John Jeremiah Ahearne


Bond Street, Wimpole Street, oxford street, and Marylebone

London Counselling and Psychotherapy (LCaP)

Integrative Therapeutic or Psychodynamic Talking Therapy

Counselling and psychotherapy are available across Angel Islington, Holborn, Bond Street, Wimpole Street, Oxford Street, the West End, and Marylebone.

Face-to-face & online counselling sessions for adult individuals and couples.

Welcome to my website

I am a qualified counsellor with clinics across Angel Islington, Holborn, Bond Street, Wimpole Street, Oxford Street, the West End, and Marylebone.

I am committed to providing counselling, psychotherapy, and talking therapy in a safe, confidential, and non-judgmental environment. I work with individuals and couples using an open-ended counsellor approach or for an agreed-upon period to enable you to enhance your lives and live them more fully.

I understand that seeking out therapy might be a difficult decision for some, but I firmly believe that when an individual makes that step, it is because they are ready for change and growth. Using my counsellor training and counsellor knowledge, I will work with you towards a better awareness of yourself and yourself in relation to those around you.

Nothing you say will shock me, and everything you say is always confidential.

Together, we will recognise and explore patterns in yourself and others, what your triggers are, and where those patterns may have originated. I do not believe in immediate fixes; rather, most issues are relational problems.

I work from clinics in Angel Islington, Holborn, Bond Street, Wimpole Street, Oxford Street, the West End, and Marylebone. Currently, I have availability in the West End and Marylebone - behind Selfridges.

It's about the relationship we have with a problem that causes us pain; how you react to a topic, person or life event that causes upset in your personal and/or professional life.

“Being entirely honest with oneself is a good exercise.”

– Sigmund Freud

”The fact that grief takes so long to resolve is not a sign of inadequacy, but betokens depth of soul.”

– Donald Winnicott

“Happiness is when what you think, what you say, and what you do are in harmony.”

– Mahatma Gandhi

“Let me say to begin with: It is not neurotic to have conflict...Conflicts within ourselves are an integral part of human life.”

– Karen Horney

“How people treat you is their karma; how you react is yours.”

– Wayne W. Dyer

“It is a joy to be hidden, and disaster not to be found.”

– Donald Winnicott

“The primary cause of unhappiness is never the situation but your thoughts about it.”

– Eckhart Tolle

The Process for starting

The process is something like this:

  • We have an initial 15-minute telephone call.
  • You tell me a little bit about what is going on for you and why you have reached out for counselling and psychotherapy.
  • I will tell you a bit about what I can offer you as an integrative therapist.
  • If by the end of the telephone consultation we are both happy to go ahead, we move on to looking at both our diaries to agree on a weekly day/time slot for each week in person at Angel Islington, Holborn, Bond Street, Wimpole Street, Oxford Street, the West End, and Marylebone. I also offer online counselling sessions or hybrid counselling sessions.
  • I offer a once-weekly model, which can be short-term therapy or long-term therapy (open-ended).

  • If you would prefer a full in-person assessment session in Angel Islington, Holborn, Bond Street, Wimpole Street, Oxford Street, the West End, and Marylebone, please do ask.

Couns.Dip, Cert.Psych, MBACP

Enhanced DBS Renewed May 2023

My locations

I am a qualified counsellor offering face-to-face counselling and psychotherapy services in Angel Islington, Holborn, Bond Street, Wimpole Street, Oxford Street, the West End, and Marylebone, London.

I also offer online counselling sessions via the secure platform Zoom. Hybrid online and face-to-face counselling sessions are also available.

Angel Islington

Counselling Therapy Room

Holborn, High Holborn & Chancery Lane Counselling Therapy Room:

Oxford/Bond/Wimpole Street, Marylebone Counselling Room:

Fees & availability

  • Adult Individual Counselling and Psychotherapy: £90–£150 per therapeutic session (50 minutes)

  • Adult Individual Counselling and Psychotherapy: more than once per week: £75–£95 per therapeutic session (50 minutes)

  • Adult Couple Counselling and Psychotherapy/ Separation Therapy: £125–£175 per therapeutic session, depending on length

  • Other Relationships Counseling and Psychotherapy: £125–£175 per therapeutic session, depending on length

I am available for a free 15-minute conversation on the telephone for clients to discuss what they want out of therapy. Please ask about an in-person full assessment session if you prefer—in Angel Islington, Holborn, Bond Street, Wimpole Street, Oxford Street, the West End, and Marylebone.

