“Improving
the quality of people’s lives”
Dr Michael C
Paterson
BSc PhD
DClinPsych CClinPsychol CSci AFBPsS
Consultant
Clinical Psychologist
By Dr
EMDR – Eye Movement Desensitization and Reprocessing
Imagine a
primitive man, a hunter-gatherer, creeping stealthily through the woods on the
lookout for some game. Suddenly he becomes aware of a sound behind him. He
turns around and sees a wild beast that has been stalking him, it is intent
upon killing and eating him. The beast looks as if it is about to spring and
the man feels fear. His brain activates the ‘fight or flight’ response; he
starts to breathe quickly getting more oxygen into his bloodstream, his heart
beats faster to get the oxygenated blood around the body to the muscles that
have now tensed. He tries to decide whether to run or fight, instead he
freezes, rooted to the spot. The beast springs and...
Fear is a
primitive emotion that is a basic response to threatening situations. It exists with the function of protecting
your life. Generally, feeling fear is unpleasant and most people prefer to
avoid it. Because of its unpleasant
nature, it is not surprising that many people develop a fear of becoming
fearful. This is what you will know as anxiety.
Anxiety
signals a potential danger. It may be
quite rational for a lone female to feel anxious about walking down a dark
street in an unfamiliar area. It would
be irrational, however, for a company executive to feel anxious about giving an
interview for television or radio.
Why people
become anxious in harmless situations
People
learn to fear certain situations (e.g. speaking in public, travelling in a lift,
visiting a dentist). Invariably this
fear will have its roots in an earlier unpleasant life experience, with present
day reminders being anxiety-provoking.
While the initial situation may have been quite specific, over time
people learn to identify more general cues in their environment as triggers for
their anxiety (e.g. sounds, smells, temperature).
Case example
As a child,
How to cope
with anxiety
When you
are anxious performance on tasks is impaired.
Your muscles become tense, your breathing will be fast and shallow, and
your heart will be racing. These symptoms are controlled by the Sympathetic
Nervous System within your body, but they can be reversed by a few simple steps
that activate the Parasympathetic Nervous System, a bit like counterbalancing a
set of kitchen scales.
You can
reduce your anxiety by concentrating on your breathing, getting into a rhythm
of longer slower breaths. Notice also where you are tense in your body. Apply more
tension to these muscles and notice and that the tension exhausts itself and
the muscles relax. Your heart rate will
slow down and you will return to a more comfortable state.
Now you
are ready to face your feared situation. As you approach it, notice any anxiety
symptoms and introduce the counter measures.
By facing the situation you can gain a sense of familiarity and control,
and not be distressed by it again.
Sometimes, however, people may feel that they need professional help to
overcome their fears. Clinical
Psychologists, among others, are well-qualified to offer help in these
circumstances.
Note: The
information on anxiety management techniques, contained herein, is intended for
the guidance of persons who have been trained in their use by Dr Paterson or
his associates.
Information on quality standards, Dr Paterson’s biography,
contact details, consultations, and
fees.
What
clients have said about their experience with me
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Post-Trauma Stress: What it is
and What You Can do About it
Case
Example
A
police officer with twelve months service was first to arrive at an incident
where a man was lying on the ground in a pool of blood that flowed from an open
head wound. She realised that the victim
still had a pulse and administered first aid, however he died within a few minutes. The officer preserved the scene and
maintained an incident log until she was relieved by a colleague on the next
shift, an experienced constable with 18 years service. When her colleague arrived he found the scene
taped-off and a Scenes of Crime tent erected above where the body had
been. All that remained was a pool of
congealed blood. By this time the victim’s
brother had been arrested and charged with murder.
The
junior officer was back on duty the next day having thought about the incident
several times. Within a few days she had
attended a critical incident debrief and did not recognise any undue signs of
discomfort regarding the incident. Her
male colleague, on the other hand, reported sick for his next turn of duty,
citing “flu” as the reason for his absence.
He suffered nightmares and intrusive thoughts about the incident. His dreams related to incidents in the early
1980s where police and army had been killed and he was required to preserve the
scene. The intrusive thoughts related to
these too, and also to the pain and guilt the perpetrator must be feeling: the
officer felt guilty about his own poor relationship with his brother and a time
when he got angry and broke the brother’s arm in a struggle.
An Analysis
In the
above fictitious account, the junior officer blocked off her emotions and got
on with her job and life. The more
experienced officer tried to do the same, it had always worked before, but try as
he might he could not get an undisturbed night’s sleep and every waking moment
seemed to be filled with disturbing thoughts.
