EMDR: The Therapy That Can Help You Overcome your Flashbacks and Nightmares
Trauma symptoms, such as flashbacks and nightmares, are a normal and understandable response to experiencing unusual and highly distressing events. Some people with trauma symptoms think that they are weak, “going crazy” or to blame for their trauma symptoms. I hope by reading this article, you will realise that this is absolutely not true. I think of post-traumatic stress disorder (PTSD) as a physiological problem; because of the nature of the traumatic experience, the trauma memory has not been properly processed and so has been stored in a raw form in a different part of the person’s brain to their other long-term memories. It is this dysfunctional storage of the trauma memory that causes people with PTSD to have re-experiencing symptoms such as flashbacks and nightmares.
If you are experiencing flashbacks related to your birth or pregnancy, this suggests that the memories you are reliving have not been fully processed by your brain. The good news is that there are some evidence-based therapies that can resolve trauma symptoms, one of which is Eye Movement Desensitisation and Reprocessing (EMDR) therapy. EMDR has been shown to be helpful for prenatal, post-natal and perinatal mental health.
What happens in the brain when we experience a traumatic situation?
To understand more about why trauma symptoms persist, it is helpful to think about how the brain creates memories and then consider what happens when we experience a traumatic event or series of highly distressing situations. Imagine that the brain is like a factory, which turns our day-to-day experiences into long-term memories that we can then use to guide our learning and development and be better prepared for situations in the future. When we experience a traumatic event, or a set of distressing experiences, the situation(s) may be so overwhelming that the brain switches into a survival mode, in order to enable us do what we need to do to tolerate and/or survive the experience. Whilst in survival mode the brain cannot process what is happening in the same way. It is as if the factory has shut down because the experience is “too big” to process. The traumatic experience therefore gets stored in its current, sensory form, rather than being processed and stored as a stable, long-term memory with a context and a place in time. This means that when memory is triggered, the person tends to have re-experiencing symptoms like flashbacks in which they may experience the same thoughts, emotions, sensations, smells and sounds that they experienced at the time.
Re-experiencing symptoms are understandably very distressing and tend to create an ongoing sense of threat, which can lead to avoidance behaviours and symptoms of hyper arousal. These symptoms can then have a ripple effect on various aspects of a person’s life, including their relationships and goals for the future; lives tend to shrink when people are experiencing trauma symptoms. This is particularly difficult in the case of birth trauma, as the trauma symptoms can impact on a parent’s mood and relationship with their child and/or other significant people in their life and may also cause anxiety about future pregnancies and births. EMDR has been found to be an effective therapy for birth trauma.
What is EMDR?
EMDR is structured psychological therapy that is recommended by the World Health Organisation (WHO) for people with post-traumatic stress disorder (PTSD) due to its effectiveness at resolving trauma symptoms. EMDR has been shown to be reduce trauma symptoms and has been found to be the most cost effective trauma therapy. Further details about EMDR can be found on the EMDR Association of Australia website and an overview of EMDR Therapy for PTSD can be found here.
EMDR is also effective for a range of other conditions including depression, phobias, anxiety disorders and traumatic grief. EMDR can work relatively quickly, a typical course of therapy for someone with a single trauma can be around 6-12 sessions, although some people require fewer sessions. The length of treatment depends on the complexity of a person’s trauma history; people who have experienced multiple or prolonged traumatic events and those who have experienced childhood trauma and / or neglect often require a longer course of therapy.
How does EMDR help?
We believe that trauma symptoms occur because the trauma memories have not been properly processed and are dysfunctionally stored in the brain in a raw, sensory form. EMDR helps to unblock the blocked processing, so that the brain can do its natural healing process and turn the trauma memory into a long-term stable memory. Earlier I said that the brain was like a factory; EMDR helps the factory start working again. The EMDR therapist helps their client process the traumatic event by breaking things down and focusing on specific aspects of the trauma memory. The therapist also guides the client to use bilateral stimulation, often in the form of side-to-side eye movements or tapping, whilst reprocessing the memory. The bilateral stimulation creates a demand on the person’s working memory (i.e. it gives the brain another job to do), which means that the memory is a little less intense and therefore easier to think about. It also helps the person to stay focused on the present, whilst thinking about the past and this means that it is easier to tolerate. As a result of thinking about the trauma during EMDR sessions the person becomes desensitised to the memory, meaning that the emotional disturbance associated with the memory reduces.
EMDR typically has three main stages with three main aims.
- Stage 1: Learning helpful coping strategies. In the first stage, the therapist teaches the clients some coping strategies or “resources” to help them handle their trauma symptoms and any distressing thoughts and feelings that may occur between sessions.
- Stage 2: Reprocessing the trauma memory. In the second stage, the trauma memory is processed to enable it to become a stable long-term memory without a high level of emotional charge. Current triggers for trauma symptoms are also processed and future templates for how to cope with challenging situations in the future are developed. During this stage the processing that occurs helps to connect or link the traumatic experience with all the other adaptive information that a person has, and this leads to the development of new, more adaptive perspectives.
- Stage 3: Reclaiming one’s life. In the third stage the person is encouraged to reclaim their life. Trauma symptoms often cause lives to shrink; people stop doing the things that matter to them, don’t pursue goals or opportunities and relationships are often adversely affected. In this last phase of therapy the therapist encourages to the client to take a new look at their life, consider their values and set goals for the future in order to create a richer, more purposeful life in which they can flourish.
You can find a local EMDR therapist via the EMDR Association of Australia.
Images by Unsplash.
Dr Rachel Lee is a Chartered Clinical Psychologist working in the NHS and in private practice in the UK. She is an accredited EMDR and Cognitive Behavioural Therapist and specialises in working with people with trauma histories.
For coping strategies to help with trauma symptoms see https://www.northstarpsychology.co.uk/coping-with-trauma-symptoms