Case Study: EMDR Treatment – Claudia

A little bit about my life with PTSD before treatment

I didn’t know I had PTSD.  I’m still not absolutely certain when it kicked in, as I think I had delayed onset PTSD.  I had a number of different traumatic experiences (2x separate sexual assaults at age 21, 1x medical emergency with life-saving operation followed 1 week later by a miscarriage age 29); I believe it was a culmination of these events and other life stressors, which caused my mental health to really deteriorate in my late 30’s. 

I have suffered from migraines since I was a teenager, however these became chronic by my mid-30’s (around 20-25 per month).  I have a husband who is loving and supportive, but he worked a 70 hour week, we had a young family and I had a fairly new career full-time.  All the pressure became unmanageable with my deteriorating health and I had a breakdown, taking 5 months off work.  I knew I was anxious and depressed, but I blamed the stresses mentioned above as well as all the various side-effects of preventative migraine medicine (which probably didn’t help).

I was assessed by my work’s Occupational Health team, who recommended a number of CBT sessions.  I returned to work part-time 3 days per week, which seemed to work for a while.  However, my youngest child had never had good health and was diagnosed with a number of permanent conditions.  This time round, I recognised that my mental health was starting to deteriorate again.  I wanted to prevent another break down as it was putting pressure on family and married life too.

How I discovered EMDR treatment

I had tried the CBT therapy recommended by Occupational Health, however, the private therapist (supplied by work) was overly-focused on migraines and sharing therapies which had worked for her (fellow sufferer).  She was a very stern, straightforward character, lacking in warmth and empathy.  I used to spend most of my sessions wanting to talk, but mainly crying.  She talked about how every single thing we do is a choice that we have made and that we choose how we react to things and we are ultimately responsible for our choices.  I didn’t understand at the time why I found this so upsetting, but can understand now I have had trauma response explained to me, that this is simply not true.  Without either of us knowing it, it increased the shame and responsibility I felt for past trauma.  It silenced me further.

When I sought help the second time (3 years later), I was fortunate enough to be referred to an experienced IAPT counsellor through my local GP.  Initially, I had just been put on a trial to receive either counselling or more CBT, but during our first session when she was taking a more detailed picture of my symptoms, I found myself disclosing one of the sexual assaults to her.  It was as if I couldn’t hold it in any longer.  I can’t remember at which appointment, but she introduced me to the idea of EMDR and the fact that she thought I had more than just anxiety and low mood, she thought it was PTSD.  It took me a while to come to terms with this, but it was only when I went on the PTSD UK website that I realised how many symptoms I had been living with; some of them for years (poor sleep, night sweats, teeth clenching, disturbing, recurring nightmares, feeling irritable, avoidance of reminders, lack of trust particularly anyone not in the immediate family) and some more recent (flashbacks, intrusive thoughts, feeling numb and detached, feeling no joy in life and nothing to look forward to, memory loss, difficulty concentrating and relaxing, negative thoughts and emotions – sadness, guilt and shame).  At that point I realised how much it had affected every aspect of my life.

What were your initial thoughts about EMDR?

I remember thinking EMDR sounded a bit weird, like some sort of hypnotism or interrogation technique.  I was a bit sceptical, so I made sure I read up on it as much as I could, but I felt so lost at the time.  I didn’t want to seek opinions because I didn’t want people asking about why I was having it.  I remember almost wanting the IAPT therapist to make all my decisions for me at the time, I didn’t feel capable of making my own.  She also offered to refer me for counselling at my local Rape Crisis Centre, but I felt so desperate to start therapy that I didn’t want to have to go on another waiting list or have to tell anyone else.  I wanted to do EMDR because it sounded better than CBT and I didn’t fancy the idea of this other choice of some sort of exposure therapy, where you had to write out a recount of your trauma and then read it back at home regularly.  I think I was a little bit naive initially, thinking that it would be a quick, easy fix like waving a magic wand and I would get better.  (Not that that is how it was explained!)  Only my husband, mum and dad knew I was having this therapy.  I told 2 friends along the journey.  I think everyone just hoped it would help.

