EMDR – An Extremely Versatile Therapy

Although developed for the treatment of psychological trauma and post-traumatic stress disorder (PTSD), over the years since Shapiro’s original discovery, EMDR therapy has been found helpful in many situations, and for many disorders and symptoms. Following are some indications of the wide variety of its application today, and this is increasing.

EMDR – An Extremely Versatile Therapy

Although developed for the treatment of psychological trauma and post-traumatic stress disorder (PTSD), over the years since Shapiro’s original discovery, EMDR therapy has been found helpful in many situations, and for many disorders and symptoms. Following are some indications of the wide variety of its application today, and this is increasing.

What can EMDR help with?

Single Event Trauma

Many forms of psychological trauma that are incompletely processed in your system may respond well to EMDR therapy. Following are some examples of the kinds of issues that may give rise to psychological trauma for some people. These things might have happened to you, a loved one, or you may have had exposure to them through your work.

Physical or sexual assault and/or injury, including rape
Motor vehicle accident
Other kinds of accident where you feared for your life
Natural disasters
War trauma
Medical trauma
Traumatic childbirth
Bereavement, miscarriage, stillbirth
Divorce or other loss

The diagnosis of post-traumatic stress disorder (PTSD) was introduced to recognise the syndrome of symptoms that often results from single event traumas. These symptoms include: (A) Exposure to actual or threatened death, serious injury or sexual violence, (B) intrusion symptoms, e.g. flashbacks or nightmares, (C) avoidance of stimuli associated with the traumatic event, (D) negative cognitions and mood, (E) marked alterations in arousal and reactivity, (F) the disturbance has lasted more than one month. In addition, there may be dissociative symptoms, and delayed onset of symptoms. (American Psychiatric Association, 2013).

Single Event Trauma

Many forms of psychological trauma that are incompletely processed in your system may respond well to EMDR therapy. Following are some examples of the kinds of issues that may give rise to psychological trauma for some people. These things might have happened to you, a loved one, or you may have had exposure to them through your work.

Physical or sexual assault and/or injury, including rape
Motor vehicle accident
Other kinds of accident where you feared for your life
Natural disasters
War trauma
Medical trauma
Traumatic childbirth
Bereavement, miscarriage, stillbirth
Divorce or other loss

The diagnosis of post-traumatic stress disorder (PTSD) was introduced to recognise the syndrome of symptoms that often results from single event traumas. These symptoms include: (A) Exposure to actual or threatened death, serious injury or sexual violence, (B) intrusion symptoms, e.g. flashbacks or nightmares, (C) avoidance of stimuli associated with the traumatic event, (D) negative cognitions and mood, (E) marked alterations in arousal and reactivity, (F) the disturbance has lasted more than one month. In addition, there may be dissociative symptoms, and delayed onset of symptoms. (American Psychiatric Association, 2013).

Complex Trauma

Another form of psychological trauma is known as complex trauma. This results from an accumulation of neglect, abuse, or other ongoing situations, and would include, for example:

Being bullied in childhood or adulthood
Abandonment, neglect or abuse in childhood
Domestic coercion, threats, intimidation, humiliation and actual physical violence

Event(s) that you feel you’ve never been able to fully come to terms with may also be an indication of psychological trauma.

Complex Trauma

Another form of psychological trauma is known as complex trauma. This results from an accumulation of neglect, abuse, or other ongoing situations, and would include, for example:

Being bullied in childhood or adulthood
Abandonment, neglect or abuse in childhood
Domestic coercion, threats, intimidation, humiliation and actual physical violence

Event(s) that you feel you’ve never been able to fully come to terms with may also be an indication of psychological trauma.

