EMILY – TRAUMA

THERAPEUTIC APPROACH – TRAUMA

Events that may leave a person feeling traumatised include road traffic accidents, accidents at work, childhood abuse, rape and sexual assault, physical assaults or muggings, childbirth, natural or man made disasters and war.

Following the trauma, a person may experience symptoms including:

  • Flashbacks
  • Nightmares
  • Avoidance of people or places that remind you of the events
  • Emotional numbing
  • Concentration problems
  • Difficulty sleeping
  • Anger
  • Hypervigiliance
  • Feeling jumpy
  • Fearfulness and anxiety
  • Challenging behaviour
  • Changes in play

 Trauma-focused CBT (cognitive behavioural therapy) has been shown to be helpful for individuals who have suffered trauma and is recommended in the NICE (National Institute for Clinical Evidence) guidelines for individuals experiencing symptoms of PTSD. Therapy would typically involve an exploration of the short and long term impacts of the event on yourself and of how the incident has affected your views of yourself, others and the world. Aims of therapy would include reframing the meaning of the trauma for you and updating of the trauma memory.  This is accomplished through reliving – a process similar to traditional exposure therapy but without the need for repeated exposures. This is all carried out safely with the support of the therapist and at your pace.

Therapy sessions typically last either 50 or 90 minutes and are usually weekly, although it is sometimes useful to meet twice weekly.

Emily also offers EMDR (eye movement desensitisation and reprocessing), a therapeutic approach that has had great success in helping people who have suffered trauma – both single and multiple trauma.

EMDR is an extremely effective treatment for children and adults who have had traumatic experiences. 

EMDR is also helpful for a variety of emotional and behaviour problems in adults and children. Everyone has 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.

Sometimes the traumas a person experiences are easy to see, such as a death or road traffic accident, for example. But it is not always that easy. Sometimes a parent may know what traumas their child has experienced, but their 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 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 something is very wrong but are not aware that anything traumatic has happened. ‘Emotional stuck points’ tend to be less clearcut than specific traumas. EMDR can be used to improve self-esteem and help with depression, anxiety, non-co-operation or antisocial behaviour such as lying and stealing.

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.

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 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 even 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.

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. 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 client 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 client reports a new image, thought, feeling, or physical sensation. Then the child 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 until the event no longer seems upsetting for the client.

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 place” with the child 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 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 client during EMDR or between sessions at any time.

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