Books of Interest

  • Christiane Sanderson - Counselling Adult Survivors of Child Sexual Abuse
  • The Origins of Psychoanalysis: Freud, Ferenczi and the Challenge of Thought, Maria Pierri 
  • Object relations & relationality in couple therapy - James L. Poulton
  • Mentalizing in Psychotherapy - Carla Sharp; Dickton Bevington; Peter Fonagy
  • Psychoanalytic Ideas series - Vol 1, Psychosis (Madness) & Vol 2, Perinatal Loss & Breakdown
  • Mother, Madonna, Whore, Estela Welldon
  • Ward Is it Ever Just Sex? - Darian Leader
  • Early Development and its Disturbances, Canestri, Leuzinger-Bohleber, Target.
  • Psychoanalytic theories: perspectives from developmental psychopathology - Peter Fonagy & Mary Target
  • Games People Play - Eric Berne (Transactional Analysis)
  • Playing with Dynamite, Estela Welldon
  • Mad, Bad and Sad - Lisa Appignanesi
  • The Unconscious at Work - Anton Obholzer
  • Thinking Space: Thinking About Race, Culture and Diversity in Psychotherapy and Beyond - Tavistock Clinic - Frank Lowe
  • Dreams That Turn Over a Page: Paradoxical Dreams in Psychoanalysis - Jean-Mitchel Quinodoz
  • Mapping the field of psychoanalytic psychosocial practice - Laurnece Spurling
  • Michael Balint and his World: The Budapest Years - ed. Judit Szekacs-Weisz, Raluca Soreanu and Ivan Ward
  • From Breakdown to Breakthrough: Psychoanalytic Treatment of Psychosis - Danielle Knafo and Michael Selzer
  • Christiane Sanderson - Counselling Skills for Working with Trauma and Shame

Some of the words that people seeking therapy search for

  • Anxiety
  • Depression
  • Low self-esteem
  • Family issues
  • Trauma
  • Low self-confidence
  • Bereavement
  • Couples counselling
  • Stress
  • Feeling sad
  • Obsessive compulsive disorder (OCD)
  • Post-traumatic stress disorder (PTSD)
  • Addiction(s)
  • Loneliness
  • Anger management
  • Social anxiety
  • LGBTQ+ counselling
  • Suicidal thoughts
  • Neurodiversity
  • Abuse
  • Eating disorders
  • Disorderly eating
  • Panic attacks
  • Integrative
  • Sex problems
  • Emotional abuse
  • Psychodynamic therapy
  • Self-harm
  • Generalised anxiety disorder (GAD)
  • Perfectionism
  • Dissociation
  • Career Counselling
  • Sexual abuse
  • Psychoanalytical and psychodynamic
  • Separation therapy
  • Divorce divorce
  • Psychoanalytic therapy
  • Sexual assault
  • Behaviour problems
  • Cognitive and behavioural therapies
  • Affairs and betrayals
  • Work-related stress
  • Health anxiety
  • Marylebone Therapy

Ask about DIT - which is a short term psychodynamic therapy.


Dynamic Interpersonal Therapy (DIT) is a brief, structured psychodynamic psychotherapy developed to treat depression and anxiety disorders. Alessandra Lemma, along with her colleagues, played a pivotal role in the conceptualization and dissemination of DIT. This therapy emphasizes the role of interpersonal relationships and aims to help individuals understand and alter problematic patterns in their interactions with others. DIT has gained prominence for its effectiveness in addressing complex psychological issues within a relatively short timeframe, making it a valuable tool in contemporary psychotherapy.

