In this episode, Family Features therapist Adrian Perks
demystifies eye movement desensitization reprocessing,
more commonly known as EMDR. We discuss how EMDR works, what
a session can consist of, how quickly it works, and who it's
for. Currently, we offer EMDR through
our well-being Hub service to speak to a member of the team
about how EMDR could help you or someone in your family.
You can find our contact details and the relevant links in the
caption. I think people have a sort of
misconcept, quite a few misconceptions of what EMDR is,
and it just feels like this mystical, magical thing.
It's almost a bit like sci-fi, but just from the things that
I've heard about it. But how would you explain EMDR
to someone who was sceptical about it?
Well, I suppose I'd, I'd talk about, so it was kind of
developed for like PTSD symptoms and like explaining it in a kind
of way that people understand, I suppose is that when you have
PTSD, that memory is kind of flowing around in your brain and
it's easily triggered or activated at any time.
So that's why people can experience the feelings they had
in their event now. So what EMDR does by bilateral
stimulation is helping the brain far away that memory.
So it's not floating around to be activated all the time.
So I don't know if that makes sense.
I mean, the what what happens for people is they will remember
something really intensely and after EMDR they'll still
remember it, but it won't have the intensity to them.
That. Feeling.
Yeah, yeah. And I guess the thing that
sounds a bit kind of I've heard EMDR described recently in an
interview where someone talks about being on a train and
almost going past windows of their experience and looking
back over their life. So like a very out of body
experience. Yeah.
And is that common for people to experience?
Is that part of it? Yeah.
I mean, there's various ways of accessing the memories, but
generally people have an image that they focus on and very
much, yeah, that kind of almost like watching from a train or
watching a film of your life and watching it kind of change is,
is the experience of lots of people in EMDRS.
But also you can, you can, it doesn't have to be an image.
It can be feelings as well. So you can process the feelings
in your body. I mean, I suppose to bring
things to life is probably to give you an example.
So I mean, really why I, why I trained in EMDR is I felt that
with a lot of young people that I was working with, you know, we
would, we would talk about it, we would draw it, we'd do it in
a sand tray, but it was still like.
There. You know, and I thought, what
else is there? And EMDR was something that one
of my colleagues knew about and I looked into and I thought,
well, this could be the answer. So my first kind of client was
somebody who'd had a reoccurring dream.
So when he was young, he'd witnessed a parent taking heroin
in the bathroom when he was about two.
And he, he was a young adult now, so 17 or 18.
And he was still having that dream every night.
So it's obviously something on process there.
So that's an example of that's the image.
And we use that as a starting point.
And you you kind of associate like a negative feeling with it
and a positive feeling and you move from the negative to the
positive and. What's that?
What's that like for you as a therapist?
So you're sat with this person and they're, so you're, we'll go
back to the bilateral stimulation because I want to
explore that in a more kind of like scientific way.
But you're sat there and you're, I guess prompting and asking
them to relive or go back to that really, really traumatic
and significant moment that is very present in their day-to-day
life. And you're sitting there and
you're guiding them through it, but you're also sat there seeing
them go back to that place. And then what's that like for
you? I mean, certainly when you
start, it's quite scary because you're like, you're taking
someone back to something that's really like really hard for
them. But the idea, and I think this
is true of a lot of therapy is the idea is to be 1 foot in the
past and 1 foot in the present. You know, so always you're with,
you're with them and you tell them that you're with them.
And, and it's very different from talking therapy.
And that's why psychologists and social workers do EMDR as well,
because it's, it's very much you, you do some processing, you
ask what's happened to the image and then you do more processing.
You know, you don't say, oh, and how do you feel about that?
And it's, it's a process. So it's also good for people
that find talking about things hard, because you're not
talking, you're processing, using the image and focusing on
stuff. That must be quite hard for
people who are used to having traditional therapy or say
traditional because there are so many different types.
But talking therapy where you discuss how it made you feel and
have you struggled when you've done an EMDR session with
someone who has maybe through their life, done lots of talking
therapy, lots of exploratory, and then they've sat down and
you're trying to do EMDR and they keep talking about how
they're feeling. You do prep them a bit, so you
say right after each each processor.
