AIBU: Challenges of EDMR on NHS (trauma, sea, but no details)

[DonnaHadDee]

I was involved in a very scary incident about 12 years ago with my step mother and a friend. I won’t go into the details but for 30 minutes it looked really bad. Boating, mechanical failure, dramatic weather change, dark, broken ribs for me, etc.

Afterwards I just got on with things, busy with work, teenagers, changing jobs and countries, family health issues, and so on. Went back sailing within months too. I’m very fit and active, an army and farming family background where you get on with things. It’s always been in the background though. Due to some health check up things and what I attributed to work-stress I ended up doing EDMR after recommendation from my GP in the past year. Paid for myself. I’ve found it so helpful for me personally both mentally, and it helped with general health too.

It was an unknown topic to me, but as I mentioned it to others I learned more. I was very skeptical, I did not want to talk about it with people (I can and have done that with DH).

No problem for me to afford this myself. But I’m thinking about others who cannot. It has been a very effective approach for me. It seems a very cost-effective option, and limited time duration, and has well documented results. One year later, I really think it should be a more readily available on NHS

YANBU: Yes of course. It works and could be limited time/cost.
YABU: If people think it works they should pay for me

It is readily available on the NHS, so much as anything is "readily available". You can be referred for EMDR for a signal traumatic incident and then you wait for a while (months or years) to actually be seen.

It's a standard treatment for PTSD on the NHS

EMDR is available on NHS, I know several people who’ve had it. The problem is people first have to be seen by a trauma specialist and the waiting lists are long for specialist psychological therapies on NHS

EMDR is available in adult and childrens MH in my area.

YANBU. My young person only managed 3 sessions of EMDR but it was life changing. But even though she was unable to go to school and in so much distress she was pulling her own fingernails out, she was triaged out by CAMHS as not high need enough to be seen.

This is also a huge issue in under 18s getting antidepressants. There must be thousands like my child who desperately needed them and could be helped by them, but couldn't get them because the bar for getting accepted by CAMHS is so much higher than the level at which they are therapeutically indicated. Children are rotting away unable to leave the house or access school, their life chances and potential future tax payments ebbing away all because CAMHS is too underfunded to help everyone who needs them.

I agree with you OP. Saying it is already available is missing the point, because to so many, it actually isn't.

Technically it is available, but I think it should be more readily available, considering the time/cost versus potential benefit. With my GP discussion, she strongly recommended paying myself due to time/backlog/prioritization.

I'm certain that today I would not meet the "patients typically must be diagnosed with Post-Traumatic Stress Disorder (PTSD)" criteria. I think I coped OK myself, so there would be much higher priority cases.

And subjectively I feel it made a big difference to my health. Even though the incident was over 12 years and I'd have though it would have faded into the background more.

I was in a traumatic accident a number of years ago which left me seriously injured. I did not know about it being available on the nhs nor have I ever been offered it.

i have considered it privately

Working in the science area, I also did a certain amount of research prior to doing it, as it was not something I was aware of, or properly understood (and I'm not sure I really get the "how it works" part today).

For my specific case, one very specific traumatic event a long time in the past, was a bit different too? The fact I did not have to do all this "talk therapy" stuff helped a lot too, as that's something I feel I would have struggled with.

It's very much a postcode lottery.

I had severe PNA whilst living in London, picked up quickly by crisis mental health and visited daily by MH nurses for over a month, saw a maternity specialist consultant psychologist every week for nearly a year. I was so much better by 4 months later, and by 8 months I came off medications fully and went on to have a 2nd child with no relapse - psychologist even saw me for a few sessions before birth of 2nd child for a few 'preventative' sessions. I returned to work on schedule 1 year after birth of first, no sick leave.

We now live 20 miles outside London, DH went to GP saying having suicidal thoughts, got handed a leaflet to call talking therapies, our GP (who is excellent) tried to get him prioritised and apologised that services so bad. I had to get his mum to come stay whilst I went to work as he was 'at risk' but not high enough to receive any support. After 4 months he received online group therapy for 6 weeks. 8 months later still no individual support. He has tried to push through but has needed extended periods sick leave when at worst - he is public sector so this is costing the country far more than providing better MH support.

Working for the nhs, I can see it getting even worse under this government, the services my team could provide a few years ago we no longer have capacity to provide. So that might be part of it - my MH crisis was 8 years ago, under previous government.

The not having to talk too much also makes it unusually accessible to autistic people. Standard evidence based talking therapy can be a very poor fit for someone with expressive communication difficulties.

I had EMDR on the NHS. It is good when you are struggling with one to five isolated traumatic events as it takes a lot of time and effort per event. It is useless if your PTSD stems from hundreds to thousands of events- for that theme based flash therapy and CBT on survival habits/beliefs caused by decades of repeated trauma has more success.

It's interesting to see the variety of posts. It makes me think my case is in no way typical.

It was one very specific event at a known time/location over a decade prior. The time was about 30 minutes. I had 8 sessions, one week apart. I did not have to speak about any details other than give basic context for the event.That was important for me.

So I was the ideal case maybe? And that is why it worked so well in a short period of time? My general health is much better (less stress, stomach issues). I've enjoyed the few times I'm sailing again a lot more, a lot less stress. It's easier to look back and thing about it now, if I need to. It's helped my framing of the event, there were some things could have done marginally better, but overall what happened was out of my hands. It was indeed bad, but given the time, weather, injury, rope/cabling issues I was fortunate to survive.