Historical Background of DIT

The origins of DIT can be traced back to the rich tradition of psychodynamic therapy, which has its roots in the work of Sigmund Freud. Over the years, psychodynamic therapy has evolved, incorporating insights from various theorists and adapting to new clinical needs. DIT emerged as part of this evolution, with a specific focus on interpersonal relationships. The development of DIT was influenced by attachment theory, object relations theory, and interpersonal psychoanalysis, among others. Unlike traditional long-term psychodynamic therapy, DIT is designed to be brief, typically lasting 16 sessions, making it more accessible and cost-effective for a broader range of clients.

Core Principles of DIT

At the heart of DIT is the belief that understanding and altering interpersonal relationships can lead to significant improvements in psychological well-being. One of the core principles of DIT is the focus on the unconscious processes that influence these relationships. Therapists work with clients to uncover recurring patterns in their interactions, often rooted in early attachment experiences. Transference and countertransference play crucial roles in this process, as the therapeutic relationship itself becomes a space where these patterns can be observed and understood. By bringing these unconscious processes into awareness, clients can begin to make conscious choices about their relationships and behaviours.

DIT Framework and Structure

DIT is structured into three main phases: the initial assessment and formulation, the middle phase of working through interpersonal patterns, and the ending phase of consolidation and termination. The therapy typically spans 16 sessions, providing a clear timeline for both therapist and client.

  1. Initial Assessment and Formulation: During the first few sessions, the therapist conducts a thorough assessment to understand the client's presenting issues, interpersonal history, and current relationships. This phase culminates in a psychodynamic formulation that identifies the central unconscious conflict driving the client's symptoms.
  2. Middle Phase: The bulk of the therapy is spent working through the identified interpersonal patterns. The therapist and client explore how these patterns manifest in the client's life and relationships, including the therapeutic relationship itself. This phase involves a deep exploration of the client's past experiences and their impact on current behaviors and emotions.
  3. Ending Phase: As therapy approaches its conclusion, the focus shifts to consolidating the insights gained and planning for the future. The therapist helps the client develop strategies for maintaining progress and managing potential challenges. The termination of therapy is also an opportunity to address any feelings of loss or separation that may arise.

Techniques and Interventions in DIT

DIT employs a range of therapeutic techniques to help clients identify and alter problematic interpersonal patterns. Key techniques include the use of the therapeutic relationship as a tool for understanding and change, exploration of transference and countertransference, and interpretation of unconscious processes. Therapists may also use techniques such as clarification, confrontation, and linking past experiences to present behaviors. These interventions are aimed at fostering insight and promoting change within the client's interpersonal world.

Case Formulation in DIT

A cornerstone of DIT is the development of a psychodynamic case formulation, which serves as a roadmap for the therapy. This formulation identifies the central unconscious conflict, linking it to the client's symptoms and interpersonal patterns. The formulation process involves gathering detailed information about the client's early experiences, attachment relationships, and significant life events. This information is then synthesized into a coherent narrative that guides the therapeutic work. The formulation is revisited and refined throughout the therapy, ensuring that it remains relevant and helpful.

Effectiveness and Evidence Base

Numerous studies have demonstrated the effectiveness of DIT in treating depression and anxiety disorders. Research has shown that DIT can lead to significant improvements in symptoms, with effects often maintained after the conclusion of therapy. Comparative studies have also indicated that DIT is as effective as other established psychotherapies, such as cognitive-behavioral therapy (CBT). The evidence base for DIT continues to grow, with ongoing research exploring its application to different populations and settings.

Applications of DIT

DIT has been successfully applied in a variety of clinical settings, including primary care, outpatient clinics, and private practice. It has been adapted for use with different mental health conditions, such as personality disorders and complex trauma. The flexibility of the DIT model allows it to be tailored to the specific needs of individual clients, making it a versatile tool in the therapist's repertoire. DIT is particularly well-suited for clients who benefit from a structured, time-limited approach, and it can be integrated with other therapeutic modalities as needed.

