What is EMDR?
EMDR is a relatively new treatment for people – children as well as adults – who have had traumatic experiences. It is also helpful for a variety of emotional and behaviour problems in adults and children.
Everyone has traumatic experiences during their life and the effects can be physical, psychological or a mixture of the two. Most people recover quickly, but some do not. Sometimes the effect of a trauma can stay with us, affecting our lives long after the event. Specialist help might be needed to aid recovery.
The effects of trauma on children
Sometimes the traumas a child experiences are easy to see, such as a death or road traffic accident, but others are not so visible. Sometimes you know what they are but your child does not. The traumas may have taken place so early in life that your child may not remember them or he or she has pushed them out of mind or ‘forgotten’ them.
When children do not remember traumatic experiences, they often show the effects of them through behaviour. These are often signs of ‘emotional stuck points’ or ESP. For example, they may not laugh, play or smile much. They may be too obedient and willing to go with any adult. They may be unable to stand up for themselves or protest when badly treated. Sometimes parents know that something is very wrong but are not aware that anything traumatic has happened.
ESP tend to be less clear-cut than specific traumas. EMDR can be used to improve self-esteem and help with depression, anxiety, non-cooperation or anti-social behaviour such as lying and stealing.
How are memories formed?
This seems to have something to do with the way the brain processes information when traumas occur. Understanding how ordinary memories are formed can help us understand how traumatic memories form. Usually, when something happens, your eyes, ears and other senses are the first to respond. This 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 respond 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-forming processes. These experiences, with the original sounds, thoughts and feelings are recorded in the brain as raw unprocessed information. Sometimes the brain does not process them in the normal way to form ordinary memories. They are even stored in a different part of the brain.
Traumatic memories seem to become ‘locked’ in the brain in their raw form. When these memories are recalled, they can be very upsetting. Sometimes, they can be triggered apparently 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 we normally would.
How can EMDR help?
EMDR is an approach that seems to ‘unblock’ the brain’s processing so that traumatic memories become ordinary ones. We do not know exactly 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 child to think about the upsetting event, after which he or she is asked to look at the therapist’s finger and follow its movements back and forth or about 15 to 30 seconds. Other types of left-right stimulation, such as hand taps or drumming, might be used if a child 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 child what comes up next in his or her mind. Typically something shifts and the child reports a new image, thought, feeling or physical sensation. The child is then asked to hold this in mind and follow another set of eye movements, hands taps or sounds. Sometimes upsetting thoughts and feelings come up and need to be dealt with so the procedure continues, unless the child gives the ‘stop signal’ (see below) until the event no longer seems upsetting for the child.
When a therapist is working with a child on upsetting experiences and feelings, it is very important that the child feels safe and in control at all times. The therapist will usually set up a ‘safe place’ with the child before starting to use EMDR to work on upset feelings or memories. This involves the child imagining a place where he or she feels safe and happy, and using eye movements to ‘install’ a strong image of this. This ‘safe place’ is a relaxation technique. It can be a refuge for the child during EMDR or between sessions at any time.
The ‘stop signal’
This gives the child control and helps him or her feel safe. The child is asked to raise a hand if he or she wants to stop. This signals to the therapist to ‘stop immediately’. We always tell the child that it is his or her own brain that will be doing the healing and he or she is in control.
The information given here does not replace any advice given by your therapist. Please discuss it with your therapist, who will be able to given you more detailed information.
Last reviewed by Great Ormond Street Hospital: June 2007
Ref: F070326 © GOSH Trust June 2007
Compiled by the Island Day Unit in collaboration with the Child and Family Information Group.
This information does not constitute health or medical advice and will not necessarily reflect treatment at other hospitals. If you have any questions, please ask your doctor. No liability can be taken as a result of using this information.