Q&A with Dr Francesco Bernardi, London based Counselling Psychologist, Accredited CBT and EMDR Trained Therapist

EMDR stands for Eye Movement, Desensitisation and Reprocessing. It is a well-established type of therapy that utilizes specific techniques to reach insight into problems and promote positive change. The main technique consists of performing fast Bilateral Stimulations (BLS) on the client. This occurs in the form of asking the client to follow the therapist’s hand as it waves from one side to the other at a short distance of the client’s eyes. However, the therapist and client might decide that alternatively tapping the client’s knee feels more effective. There are also other methods of BLS, but the principles are the same. 

EMDR is likened to talk therapy on speed? Is this true?

EMDR tends to bring about amazingly positive results within a shorter period of time relative to other traditional talking therapies. I regard the phrase ‘talk therapy on speed’ as a catch-phrase used for marketing. Such a phrase can be misleading and easily misinterpreted. It could be disappointing for a client to find out that changes during therapy are not quick and/or evident. Clients must be prepared for the possibility that changes can be slow, subtle.

“The most popular theory behind EMDR is that the brain can keep alive the emotional aspects of negative events. It’s as though they were frozen in time, even after many years. So they can feel as they keep happening here and now.” 

What Does EMDR Treat?

EMDR was developed to treat Post-traumatic Stress Disorders (PTSD). PTSD is a psychological syndrome that people can develop following a traumatic experience.

People with PTSD present with the following symptoms: severe anxiety when remembering the event; intrusive memories of the event. They avoid any reminders of the traumatic event. Other symptoms include hyper-awareness and vigilance towards any sort of real or perceived danger (i.e. loud sounds. EMDR is also effective when used to treat other issues including phobia, depression, social anxiety, interpersonal problems, and other clusters of psychological symptoms. 

How Quickly Does it Work?

EMDR, like all other therapeutic approaches, is a very subjective process. In my experience, clients tend to notice more or less evident changes between 10 and 20 sessions. However, I have worked with clients who required much less time and others that required many more sessions. This depends on the client’s preparedness to embark on EMDR, which in turn depends on their history and background.

I find that the more difficult and emotionally charged their stories, the longer it might take for clients to obtain positive changes. However, this is not a rule of thumb. 

Is EMDR a Last Resort? 

First of all, it is important to highlight that EMDR is not a ‘non-talk’ therapy. Sure, during the BLS few words are exchanged between the therapist and client. However, there are conversations to be had during the assessment and preparation phases, and in between sessions. In other words, assessment, preparation, BLS, debrief and future planning are all essential elements of EMDR. 

To answer the question of whether EMDR is a last resort, the answer is simply, no. Based on my experience, people often seek EMDR because other therapies seemed not to have fully helped them or reached the core of their issues.

EMDR connects the right and left side of the brain? Why is it so important that these sides speak to each other? 

One of the most popular theories behind EMDR, is that the brain can keep alive the emotional aspects of traumatic events alive, even after many years. So they can feel as they keep happening ‘here and now’. One good example is experiencing a flashback, during which the person feels and reacts as if they were back in the trauma. 

Emotions are stored and processed on the right side of the brain. When a traumatic event takes place, most of its emotional and perceptual (hearing, sight, smell) elements are stored in the right side and are most often fragmented and incomprehensible in format. For example, a person who has had a car accident might vividly remember the smell of smoke and the screams of people in an irregular way. 

The left hemisphere is where our language abilities are based. Language is what we use to make sense of the world and put things in order in our heads. Therefore, the suggestion is that stimulating the client bilaterally will allow the right and left side of the brain to communicate, therefore words and emotions/perceptions will finally meet. 

If the client can put into words what has happened to them, they will be able to create a narrative of the negative events and they will understand them better. This will lead to better insight and empowerment, and will ultimately enable the person to incorporate the negative experience into their storyline. If a negative event becomes part of a coherent storyline, it will not have a ‘here and now’ nature and will no longer affect the person. In other words, the negative event will become just ‘a negative memory’, rather than a memory that has a negative emotional grip on the person. 

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