Challenges and Criticisms

While DIT has many strengths, it also faces certain challenges and criticisms. One common challenge is the limited timeframe, which may not be sufficient for clients with deeply entrenched issues or severe psychopathology. Additionally, some critics argue that DIT's focus on interpersonal relationships may overlook other important aspects of a client's experience, such as intrapsychic conflicts or socio-cultural factors. Despite these challenges, DIT continues to evolve, with ongoing efforts to refine its methods and expand its applicability. I offer a 32 week model, too.


Dynamic Interpersonal Therapy (DIT), represents a significant advancement in the field of psychodynamic therapy. By focusing on the interpersonal dimensions of psychological distress, DIT offers a powerful framework for understanding and addressing the complex interplay between relationships and mental health. Its structured, time-limited approach makes it an accessible and effective option for many clients, while ongoing research and clinical innovation continue to enhance its impact and relevance. As the field of psychotherapy progresses, DIT remains a vital and evolving component of contemporary therapeutic practice.

Ask about: GABOR MATE

Gabor Maté, a renowned physician and author, has made significant contributions to our understanding of addiction, trauma, and the mind-body connection. His work, deeply rooted in his experiences as a medical doctor and his insights into human psychology, has influenced a wide range of therapeutic practices. This article delves into the intricacies of Gabor Maté's modality, exploring his unique approach to healing and the profound impact of his theories on modern healthcare.

Maté’s approach is not just about treating symptoms but understanding the underlying causes of physical and mental health issues. By emphasizing the importance of trauma and the mind-body connection, he offers a holistic perspective that challenges traditional medical practices. His work has sparked both admiration and debate within the medical community, making it a critical area of study for anyone interested in comprehensive healthcare approaches.

Background and Philosophy

Early Life and Influences

Gabor Maté was born in Budapest, Hungary, in 1944, during the final months of World War II. His early life was marked by significant trauma; his family was Jewish and suffered under the Nazi occupation. This experience of early trauma has profoundly influenced his work. Maté emigrated to Canada in 1957 and later pursued a career in medicine, specializing in family practice and palliative care.

Development of His Ideas

Maté's experiences as a physician in Vancouver's Downtown Eastside, a neighborhood plagued by addiction and poverty, provided him with unique insights into the lives of his patients. He observed a strong link between childhood trauma and adult addiction, prompting him to explore this connection more deeply. Through his work, Maté developed a keen interest in the psychological roots of physical and mental illnesses, leading him to question conventional medical practices that often overlook these aspects.

Core Principles of His Approach

At the heart of Gabor Maté's modality are several core principles:

  1. Trauma's Long-Term Impact: Maté emphasizes that early childhood trauma can have lasting effects on an individual's physical and mental health. He argues that many chronic illnesses and addictions can be traced back to unresolved childhood trauma.
  2. Mind-Body Connection: Maté believes that the mind and body are inseparable and that psychological factors can significantly influence physical health. This perspective is often overlooked in conventional medicine, which tends to treat the mind and body as separate entities.
  3. Addiction as a Coping Mechanism: According to Maté, addiction is not a choice or a disease but a coping mechanism developed in response to pain and trauma. He suggests that to treat addiction effectively, one must address the underlying emotional wounds.
  4. Empathy and Compassion: Maté advocates for an empathetic and compassionate approach to healing. He believes that understanding and addressing the emotional needs of patients is crucial for their recovery.

Key Concepts in Gabor Maté's Modality

Trauma and Its Impact on Health

Gabor Maté's work centers on the idea that trauma, especially when experienced in childhood, has profound and lasting effects on an individual's health. Trauma, as defined by Maté, is not just a significant catastrophic event but any experience that overwhelms an individual’s ability to cope. This broad definition includes a wide range of experiences, from neglect and emotional abuse to more overt forms of physical abuse and violence.

Maté explains that trauma disrupts the normal development of the brain and nervous system, leading to various psychological and physiological issues. These disruptions can manifest as anxiety, depression, autoimmune diseases, and other chronic conditions. By understanding the role of trauma, healthcare providers can develop more effective treatment plans that address the root causes of these conditions.