My EMDR journey

Due to me having migraines, the NHS therapist opted for using a pen/pencil for my eyes to follow for treatment rather than a lightbar.  I remember feeling frustrated at not starting the actual therapy and having to do the prep work before using the technique.  But my therapist waited until we had established a good bond and some trust.  Plus I really struggled with visualisation and creating a “safe place” it took huge amounts of work, but she was creative and patient with her approach.  Therapy sessions were very up and down.  It was very difficult to open up as I have spent years in silence.  It was extremely challenging to trust someone.  The memories and going back to the past was so overwhelming and frightening at times.  Some weeks I felt I was really resisting/ avoiding it.  On the whole sessions were well controlled by the therapist, but it is a very uncomfortable experience.  Some sessions were “a necessary evil”.  Sessions were always absolutely draining.  Sometimes I went home thinking “Why the hell have I done this, now I have recalled memories that I never knew I had – surely that’s more traumatic?”  I could be really angry and resentful with my therapist and go home thinking she was useless and horrible for making me feel like this.  Then the next week, I would feel as though it was all working and I could feel things slowly shifting and I would think she was amazing.  Following each session, I would also inevitably have a really bad 24-48 hours of much worse PTSD symptoms, when the brain starts to allow itself to process the memories due to the EMDR treatment.  Luckily, I always timed therapy for my day off on a Friday so that I could just have a really quiet day on my own and practise the mindful/ self-care activities that my therapist taught me.  She also made sure that she would time really emotive sessions around any significant events so that treatment didn’t negatively impact a holiday or wedding etc.  What surprised me was how many strange links the brain makes due to trauma.  It was during sessions that I realised that other traumas had affected me as they kept getting mixed up together.  That was when I discovered there had been a second sexual assault. It also emerged that the emergency operation and miscarriage were still not processed and were part of the PTSD.  The therapist always made sure that I didn’t leave any session in distress and gave me lots of guidance and information around trauma and self-care.  Mid-point, I was terrified about ending the treatment and whether it would work.  But by the time I got to the last couple of sessions I realised how much progress had been made and how much more positive and empowered I felt.

What is life like after your EMDR treatment?

I feel like EMDR has really transformed my life because it has dampened down or eradicated most of my PTSD symptoms.  I’m still me, just a better, happier version.  It cannot erase your memories or your trauma or change the past, but it allows you to process the memories so that they don’t have the same sting and they don’t carry all that emotional weight.  I am also much better at recognising my triggers or anticipating potential stressful situations/ triggers, so I can do a much better job of being kind to myself and practising regular self-care.  I do have the odd flare up, which can be frustrating, but I can work my way through the symptoms and know that it will pass and I’ll be OK again.  I did end up seeing a private therapist about a year after the EMDR finished as you only have a limited number of NHS sessions and I realised that I could benefit more from just talking therapy about unresolved issues from school days, coping with the ongoing care for my child and anything else that pops up.   I just visit this therapist very occasionally now to check in and make sure my mental health is as good as my physical health.

Is there anything else you’d like to add? Any advice/words of wisdom/inspiration you’d like to give to people struggling with PTSD?

There is hope. EMDR can work if you engage and commit to it.  It is very challenging emotionally, mentally and even at times physically.  It isn’t a quick fix.  It is also about finding the right therapist – you need to feel trust and that you like and respect your therapist.  You may need to take time off work – take the time if you need it.  Invest in your mental health!  You will need support, someone on your side who is open to reading up on PTSD and EMDR so they can be there for you. 

Before the pandemic I managed to train and work as a helpline volunteer for a women’s sexual assault centre working a few hours a month on my days off.  I could not have done this without EMDR and it has turned a negative trauma into something positive.  I made new friends and I was among people who had experienced and understood what I had.  I feel that my confidence and self-esteem are improving.  I have even considered giving it a little more time and training to be a counsellor.  I did an online beginners counselling course during the first lockdown.  I really hope by sharing my experience it will encourage others to give EMDR a try.

You can find out more about EMDR treatment here.