Developmental Trauma

This is a form of complex trauma that may result from neglect and abuse in childhood. When an infant or young child is subjected to chronic trauma, it can adversely affect their neurological development. As the child grows, they may show a large variety of apparently unrelated symptoms, from anxiety and depression, autism spectrum disorders, and personality disorders, to various disturbances in behaviour which might be diagnosed as things like oppositional defiant disorder, ADD, ADHD, reactive attachment disorder, and so on. The vast majority of these kinds of problems stem from interpersonal trauma, often in the parental home, but it is thought that other situations, such as ongoing medical treatment and hospitalisation during childhood could also be a cause of trauma. Many such children do not meet the criteria for a diagnosis of PTSD because developmental trauma is about relational trauma rather than specific traumatic incidents.

In 2009, clinicians from The Trauma Center in Brookline MA submitted a suggested new diagnosis of Developmental Trauma Disorder to the subwork group in charge of revising DSM-IV’s trauma section (Sykes Wylie, 2013; Van der Kolk, 2005; Van der Kolk, Roth, Pelcovitz, Sunday, & Spinazzola, 2005). Unfortunately, it was not accepted as an official diagnosis for DSM-5, but the syndrome that Van der Kolk and his colleagues described is well-known to survivors and is becoming better recognised among clinicians. The suggested new diagnosis had a lot of support (Bremness & Polzin, 2014).

In adulthood, a person with unresolved developmental trauma may have problems such as affect dysregulation, depression and other mood disturbances, suicidal ideation, self-harming behaviours, difficulties with personal and social relationships, disturbances in executive function and mentalisation, and many more. They may therefore collect diagnoses, none of which get linked to the common underlying cause of developmental trauma. When the etiology of these symptoms is correctly identified, it is possible to treat the unresolved trauma and its sequelae in adulthood, EMDR being one of the successful treatments for this condition (Copeley & Forgash, 2008; Korn, 2009; Parnell, 2013; Paulsen, 2009, 2017; Van der Hart, Groenendijk, Gonzalez, Mosquera, & Solomon, 2013; Van der Hart, Nijenhuis, & Solomon, 2010).

Developmental Trauma

This is a form of complex trauma that may result from neglect and abuse in childhood. When an infant or young child is subjected to chronic trauma, it can adversely affect their neurological development. As the child grows, they may show a large variety of apparently unrelated symptoms, from anxiety and depression, autism spectrum disorders, and personality disorders, to various disturbances in behaviour which might be diagnosed as things like oppositional defiant disorder, ADD, ADHD, reactive attachment disorder, and so on. The vast majority of these kinds of problems stem from interpersonal trauma, often in the parental home, but it is thought that other situations, such as ongoing medical treatment and hospitalisation during childhood could also be a cause of trauma. Many such children do not meet the criteria for a diagnosis of PTSD because developmental trauma is about relational trauma rather than specific traumatic incidents.

In 2009, clinicians from The Trauma Center in Brookline MA submitted a suggested new diagnosis of Developmental Trauma Disorder to the subwork group in charge of revising DSM-IV’s trauma section (Sykes Wylie, 2013; Van der Kolk, 2005; Van der Kolk, Roth, Pelcovitz, Sunday, & Spinazzola, 2005). Unfortunately, it was not accepted as an official diagnosis for DSM-5, but the syndrome that Van der Kolk and his colleagues described is well-known to survivors and is becoming better recognised among clinicians. The suggested new diagnosis had a lot of support (Bremness & Polzin, 2014).

In adulthood, a person with unresolved developmental trauma may have problems such as affect dysregulation, depression and other mood disturbances, suicidal ideation, self-harming behaviours, difficulties with personal and social relationships, disturbances in executive function and mentalisation, and many more. They may therefore collect diagnoses, none of which get linked to the common underlying cause of developmental trauma. When the etiology of these symptoms is correctly identified, it is possible to treat the unresolved trauma and its sequelae in adulthood, EMDR being one of the successful treatments for this condition (Copeley & Forgash, 2008; Korn, 2009; Parnell, 2013; Paulsen, 2009, 2017; Van der Hart, Groenendijk, Gonzalez, Mosquera, & Solomon, 2013; Van der Hart, Nijenhuis, & Solomon, 2010).