The Mind-Body Connection

One of the most significant aspects of Maté's modality is his emphasis on the mind-body connection. He argues that emotions and psychological states are deeply intertwined with physical health. This perspective challenges the traditional biomedical model, which often treats physical and mental health issues separately.

Maté provides numerous examples of how stress and emotional turmoil can lead to physical ailments. For instance, chronic stress can suppress the immune system, making an individual more susceptible to illnesses. Similarly, unresolved emotional pain can manifest as chronic pain or other physical symptoms. By addressing these emotional and psychological factors, healthcare providers can help patients achieve better overall health.

Addiction and Its Roots in Childhood Trauma

Maté's views on addiction are perhaps the most well-known and controversial aspect of his work. He argues that addiction is not a disease or a moral failing but a coping mechanism developed in response to pain and trauma. This perspective shifts the focus from treating the symptoms of addiction to addressing the underlying causes.

According to Maté, many individuals who struggle with addiction have experienced significant trauma in their lives, particularly in childhood. This trauma leads to a disconnection from the self and a need to seek external sources of comfort and relief. Substances such as drugs and alcohol provide temporary relief from this pain, leading to addiction.

To effectively treat addiction, Maté advocates for a compassionate and empathetic approach that seeks to heal the underlying emotional wounds. This involves creating a safe and supportive environment where individuals can explore and address their trauma.

The Importance of Empathy and Compassion in Healing

Empathy and compassion are central to Maté's approach to healing. He believes that understanding and addressing the emotional needs of patients is crucial for their recovery. This involves creating a therapeutic environment where patients feel safe, understood, and supported.

Maté argues that traditional medical practices often lack this empathetic approach, leading to a disconnect between healthcare providers and patients. By fostering a compassionate and empathetic relationship, healthcare providers can help patients feel more comfortable and open, which is essential for effective healing.

Applications of Gabor Maté's Modality

Clinical Applications in Therapy

Gabor Maté's principles have been integrated into various therapeutic practices, particularly those focused on trauma and addiction. Therapists who adopt Maté's approach prioritize understanding the patient's life history and emotional experiences, recognizing the impact of trauma on their current behavior and health.

Therapies such as trauma-focused cognitive-behavioral therapy (CBT) and eye movement desensitization and reprocessing (EMDR) align well with Maté's emphasis on addressing the roots of trauma. These therapies aim to help individuals process and integrate traumatic experiences, reducing their impact on present-day functioning.

Moreover, therapists adopting Maté's approach often incorporate mindfulness and somatic experiencing techniques to help patients reconnect with their bodies and emotions. By fostering a holistic understanding of their experiences, patients can develop healthier coping mechanisms and improve their overall well-being.

Applications in Addiction Treatment

Maté's insights into the roots of addiction have significantly influenced addiction treatment programs. Many treatment centers now incorporate trauma-informed care, recognizing the importance of addressing underlying emotional wounds to facilitate recovery. This approach contrasts with traditional models that often focus solely on abstinence and symptom management.

Programs that adopt Maté's principles emphasize creating a safe and supportive environment for individuals in recovery. This involves building trusting relationships, fostering empathy and compassion, and providing opportunities for individuals to explore and heal their trauma.

Additionally, these programs often incorporate a range of therapeutic modalities, including individual therapy, group therapy, and holistic practices such as yoga and meditation. By addressing the physical, emotional, and psychological aspects of addiction, these programs aim to provide comprehensive support for individuals on their recovery journey.

Impact on General Healthcare Practices

Beyond therapy and addiction treatment, Maté's ideas have broader implications for general healthcare practices. His emphasis on the mind-body connection encourages healthcare providers to adopt a more holistic approach to patient care. This involves recognizing the interplay between emotional and physical health and considering the patient's life history and experiences when developing treatment plans.

For example, primary care physicians may incorporate questions about stress, trauma, and emotional well-being into their assessments. By understanding the broader context of a patient's life, healthcare providers can develop more personalized and effective treatment plans.

Additionally, Maté's principles have influenced the integration of complementary and alternative medicine (CAM) practices into mainstream healthcare. Practices such as acupuncture, massage therapy, and mindfulness-based stress reduction (MBSR) align well with Maté's holistic approach and are increasingly recognized for their potential to enhance overall health and well-being.

