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Working with complex trauma (C-PTSD) in attachment-focused EMDR

As an EMDR (Eye Movement Desensitisation and Reprocessing) therapist one of the myths that clients initially bring to the therapy room is that EMDR is only a suitable for single incident traumas. This may have been how the modality was used initially but in the 36 years that EMDR has existed it has evolved in its use.

In my professional experience very few people experience single incident traumas as isolated incidents and are otherwise fine. Often the trauma has impacted them because it taps into an already heightened fear response which developed in early childhood. In fact we know that one of the risk factors for developing PTSD is adverse experience in early childhood.

Attachment-focused EMDR is a technique developed by American Psychotherapist Laurel Parnell and popularised in the UK by psychotherapist Mark Brayne. Its premise is that much of our emotional patterning is laid down in early life (age 7 or earlier) and often issues that we are struggling with in our daily lives relate to patterns of behaviour or thinking established in these years. If we have experienced trauma in early life, it is highly likely that these patterns are maladaptive. Attachment-focused EMDR also has additional resourcing exercises that stabilise a client before starting the processing phase.

This is no different to the general premise of talking psychotherapy but the difference is that attachment-focused EMDR is able to process a difficult issue in the past and an issue in the present simultaneously as well as the unpleasant physical sensations that accompany it. This means that patterns of thinking, negative emotions and unpleasant bodily reactions to the trauma can change. Attachment-focused EMDR can stop us falling into child ego states where we may be responding from a wounded or frightened place that does not reflect our current reality. Those around us may feel confused by our behaviour as it may seem disproportionate or inexplicable.

How does attachment-focused EMDR work?

Attachment-focused EMDR uses the same Adaptive Information processing (AIP) model as standard EMDR. AIP assumes that there is an information processing system in the brain that gets blocked when difficult or traumatic events occur. These events get locked in the brain with the associated pictures, noises, thoughts, feelings and body sensations that originally accompanied them.

Whenever a reminder of the traumatic event arises, the images, noises, sounds, thoughts, feelings and body sensations can continue to be triggered. When these memories are stored in their unprocessed state they can result in emotional problems and psychological disorders. EMDR helps the brain to reprocess these memories, alleviating the distress. It also uses the same eight phase protocol as standard EMDR. The difference lies in its ability to work with a past memory and a present problem simultaneously.

Initially we would begin with a presenting problem, then trace the physical sensations and emotions back in time to find their root. Very often we are not conscious of the root but there are techniques we can use to draw that out. We then work through where the problem began and then after that we return to presenting problem in the present and work through that. We might also imagine a future scenario where the presenting problem may occur to check that all the associated distress has been removed or lessened.

For example, if somebody had a strong traumatic response to their boss raising their voice we might trace that back in time, find its root in earlier childhood abuse from a domineering or frightening care giver, we would process the original memory first, which naturally would reduce the distress of the present trigger. We then install more positive self-concept using the same process of eye movement or tapping.

To book an attachment-focused EMDR consultation click here


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