What had
happened for the experienced officer was that the recent incident held such
meaning for him it linked back to incidents in the past that he had never been
able to resolve emotionally. He had
usually had a binge on beer and vodka after incidents in the 1980s but this had
never allowed him to process the emotional affect that he experienced. The junior constable had adopted much the
same way of coping but had not had the cumulative exposure to critical
incidents that the more senior constable had experienced. The critical incident debrief gave her the
opportunity to recognise any distress.
The more
experienced officer was having a post-trauma stress response to events outside
the normal human experience. This was
characterised by persistent re-experiencing of the incidents. Clearly the re-experiencing phenomenon would
be distressing for the officer, but his problem may not meet the criteria for
Post-Traumatic Stress Disorder (PTSD) which is really just a diagnostic
category for the presence of specific symptoms.
How to Get
Help
Many
people, as well as police officers and other emergency service workers,
experience distress or emotional upset
following exposure to an unpleasant incident.
Sometimes this will resolve itself, but it can develop into a prolonged
condition such as PTSD. For some people,
however, distress related to a particular incident may only appear later in
life, such as at retirement or other significant life milestone.
If you
find that you are distressed by recurrent thoughts and/or nightmares about past
experiences, you could speak initially to your GP. Alternatively, you can speak with me, in
confidence, to find out what you should do.
I have treated numerous cases of PTSD successfully and would be happy to
receive a referral for you.
Information on quality standards, Dr Paterson’s biography, contact
details, consultations, and fees.
What
clients have said about their experience with me
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The name, EMDR, refers to a
psychological therapy originally known as Eye Movement Desensitization and
Reprocessing. Its originator, Dr Francine
Shapiro, discovered by accident that disturbing thoughts she was having seemed
to disappear as she moved her eyes in rapid sideways movements.
The approach was developed initially
as a treatment for Post Traumatic Stress Disorder and found great success with
veterans of the Vietnam War. In 2000,
EMDR was recognised by the International Society for Traumatic Stress Studies
as an effective treatment for PTSD. Since then, learned bodies throughout the
world, including the National Institute of Clinical Excellence in the UK
What Happens in EMDR?
When we receive sensory information
it passes through an emotional filter (amygdala) in the right half of the
brain. If there is nothing
emotionally-charged, the information then passes through another structure (hippocampus)
that processes the information for its time and space properties and allows it
to pass to the left hemisphere. This
experience is then stored normally in memory.
However, when incoming sensory
information is emotionally-charged (e.g. traumatic), it gets stuck in the
Central Nervous System (CNS) in the right hemisphere of the brain. It does not get processed in time and space
so, when reminders occur, the stuck memory is triggered and feels emotionally
that it is happening in the present. This
accounts for flashbacks, intrusive thoughts and nightmares.
EMDR therapists help clients
reprocess their traumatic memories by using a process that involves repeated
left-right (bilateral) stimulation of the brain while noticing different
aspects of the traumatic memory. The bilateral stimulation is achieved through
either rapid eye movements across the field of vision, auditory tones or
clicks, or tactile stimulation of
alternate sides of the body. It is
believed that the bilateral stimulation of EMDR creates biochemical changes in
the brain that aid processing of information.
Theorists suggest that the mode of action occurs in the Limbic System,
where the amygdala and hippocampus are located.
In EMDR sessions, therapists
initially ask their clients to bring up an image that represents the worst part
of the incident for them now (remember the image is locked in the CNS). They then elicit what negative thought about
the client is triggered by the image: this is a core belief that has been
affected by the experience. Thirdly, the
emotion that is generated by triggering the negative belief is then ascertained
and, finally, where a related sensation is located in the client’s body is then
identified.
Therapists then ask their clients to
link together the four components and then they commence the bilateral
stimulation of the brain. The therapist
makes regular checks on what the client is experiencing and guides them through
the process where the client’s brain does the healing, much like the body
healing a cut.
At the end of a session, clients
often report that the experience is “in the past… it’s over”. Other clients report a “spiritual
experience”. Whatever way the experience
is described by the client, the process is effective and rapid compared with
other therapies that are in general use today.
For more information visit EMDR
FAQ and EMDR Europe
.
Information on quality standards, Dr Paterson’s biography,
contact details, consultations, and
fees.
What
clients have said about their experience with me
Contact me
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