I mean literally. I mean, it might be worth
talking about the actual mechanics of it as well.
Yes. I have questions.
On that as well. Because it's not for long.
So each processing part is between the half a minute and a
minute. So it's not like you're doing
tons of stuff. The answer to your question is
yes, for some people you have, you have to be quite directed
and say, I don't need loads, I just need what's happened to the
image. But for a lot of people, it's a
relief because they're not, they're not into the I want to
talk about this. So it's a way of processing it
without talking about it. And imagine a lot of our
especially young people we work with, you ask them how they are
and they'll say, good, how are you?
You know, they're not, they're not going to be talking loads
about it. So and for, I mean, I'm training
a bit more in working with really young kids.
I mean that's really exciting because the brain is more
plastic and more able to change and it's not as formulaic.
So the way of doing the bilateral stimulation can be
with the buzzers that we can talk about a bit more or you can
do jumping from left to right or use feathers to it's just to
stimulate that bilateral kind of.
Well, that what is it about the bilateral movement, which is
from left to right or right to left in sort of lay terms, but
correct me if I'm wrong, what is it about that that helps the
brain process the trauma and file it away?
Yeah, this is the bit I might need to do a bit of reading up
on so I can add anything into it.
But I mean it, it's a way of focusing the brain on that
memory because obviously with PTSD and stuff like that, your
brain is always trying to avoid it because it's that's, that's
the kind of survival response is to not look at it.
So we are looking at it and it's a way of focusing as well to do
that bilateral kind of work. I mean, originally what what
happened with the MDR was the founder, I can't remember her
first name. Her second name was Shapiro.
She she'd had a trauma of someone dying and I think it was
someone dying and she went for a walk and she was looking at the
trees from left to right. And she is a psychologist and
she realized that this had some kind of calming effect on her.
So the original like pure EMDR is where someone holds up a
finger and you follow the finger like this.
I don't do that. I use buzzers or if I do it
online, you can look at a dot on a screen.
It's. Yeah.
And how do you know it's worked? So I guess based on my
experience of talking therapy, you talk through the issue or
the thing that you're struggling with or the the thing that's
being, you know, triggering. And then your therapist helps
you unpick it, gives you advice on how to manage that situation
when it comes up or if it comes up again.
And then you go to your next session and probably that
situation has come up again and you go, oh, yeah, I actually
felt differently this time because we'd spoken about, you
know, what was going on in my body or I feel like I've I've,
you know, been able to reframe it and, and you have that back
and forth. But it sounds like with this, is
it at the end of the session someone goes, oh, OK, I feel is
there a release is or do they just go on and then, you know,
pop you an e-mail and go, oh, by the way, it doesn't feel as
upsetting for me anymore. Like how do you know?
It's a bit more formulaic than that, so particularly.
With adults. So literally you will think of
an image and you will then I'll take you through a number of
questions and then you will rate how intense that feels out of
10. So generally people will come
and you know, it's normally A7 plus I get some people saying
it's a 10 and if EMDR works you get that feeling down to 1 or 0.
Wow. I mean, for some things, you
know, maybe a bereavement or something like that, maybe you
don't expect to get it down to 1 because it is sad.
Yeah, you take the intense feelings away.
But yeah, I mean, I say to people when I start with them,
you said that's an 8, we'll get that down to 1.
And they look at me like I'm like talking rubbish at them.
But it happens. Does it happen?
I guess I'm trying to get you to put some parameters on, but and
it's, you know, it's how long is a piece of string maybe or maybe
it's not. Is it OK, we'll get that down
from an 8 to a one or a zero in six sessions or in two sessions?
Or does it depend on the person? Depends on, I guess, the trauma.
So for example, and I don't do so much of this work, but lots
of police officers, firefighters have EMDR for really tough
situations that they've been in. But like a single incident
trauma, normally you would expect to within sort of 6 to 10
sessions process that. Yeah, obviously in our work
we're dealing with people that have had complex trauma.
So it can take longer or you choose to go down different
channels where you'll you'll process 1 channel and then
you'll then move to something else.