Case Studies and Examples

To illustrate the application of Maté's modality, consider the following case studies and examples:

  1. Case Study 1: Childhood Trauma and Chronic Illness
  • A patient with a history of childhood abuse presents with chronic pain and autoimmune disease. By exploring the patient's trauma history and incorporating trauma-focused therapy, the healthcare provider helps the patient process their emotional pain, leading to significant improvements in their physical symptoms.
  1. Case Study 2: Addiction and Trauma-Informed Care
  • An individual struggling with addiction enters a treatment program that adopts Maté's principles. Through individual and group therapy, mindfulness practices, and a supportive environment, the individual addresses their underlying trauma and develops healthier coping mechanisms, leading to sustained recovery.
  1. Case Study 3: Holistic Primary Care
  • A primary care physician integrates Maté's approach into their practice, asking patients about their emotional well-being and life experiences during routine assessments. This holistic approach helps the physician identify underlying stressors and trauma, leading to more personalized and effective treatment plans.

Criticisms and Controversies

Despite the widespread influence of Gabor Maté's work, it has not been without criticism and controversy. Some critics argue that Maté's emphasis on trauma and the mind-body connection lacks sufficient empirical evidence. They contend that while his theories are compelling, more rigorous scientific research is needed to validate his claims.

Additionally, Maté's views on addiction have sparked debate. Critics argue that his perspective may downplay the role of biological and genetic factors in addiction. They also express concern that focusing too heavily on trauma may lead to an overemphasis on past experiences at the expense of addressing present-day behaviors and challenges.

Maté has responded to these criticisms by emphasizing the need for a holistic and integrative approach to healthcare. He acknowledges the importance of empirical research while advocating for a broader understanding of health that includes psychological, emotional, and social factors.


Gabor Maté's modality offers a transformative approach to understanding and addressing physical and mental health. By emphasizing the impact of trauma, the mind-body connection, and the importance of empathy and compassion, Maté challenges traditional medical practices and offers a holistic perspective on healing.

His work has had a profound impact on therapeutic practices, addiction treatment, and general healthcare, inspiring a more comprehensive and empathetic approach to patient care. While his ideas continue to spark debate and require further empirical validation, Maté's contributions have undoubtedly enriched our understanding of health and wellness.

As the healthcare field continues to evolve, Gabor Maté's modality serves as a reminder of the importance of addressing the whole person—mind, body, and spirit. By integrating these principles into our practices, we can foster more effective and compassionate care, ultimately leading to better health outcomes for all.

Ask about EMDR Therapy


Eye Movement Desensitization and Reprocessing (EMDR) therapy is a structured therapeutic approach that has gained widespread recognition for its effectiveness in treating trauma and other distressing life experiences. Developed by Francine Shapiro in the late 1980s, EMDR integrates elements of cognitive-behavioral therapy (CBT) with bilateral sensory input, primarily in the form of eye movements, to facilitate the processing and integration of traumatic memories. This innovative approach has shown significant promise, particularly for individuals suffering from post-traumatic stress disorder (PTSD), anxiety, depression, and a range of other psychological conditions.

The foundational principle of EMDR is based on the concept that unprocessed traumatic memories can cause ongoing psychological distress. EMDR aims to help patients process these memories in a way that reduces their negative impact, enabling individuals to integrate these experiences into their broader cognitive framework. This process involves the patient recalling distressing memories while simultaneously undergoing bilateral sensory input, which is believed to facilitate adaptive information processing.

EMDR's growing popularity in modern psychotherapy is attributed to its robust evidence base and its applicability to a wide range of psychological conditions. Numerous clinical trials and studies have demonstrated its efficacy, leading to endorsements from major health organizations such as the World Health Organization (WHO) and the American Psychological Association (APA). As a result, EMDR has become an integral part of therapeutic practice, offering hope and healing to countless individuals affected by trauma.

