The Royal Treatment


It's not often you get to share something in common with royalty, beyond pulling your trousers on one leg at a time and pooping, but now you very much can. Prince Harry has revealed that to help him cope with the trauma of the loss of his Mother at aged 12, he has undergone EMDR Therapy.


Did you know that The Secret Keeper has two certified EMDR practitioners in house. Frances and Rodney spent most of 2020 learning and practicing the technique and have already seen success in clients.


But what is it?

Eye Movement Desensitisation and Reprocessing (EMDR) is a therapeutic technique that can be used for a range of conditions. It is done in eight phases and is an evidenced treatment that requires comprehensive training.

This is one of our longer posts, but that’s because this technique is a powerful way of shifting issues that have been stubborn to other forms of therapy.


The development of EMDR?

The creator of EMDR, Francine Shapiro, defines it as ‘an empirically validated treatment for trauma, including such negative life experiences as commonly present in medical practice’ (Shapiro, 2014). Being developed in the 80s makes this non-traditional type of psychotherapy a new kid on the block. If you’ve heard anything about it, though – or even registered its name of ‘eye movement reprocessing’ – you are probably wondering how, or why, it works, especially given that it doesn’t rely on talk therapy or medications.


EMDR doesn’t focus on changing the thoughts, emotions, or behaviours resulting from a traumatic event or distressing issue. Rather, EMDR uses a patient’s own rapid, rhythmic eye movements and other non-invasive stimulation to allow the brain to resume its natural healing process (EMDRIA, 2021).


Like some other therapies, EMDR came into existence as a result of serendipity. One day in 1987, Shapiro, a psychologist in California, took a walk in the woods, absorbed with distressing thoughts. Yet, as her walk came to an end, she realised that her mood had lifted after observing her environment, often scanning the environment from left to right and back. Curious, Shapiro tried different ways of bringing about the same experience for her clients and found that they, too, felt better afterwards. EMDR was born. After an initial study was published in 1989, numerous investigations focused on the outcomes on it, it was revealed to be a surprisingly effective means of helping clients overcome the symptoms associated with PTSD and other anxiety disorders. It quickly became a go-to therapy for military veterans struggling with combat-related trauma (Arkowitz & Lilienfeld, 2012; Tejcek, 2016). Now it can be used with any person that has suffered trauma from any means.


How does it work?

We don’t actually know the answer to this! Shapiro’s proposes that EMDR therapy uses accessing and processing of traumatic memories by bringing about an adaptive resolution. Our brains have an inbuilt way for recovering from traumatic events. It involves communication between the amygdala (our pea sized, primitive alarm signal that triggers anxiety), the hippocampus (which helps us with learning – especially memories about safety and danger), and the prefrontal cortex (which analyses and works to control behaviour and emotion). While it’s often true that traumatic experiences can be managed and resolved spontaneously, sometimes the system is overwhelmed and people need help, sometime months or years later. Stress and anxiety responses are part of our natural instincts of fight, flight, or freeze. When distress remains with us after a disturbing event, the images, thoughts, and emotions can create feelings of overwhelm. Sometimes it can be like being back in that moment, or of being ‘frozen in time’.

EMDR therapy helps the brain to process the memories, allowing normal healing to resume. The person still remembers the experience, but the fight/flight/freeze response from the original event is resolved (EMDRIA, 2021; EMDR Institute, 2020), without having to describe the event in great detail. Upon the completion of successful treatment, emotional distress is decreased, negative beliefs are reformed, and physiological arousal is reduced.

During the therapy, the client concentrates on emotionally disturbing material in ‘snapshots’ while also focusing on an external stimulus. Typically, the external stimulus is bilateral eye movements or hand ‘tappers’ directed by the therapist, but other stimuli, audio stimulation can be used. Shapiro hypothesises that EMDR therapy helps clients access the traumatic memory network, and linking it to more adaptive memories or information.

What EMDR is used for?

While EMDR started as a way to treat anxieties and post trauma symptoms, it can be used for a number of other conditions, although some are unproven at this stage. The Secret Keeper can assist with the highlighted:

  • Depression and bipolar depression

  • Phobias

  • Anxiety

  • Chronic pain

  • Panic attacks

  • Eating disorders

  • Grief and loss

  • Performance anxiety

  • Personality disorders

  • Psychotic symptoms

  • Self-esteem issues

  • Sexual assault, violence, and abuse

  • Sleep disturbance

  • Stress-induced flare-ups of skin problems

  • Trauma

  • Dissociative disorders

  • Addictions (Leonard, 2019; WebMD, n.d.; EMDRIA, 2021)

Length of Treatment

EMDR sessions may be around an hour to 90 minutes in length depending on the stage of treatment, and the full treatment may be delivered one to two times per week for a total of 6 – 12 sessions, although some people benefit from fewer sessions. Frequency and length of treatment is client specific and this is best discussed with your therapeutic professional.