Yeah. I mean, it's, it's normally
quite it stays high, stays high, stays high and I normal
experiences it's suddenly dropped.
So when you processed all the. So what tends to happen is the
image kind of changes and a bit like you were saying, you're
watching it from a train and then your brain will take you to
all the places that you need to go to process that trauma.
Once that's done then then the rating will drop right down.
Wow. And I mean, so we're talking
about it in terms of like being a tool or an intervention for
extreme trauma, high level trauma, let's say trauma with a
big T, which do use it for kind of anything that is difficult or
is it only applicable for really intent?
So if you would say going through something that you were
just ruminating on the same experience that you found really
hard, but really it was sort of at A5, yeah.
Would you do that? Yeah, you.
Could definitely do that and obviously you you've experienced
that like the calming exercise. So you can do those kind of
exercise as well. When I was doing my training, we
were split into little groups and there was someone who said,
oh, I've had a migraine this week.
I've got quite a pain left in my shoulder and the side of my
head. Let's try and do that.
And it took the pain away, so. What did, what did they do?
So they've had a, they've had a migraine and they had all this
off. I've had migraines and you do
feel almost like bruised from it.
They're awful. So what was the process of
reprocessing that or getting rid of the pain?
Did they talk about the intense feeling of having the migraine?
And felt that, just really focused on the feeling.
OK. Use the buzzers to focus on that
and after using the buzzers that then shifted that.
Oh yeah. And would you, would you say
that anyone who's experienced trauma should have EMDR?
Because it sounds like it really.
I mean, it's not sounds like it's evidence based, you know?
But yeah, nice approved as well. So yeah, I mean, I suppose what
what the only areas where it hasn't worked for me is when
people are still in something. So an example was an adoptive
parent where there was still child to parent violence going
on a lot. So they were really dysregulated
by that. So that was hard to get them
into a calm space to be able to do the EMDR, but definitely
something. Experienced, yeah.
Yeah, that's hard. I mean, there are tools to deal
with that as well, but it's hard if people can't concentrate on
it. You know, you need to be able to
concentrate on the process and the image.
But yeah, I mean, I I think for adults that have experienced
something in the past that's still affecting them now, EMDR
is a great thing to try. Yeah.
And how would you compare it? Because it's that we've just
discussed, it's a different process completely to talking
therapy and you're a talking therapist as well.
Yeah, I'm a psychotherapist, so. You're a psychotherapist.
So what I love is what I really love the the way of working
would be to do some psychotherapy and explore
history and that kind of thing and then identify the EMDR,
something that can really help do the EMDR and then maybe
return to psychotherapy for a bit.
So it's kind of an integrated approach.
There are people that do pure EMDR and that you would go in
with an issue, you'd spend a few sessions or maybe even one
session talking about what that is and then you'd start doing it
and that would be the end of it. And I guess some people, what
you described about prepping people when they come into the
session to let them know like what to expect is probably,
well, I would imagine very, very helpful because you're, you're
aware that you're going to talk about something really
traumatic. And you know, you're just
describing it. Like you said, you're not
talking about the feeling description or not talk about
the feeling in the same way that you would in an exploratory
psychotherapy way. And you prep them and you
obviously let them know that it's a short period of time.
So you'll only be talking about this for a minute, which is
probably mitigates quite a lot of worry for people.
Well, I mean, it's so let me explain that process a bit more
to you. So what happens is you would
identify the target. You would then where are you
feeling it in your body, that kind of thing.
And then you would rate it. And then you do what are called
passes. So you do like I would ask
someone to think about the image while holding.
I use buzzers. So while holding the buzzers.
So I'll put the buzzers on for 45 seconds and then I'll say to
them, OK, what did you say? What happened?
They'll tell me. Right.
Go with that. We do another 45 seconds, then
we stop what happened? And we might do up to 20 of
those in an hour. Wow.
But you can see it's quite a process.
Yeah. Yeah.
And are they describing it or does it change?
Do they describe it out loud to you while the buzzer?
OK, so they just do and you ask some questions as they if.
They ask some questions, I get them to focus on a particular
part of it. OK.
We'll just so they'll say, oh, this has happened in the image,
I'll be OK. We'll just go with that then
focus on that and then we start it.
