What is EDMR with Children?

 

Eye Movement Desensitisation and Reprocessing is a psychotherapy treatment that is effective for resolving emotional difficulties caused by disturbing, difficult, or frightening life experiences. When children are traumatised, have upsetting experiences or repeated failures, they lose a sense of control over their lives. This can result in symptoms of anxiety, depression, irritability, anger, guilt, and/or behavioural problems. Events such as accidents, abuse, violence, death, and natural disasters are traumatic, but we do not always recognise the ways they affect and influence a child’s everyday life. Even common upsetting childhood events such as divorce, school problems, peer difficulties, failures, and family problems can deeply affect a child's security, self-esteem, and development.

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When upsetting, scary, or painful experiences happen, sometimes the memories of the experiences stay “stuck” or “frozen” in the mind and body. That experience may return in a distressing, intrusive way and the child may cope by avoiding everything associated with the upsetting experience. For example, a child who has experienced a bad bicycle accident may have repeated nightmares, be fearful of trying new things, and avoid things that are associated with the bicycle.

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Most experts agree that the best way to get “unstuck” and become free from the symptoms is through exposure to the traumatic experience. This means the person will work through facing the memories or troubling events until they are no longer disturbing.

 

Bilateral stimulation (BLS) refers to the use of alternating, right-left tracking that may take the form of eye movements, tones or music delivered to each ear, or tactile stimulation such as hand taps. Creative alternatives have been developed for children that incorporate BLS through the use of puppets, stories and dance.

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EMDR helps resolve the troubling thoughts and feelings related to the distressing memories so that children can return to their normal developmental tasks and prior levels of coping. In addition, EMDR can help to strengthen feelings of confidence, calmness, and mastery.

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What is an EMDR session like?

A typical EMDR treatment session begins in a positive way by having children use their imagination to strengthen their sense of confidence and well-being. For example, children may be asked to imagine a safe or protected place where they feel relaxed or remember a time when they felt strong or confident. These positive images, thoughts, and feelings are then combined with eye movements or other forms of dual attention stimulation. These beginning experiences with EMDR typically give children increased positive feelings and help children know what to expect during a session.

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The child is then asked to bring up an upsetting memory or event that is related to presenting problems. BLS is used again while the child focuses on the disturbing experience. When an upsetting memory is “desensitised”, the child can face the past events without feeling disturbed, frightened, or avoidant. “Reprocessing” simply means that new understandings, sensations, and feelings can be paired up with the old disturbing thoughts, feelings and images. After EMDR treatment, the troubling memories can be more comfortably recalled as “just something that happened”, and children can more easily believe, “it’s over.” “I’m safe now.” “I did the best I could.” “It’s not my fault,” and, “I have other choices now.”

 

How does EMR work?

While it is not clear how eye movements or other forms of BLS in EMDR work (e.g., hand taps or tones), ongoing investigations continue. We do know that the BLS component is not hypnosis; it may be that eye movements work similarly to what occurs naturally during dreaming or Rapid Eye Movement (REM) sleep, where certain information is processed. Additionally, it is possible that BLS produces a relaxation response or a distraction that helps children relax rather than avoid facing disturbing events. Others think that the BLS may help bring all parts of the brain/mind together, and therefore, allow access to the body’s natural healing mechanisms.

Preparation and Assessment: Just like with adults, it’s important to establish a strong therapeutic relationship and ensure the child feels safe and supported before beginning EMDR. A comprehensive assessment will be conducted to determine the child’s readiness for EMDR and to identify specific targets (traumatic memories or distressing experiences) that need to be addressed.

 

Adaptation of Techniques: The traditional EMDR protocol may need to be adapted for children based on their developmental stage, age, and cognitive abilities. This might involve using age-appropriate language, creative techniques (such as drawing, storytelling, or play therapy), and shorter sessions to maintain the child’s engagement and comfort.

 

Calming Techniques: Children might experience heightened emotions during EMDR sessions, so it’s important to teach them relaxation and grounding techniques to manage distress. Breathing exercises, visualisation, and sensory grounding activities can be useful tools.

 

Parental Involvement: Depending on the child’s age and situation, involving parents or caregivers can be valuable. Parents can provide additional support at home and help reinforce the child’s progress.

 

Flexibility and Patience: Children’s responses to EMDR can vary widely. Some children might show significant improvement after a few sessions, while others might need more time. It’s important to be patient, flexible, and willing to adjust the approach based on the child’s reactions and needs.

 

Ethical Considerations: When working with children, therapists must ensure that they have the necessary training and expertise in child development, trauma, and EMDR techniques. Additionally, obtaining informed consent from parents or legal guardians is crucial. You will be asked to fill out a consent form prior to the session commencing.