What is EMDR?
EMDR stands for “Eye Movement Desensitisation and Reprocessing Therapy” – not the most user-friendly name for a therapy! Fortunately, the therapy itself is more user-friendly than its name and there’s a strong argument for saying it’s particularly user-friendly for people with ADHD.
EMDR was developed in the late 1980’s by an American psychologist, Francine Shapiro. It was designed for people who had experienced trauma. It was quickly applied, and found to be effective, for work with traumatised Vietnam war veterans. EMDR is one of the most evidence-based psychotherapies for trauma. It has strong support from the UK National Institute for Health and Care Excellence (NICE) and the American Department of Veterans Affairs / Department of Defence. Recent studies have continued to prove its effectiveness in Randomised Controlled Trials which are the gold standard for research.
What is Trauma?
Trauma is by definition, an experience which overwhelms our ability to cope. The brain gets jammed by trauma and time alone will not heal it. EMDR helps the brain to un-jam and to process the trauma and get moving again. A colleague of mine, Dr Russell Hurn, who works with children, once told me that he explains trauma to children, by saying it’s like a burger that gets stuck in your tummy and keeps causing problems. So trauma is a bit like an emotional burp – it keeps repeating! Until the tummy can break down the burger: until the brain can break down the trauma – the problems will carry on.
EMDR uses bilateral stimulation to help the brain get moving again. Bilateral stimulation is just a side to side rhythm or movement – like a sound alternately in your left and right ear through headphones, or alternate buzzers to your left and right hand, or moving your eyes left and right by watching a light or the therapist’s hand. Walking is a form of bilateral stimulation which most of us do every day: left/right, left/right, left/right. It’s common to hear people say that they had got stuck on a problem and couldn’t see a way out, but they went for a walk and somehow they managed to solve the problem when they were walking. Somehow the left/right rhythm got the brain moving in a different way and their brain un-jammed and started processing again.
EMDR for ADHD?
It is important to emphasise that EMDR is not a treatment designed to target the symptoms of ADHD. However, there are many reasons to believe that it may be a very suitable therapy for people with ADHD who have also experienced trauma, including those who may have a diagnosis of PTSD (Post Traumatic Stress Disorder).
EMDR: A good therapy for someone with Inattentive symptoms of ADHD
1.Less words
In lots of ways, EMDR is not a talking therapy. It doesn’t require a lot of discussion. You don’t have to talk through the trauma in any detail. An EMDR session is very structured and it’s very task-oriented. This reduces the chance that you will get bored or distracted and that you will lose concentration. The structure is also very containing which means you’re less like to get overwhelmed, which can often be a problem because many people with ADHD struggle with emotion regulation.
2. Short bursts of concentration
EMDR uses very brief periods/sets of bilateral stimulation (eye movements, buzzers or left/right sounds via headphones) of only about 20 – 60 seconds. So you are not being asked to sustain your concentration for an extended time which is often very difficult for someone with ADHD. Also, you will be asked after each set what you notice, so that you get a clear reminder to concentrate in the present, with 1:1 support to help you to do this.
3. Sensory focus
The bilateral stimulation gives you a clear sensory focus. For most people with ADHD, even if they have Predominantly Inattentive presentation ADHD (which used to be called ADD), some sensory stimulation helps them to concentrate, just as many people with ADHD say that doodling or fidgeting helps them to focus. This helps a racing brain which, left to its own devices may go at 110 mph in multiple different directions, to settle and focus/
4. Targeting of Emotion dysregulation
People with ADHD often report that they struggle with emotion regulation and “go from 0 to a 100 in a flash” and will suddenly feel intensely angry or intensely upset. EMDR targets the nervous system directly and helps reduce overwhelm, hyperarousal and reactivity to being triggered.
5. Containing structure
EMDR is very containing because it has a clear 8-phase protocol. It is predictable and structured. Lots of people with ADHD benefit from structure and will say that although routine and structure help them, they find it difficult to create this structure for themselves. An EMDR therapist by definition, will give you this structure. If they don’t - it’s not EMDR! So, EMDR is very containing emotionally but it is also predictable. The structure and predictability mean that it reduces the executive functioning load which is a key symptom of ADHD. This means that your brain doesn’t have to worry about how to interact with the therapist or how to follow the key points in a discussion. Instead it frees up capacity in the brain to process the trauma memory.
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Photo credits: Alireza Attari, Jenny Arthern.
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