So it is like really like a repetitive process.
And then how, how do you bring someone back to a place where
they feel safe and able to go about their day?
Because that's an intense process.
And then to go, all right, thanks for the session and just
go, yeah, it's obviously an. Ending I would do that.
So the calm peaceful place exercise that you've witnessed,
I would always do that at the end of the session.
So that is using the buzzers, but I would put them on a lot
slower speed. So it's a really farming and
that calms the system and a lot of the EMDR processing will
continue after the session. People often describe being a
lot more, needing a bit more sleep and that kind of thing
because the brain is processing what's what's.
Happening. Yeah.
Because you're, you're, you're asking it to work a lot harder
and it's being prompted with something.
And do people find, do you, is there a chance that you can end
up associating the buzzers with the trauma?
How does that work? Because I would imagine if
you're, because I know I've spoken to, you know, we have a
whole team of people who offered loads of different types of
therapy and have experienced loads of different type of
therapeutic interventions. What's really nice is that
everybody shares their experiences.
And I know one of our team was talking about the tapping and
like doing these taps and that is EMDR.
But then how do you separate out the the tapping sensation as a
calming thing and not as it's bringing you back to the moment
of stress? When when you're doing the
processing, the tapping is a lot far.
So if you were to use bilateral sort of the butterfly type
stuff, you would tap a lot faster.
So tapping on your I just I realised this is an audio
recording. Tapping on your shoulders.
Tapping on your shoulders with your hands or holding a buzz.
Holding buzzes so they wouldn't. It wouldn't be triggering
outside of the session. No, and I often give homework of
doing the the kind of calming place yourself with the slow
tapping at home. I mean that's what I love so
much about the buzzes is you. It's not only the speed of the
buzzing, it's the intensity as well.
So when you hold on to them, I can control how intense that
buzzing is if you. Yeah.
Kind of know what I and, and I definitely worked with one young
person that that was key, like finding the exact intensity that
they needed to process stuff. It took us ages and we're
fiddling around with percentages and stuff.
And then it was like, yeah, that's it, that's it.
And now I I can process. Oh, you know, because I guess
otherwise if it's too, if it's not intense enough, it's you
just forget it's happening and it's too intense, it's
distracting and you can't think about what you need to be
thinking about. Is that because there's so much
with all therapy, it's heart, it's general, but it's also
individual experience and case by case as well.
Is there anything that is kind of consistent with something
that everybody who you've done EMDR with has fed back that
they're like, this part was amazing or something that with
EMDR everybody's like, you know, wow, there's, there's like one
specific part of it that's particularly interesting or
people often connects with. I mean, honestly, it's the
reducing the intensity of stuff. I mean, I'm never like in
psychotherapy, it's a much longer process.
And you very rarely have people saying, well, that has changed
how I feel. You know, in six sessions.
It happens with the MDR, you know, that these are things that
people have been living with for years and suddenly they're much
less intense and it frees them. So it if it works, it's it's
great and it does it does work most of the time.
I mean, that kind of brings me back to why would anyone not
have EMDR? I know you've mentioned about if
someone's still in it, you know, if they're still experiencing
child, you know, child to parent violence.
Using the example you gave, it's not.
It's too difficult because it's still actually happening to
them. I mean that would be.
True of that would be true of psychotherapy as well with with
that particular client because they were so dysregulated that
it's really hard. I mean that you know, there
there there is a concept of being therapy ready and being
ready for the work, which I'm sure you know about as you've
been someone who's had therapy. So you have to be ready for it
as well. I think some of it is people
think it's, they don't understand what it is and I
don't think it's that widely known even though do.
You think that's just because it's a kind of, I don't know,
it's more fish in a big pond. Everyone's people are just
generally more prescriptive of psychotherapy, CBT, and that
that's just a more known about thing and this is an unknown and
people don't gravitate towards it or it feels too good to be
true because it just sounds, you know, it's incredible the
results you're talking about. I'm not sure actually why it.
I mean, I think one of the problems is lots of people
trained in it and then they don't use it very quickly and
then they decide because you know it.
