Esen Uygun

This paper will look at how the use of Eye Movement Desensitisation and Reprocessing (EMDR) can assist sexual assault counsellors when working with victim/survivors of sexual assault. EMDR can be a very effective tool when working with victim/survivors, who have experienced either a single trauma or multiple traumas. The EMDR works well alongside of body work, and this appears to create big cognitive and physical shifts.  The benefits of the EMDR were decrease in trauma symptoms, and increase in affect regulation.

The Basics of EMDR:

Eye Movement Desensitisation and reprocessing was developed by Francine Shapiro in 1987.  She discovered the positive effects of spontaneous eye movement and started developing procedures around it.  In 1989 she published the impact of EMDR on clients who have PTSD. Research has shown that EMDR has had very positive outcomes in the treatment of PTSD.  Of course, like all other treatments, one size does not fit all, so EMDR may not be suitable for everyone, and assessment should be done individually for each client. 

EMDR addresses the stored memory to deal with dysfunctional/distorted beliefs arising as a result of a traumatic experience.  This treatment incorporates past, present and future. 

When a traumatic event occurs, it can get locked in the brain with the original picture, sounds, thoughts, feelings, and in the body as body sensations. Trauma memory has been stored differently than day to day memories. These “memories are considered dysfunctional because they are physiologically stored in a way that does not allow them to link to any positive/adoptive networks” (Shapiro, 2009. P. 8)

The theory of EMDR proposes that unprocessed memories can create unwanted physical sensations, thoughts and emotional disturbance leading to the intrusive impacts we commonly see in victims of sexual assault.

EMDR appears to stimulate the locked information and allows the brain to reprocess the traumatic experience. This is similar to what happens in REM or dream sleep. So the eye movements may help to reprocess the unconscious material (Shapiro,, 2009).  

When the memory is processed by eye movements it is quite common that the client will recall other past negative memories. When we consider that we associate thoughts, feelings, and events together, and store our information accordingly, it is normal that one event or memory can remind or trigger other unresolved memories. For example, when I have an experience of grief or loss this can remind me of other previous losses or deaths and therefore my grief response to the more recent experience can be exacerbated for a 

With EMDR therapy, when a traumatic memory is processed by eye movements, it will integrate and become an adaptive/functional memory.

In my experience, sometimes using bilateral eye movements is not possible or not practical for various reasons e.g. medical condition. In these situations, different techniques can be used such as bilateral tapping (sensations), or bilateral clicking fingers (auditory).                                                              

EMDR is applied in eight phases:

1. History taking
2. Preparation
3. Assessment
4. Desensitization
5. Installation
6. Body Scan
7. Closure
8. Re-evaluation (Shapiro,, 2009).  

It is important that the client provides informed consent to EMDR therapy due to:

1. The possibility that the memory or image may change, or fade
2. The volume of emotions can decrease or disappear 
3. More information can be recalled which may not be accurate

These first three can create problems if the person is involved in sexual assault legal investigations or court hearings.

1. The volume of emotions can increase during the EMDR treatment, which can trigger the use of maladaptive coping strategies such as substance abuse.

How clients responded to EMDR:

Between January and August 2010, I have proceeded with EMDR therapy with eight clients who were sexually assaulted. Responses to the EMDR sessions were consistent. However, there was slight information processing differences between male and female clients.

The eight clients were made up of two males and six females.  Ages of the clients were varied between 17 and 40. 

I observed the eight clients, who were attending counselling for EMDR sessions were able to make shifts around their fears and concerns. Their distorted thinking about the traumatising events changed from self-blaming and judgmental to non-blaming and non -judgmental. Despite the small sample of clients (eight clients), it was noticeable to me that mature clients had multiple traumatic associations to a specific targeted memory.  This is possibly due to greater life experiences from which to draw from. 

Conclusion: Overall I have found EMDR a great tool to use in trauma counselling.  I share the experience with many of my colleague working in the trauma and sexual assault sectors that negative cognitions such as self-blame in relation to abuse are very difficult to shift.  Similarly, I have found accessing and discharging body memories connected to sexual assault a difficult task in my counselling with victim/survivors.  However, in my experience,  the use of EMDR with women and men who are victims of sexual assault has been very successful in shifting cognitive and physical memories and in addition I have found these shifts occur much faster than with the use of other counselling frameworks familiar to me