While PTSD is a good definition for acute trauma in adults, it doesn’t apply well to children, who are often traumatized in the context of relationships. Because children’s brains are still developing, trauma has a much more pervasive and long-range influence on their self-concept, on their sense of the world and on their ability to regulate themselves. (Van der Kolk, as quoted in DeAngelis, 2007).

Bessel van der Kolk, MD

Professor of Psychiatry, Boston University School of Medicine

As adults, survivors of childhood maltreatment are at risk not only for PTSD but also for other anxiety, affective, addictive, psychotic, and personality disorders, suicidality, revictimization, and even diabetes, heart disease, and immune disorders. Neurobiological studies document dysregulation in hypothalamic-pituitaryadrenal (HPA) axis stress response systems and associated neurotransmitters and neuropeptides among women who are survivors of childhood abuse. (Ford, 2005, p. 411).

Julian D Ford

Associate Professor, Department of Psychiatry, University of Connecticut, and research and evaluation director, Yale/University of Connecticut Child Violent Trauma Center

Vicarious and Secondary Trauma

Vicarious traumatisation has been identified in some members of the helping professions that come into contact with trauma survivors through their work. They have not experienced the traumatic events themselves. Examples of professions subject to vicarious trauma include police officers, fire fighters, paramedics, other types of specialist rescue personnel, humanitarian aid workers, health care providers, social workers, clergy, journalists, and various types of workers in the justice system.

It is also known that people can suffer secondary trauma when a family member or someone else they feel an empathic connection with is a primary trauma victim. It’s possible this phenomenon might also be relevant to the acute stress reactions suffered by some people on exposure to media reports of traumatic incidents that they feel a strong emotional connection with.

Vicarious trauma and secondary trauma are not the same (Baird & Kracen, 2006). Vicarious traumatization refers to harmful changes that occur in professional helpers’ views of themselves, others, and the world caused by exposure to traumatic material. These are all cognitive changes and can result in decreased motivation, efficacy, and empathy. Secondary traumatic stress is a syndrome with a wider spectrum of symptoms that mimic PTSD and occurs as a result of exposure to the traumatic experiences of others.

Vicarious and Secondary Trauma

Vicarious traumatisation has been identified in some members of the helping professions that come into contact with trauma survivors through their work. They have not experienced the traumatic events themselves. Examples of professions subject to vicarious trauma include police officers, fire fighters, paramedics, other types of specialist rescue personnel, humanitarian aid workers, health care providers, social workers, clergy, journalists, and various types of workers in the justice system.

It is also known that people can suffer secondary trauma when a family member or someone else they feel an empathic connection with is a primary trauma victim. It’s possible this phenomenon might also be relevant to the acute stress reactions suffered by some people on exposure to media reports of traumatic incidents that they feel a strong emotional connection with.

Vicarious trauma and secondary trauma are not the same (Baird & Kracen, 2006). Vicarious traumatization refers to harmful changes that occur in professional helpers’ views of themselves, others, and the world caused by exposure to traumatic material. These are all cognitive changes and can result in decreased motivation, efficacy, and empathy. Secondary traumatic stress is a syndrome with a wider spectrum of symptoms that mimic PTSD and occurs as a result of exposure to the traumatic experiences of others.

Symptoms

EMDR was originally developed to treat PTSD and psychological trauma. It is also being found effective for an increasing number of symptoms which may or may not be easily attributable to trauma. So following are some symptoms and other conditions, rather than precipitating circumstances, which may respond well to EMDR therapy:

Anxiety
Phobias
Obsessive compulsive disorder (OCD)
Depression
Insomnia
Anger
Eating disorders
Self-harm
Suicidal ideation
Addictions
Somatisation of psychological or emotional distress
Medically unexplained symptoms (MUS)
Grief which does not process naturally (known as complicated or complex grief)
Some kinds of relationship difficulties
Some instances of chronic physical pain have a psychological component, for example, phantom limb pain, whiplash injury, and many others. These may also be amenable to EMDR therapy.

