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Child and Adult EMDR

Eye Movement Desensitisation and Reprocessing (EMDR) is a relatively new therapy established within the last 10 years and is an extremely effective treatment for children, young people and adults who have had traumatic experiences. EMDR is a highly effective way of processing traumatic memories. It is one of the few methods for working with traumatic memories recommended by the National Institute of Clinical Excellence.

I have specialist training specifically in adapting EMDR for children and adolescents. EMDR is an effective way of working with children, young people and adults affected by distressing events. It is also helpful for a variety of emotional and behaviour problems in adults and children.

Lots of people have traumatic experiences during their lives. The effects can be physical, psychological or a mixture of the two. Most recover quickly, some do not. Sometimes the effect of a trauma can stay with us and affect our lives long after the event. Specialist help such as EMDR may be needed to aid recovery.

I hope the information I have provided answers the questions I am most frequently asked.

The effects of Trauma on Children and Young People

Sometimes the traumas a child experiences are easy to see death, or a road traffic accident, for example. But it is not always that easy.

Sometimes you know what they are but your child does not. The traumas may have taken place so early in life that they are not remembered or the child may have pushed them out of mind or "forgotten" them. When children do not remember they often show the effects through behaviour. These are often signs of 'Emotional stuck points' (ESP).

For example they may not laugh, play or smile much. They may not be compliant, misbehave or engage in anti- social behaviour such as lying and stealing. The may not be able to leave you and become clingy. They may be unable to stand up for themselves or protest when badly treated. Sometimes parents know something is very wrong but are not aware that anything traumatic has happened.

'Emotional stuck points' tend to be less clear- cut than specific traumas. EMDR can be used to improve self-esteem and help with depression and anxiety.

The effects of Trauma on Adults

Most of the time our bodies naturally manage new experiences, events and processes things and we are not even aware of it. This is called information processing. However, if something out of the ordinary happens and we become overwhelmed then our natural ways of processing information and coping can become overloaded. This can lead to the distressing experience or traumatic event becoming frozen in our brain, unprocessed and being in a raw form rather than processed as a memory; something that has happened in the past.

Often, as a result of trauma we can become avoidant, on edge or more hyper vigilant. We may feel detached from ourselves and other people feel unable to do what we have previously enjoyed, we can feel numb or cut off from things. Depression and anxiety are commonly experienced feelings and for some sleep becomes disturbed and feelings of anger and irritability can increase. We may feel less able to concentrate on things and use drugs and alcohol to manage difficult emotions.

People around us may notice that we are different, we may fee unable to socialise or leave the house and experience problems going about our daily activities or jobs.

How are memories formed?

This seems to have something to do with the way the brain processes information when traumas occur.

Let's think about how ordinary memories are formed. Usually, when something happens, your eyes, ears and other senses are the first to respond. This body information is then stored as memories. These usually have a story-like quality, and contain your impressions and interpretations as well as facts about what happened.

How are Traumatic memories different?

When something dangerous happens, your body and brain responds in a different way. Your body recognises the emergency and takes protective action, its messages to the brain seem to be put into an emergency store often without going through the normal memory processing.

These experiences with the original sound, thoughts and feelings are recorded in your brain in the raw unprocessed form. Sometimes the brain does not process them in the normal way to form ordinary memories. They are stored in a different part of the brain.

Traumatic memories seem to become locked into the brain in their "raw" form. When these memories are recalled they can be very upsetting. Sometimes they can be recalled out of the blue causing flashbacks, nightmares and outbursts. They can make it very difficult to deal with ordinary stressful situations in the calm and reasonable way that we normally would.

How can EMDR help?

EMDR is an approach that seems to help 'unblock' the brain's processing so that traumatic memories can become "ordinary" memories. We do not know precisely how this treatment works. It may have something to do with the alternating left- right stimulation of the brain or with REM sleep in which the eyes often move from side to side on their own. The eye movements may help to process the unconscious material.

What does EMDR involve?

EMDR involves asking the client to think about the upsetting events after which he or she is asked to look at the therapist's finger and follow it back and forth for about 15 to 30 seconds.

Other types of left-right stimulation such as hand taps or drumming might be used if a client finds the eye movements difficult. After a few seconds of eye movements or other right-left stimulation, the therapist stops, asks the child to take a deep breath, let go of the image, and rest.

The therapist then asks the client what comes up next in his or her mind. Typically something shifts and the child reports a new image, thought, feeling, or physical sensation. Then the client is asked to hold this in mind and follow another set of eye movements, hand taps or sounds. Sometimes upsetting thoughts and feelings come up and need to be dealt with. The procedure continues (unless the client gives the STOP signal see below) until the event no longer seems upsetting for the client.

Feeling safe and contained

When upsetting experiences and feelings are being worked with, it is very important that the client feels safe and in control at all times.

The therapist will usually set up a "safe/calm place" with the client before starting to use EMDR to work on upset feelings or memories. This procedure involves the client imagining a place where he or she feels safe, calm and happy, and using eye movements to "install" a strong image of this. This safe/calm place is a relaxation technique. It can be a refuge for the client during EMDR or between sessions at any time.

The 'Stop Signal'

This gives the client control, and helps him or her to feel safe. The client is asked to raise a hand if they want to stop. This signals to the therapist 'stop immediately'. The client is told that it is important to remember, "it is your own brain that will be doing the healing and you are tchildcbt.phphe one in control".

How many sessions will we need?

The number of sessions depends upon the specific problem and history. However, repeated controlled studies have shown that a single traumatic experience can be processed within 3 sessions in 80-90% of the participants. While every disturbing event need not be processed, the amount of therapy will depend upon the complexity of the history.

It is difficult to predict without meeting with you how many sessions you may need as this depends very much on the problems you are is facing. I will work with you to decide together how many sessions you think are necessary and progress will be reviewed at regular intervals. With children and young people, it often takes a little longer to build up a therapeutic relationship (without which no meaningful work can take place).

I hope that you have found this information of interest and that it has and answered any questions you may have. Please feel free to contact me to discuss further or to make an appointment to meet for assessment. - Clinical Guideline 26

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