In late 2016, Ben had a breakdown, triggered by someone getting too close to him on a crowded train. It brought on vivid flashbacks of a severe childhood trauma 30 years ago. Until then he had lived a successful life – he had done well at school, had a good career and was married with a family. Referred to a trauma clinic at his local hospital, Ben started a psychotherapy treatment, Eye Movement Desensitisation and Reprocessing (EMDR) earlier this year. It sounded, he says: “like witchcraft. How can this possibly work? They sit you in front of flashing lights and it makes you better? It sounds like alchemy.”
EMDR was recently highlighted by the pop singer Mel B, who is said to be undergoing the therapy for post-traumatic stress disorder (PTSD). Talking about her diagnosis, a condition she had been using sex and alcohol to self-treat, she said: “I am still struggling but if I can shine a light on the issue of pain, PTSD and the things men and women do to mask it, I will do”. Of the EMDR, she said: “So far, it’s really helping me.”
EMDR works, says Robin Logie, clinical psychologist and former president of the EMDR Association, by helping the brain to process traumatic memories – it is mainly used as a treatment for PTSD, but can be used for depression, anxiety, addiction and phobias. “The way we do that is to get the person to think about a particular moment. For example, with a road traffic accident – it could be the moment just before you’re hit. We ask them to describe what negative belief they have about themselves.” It could be something like: ‘I’m not safe.’” We ask what emotion seems to go with that and where they feel it in their body.”
While the person is doing all this, they are asked to move their eyes from side to side – this could be by following the therapist’s finger, or following flashing lights. It can also be done by holding a device in each hand, which pulses alternately. Each set could be repeated 20 or 30 times in each session. “The memory starts to become less distressing,” he says. “It transforms it from a memory that previously made you feel anxious or scared, into a memory that is like any other that wouldn’t normally produce an emotional response. People start to be more rational about it: ‘I wasn’t in a safe situation then, but I’m safe now.’”
In the early stages of treatment, says Ben: “It was like being in the event. It’s like a kind of time travel. The whole EMDR process is like a controlled flashback – you’re aware that you’re here and now, but you also feel like you’re in the body from then and re-experiencing as then. I was not prepared for the physical, visceral nature of reliving the experience. I would be seeing things, smelling things. I felt this pressure across my front and it was unnerving.”
He says he felt like a ventriloquist’s dummy “because the words I was using to describe [my experiences] were children’s words. It was like the child, the person who experienced the trauma, was using me as a mouthpiece.”
As the treatment went on, the memories became more and more vivid and detailed. It has, unsurprisingly, been a difficult process to go through, and Ben’s mental health seemed to get worse before it started to get better. He is still going through treatment. “It’s a process I have found genuinely transformative,” he says.
EMDR was discovered by accident in the late 80s by an American psychologist, Francine Shapiro, who noticed that her eye movements, while looking at things on a walk through a park, appeared to reduce negative emotions. It used to be considered controversial but that is now an outdated view, says Melanie Temple, consultant psychiatrist and EMDR consultant (it is approved for use by the National Institute for Health and Care Excellence).
One of the problems for EMDR is that nobody can explain exactly how it works – one theory is that the eye movements mimic the rapid-eye-movement phase of sleep, which is when the day’s events are processed. “We understand it works on the information-processing models within the brain, but we don’t know exactly how,” says Temple. “But then we don’t know exactly how cognitive behavioural therapy (CBT) works. It’s really the same for all therapies.”
Not everyone is ready for EMDR. “If someone has had a simple one-off trauma, such as an accident, in their adult life, you don’t need to do a lot of preparation, but we also work with people who have multiple traumas going back to early childhood,” says Logie. “With people like that you have to do more preparation and the therapy will last longer.” Preparing someone to undergo EMDR can include teaching them relaxation techniques, and strengthening the support structures in their lives.
If not properly used, says Claudia Herbert, clinical psychologist and managing director of the Oxford Development Centre and author of Overcoming Traumatic Stress: “Any type of therapy can be re-traumatising. It has to be used by someone who is properly trained and experienced to know when to use it and not to use it.” It wouldn’t be used with someone who was dissociated – one symptom of PTSD – where they are not “grounded” in their body, or feel disoriented. “We would have to work with the dissociation first before we work with EMDR.”
For Katherine Gilmartin, an artist and family mental health activist, diagnosed with complex PTSD as a result of childhood abuse, EMDR couldn’t begin immediately. “I was asked to think of somewhere I’d felt safe in the past. There was nothing,” she says. “So I had to make one.” She says EMDR, which she had once a week for more than six months, was “physically exhausting. The heightened experience of being in those traumatic memories whirls everything up and nightmares occur.”
Was it difficult to go through? “Yes, but I felt in control [when] ordinarily I didn’t feel in control. It is hard work and [you have to be] open to it. It’s not a fix-all and you have to trust the person you are doing it with.” For her, it has made an improvement. “Different places, or really silly things, which could be quite triggering are no longer a problem. I’m able to recognise and understand my feelings around whatever the thing is.” These tend to be things she recognises from childhood – once, she was in a department store and saw a houseplant she hadn’t seen for decades. “I was taken right back to being 10. I couldn’t be anywhere near it and I walked out of the shop.” That sort of thing, she says, wouldn’t happen now.
Temple used to work for the military where EMDR is a standard therapy for people suffering PTSD; she now practises it for the NHS. Where EMDR may have the edge, she says, is that it: “Suits a lot of people because unlike CBT [which is also offered as treatment for trauma], it doesn’t have homework. EMDR is very well-established now [and is] equally offered alongside trauma-focused CBT because one size doesn’t fit all. If one doesn’t suit them, then they can use something different, so they don’t feel that they’re not treatable.”
Although it can be powerful and effective, people shouldn’t expect a magical quick fix, she says. Ben has had more than 30 sessions and does not know when he will stop. “It’s had a hugely beneficial effect,” he says. Although the two or three days after each session are, he says, a “write-off”, he has been able to go back to work part-time. “I have moved from being this ventriloquist’s dummy for the child inside, to being an adult looking at what was happening; being really sad and upset and angry about it, but having a natural emotional reaction, rather than feeling the distress of it happening to me.”
