Online therapy enables you to access EMDR therapy with an expert therapist from the comfort of your own home.
Paul Gebka-Scuffins is among an increasing number of EMDR therapists within the EMDR UK & IRELAND Association, using EMDR online. In this article Lisa from My Therapist Online interviews Paul and finds more about his experience of using EMDR for online video based therapy and the positive results he sees.
The EMDR Institute best describes EMDR as;
“EMDR (Eye Movement Desensitization and Reprocessing) is a psychotherapy that enables people to heal from the symptoms and emotional distress that are the result of disturbing life experiences.
Repeated studies show that by using EMDR therapy people can experience the benefits of psychotherapy that once took years to make a difference. It is widely assumed that severe emotional pain requires a long time to heal.
EMDR therapy shows that the mind can in fact heal from psychological trauma much as the body recovers from physical trauma.”
“EMDR therapy demonstrates that a similar sequence of events occurs with mental processes. The brain’s information processing system naturally moves toward mental health. If the system is blocked or imbalanced by the impact of a disturbing event, the emotional wound festers and can cause intense suffering.
Once the block is removed, healing resumes. Using the detailed protocols and procedures learned in EMDR therapy training sessions, clinicians help clients activate their natural healing processes.”
Paul, can you tell us about your experience of online therapy and the use of EMDR within it.
There is an increasing need for online working as clients are busy, homebound, or just too far away from a suitable therapist.
Online working (counter intuitively) can be very intimate. The head phones and microphone create a very intimate personal bubble which allows the therapist and clients to hear the fine emotional nuances of our voices, i.e. deep focussed listening. And the bonus is we can still see the client’s face and body language.
This ‘bubble of intimacy’ (as I call it) counterbalances the fact we are not sitting in the room together.
The safety and comfort of the home environment, empowers our clients, allows for them to open up more.
I use EMDR online as a stand alone treatment but very often combine it with other talking therapies online.
How does EMDR work?
EMDR is 70% talking, history taking, installing a safe or calm place (a good memory that feels safe), then identifying: target memories, negative and positive cognitions, sensations.
The other 30% is getting client to mindfully attend to the trauma memory as composed of feelings, sensations or images until the brain naturally reprocesses and desensitises the memories.
In CBT language, it is imaginal exposure to upsetting memories until the person has desensitised to them. The hot thoughts are no longer hot.
This is all entirely possible to do online via web cam. I have experienced no hindrances what-so-ever, except via our own preconceptions.
The clients have to have some belief or hope in working online. Technology does not suit everyone.
How effective is the online video therapy application of EMDR?
It is early days in the evidence for online EMDR. More than 30 positive controlled outcome studies have been done on EMDR therapy, and NICE has collated evidence for the use of EMDR here. Some of the studies show that 84%-90% of single-trauma victims no longer have post-traumatic stress disorder after only three 90-minute sessions.
An EMDR therapist called Mark Brayne, a senior member of the association, is group lead for an EMDR online special interest group. He is spear heading developing best practice in this area.
There is increasing evidence for online CBT therapy in the form of messaging as used but IESO. Counterintuitively they found clients took to it very well to added privacy and made use of having a written version of therapy session to re-read during the week for homework. This counterbalanced the slow pace of typing instead of talking in session.
All I can say is I do the same work face to face as I do online with EMDR and is just as effective.
Clients and therapists can initially distrust this way of working due to a lack of confidence in using technology and having preconceived expectations of therapy only being face to face.
Experientially there is new knowledge to be learned, new ways of working that clients and therapists never imagined were now possible.
“I do the same work face to face as I do online with EMDR and is just as effective.”
Are there any practical solutions you have developed to enable EMDR therapy to be delivered on an online platform?
In terms of the practicalities of using bi-lateral stimulation online. I ask clients to do the butterfly hug i.e. hands across chest self tapping on arms (tactile bi-lateral stimulation) or I can also ask clients to stick stickers or blue tack, one on each side of the monitor and ask them to move their eyes from one to the other during the reprocessing stages of therapy (visual bi-lateral stimulation). There are phone apps like "BDSR player" using headphones (auditory bi-lateral stimulation).
How do you manage any risk the might come up?
Some therapists expressed concern about clients disassociating during therapy and would this be a risk?
Well if the client is known to highly disassociate perhaps I would not offer online therapy but face to face working instead.
With any type of online working their is a risk of a client suddenly feeling suicidal or disassociating. This is counterbalanced by the fact that the client is in the safety of their own home, with family nearby. And of course I check for likelihood of disassociation and suicidality and make sure the client has some fallback options in place. I.e. making sure they have family or partner in the home while doing therapy (only if there is increased risk). And of course emergency numbers to call like samaritans.
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