Trauma and EMDR Therapy
The fundamental idea behind psychotherapy is that we tend to grow mentally unwell because we haven’t been able to think with sufficient clarity about the difficulties in our past, typically in our distant childhoods. Damaging incidents have been locked away, and continue to have an outsized impact on us, but we have no way of going back over them in order to liberate ourselves from their distorting influences. A sense that we are bad or disgusting, acquired in our fifth year, may ruin our chances of fulfilment in our fiftieth.
Therapy is useful because it provides a context in which we can properly focus on what we went through and can make sense of our experiences with the help of our own more adult minds as well as the insights and compassion of a therapist.
To work its effect, therapy makes a number of moves. Firstly, it provides us with time and space. A few times a week, we’re invited to put aside our other responsibilities and, in a quiet room, devote fifty minutes to concentrating on our interior lives: we can think about our relationship with our mother or the troubles with our father without the usual interruptions and distractions. Furthermore, the therapists’s own curiosity helps to steady and direct our minds: we can be interested because they are. We can take things seriously that we might normally be encouraged to denigrate in the more prosaic world beyond.
At the dawn of therapy, Sigmund Freud noticed something else that was to prove key to therapy’s effectiveness: he observed that many patients, when asked about their childhoods, provided accounts that were too neat, too intellectual, too distanced from the emotion contained in events to be of any use. These patients might talk eloquently about their relationships with their families or about certain terrifying or disorienting moments in their earliest years, but their intelligence and rationality worked against their chances of ever authentically reconnecting with the past – and therefore of being cured.
Freud understood that if therapy was to work, patients had to feel their way back to their traumas, not merely serve them up in eloquent but rote or cold summaries. In order to encourage this, he made a radical innovation: he asked if his patients might stop using his consulting room chair and instead lie on a couch, shut their eyes and enter a dreamy state that he called ‘free association’. Positioned like this, he urged them, in what he called ‘the basic rule’ of therapy, to share with him everything that floated through their minds, however trivial or embarrassing it might seem. He soon found that these patients recovered far faster than those who insisted on sitting in chairs and chatting sensibly and stoically as one might to a dinner companion.
As a result, there are now couches in therapy rooms around the world – and the past has for many of us been a lot easier to access.
Then, in the early 1990s, an American psychologist called Francine Shapiro became fascinated, as Freud had been, with the damage done in therapy by our tendencies to intellectualise the past rather than re-live it. Not coincidentally, Shapiro was at work on a PhD in English literature which drew her attention to a key difference between the methods of the non-fiction essay and those of the novel. In the former, an author provides neat summaries of positions and emotions: they might tell us that their mother was often ‘sad’ and their father ‘frightening’. But novelists do something very different, they provide us with ‘scenes’: they don’t state, they show. They take us to a particular moment and let us experience it vividly through our senses: we are taken to a scene at dusk on an autumn evening, where a beloved mother is weeping on the edge of a bed covered with a burgundy blanket and a little child is standing in the hallway that smells of a lemon disinfectant, watching and wanting to die. Or we witness a particular Christmas morning; an orange cake is cooking in the oven, and a father smashes a bottle of whisky on a sideboard and it feels as if one is somehow to blame and must offer up one’s life in penance though he is the one acting insanely. Novelists evoke scenes with sensory details: they talk about colours, smells and physical sensations. As a result, we cry, we laugh, we ache; we don’t only understand dynamics, we feel them as well.
With this distinction in mind, Shapiro wondered if patients in therapy could become more like novelists of their childhoods rather than just their non-fiction narrators. And it was here that she stumbled on a remarkable phenomenon. When we are asked to perform a repetitive movement – like tapping gently on our knees or our chests from left to right or look at a finger moving from side to side a few inches from our eyes – then our ordinary practical day to day mentality often cedes to a more trance-like, speculative state of consciousness (something similar can occur when we are on a long train journey in a quiet carriage and follow a line of telephone poles flashing past us). In this state, if we are asked to think back to a scene in our past, we may remember an emotional texture that would previously have eluded us; we become more like novelists than essayists.
This special state became the bedrock of what Shapiro termed EMDR therapy (Eye Movement Desensitization and Reprocessing therapy). The EMDR therapist, entirely loyal to Freud’s basic insight about the need to bring traumatic scenes back to conscious awareness, invites patients to return to key scenes that make them who they now are, often scenes of great difficulty: their first night at boarding school, the day their mother told them about the divorce, the moment they were humiliated by a stranger. They are helped to linger in the past, to experience it in all its dimensions. The patient might cry in a way they haven’t in years – if ever.
But the idea is not to abandon a younger self in one of the most difficult moments of their lives, it’s to help them find a way out of their pain. So an EMDR therapist might, after a time back in a foundational ‘scene’, ask the patient what they might want to tell their younger self; they might want to comfort them, to encourage them to be angry, to help them stop taking all the blame. Before initiating a session of time travel, the EMDR therapist will also ask a patient to identify both someone who gives them support and someone who is wise. These two characters will then be asked to enter an early traumatic scene to give it a new more redemptive ending. A current loving partner might be asked to comfort a child-self; Winnicott, the Buddha or Plato might say a few words to an angry father or weeping mother.
In this way, EMDR honours the traditional ambitions of therapy: it renders conscious feelings that had been shut away, and it liberates us from the influence of the past through a deeper understanding of its secrets. But it has the added advantage of allowing us to reconnect with our histories via sensorily-rich scenes rather than analytical summaries. In this way, the world can become less oppressive and fear laden, as our formative moments are unearthed, understood and properly laid to rest.