History and Development

Origins and Evolution

EMDR therapy was discovered by Francine Shapiro, an American psychologist, in 1987. The discovery was somewhat serendipitous; Shapiro noticed that her own distressing thoughts diminished when her eyes moved rapidly from side to side. Intrigued by this phenomenon, she conducted a controlled study with trauma survivors, which provided preliminary evidence that directed eye movements could indeed reduce the emotional charge of traumatic memories. This initial study, published in the Journal of Traumatic Stress in 1989, laid the groundwork for further research and development of EMDR as a therapeutic modality.

Following its discovery, EMDR underwent extensive validation and refinement. Early research focused on understanding the mechanisms underlying its effectiveness and establishing standardized protocols. In 1991, Shapiro published a comprehensive book, "Eye Movement Desensitization and Reprocessing: Basic Principles, Protocols, and Procedures," which detailed the theoretical foundations and practical applications of EMDR. This work was instrumental in garnering interest and acceptance within the psychological community.

Over the years, EMDR has evolved into a sophisticated therapeutic approach, incorporating a structured eight-phase protocol. These phases guide therapists in systematically addressing the patient's distressing memories, ensuring a comprehensive and effective treatment process. The development of these protocols was informed by ongoing research and clinical practice, with contributions from a diverse range of practitioners and researchers.

The early 1990s saw the establishment of the EMDR International Association (EMDRIA), which aimed to promote research, education, and clinical practice of EMDR therapy. This organization has played a crucial role in advancing the field, providing training and certification for therapists, and fostering a global community of EMDR practitioners.

Theoretical Foundations

Psychological and Neurobiological Basis

The theoretical foundations of EMDR therapy are multifaceted, integrating concepts from various psychological theories and neurobiological research. One of the central tenets of EMDR is the Adaptive Information Processing (AIP) model, which posits that psychological distress arises from the inadequate processing of traumatic memories. According to this model, when a traumatic event occurs, the information related to that event may be inadequately processed, leading to the storage of maladaptive thoughts, emotions, and sensory impressions.

The AIP model suggests that these unprocessed memories can cause ongoing psychological distress and maladaptive behaviors. EMDR therapy aims to activate the brain's inherent information processing system to facilitate the integration and resolution of these memories. By doing so, the therapy helps individuals reprocess traumatic experiences in a way that reduces their emotional impact and promotes adaptive functioning.

Neurobiological research provides additional insights into the mechanisms underlying EMDR's effectiveness. Studies have shown that bilateral stimulation, such as eye movements, can influence the brain's information processing pathways. Functional MRI studies have demonstrated changes in brain activity during EMDR sessions, particularly in areas associated with memory processing and emotional regulation, such as the amygdala and prefrontal cortex. These findings suggest that EMDR may facilitate the reconsolidation of traumatic memories, allowing them to be stored in a less distressing form.

EMDR also draws on concepts from other psychological theories, including cognitive-behavioral therapy (CBT) and psychodynamic therapy. For instance, EMDR incorporates elements of exposure therapy, where patients are encouraged to recall distressing memories, and cognitive restructuring, where maladaptive beliefs are challenged and reframed. This integrative approach enhances the therapy's effectiveness by addressing both the cognitive and emotional aspects of trauma.

Eye Movement and Bilateral Stimulation

The use of bilateral stimulation, particularly eye movements, is a hallmark of EMDR therapy. While the exact mechanism of action remains a subject of ongoing research, several hypotheses have been proposed to explain how bilateral stimulation facilitates therapeutic change.

One hypothesis is that eye movements mimic the natural processes that occur during rapid eye movement (REM) sleep, a stage of sleep associated with memory consolidation and emotional processing. During REM sleep, the brain processes and integrates emotional experiences, which may help explain why eye movements during EMDR can facilitate the processing of traumatic memories.

Another hypothesis suggests that bilateral stimulation may enhance communication between the brain's hemispheres, promoting more efficient information processing. This interhemispheric communication is thought to help integrate fragmented and distressing memories into a coherent and adaptive narrative.

Additionally, bilateral stimulation may induce a state of relaxation and reduce physiological arousal, making it easier for patients to engage with and process distressing memories. This effect is consistent with the broader principles of exposure therapy, where a state of reduced arousal can enhance the therapeutic benefits of recalling traumatic experiences.

