How EMDR Can Help Survivors of Childhood Sexual Abuse and Trauma

EMDR can help a survivor of sexual abuse to be free of disturbing images, body sensations and emotions.  It can help to diminish or extinguish feelings of shame, embarrassment and humiliation and bring the survivor a sense of peace.  It can help to refocus a sense of responsibility, back to the perpetrator, where it belongs.  EMDR will assist in integrating concerns about sexual problems, sexual orientation, connecting in relationships and resolving issues of mistrust.

What is EMDR?

EMDR is an approach to therapy that I find particularly helpful for people who have experienced trauma.  This can be something normally associated with trauma (a sexual assault, an earthquake or a bank robbery) or an experience that was disturbing and personally traumatizing (bullying, humiliation or betrayal.)

To begin the therapeutic process, a relationship of trust must be established between you and your therapist.  Your therapist will identify situations or "targets" for EMDR processing.  Targets are often individual events.  On the day of processing, your therapist will ask you a few questions about the event to identify any negative beliefs, images, emotions and body sensations that are associated to the target.  Your therapist will use bilateral stimulation (ask you to move your eyes, tap your knees or play music or sounds in your right, then left ear.)  Bilateral stimulation helps to activate the way messages travel in your brain and helps you process the lingering aspects of the memory.

While your therapist is doing the bilateral stimulation, he will be stopping to ask you what you are experiencing.  You may have images (similar to watching a movie of your life,) body sensations (upset stomach, quickened breath,) thoughts or emotions.  Typically you will alternate between images, body sensations, thoughts and emotions while you are processing.  Your therapist will be observing while you are processing.  Some common observations may include:   whether your face is flushed, how your eyes are moving, changes in facial expressions, etc.  These observations help your therapist to determine how the therapy is progressing and what the next step should be.  Your therapist will ask you to pay attention to certain aspects of processing at different points in time.  For example, he may ask you to focus on a pain you mention in your shoulder or to pay close attention to a strong feeling of sadness.  At other times, your therapist may ask a question.

The dilemma of sexual abuse treatment

The dilemma in treating sexual abuse is the need for disclosure.  Adults abused as children hesitate to tell anyone about the abuse, and as a result are unable to get help in managing their problematic feelings and behaviours in the present day.  There are many reasons why people do not disclose their incidents of childhood sexualized abuse:

• For many people, there is an overriding feeling that they should have been able to do something to stop the abuse.  This is not the case as the victim was not in a position to prevent this predatory abuse of power from an adult.  As adults, it is often difficult to remember that as children they did not have the power to stop the abuse.
• There may have been threats of violence, humiliation or blame by the perpetrator which still feel resonant for the adult survivor.
• The shame and discomfort of acknowledging sexual experience at such a young age often prevents them from speaking out.  The topic of sexuality remains taboo in North American society as it is perceived as an intimate subject and in disclosing experiences of abuse; many people feel that they risk a part of themselves.
• There may be embarrassment and humiliation associated with the experience.
• For most, the experience was traumatizing.  Many are fearful about opening up the subject, for fear they will feel worse for having disclosed the details of the abuse.

People may be hesitant to meet with a therapist because they do not feel ready to deal with their memories of abuse.  This is a healthy and appropriate response.  It takes strength and courage to deal with difficult traumatic memories, particularly when those memories may be revisited.  This process cannot be forced.  You will know when you are ready and that is the best time to contact a therapist.

Treating sexual abuse means targeting instances of abuse.  As a result, sometimes people experience powerful emotions or body sensations during EMDR processing.  On the other hand, at other times the shifts will feel subtle and not perceived as distressing.  Your therapist will guide the process and has the responsibility of keeping you safe.  This means that if you are experiencing a distressing emotion or body sensation, your therapist may allow it to continue for a few minutes.  If this distress does not appear to be shifting, your therapist will employ techniques to take you away from those feelings and will assist you in relaxing and feeling grounded.