I am currently receiving EMDR on the NHS. Wait time was around 5 months and a therapist related to my GP kept in regular contact during the wait. There is some childhood trauma that was selected for one event but the rest of the sessions relate to an abusive relationship of 30 years. I finally contacted my GP as I was really struggling to cope with post separation abuse during the divorce. I had to complete questionnaires that diagnosed anxiety, moderately severe depression and PTSD.

The sessions focus on particular events during that time of which I have a clear and overwhelming memory but are thematically related to other multiple events. I have had talking therapy in the past that leaves you stuck in overwhelm when the session ends. EMDR is different. The initial panic and overwhelm is horrible but dramatically reduces during the session so that you are not reliving and taken over by automatic bodily reactions but are remembering an event in the past. My therapist said last week that this happened in the past but trauma makes it feel as if it is happening now. I have found the sessions challenging but cathartic and liberating as effectively clearing the ‘block’ makes it easier to cope with current stresses.

I agree with you OP. It’s simple economics. Help prevent and treat longer term issues will maximise productive capacity for people being able to function etc. sadly our nhs don’t seem to favour preventative, proactive approaches.

Could I hijack very briefly Donna? Just because there's a few here who seem to have had success with EMDR. Would it work on someone like me who had traumatic incident decades ago - horrific crowd crush decades ago - that triggered claustrophobia/mega anxiety? Heard mixed things...

I'd like that for my PTSD but it wasn't offered. I was only offered trauma therapy but then they said it would be dangerous for me as it could be too traumatic so they couldn't let me do it?!
I can't afford anything really so I guess I might have to try some kind of charity.

I think our nhs is so overwhelmed firefighting emergencies (which they generally do well) that there is no capacity for individualised preventative healthcare.

My team is semi preventative, in that we try to prevent/reduce chance of children from needing complex, painful surgeries by intervening early, whilst also trying to maximise their mobility. One member of our team costs the nhs around 40-50k. One surgery for one child costs more than that, but still they cut our budget.

I got a high level of support for my MH challenges and didn't need to take any sick leave and am now thriving, DH has has minimal and has taken chunks of sick leave and is slowly drowning, I'm just so sad and frustrates that he can't get the great support I got.

@Alicay I really can't give any medical advice (I've a PhD, but in a science field!). But I'll explain my path. It was suggested to me by our GP. I'm in very good health and fit, but I was having some headaches, stomach distress, sleep, and I do have a stressful job in tech area, endless crises/layoffs these days. During discussion with GP she did ask about other stress events, and that was the only one. She said I should speak with a therapist.

Honestly, I was reluctant as I'm very self sufficient, this was one event 10+ years ago, I still do some sailing, but there is an underlying visceral fear when I think about it, and it cane be there for days. I do a lot of exercise, and I'm also religious and actively pray. But I decided to have consultation. She recommended I try a few sessions, focus around this specific event. Afterwards I did some reading, it seems very appropriate for a specific trauma event, even a long time ago. So I said I'd try it.

The process itself is somewhat strange. It's hard to explain the feeling. I did not need to talk (much at all), but thought about the rough water, dark, the multiple collision and broken ribs, not being able to find my step mother, etc. I'm not sure how to explain it, but it's easy for me to write this now, and even talk about it with DH. I still have work stress (and other life stressors), but that is not totally separate from this event, and I can manage it much better.

My strong advice to you would be to investigate. It made a big difference to me. You'll have to have a therapist review first and they'll guide you to see if it is suitable.

It's interesting that you heard mixed things, so that's a topic worth to discuss with them. Everything has pros/cons. The results from this technique has been great for me. This is reflective of what I've read in studies too. But you'll have to do some research yourself.

It works because you believe it's going to work, like most things.

There's an interesting video by Neuro Transmissions on Youtube which goes into the history of the treatment and it's founder.

It's pretty readily available although there is usually a wait -around 3 months where I am based. I can offer up to 20 sessions which is enough for most people.

@Eyesopenwideawake "It works because you believe it's going to work, like most thing" ... Is that your scientific opinion based on primary research? Or have you conducted a scientific literature review on the topic? If you have supporting academic references please do share. It's not a primary reason based on my review (I'm not working in this field though).

I'll check out the YouTube channel. It sounds interesting.

I certainly went in to the process very very skeptical, but curious.

It is NICE recommended for PTSD, however there are relatively few people trained in it, and those who are can make way way more working privately than working for the NHS.

I personally know an NHS therapist who really wants to train to deliver EMDR and believes it would be really good for her client group, but the Trust won't fund her until she's trained in a different type of therapy first - a type that isn't indicated for the client group she works with.

Thanks for that Donna. I've spent so much money on CBT/hypnosis/talking therapies and am not much further on. I'll
definitely go back and check out EMDR again

There are many studies showing that it works, but not actually why it works. So yes, believing it's going to work, and you trust it because the NHS has authorised it, it will work. Which is really all that matters to the person who is in distress.

It's really not that different from when someone post on MN asking if anyone wants a tarot reading and dozens of people pile on wanting to know what's going to happen in their future. No one posts to say their prediction didn't come true.

Bottom line, it works.

pmc.ncbi.nlm.nih.gov/articles/PMC6106867/

Sympathies BTW Donna - your traumatic event sounds horrible.

You’re right. Not just EMDR but many types of therapies should be more available on the NHS. I have cPTSD, GAD and Panic Disorder. I was offered 6 sessions of counselling and on another occasion 6 sessions of CBT. That was the only support that was available in my area. It was a drop in the ocean in comparison to what I needed.

Eventually once I was in a position to pay for it myself I had a mixture of different therapies (including EMDR) weekly for three years. It changed my life and I consider myself largely recovered now.