Where there is difficulty ameliorating any of these symptoms by means of the usual treatments for them, it may be worth considering whether EMDR therapy could help.

Symptoms

EMDR was originally developed to treat PTSD and psychological trauma. It is also being found effective for an increasing number of symptoms which may or may not be easily attributable to trauma. So following are some symptoms and other conditions, rather than precipitating circumstances, which may respond well to EMDR therapy:

Anxiety
Phobias
Obsessive compulsive disorder (OCD)
Depression
Insomnia
Anger
Eating disorders
Self-harm
Suicidal ideation
Addictions
Somatisation of psychological or emotional distress
Medically unexplained symptoms (MUS)
Grief which does not process naturally (known as complicated or complex grief)
Some kinds of relationship difficulties
Some instances of chronic physical pain have a psychological component, for example, phantom limb pain, whiplash injury, and many others. These may also be amenable to EMDR therapy.

Where there is difficulty ameliorating any of these symptoms by means of the usual treatments for them, it may be worth considering whether EMDR therapy could help.

Make an Enquiry

If you would like more information about psychological therapy and how we may be able to work together to address your concerns,
you are warmly invited to call, email, or message me through the form on the Contact page.

07801 273768 / info@karenjwilliams.co.uk

Contact Karen Williams

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Baird, K., & Kracen, A. C. (2006). Vicarious traumatization and secondary traumatic stress: A research synthesis. Counselling Psychology Quarterly, 19(2), 181–188.

Bremness, A., & Polzin, W. (2014). Commentary: Developmental trauma disorder: A missed opportunity in DSM V. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 23(2), 142-145.

Copeley, M., & Forgash, C. (2008). Healing the heart of trauma and dissociation with EMDR and ego state therapy. New York, NY: Springer.

DeAngelis, T. (2007). A new diagnosis for childhood trauma? Some push for a new DSM category for children who undergo multiple, complex traumas. Monitor on Psychology, 38(3), 32-34.

Korn, D. L. (2009). EMDR and the treatment of complex PTSD: A review. Journal of EMDR Practice and Research, 3(4), 264-278.

Parnell, L. (2013). Attachment-focused EMDR: Healing relational trauma. New York, NY: Norton.

Paulsen, S. (2009). Looking through the eyes of trauma and dissociation: An illustrated guide for EMDR therapists and clients. Washington, DC: Bainbridge Institute for Integrative Psychology.

Paulsen, S. L. (2017). When there are no words: Repairing early trauma and neglect from the attachment period with EMDR therapy. Washington, DC: Bainbridge Institute for Integrative Psychology.

Sykes Wylie, M. (2013, November 21). Developmental trauma disorder: Distinguishing, diagnosing, and the DSM. How one tenacious task force worked to separate developmental trauma disorder from PTSD in DSM-5 [Web log post]. Retrieved June 9th, 2018, from https://www.psychotherapynetworker.org/blog/details/35/developmental-trauma-disorder-distinguishing-diagnosing

Van der Hart, O., Groenendijk, M., Gonzalez, A., Mosquera, D., & Solomon, R. (2013). Dissociation of the personality and EMDR therapy in complex trauma-related disorders: Applications in the stabilization phase. Journal of EMDR Practice and research, 7(2), 81-94.

Van der Hart, O., Nijenhuis, E. R., & Solomon, R. (2010). Dissociation of the personality in complex trauma-related disorders and EMDR: Theoretical considerations. Journal of EMDR Practice and Research, 4(2), 76-92.

Van der Kolk, B. A. (2005). Developmental trauma disorder: Toward a rational diagnosis for children with complex trauma histories. Psychiatric Annals, 35(5), 401-408.

Van der Kolk, B. A., Roth, S., Pelcovitz, D., Sunday, S., & Spinazzola, J. (2005). Disorders of extreme stress: The empirical foundation of a complex adaptation to trauma. Journal of Traumatic Stress, 18(5), 389-399.