Eye-movement desensitisation and reprocessing therapy is a type of trauma therapy. It uses rapid left-right eye movements and other forms of sensory stimulation to help individuals process distressing and traumatic memories. It aims to change the character of traumatic memories into a more positive state that can be integrated with other experiences and recalled without triggering intense distress.
Before teenagers begin to reprocess traumatic events, they have to be able to access these memories, thoughts, and emotions safely. The preparation phase of EMDR supports teenagers in developing distress tolerance skills that help them cope with the pain connected with traumatic memories. It also helps them to access suppressed emotions and feelings in their bodies.
This blog offers some information on how EMDR works, what the preparation phase involves, and why it is so important for teenagers who have experienced trauma.
How Does EMDR Work?
Scientists still aren’t clear about the mechanisms underlying EMDR therapy. Some evidence suggests that the eye movements used in EMDR tap into the brain’s inherent mechanisms for processing experiences, which can be disrupted by trauma.
The dual focus of attention concept describes the splitting of attention between a traumatic memory and the present moment, balancing a focus on the traumatic material with a sense of not being part of the trauma. Research suggests that this ‘distancing’ is associated with improvements in trauma symptoms.
What Is the Adaptive Information Processing Model?
The adaptive information processing (AIP) model is a theory about how our minds process information. It assumes that just as our bodies are designed to heal cuts and wounds, our minds (and bodies) contain processes that ‘heal’ memories, transforming distressing information and experiences into something that’s tolerable.
However, when a traumatic experience overwhelms the brain, these processes don’t function properly, and a memory can be stored in a way that causes intense distress.
AIP is the theoretical basis of EMDR therapy, which aims to use the AIP systems to reprocess traumatic memories.
What Does EMDR Therapy Involve?
EMDR therapy involves eight phases of treatment. The first phase centres around building a therapeutic relationship between the young person and therapist and developing a treatment plan.
The second phase (the preparation or stabilisation phase) involves developing distress tolerance skills to help young people cope with difficult emotions that may arise during the treatment process when they are asked to recall a traumatic memory. The young person may develop mindfulness skills, learning how to distance themselves from a traumatic memory and observe their experiences as they pass through their mind, without holding onto them or making them significant.
When a young person is ready, they begin the processing phases. These involve observing the traumatic memory while experiencing sound, light, or touch stimulation on the left and right sides of the body for around twenty to thirty seconds at a time.
For some people, reprocessing these traumatic memories may automatically lead to new insights, a more positive self-concept, and more helpful behaviours surrounding the trauma. For others, therapists may support the development of cognitive, emotional, or social skills where trauma has disrupted learning processes, especially those that occurred during childhood.
Each session ends with closure (returning to a state of calm) and re-evaluation, preparing a young person for the next session.
Why Is the Preparation Phase So Important?
The preparation phase of EMDR therapy is crucial to the effectiveness of treatment. Reprocessing without adequate preparation can leave young people traumatised, unsettled, and feeling like therapy isn’t working.
The preparation phase involves several different elements, including consolidating trust between the therapist and teenager, providing information about EMDR, and developing skills for coping with emotional distress. It helps teenagers feel secure and able to manage the inner experiences that may arise as they confront traumatic memories.
On the other hand, reprocessing without adequate preparation can lead to retraumatisation or additional distress. Without the necessary coping mechanisms, the reprocessing phase can trigger a young person, moving them into an emotional and cognitive state that overwhelms them. Instead of enabling the reprocessing of a memory into a more positive, integrated state, it can reproduce and reinforce the previous, harmful impact of the traumatic memory on the mind and body.
Some teenagers may also require support in accessing their traumatic memories or emotions. These emotions may have been suppressed because they were too painful to experience. Sometimes, the whole memory may have been suppressed; in other cases, young people may have detached the memory from its emotions by focusing on their thoughts and not allowing the emotion to be there.
Preparation also involves learning to access the body and notice how it is feeling. The body is a major part of our memory, but traumatic experiences can make the body a painful place to be. Some teenagers may have distanced themselves from their bodies to avoid this pain. EMDR preparation helps young people to rebuild the mind-body connection.
The preparation phase is about accessing memories, the body, and emotions without being overwhelmed. Some skills learnt in this phase may include:
- Grounding exercises – connecting with the present moment by using your senses and body
- Calm place activities – using real or imagined calm places to soothe distressing emotions
- Container exercises – visualising a secure container to store distressing thoughts and feelings until you are able to cope with them
- Recognising personal strengths – focusing on strengths, gifts, and talents to build resilience
The amount of time a young person spends in the preparation phase varies with the kind of trauma they’ve experienced and the coping mechanisms they already hold. In general, teenagers who have experienced complex trauma will need more preparation time than those who have non-complex PTSD. Young people who have already spent time in different kinds of therapy and acquired distress tolerance skills, such as DBT or trauma-informed yoga, may move through preparation more quickly.
While in a few cases preparation can take a few sessions, many young people spend several months in the preparation phase.
How Effective is EMDR Among Teenagers Who Have Experienced Trauma?
Research has established EMDR as an effective trauma treatment for adults. While there are fewer studies researching the effectiveness of EMDR among adolescents, the results are promising.
One study among adolescents with severe PTSD found that EMDR, combined with physical activity and prolonged exposure therapy, led to significant improvements in trauma symptoms. Another study among adolescents with complex PTSD found that EMDR improved symptoms of PTSD, depression, insomnia, and anxiety, emotional regulation and quality of life.
EMDR and Trauma-Focused Treatment at The Wave Clinic
At the Wave Clinic, we offer EMDR alongside other trauma treatments for young people with complex trauma, PTSD, borderline personality disorder, eating disorders, and other mental health concerns where childhood trauma often underpins symptoms.
Unaddressed experiences of trauma often contribute to and maintain mental health symptoms, acting as a barrier to holistic recovery and complicating the treatment process. For us, trauma-focused means addressing these experiences from the very start of a treatment program and integrating trauma treatment throughout the program.
Our programs combine EMDR, trauma-focused yoga, neuroaffective relational model therapy, somatic experiencing, prolonged exposure, and other types of trauma therapy, tailored to suit each young person’s needs.