It is not the goal of EMDR therapy to retrieve memories.  However, sometimes you can gain clarity during EMDR processing and gain more information about a situation.  For instance, you might target a work meeting eight years ago where you felt humiliated.  During processing you may recall the first and last names of everyone who was present at the meeting, even though it occurred eight years ago and you have not met with some of those people since.  This type of remembering can be a by-product of EMDR processing; it is not a goal.

Will we only spend time processing difficult memories?

During the initial sessions your therapist will be building a relationship with you and hearing your story.  Only after you have begun to build trust with your therapist will it be helpful to begin processing difficult memories.  Before that happens we may use EMDR processing to build strength.  This usually involves developing images of safety (like a dock by the cottage or grandma's kitchen when she was baking bread) and using images of strength (like Wonder Woman or a protective guard dog.)  EMDR processing can be used reinforce and integrate these images.  The strength building during EMDR commonly occurs prior to processing any difficult memories by helping you to associate more with feelings of strength and safety. 

As well, once you begin processing difficult memories, you may alternate between processing difficult memories and strength building (for example, alternating between strength-building and processing sessions in different weeks).  It is also possible that you may process memories one week and have a talking session the next week (with no EMDR processing.)

What to expect from therapy for sexual abuse

In your initial meetings, you should expect your therapist to ask questions about your life.  I am influenced by writer and psychotherapist Yvonne Dolan who says that sexual abuse treatment should be divided into thirds.  One third of the time in therapy should be spent discussing the past (the abuse, your childhood, who knew, how they responded and how you responded,) one third of your therapy should be spent on the present (how it is affecting your life now,) and one third on the future (what do you want to do in order to make the necessary changes in your life to feel that you are recovered from the abuse that occurred in your youth.)  The time you spend speaking about the past, getting a context and hearing about your life today (love relationships, family, friends, work and leisure activities) are important in integrating and understanding what happened.  It is also important to set the goals for therapy.

In general, you should expect your therapist to:

• Be a good listener
• Ask pertinent questions
• Provide empathy
• Create a therapeutic environment where you feel safe so you can disclose and discuss difficult experiences and express emotion freely
• Believe you
• Within a supportive context, challenge and confront you if there may be more to explore

All of these qualities are true for the EMDR therapist as well.  I believe that in order for EMDR to be successful, therapists must develop a supportive, nurturing and empathetic relationship with their clients. By developing this sort of relationship, you are better able to trust your therapist and are more willing to take the risks necessary for successful therapy.  You need to know that if your story is difficult; your therapist will not be overwhelmed by hearing it.  You also need to know that if you are experiencing powerful emotions or body sensations, your therapist can help you process those experiences and you will leave your session feeling relaxed.

What does being an EMDRIA Certified therapist mean?

I am a member of EMDR-C (EMDR Canada,) EMDRIA (EMDR International Association) and EMDRIA Certified therapist.  I attended EMDR training with EMDRIA approved educators (two twenty hour training sessions.)  Between training sessions, I worked with my clients using EMDR and consulted with an experienced EMDR therapist.  After completing my second training, I attended twenty further hours of consultation about clients with whom I was using EMDR.  Prior to certification, someone must have conducted at least fifty sessions of EMDR with no fewer than twenty-five clients.  It has been important to me to continue my EMDR education.  I have regularly attended workshops and EMDR conferences held by EMDR-C and EMDRIA.  The conferences and workshops have empowered me with new ways to integrate EMDR in my practice (performance enhancement) as well as provide ways to work with specific populations and issues (like dissociation, sexuality or abuse.)

In Conclusion

One goal of EMDR is to process or digest a memory that may have become stuck in the experience.  In  processing a memory you will still remember that  you  experienced abuse.  However, our goals are to remove the fear, the physical manifestations and any negative beliefs, that the images of the abuse will have faded, and that you will resonate with an appropriate positive belief like "I am safe now" or "I am worthy" or "It's not my fault".  In addition, we have a goal of building strength in the form of increased confidence, self-esteem and/or an increased sense of safety.

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©Jeremy Tomlinson, M.Ed., R.M.F.T., R.S.W., EMDRIA Certified
www.alternativehorizon.com
jeremy@alternativehorizon.com