• Eye Movement Desensitization and Reprocessing (EMDR) therapy is an interactive psychotherapy technique used to relieve psychological stress

  • Therapist Christa Stadtler describes using EMDR to treat a man with fear of enclosed spaces

  • If you are looking for a therapist you can find one here

EMDR therapy (Eye Movement Desensitization and Reprocessing) is recommended by NICE for the treatment of post-traumatic stress disorder, and it is considered effective for some anxiety disorders. Here I describe an EMDR session, to give you a better idea of what to expect if you are considering seeing an EMDR therapist.

Carl (not his real name) suffered from claustrophobia for many years. He felt that the fear originated from a childhood incident. When Carl was five years old his older sister’s friend burst into his bedroom and threw a large and heavy quilt over him and held him down. Carl could barely breathe and still remembers the weight and texture of the quilt on his body and face. He froze in a panic which is still very present now.

EMDR theory suggests that all events are processed into memories. Frightening events can be so overwhelming, that the processing of memories is disrupted. The insufficiently processed memories are easily evoked; they may resurface as dreams or nightmares and can be held in the emotional system as anxiety and anger, or in the body as tension or illness. These memories can be reprocessed with EMDR and fully integrated into the existing memory system.

Following EMDR protocol, we focused on the image of Carl trapped under the quilt. Carl described feeling out of control and said that he would much prefer not to be ‘fazed’ by the memory. The incident was accompanied by a mixture of fear and panic, which he experienced in his head and arms. As he described the emotions his hands reached up and covered his ears in a gesture similar to Edvard Munch’s Scream, physically expressing the fear.

Carl rated his distress as an eight on the Subjective Units of Distress Scale or SUDs (0= no distress; 10= highest possible distress). The aim is to lower distress levels to zero. Now we were ready to begin processing the memory with bilateral stimulation.

In EMDR therapy bilateral stimulation means the left right movement of one of the senses, either eye movements, sounds played alternately into the left and the right ear, or tapping the left and right hand alternately. Carl chose hand taps. I prompted him to evoke the frightening image of himself under the blanket in connection with the thought of being out of control. He closed his eyes as I tapped, and started talking.

He saw himself scared and immobile in the dark. The blanket had moulded tight around his body, holding him rigid. He began wriggle to and then struggle; the blanket became more and more pliable and eventually he was able to escape its clinging folds. I carried on tapping and he saw himself walk to his favourite spot, a sunny bank overlooking a little pond. He rested there for a moment and then I asked him to return to the image of himself under the blanket and to rate his distress again. To his surprise and delight his distress level had fallen to a four on the SUDs scale.

After a short break he imagined himself back under the quilt again and I continued tapping. The quilt felt softer and lighter and he remembered its red colour. After a short struggle he threw it off and dumped it on the floor. He left the house and sat on the beach watching the seagulls and the surf. His distress levels had reduced to a three.

We resumed processing and this time he freed himself almost immediately. He folded the quilt up into the smallest possible square and tied it up with the orange plastic string his father used for the lobster pots. He then fused the plastic string over the fire and stored the whole parcel in the recess over the cupboard in his room. Here it was out of the way, he explained, but he could still keep an eye on it. He sat down in front of the fireplace feeling warm and relaxed. Carl now rated his distress levels as zero. He found that being under the blanket truly did not faze him anymore and we installed this new positive belief with slow hand taps. There were no further signs of physical disturbance. Carl was happy to leave the blanket tied up on top of the wardrobe and we closed the session.

A week later he reported that he could not conjure up the image of himself under the blanket anymore. He could still see the blanket in his mind’s eye, but there was no one underneath it. Carl had truly emerged from an incident, which had darkened part of his life for a very long time.

Further reading

EMDR therapy transformed my life

Understanding trauma and flashbacks

How EMDR can support you through trauma

EMDR took the edge off my panic