The EMDR took away my bad visions but it didn’t take away my memories. It just made them less real and hurtful. I feel a lot better now. EMDR is lifting. It makes you feel lighter. ~ former child EMDR client
The Basics
EMDR stands for Eye Movement Desensitization and Reprocessing, and is a relatively recent method for treating traumatic issues. A practitioner of EMDR will have a client recall the full experience of an unresolved traumatic event, while stimulating alternating sides of the brain through side-to-side eye movements, tapping lightly on alternate sides of the body, or using sound. This assists the brain in “metabolizing” the trauma, so that the person can return to healthier cognitive and emotional processing.
If a child has experienced major trauma in her life, such as the death of a family member, abuse, or a bad car accident, it could still be affecting her emotional reactions or ability to concentrate and learn. Less “dramatic” traumas, such as the chronic stress of struggling with a learning disability, can also accumulate and have a similarly traumatic effect on the psyche.
There are many ways to work with children on emotional issues, as you can see in the Mental Health chapter. However, sometimes talk therapy alone is just not enough because trauma can shift how the brain functions. Traumatic experiences increase emotional reactivity and impair logical thinking, which EMDR can address at a neurological level.
EMDR is an emotional processing technique that can be incorporated into many types of psychotherapy. It is a powerful and effective treatment for trauma and can work very rapidly. Although this treatment approach cannot treat learning disabilities, it can help clarify the picture by reducing emotional intensity and negativity.
Brief History
Francine Shapiro, Ph.D. first noted the benefits of eye movement for processing trauma in the late 1980s. She then developed it into a comprehensive protocol that has successfully reduced symptoms in a wide range of conditions, from severe trauma to simple phobias. The alternate left/right stimulation, used while keeping a traumatic memory in mind, seems to “metabolize” or process the traumatic aspect of that event. Although researchers have not been able to explain fully why this happens, a number of studies have repeatedly shown EMDR to be effective. A brain “stuck” in trauma will function very differently from a brain that is not. Brain scans taken before and after treatment clearly demonstrate a positive change in brain activation.
Dr. Shapiro published her initial findings in 1989. Since then hundreds of case studies and several controlled studies have been published that demonstrate EMDR’s effectiveness. EMDR is now recognized, by both the American Psychiatric Association and the Department of Veteran Affairs, as being efficacious in treating PTSD.
A Closer Look
When we experience trauma, the brain records it differently from other everyday events, as brain scans clearly demonstrate. The brain does this so that if anything resembling the original trauma comes our way, the emotional center of the brain is activated to move us to protect ourselves. The logical thinking centers of the brain are mostly left out of the initial reaction. This is because making a trip to the “thinking centers” would slow us down, and we could get hurt. This works great if we are about to be hit by a car. But it becomes detrimental to everyday life, and can interfere with school performance and social activities, if the emotional center responds to everyday events as traumatic.
EMDR is uniquely equipped to reduce the emotional distress of past traumatic experiences, and dismantle the negative beliefs that accompany them. A reduction in emotional intensity is visible on a post-EMDR brain scan, which shows less activity in the emotional centers of the brain and increased activity in the thinking centers. This allows a person to feel calmer, evaluate his experiences more rationally and modulate his reactions more effectively.
There are two types of trauma: Trauma with a “big T” and trauma with a “little t.” The “big T” traumas include accidents, abuse, witnessing violence and other events that are dangerous or life threatening. After “big T” traumas, such as abuse, children can become quite agitated and anxious, are easily distracted and struggle to concentrate on their schoolwork. Eventually, untreated traumas can lead to depression, chronic anxiety, difficulty with social relationships and many other issues.
Learning Disorders and Trauma
While EMDR was initially only used to treat “Big T” trauma, its wider application is to treat what is known as “little t” traumas. These types of traumas can include chronically stressful situations such as being made fun of, being ostracized or experiencing everyday frustration and shame from a learning disability. These types of events can happen to any child on occasion and may be painful, but most children learn to cope with them. However, if it happens on a regular basis, and actually becomes a consistent part of life, the distress can accumulate to have a traumatic effect.
