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EMDR and PTSD

Research from King’s College London (2019)1 found that 31% of young people in England and Wales had experienced a traumatic experience during their childhood. In addition, those exposed to trauma were twice as likely to develop mental health disorders, including Post Traumatic Stress Disorder (PTSD). People with PTSD suffer from a range of symptoms including: re-living traumatic events through distressing memories, flashbacks or nightmares; avoidance of thoughts or external reminders of the trauma; altered thoughts and feelings such as feelings of guilt, isolation or detachment; and altered levels reactivity e.g. impulsivity, hypervigilance or difficulty concentrating.

Many young people living across the UK have experienced traumatic experiences; the nature of which can vary enormously – from serious road accidents or house fires, physical/emotional or sexual abuse, parental neglect, loss/grief, life-threatening illnesses to attacks on life, terrorist attacks and war/persecution.

Young people react in different ways to trauma and sometimes their age can have a bearing on how the trauma is expressed. In younger children significant behavioural changes may be observed, for example tantrums, bedwetting or hyper-vigilance. They may express their trauma through play. Sleeping difficulties, including nightmares, are often common, although young children may be less able to recognise or describe the content of their frightening dream. They may show regression or loss of developmental skills. Older children may use drugs or alcohol, or engage in risky behaviour.

It is important that children can access help for the effects of trauma as failure to do so can have a long term negative impact on their physical and mental health.

A Proven, Effective Therapy

A highly effective way of helping young people overcome their trauma is through a technique called Eye Movement Desensitisation and Reprocessing (EMDR). EMDR is officially recognised by The National Institute for Health and Care Excellence (NICE), The World Health Organization (WHO) and The International Society for Traumatic Stress Studies (ISTSS) as a proven, effective therapy for trauma and PTSD with children and teenagers. 

When people experience trauma, the brain can have difficulties processing the thoughts, emotions and physical sensations linked to the traumatic memory. The experience may become ‘locked’ in the brain meaning that it could be frequently re-experienced both cognitively and physically. EMDR is an integrative psychotherapy that helps assist the, “maladaptive coding of and/or incomplete processing of traumatic experiences,”2 and by default helps the child or young person process the memory and re-integrate the event into the narrative of their life in a more adaptive way.

Using specialised bilateral stimulation (BLS), EMDR is a physical, cognitive and emotion-based therapy wrapped into one. There are several methods used to create BLS in EMDR therapy, depending on which is most comfortable for the young person: visual, auditory or tactile stimulation. With visual BLS the child tracks a light or fingers moving from left to right within their visual field. With auditory BLS, the child wears headphones and listens to sounds delivered to their left and right ears alternatively. With tactile BLS, the child may hold buzzers or be tapped alternately on the left and right side of their body by a trusted therapist/adult.

Expertly Trained Therapists

In EMDR sessions, the therapist carefully guides the young person to connect with the trauma whilst initiating BLS. This is only introduced after a period of ‘resourcing’, whereby the therapist ensures that the young person has enough external support and internal coping mechanisms to safely manage the exposure to the trauma. The EMDR-trained therapist is expertly trained to help ensure this process is managed safely; they will be intensely attuned to the child’s experience throughout, helping the young person keep ‘one foot in the present and one foot in the past’, and ensuring they can tolerate any distress experienced. 

During BLS, the therapist frequently asks the young person to ask what they ‘notice’, allowing them to have a shared experience of the processing that’s happening in the room. The way in which young people process their trauma varies dramatically. Some young people will describe a narrative of the event (as if describing a film from start to finish). Others might describe physical sensations (such as ‘my tummy hurts’), emotions (e.g., ‘I’m so angry’), or thought processes (e.g., ‘I hate myself’). Regardless of how the young person processes their trauma, the common phenomenon is that something will usually start to shift, and they tend to start reporting more ‘adaptive’ thoughts, feelings or sensations. Sometimes the young person spontaneously integrates adaptive material from other parts of their life into the memory and sometimes the therapist might actively help supply adaptive information (e.g., by saying “who was really to blame: you or the person who hurt you?”). 

Following EMDR, young people, when asked to think of the memory, will tend to report lower levels of distress, more positive self-beliefs (e.g., from “I’m going to get hurt or I’m going to die,” to “I’m safe and I will survive”) – and often more positive physical and emotional sensations.

EMDR for Complex Trauma

EMDR is used with ‘complex trauma’ such as childhood abuse or neglect, as well as with ‘single event’ trauma (i.e., events like car accidents or house fires). Therapy is often longer with complex trauma, focussing on multiple events and relationship difficulties in the present as well as the past. There can be many benefits to this type of therapy including creating new attachments to caregivers with adopted children. 

EMDR is a very flexible therapy which can be adapted to reach children at different developmental stages and with different abilities. When working with very young children, or children who struggle to articulate well, picture-stories or tactile play can be used in place of spoken therapy. This helps make traumatic memories malleable. Even when used together with spoken language, EMDR is often described as a therapy which places less emphasis on talking in general. 

EMDR can often be used effectively with children and young people with neurodevelopmental challenges, who have experienced traumatic experiences.  Philip Milburn, a young Autistic blogger describes the impact of EMDR on his long-standing traumatic memories, “EMDR has defused and diminished traumas I’ve carried for years…The instruction was to pat my left knee with my left hand, and right knee with the right hand, whilst talking about the memory. This compelled both sides of the brain to work and by bringing the trauma onto the radar with the brain working harder, the trauma faded. I had to repeat this a few times, but it worked well for me…Overall, I found using EMDR to be highly effective in reducing ruminative thinking and negative memories and wish I’d had access to it sooner.”3

Many therapists and families alike report EMDR to have extremely positive and powerful effects. Through EMDR, reframing traumatic childhood experiences into more adaptive memories, helps children and young people begin the healing process and move towards the future.

Getting Specialist Help

EMDR is widely available both within the National Health Service and private clinics. The Purple House Clinics, based in different locations across the UK, have a large number of EMDR therapists who are able to offer the therapy to young people.

Our Lincoln based clinic is headed up by Clinical Director, Alice Vine, who is one of the UK’s leading EMDR Consultants and training facilitators. Alice and her colleagues at the Purple House Clinic in Lincoln work with a wide range of difficulties and people of all ages. However, they also carry out a large amount of very specialised work, in conjunction with the local authority, helping adopted children overcome complex early life trauma. Alice finds EMDR “Highly effective with helping resolve tangled narratives and developing trusting, nurturing attachments with new caregivers.” Working with siblings and other family members as well as the child, Alice has seen the visible, transformative impact of EMDR on children where, “they stand taller” and have the opportunity to heal from the impact of their trauma.

For further information, please visit www.purplehouseclinic.co.uk.

 


 

References

1 The epidemiology of trauma and post-traumatic stress disorder in a representative cohort of young people in England and Wales’ by Lewis et alThe Lancet Psychiatry, DOI: 10.1016/PIIS2215-0366(19)30031-8 

2 What is EMDR: https://emdr-europe.org/about/what-is-emdr/

3 My experience with EMDR as an autistic young person: https://www.specialneedsjungle.com/my-experience-with-emdr-as-an-autistic-young-person/ via @spcialndsjungle

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