What is EMDR?
EMDR is a type of psychotherapy which is very effective for children who have had traumatic experiences. It is an extensively researched therapy to help children recover from PTSD and the difficulties this causes, for example, flashbacks, hypervigilance, intrusive upsetting thoughts or images and other somatic symptoms. It is also helpful for a variety of behaviour and emotional problems in children. EMDR provides a space for less verbal children to process and heal from their traumatic experiences without the need to speak in length about why they are feeling, thinking, and somatically experiencing the things they are.
How can EMDR help children?
Anna M. Gomez explains it like this: EMDR therapy can assist children to relieve the “yucky experiences” that their young brains have a hard time understanding. All these mixed-up feelings, thoughts and sensations do not feel good in minds, hearts and bodies and prevents children from experiencing the present. "When we are so busy carrying all these bags (mixed-up feeling and thoughts), we do not have space in our hearts, minds, and bodies for the good feelings and thoughts. EMDR can help kids by making those bags smaller or even get rid of them so kids will have space for the good feelings and the good thoughts." By helping the child to relieve the traumatic experiences with guidance, the child’s brain is able to put the puzzle together and make some sense of everything that has occurred.
What does trauma look like to a child?
Trauma is an experience which makes a child feel extremely frightened, panicked and out of control. The child thinks there is threat of serious harm or even death to either themselves or somebody else close to them. Such traumas could include: road traffic accidents, dog attacks, seeing someone else getting hurt (domestic violence), serious illness and undergoing intrusive medical procedures. Sometimes trauma affecting children can be pre-verbal, with the child having no conscious awareness of the actual memory. However, they can still show the effects through their behaviour and thoughts.
Normally an experience would go through a part of our brain called the Hippocampus, which processes the experience so it can be filed away as a memory.
When a child experiences trauma, their brains do not function like they normally do, the brain switches to survival mode, meaning the brain instructs all the mental and physical energy toward dealing with the immediate threat until it has passed. This means the experience gets stuck in the nervous system with traumatic events being stored in the brain in the form of feelings, thoughts, visions, smells, and sounds, resulting in strong emotions which overwhelm the brain. Trauma can change the way children act, think, feel, and experience situations and or people for a long time after the initial event took place. This can result in flashbacks or nightmares, feeling tense and on edge, loneliness, being angry with sometimes self-destructive actions.
What can be treated with EMDR?
It is a very effective therapy used for PTSD due to:
• Bullying, sexual / physical abuse, neglect
• Phobias, OCD, eating disorders
• Attachment issues & symptoms related to guilt, anger, fear, depression, anxiety.
• Family fragmentation – losses, divorce, bereavement
• Road traffic accidents, Invasive medical procedures
• Generalised anxiety and social anxiety
• Self-esteem issues, social embarrassment, shame
It does not require talking in detail about the distressing issue. Instead, it focusses on changing the thoughts, behaviours, emotions, and body sensations resulting from the unprocessed traumatic memories in the brain. EMDR helps the brain to reprocess and heal the traumatic memories by imitating what the brain does naturally during REM sleep using rapid eye movements. It also helps to desensitise the child to the emotional impact of the memory, so they can think about the event without experiencing such strong feelings and sensations.
The child is asked to recall the traumatic event whilst moving their eyes from side to side following my fingers, sometimes other types of bi-lateral stimulation such as drumming is used or by tapping. I can also, depending on the child’s age, and the type of trauma, ask the parent/care giver to be part of the bilateral stimulation for example, having the child sit on your knee and you tapping your child on the shoulders. Therapy is tailored to individual need and preference.
The Eight Phases of EMDR:
History taking & Treatment planning
During this phase the therapist will work with the child or parent to identify possible target memories for reprocessing and to determine the child’s readiness and suitability for treatment. This phase may take on the form of play, such as drawing a timeline of events. Alternatively, it can take place by interviewing the parent.
It is during this stage where the therapeutic relationship develops, builds, and strengthens. During this stage the therapist explains how bilateral stimulation will be used.
The therapist will ensure that the child has different coping skills in order to regulate any emotions that arises, which involves creating a “safe place”, which is a relaxation technique and can be used if processing becomes upsetting. The child will imagine a place where he or she feels calm, safe, and happy and the therapist will use eye movements to install this. This “safe place” can also be used outside of sessions. We can also use “protection figures” who the child feels safe with.
This helps the child feel safe and in control at all times.
At this stage, we will identify specific memories which causes distress that need to be targeted by EMDR along with sensations in the body, images etc.
The bilateral movement is performed while thinking/visualising a targeted, disturbing memory, sensation, image, and will start to work through this. If the child becomes distressed, the therapist will bring them back to the present immediately.
During this process the therapist will help the child install a positive belief. The goal is to concentrate on and establish the new positive self-belief that is replacing the old negative one. For example: the child believing their parents have split up or is getting divorced because “ I am bad” (negative self-belief). Using EMDR the child can conclude that their parents’ divorce was actually not their fault and not within their control. Other negative beliefs can be “I’m not good enough” or “I’m unlovable”, which can be changed into positive beliefs during this process.
After installing the new belief, the child scans their body to check for any remaining sensations/tensions which may still be present.
Every session ends with closure, making sure the child leaves the session feeling safe.
A diary can be kept till the next session to note down any disturbances/thoughts/feelings which may occur in between sessions.
Every session starts with a re-evaluation to gauge where the child is at and to plan the next session.
The above eight phases are spread between multiple therapy sessions, ranging from over a few weeks to a few months, depending on the child and the target memories.
Sessions can be adapted to specific needs and developmental stage of the child, for example, using pictures instead of words or by using a story.
Sessions can last up to 60 minutes. The number of sessions depends on the memories being re-processed.
Please contact me for further information and to discuss how EMDR can help your child to make space for good feelings and good thoughts.
Extract from EMDR Institute, Inc.
Nicky Fitzwilliam Wellness Therapies
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