Once that threshold has been crossed, it can be an uphill battle for a child to learn. There are two reasons for this:
- Stress and trauma make it more difficult for a child to access his frontal lobe (where advanced thinking and learning take place), since his emotional centers are so strongly on “red alert.”
- Enough of these difficult experiences can easily lead a child to develop negative beliefs about himself that will interfere with his confidence and abilities.
For example, if a child notices that all the other kids understand something in class but he can’t, it could result in a feeling that “something is wrong with me.” The more sensitive a child, the more susceptible he is to “little t” traumas. These traumas slowly accumulate and can be seen as chronic stress for a child who is struggling socially or academically. As we accumulate traumas that are similar to one another, they form a file of sorts in the psyche. The file name is the way we cognitively organize our life experiences, and becomes a negative belief. The child starts to believe “I am stupid,” “I am not loveable,” “there is something wrong with me,” and so on.
These negative beliefs then dictate how a child walks through life. He may be constantly on guard or jumpy, or may easily misperceive neutral situations as a threat. Eventually, he may even begin withdrawing from life and start seeing himself as damaged in some way. These negative beliefs will continue to generate difficulties and can make remediating a learning disability even more complicated. Anxiety, depression, poor concentration and behavior problems can easily develop. The child who melts down, gets in fights or lashes out could be dealing with cumulative little traumas. Symptoms like these can easily be mistaken for ADD, ADHD, depression or emotional dysregulation issues.
EMDR cannot cure or treat a learning disability. However, it can reduce the emotional distress and negative self-assessments that can result from and complicate a learning disability. This can make managing a learning disability much easier. It should also calm behavioral issues or possibly even cause them to dissipate altogether.
When Good Traits Are Labeled “Bad”
So many children with complicated diagnoses, or who simply have unique learning styles, are also extraordinarily sensitive and perceptive. Some of them, in my opinion, are actually evolving beyond teaching methods that are rooted in outdated thinking. They jump to the answer in a math problem without needing to (or sometimes understanding how to) show the steps; they see deeper layers in a story and miss the simple, “obvious” answers about it; they have difficulty explaining their intuitive leaps in words. When these attributes are punished or mocked, it is confusing, demoralizing and overwhelming.
They feel their differences from others acutely and do not understand what is “wrong” with them. This renders them even more susceptible to “little t” traumas. EMDR can be powerful, not only in addressing trauma, but in helping these children to understand the way they work and to appreciate their uniqueness.
Stephanie had just entered high school, and was on an Individualized Education Program (IEP) for Severe Emotional Disability that was set up for her in middle school. She had experienced abuse as a child, and the resulting PTSD (post-traumatic stress disorder) was crippling her ability to function at school. Her confidence was so low that she gave up easily and never seemed to do as well as her teachers thought she could. A poor grade on a quiz or sensing a teacher didn’t like her was perceived as a failure, and she would give up. Her grades would predictably start dropping around the middle of the term.
Then, things got more urgent. During freshman year, she began self-cutting to manage the “bad feelings” she had about herself. She accumulated friends based on who liked her at the moment, because this bolstered her self-esteem. But many of these “friends” would use her because she would do anything to be liked. A quiet girl who had trouble speaking up, Stephanie had trouble asserting herself and felt helpless to change this destructive pattern.
Her psychiatrist referred her for EMDR when medications did not seem to address her anxiety and depression. With EMDR, the symptoms of PTSD finally began to lift. She stopped cutting, reacted to social “drama” with less intensity and actually found the courage to join a few clubs so that she could make new friends.
However, the academic struggles continued. After years of accumulating bad grades and being placed in special classes, she carried a lot of negative beliefs about being “stupid.” Her therapist used EMDR to find and address the sources for that belief, and desensitized them. Her self-image improved and her school effort became more consistent…but still, her grades suffered.