I think you alluded to this earlier on that actually these
are quite, you're going to places where people that are
really scary. And I found that when I was
with, you know, early on after my training that I'm sorry, I
hope this works because I've asked someone to think about
something absolutely horrendous here.
But I know now that it works. So I can, I think that gives
some other, you know, confidence in for the client and they're
saying, well, it will work. So let's just keep going, you
know? Have you had it yourself?
Just only, only in the training. OK.
But it's interesting what you said, like, you know, thank you
for sharing that, that as a professional it's was hard for
you to initially to be sat there with people and be asking them
to do these things and think about these things.
And that's really scary. It does focus, focus the
therapy. And you know, you with a client
who's who's had tough experiences, you may feel that
you're both colluding in the fact that we don't talk about it
because it's too hard. It's a really hard thing to
think about. But EMDR does really focus you
on on those on those tough feelings.
Yeah. I mean, the, the other bit that
I wanted to say to you as well is that it's pretty
groundbreaking. Like some people that were
training us on my course that they use it for, they go out to
say there's been an earthquake or something like that.
And they they know that doing EMDR as quickly as possible
after something like that is the most effective way of doing.
Straight away. Straight away they'll come out,
they'll go and be in the centres where people are congregating
because they can't go back home and they'll do EMDR with people
to process that kind of trauma amazingly quickly.
That's incredible because the incident has happened like you
were saying, you know, with emergency services where they
experience one traumatic interview, some an event
happens, they experience it and it's traumatic.
We're not talking about long term complex trauma and abuse,
which is what we support at Family Futures and what a lot of
our clients have experienced, you know, one off specific
incidents. That's incredible that, you
know, almost straight away. Do you think it's more powerful
because people, I guess it's to say that happened to you, you
experienced, like you said, an earthquake, right?
And you didn't have EMDR straight away.
And you know, 10 years later, it makes logical sense.
You're then having to go back to a memory that you've tried to
suppress for 10 years and has kept coming back because it was
so traumatic and you have got PTSD from it.
So it does make complete sense that it would work more
effectively straight away because you're, you know, it
more. It's more pleasant at the front
of your mind in a way. And that's why it worked so well
with younger children. And that is the bit that I'd
really like to expand because when I was training, I watched
this video, they showed a video of a toddler who wouldn't go
into nursery. And obviously the toddler was
unable to explain why. So they, they were doing some
MDR parents were tapping and it works.
And they thought it was something like some what some
another kid had nicked a ball or something and it had distressed
this child so much that they will, I'm not going in now if
people are just going to steal my ball.
But that's a good example of something that, you know, like
really young kids can just be. And that was in one section.
How do you approach that then with, with, you know, with young
children, because like, like we've just discussed your, it's
more recent, but when they can't, what's the age, age
bracket for that? Because if it's, you know,
recent, but it's still something they have to explain.
How do you connect the tapping the reprocessing to the memory?
So it's a bit more like you, you might be talking about what's
hard with parents there and you know, put the buzzers in their
socks or something like that and turn them on when you're talking
about something that's really hard.
But that also that jumping, you know, you can jump from 2 spots,
you know, you can be really creative with it as well.
I mean, it's, it's a bit that I, I, I would like to do a bit more
training on it and do a bit more.
Because if you think in the context of exploring people's
life story, for example, when when we're in.
A bit. When we're in a bit that's
really tough, then we turn the buzzers on or we jump or, you
know, and that helps the brain to process that memory.
Yeah, that would be, yeah, I'd like to do a bit more.
Really, no really interesting and really fits in really well
with how we as an organization think about the brain and the
body working together and bringing what's happening from a
description to how does that feel in your body, which is
something we continuously do with with families and.
I think that's really interesting.
Yeah. In terms of the MPP model that
actually what can be going on with the parents is the kind of
DDP work. So reflecting on how hard it is
while the child possibly is having some tapping at the same
time, that might help them to process it.
Well, and that, you know, the whole model of is, is really
that framework of integration of multiple things and rather than
like a linear one thing bringing in different ways of working
rather than just working single in one modality.
Thank you for listening to this episode of the Family Features
Podcast. You can subscribe and share this
episode with anyone who might find it helpful.