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
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
- 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
- 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
- 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.)
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.
Download this article as a PDF
©Jeremy Tomlinson, M.Ed., R.M.F.T., R.S.W., EMDRIA Certified