Finally, it emerged that she was truly learning disabled. Being in supportive programs all those years had made it easy to hide her learning problems. She had tried to cover this up because she already felt stupid enough, and was ashamed that there was so much “wrong” with her.
She was actually so smart that she was able to hide her learning disability until high school. After the EMDR helped her overcome both her emotional distress and her debilitating lack of confidence, she was able to confront her learning disability and work with it. Her IEP was modified to address her true needs, and she finally received the academic assistance she needed in order to succeed. ~ Pat Koestner
Finding a Provider
EMDR can address a wide range of issues. However, although many therapists are trained in EMDR and work very successfully with “big T” traumas, not all have refined the technique enough to work successfully with “little t” traumas. Even fewer EMDR therapists are skilled at working with children and teens, especially around learning disabilities.
There are some modifications that are made in the EMDR protocol when using it with children. Young children especially, who are not as adept at providing feedback to the therapist, can be aided with a series of facial picture showing their level of distress using smiley and sad faces. Also, eye movements can be hard for very young children to keep up, so a therapist should have other means of bilateral stimulation available.
The good news is that children can be relieved of a lot of trauma relatively quickly, since they have less life experiences to contribute to the complexity of a problem. Teens generally respond to EMDR much like adults, although they also process things more quickly because they have less “emotional baggage” than adults.
NOTE: If you do seek a practitioner who is trained in EMDR, you might also keep an eye out for a treatment approach called brainspotting. Brainspotting was developed more recently; it actually emerged out of EMDR and operates on the same principles. Proponents claim that it is more precise in the way that it targets affected brain centers, but some people respond better to it and some to EMDR. It is simply another tool that you should be aware of as you look for answers.
Questions for a Prospective EMDR Practitioner
Here are some suggested questions to help you find the right practitioner for your child. Some are fairly open-ended, in order to elicit a broader range of answers. Other questions will reveal their usefulness when you talk to more than one practitioner, as their answers will vary by content and attitude. No matter how impressed you are by a person’s credentials, try to look for one who answers your questions patiently, thoroughly and respectfully. You and your child deserve to work with someone who will work cooperatively with both you and any other team members you assemble.
- Are you certified?
- Have you done advanced workshops? How many? What kind?
- Do you use EMDR every day in your practice? With what percentage of your clients do you use it?
- Do you work with children? Teens?
- Do you work with learning disabilities? Have you worked with children who have issues similar to my child’s?
- What will the initial sessions look like? What do EMDR sessions look like?
Resources
The EMDR Institute maintains this website, which has a national database of qualified therapists. It also provides extensive information about EMDR, including a detailed description of a typical EMDR session.
EMDR: The Breakthrough “Eye Movement” Therapy for Overcoming Anxiety, Stress and Trauma by Francine Shapiro. The author describes the possibilities for how to use this breakthrough therapy, and presents research that demonstrates its effectiveness.
Stress and Trauma by Francine Shapiro and Margot Silk Forrest. This is an excellent resource for laypeople.
About the Author
Pat Koestner, PsyD, LMFT has been working with children and families for 25 years. She has mastered many therapeutic approaches, including EMDR, and now uses an integration of these techniques, tailored to each client, to rapidly and effectively clear out old emotions and negative beliefs standing in the way of who we truly are and what we have to offer the world.
Dr. Koestner holds a master’s degrees in Humanistic Psychology and in Marriage and Family Therapy, and holds a doctorate is in Integrative and Cross-Cultural Psychology. She has also received internship training in substance abuse and family therapy, and did Post-Doctoral training with the Columbine community after the shootings. She spent three years on the board of directors of the Association for Comprehensive Energy Psychology, an international organization of professionals from many disciplines all working together to develop some of the newest tools in psychology.
You can reach Dr. Koestner at DrPat@att.net.
