EMDR. There are adaptations for children, for adolescents for older adults and for some of the other conditions that I’ve mentioned before, like pain for example. So definitely it can help treat a range of conditions and a range of populations.  And again, it’s that personalised approach. There’s a flexibility to how you want to do this.

Veena: Sometimes, people might prefer to do specific chunks of processing, but in between they might want to do some talk therapy. Either schema, act, whatever the, the modality. And then they might choose to do another chunk of EMDR.

It just really depends on what your treatment plan is that you’ve come up with and how you can work with the therapist around that. 

Aspasia: Thank you so much Vina, for your time and for helping us to, to understand what EMDR is and who it might be helpful for. 

Veena: You’re very welcome.