The phases of EMDR

There are generally eight phases of EMDR. Phase 1: History-taking and treatment planning As the therapy begins, we’ll evaluate your case, particularly assessing whether you can tolerate exposure to distressing memories. Based on your symptoms, we’ll work together to identify targets for treatment. Targets include past memories, current triggers, and future goals. If you have been seeing us for a while, we might introduce EMDR to you as a future treatment. Phase 2: Preparation The therapist will help you get ready for treatment by establishing a solid therapeutic relationship of trust and safety, we’ll explain what the treatment will involve, and introduce you to the procedures. During this phase you’ll be introduced to the safety tool ‘safe-place’. Prince Harry is pictured at the top of the story doing this (that image came from here). This is best practiced at home until you’re comfortable with it before moving to… Phase 3: Assessment During this phase, we’ll identify the traumatic memories that need to be addressed. Any memory that is being targeted is activated in session by assessing each of the memory components: image, cognition, affect, and body sensation. You’ll chooses an image (think film freeze frame) to represent each memory, noting the negative belief (eg. I should have saved him) and physical sensations that accompany each memory. You’ll then identify a positive thought (eg.I did everything I could) to replace the negative beliefs. We use two things to measure changes in emotion and cognition: The Subjective Units of Disturbance (SUD) Scale and the Validity of Cognition (VOC) Scale. This is the 0 – 10 scale you may be familiar with if someone has asked you 'On a scale of 1 - 10 how much does it hurt?'. Both measures are used throughout treatment. Phase 4: Desensitisation Here’s where your disturbing reactions to the traumatic memory, including physical sensations such as rapid heart rate or sweating, are reduced. During this phase, you focus on the memory while engaging in bilateral stimulation (eyes or hands). Then you report whatever new thoughts emerge. Your therapist determines the focus of each set of bilateral stimulation using standardised procedures, but usually the associated material becomes the focus of the next set of (brief) bilateral stimulation. The process continues until the client reports that the memory is no longer distressing.


The process of desensitisation may take a number of sessions. Phase 5: Installation The preferred positive cognition (thoughts) identified at Phase 3 are now strengthened, or installed. This only occurs once ALL distressing memories have been processed. Phase 6: Body scan The meditative technique of body scan occurs here, you will observe your physical response while thinking of the incident and the positive cognition (eg. I did everything I could) and noticing any residual physical sensations. These are then the target of further processing, via standardised techniques involving bilateral stimulation, should it be required. Phase 7: Closure This is the phase for stabilising your self-control and emotion regulation techniques and happens at the end of each session. We’ll explain what you can expect between sessions, and if the targeted memory was not fully processed in the session, specific instructions and techniques are offered to provide containment and ensure safety until the next session. You are asked to keep a record, and you’ll be given a notebook, of any negative experiences that occur so that they can be targeted at the next meeting. Phase 8: Re-evaluation Sessions after processing and body scan start with this final phase, during which we’ll evaluate your current psychological state and whether treatment effects have been maintained. We’ll also discuss with you any additional effects to target which may have emerged since the last session; those become the target for the current, or future sessions (American Psychological Association, 2017; Leonard, 2019).

What happens next?

EMDR is NOT a quick fix, but it can be more effective and quicker than traditional talk therapy methods. It can bring up memories that may or may not need to processed using EMDR. If this method sounds like something you would like to explore, please talk with Frances or Rodney, you can find their details here.

***

References:

American Psychological Association (APA). (2017). Eye Movement Desensitization and Reprocessing (EMDR) Therapy. APA. Retrieved on 18 January, 2021, from: Website.

Arkowitz, H, & Lilienfeld, S. (2012). EMDR: Taking a closer look. Scientific American. Retrieved on 18 January, 2021, from: Website.

EMDR Institute. (2020). What is EMDR? EMDR Institute, Inc. Retrieved on 18 January, 2021, from: Website.

EMDRIA. (2021). About EMDR therapy. EMDR International Association. Retrieved on 18 January, 2021, from: Website.

Leonard, J. (2019). EMDR therapy: Everything you need to know. Medical News Today. Retrieved on 18 January, 2021, from: Website.

Shapiro, F. (2014). The role of eye movement desensitization and reprocessing (EMDR) therapy in medicine: Addressing the psychological and physical symptoms stemming from adverse life experiences. Permanente Journal. 2014 Winter; 18(1): 71–77. doi: 10.7812/TPP/13-098 PMCID: PMC3951033 PMID: 24626074

Tejcek, J. (2016). 35 life changes that can happen after EMDR eye movement therapy sessions. LinkedIn. Retrieved on 19 January, 2021, from: Website.

WebMD. (n.d.). EMDR: Eye movement desensitization and reprocessing. WebMD. Retrieved on 18 January, 2021, from: Website.

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