EMDR Therapy Process

Eight Phases of EMDR Therapy

EMDR therapy is structured into eight distinct phases, each of which plays a crucial role in the therapeutic process. These phases are designed to ensure a comprehensive and systematic approach to addressing traumatic memories and facilitating healing.

Phase 1: History-taking

The initial phase involves gathering detailed information about the patient's history and identifying the specific memories and issues to be addressed during therapy. This phase is crucial for developing a comprehensive treatment plan and establishing a strong therapeutic alliance.

Phase 2: Preparation

In this phase, the therapist prepares the patient for the EMDR process by explaining the therapy's principles and techniques. The therapist also teaches the patient various coping strategies, such as relaxation techniques and grounding exercises, to manage any distress that may arise during the therapy.

Phase 3: Assessment

During the assessment phase, the therapist and patient identify specific target memories for reprocessing. The therapist assesses the emotional and sensory components of these memories, including associated beliefs and physical sensations. This information is used to develop a detailed treatment plan.

Phase 4: Desensitization

The desensitization phase involves the patient recalling the target memory while simultaneously undergoing bilateral stimulation, typically in the form of eye movements. The therapist guides the patient through this process, helping them to process the memory and reduce its emotional intensity. This phase continues until the memory no longer elicits significant distress.

Phase 5: Installation

In the installation phase, the therapist focuses on reinforcing positive beliefs and emotions associated with the processed memory. This involves identifying and strengthening adaptive beliefs that have emerged during the desensitization phase, promoting a more positive self-perception and outlook.

Phase 6: Body Scan

The body scan phase involves assessing and addressing any residual physical sensations associated with the processed memory. The therapist guides the patient in scanning their body for tension or discomfort, facilitating further processing and resolution of these sensations.

Phase 7: Closure

Closure is an important phase that ensures the patient feels stable and grounded at the end of each session. The therapist uses various techniques to help the patient return to a state of equilibrium, including relaxation exercises and reviewing coping strategies.

Phase 8: Reevaluation

The final phase involves reevaluating the patient's progress and the effectiveness of the therapy. The therapist assesses any remaining issues and determines whether further sessions are needed. This phase also includes planning for future therapy and ensuring the patient has the tools and strategies to maintain their progress.

Applications and Effectiveness

Clinical Applications

EMDR therapy has been extensively studied and validated for its effectiveness in treating a range of psychological conditions. While it is best known for its application in PTSD and trauma-related disorders, its utility extends to other mental health issues as well.

PTSD and Trauma-related Disorders

EMDR is particularly effective for individuals with PTSD, a condition characterized by intrusive memories, hyperarousal, and avoidance behaviors following exposure to traumatic events. Numerous clinical trials and meta-analyses have demonstrated that EMDR significantly reduces PTSD symptoms and enhances overall functioning.

Anxiety and Depression

Research has also shown that EMDR can be beneficial for treating anxiety and depression. By addressing underlying traumatic memories and maladaptive beliefs, EMDR helps reduce the severity of these conditions and promotes emotional regulation.

Other Psychological Conditions

EMDR has been applied to a variety of other psychological conditions, including phobias, panic disorders, and complex grief. Its versatility and adaptability make it a valuable tool in the therapeutic arsenal, capable of addressing a broad spectrum of emotional and psychological issues.

Evidence of Effectiveness

The effectiveness of EMDR therapy is supported by a substantial body of empirical evidence. Numerous studies have demonstrated its efficacy in reducing symptoms of PTSD and other trauma-related disorders. For instance, a meta-analysis published in the Journal of Clinical Psychology in 2013 found that EMDR was as effective as, or more effective than, other established trauma-focused therapies, such as cognitive-behavioral therapy (CBT).

Additionally, EMDR has been shown to produce rapid and sustained improvements in symptomatology. Patients often report significant reductions in distress and improvements in overall functioning after relatively few sessions. Long-term follow-up studies have indicated that the benefits of EMDR are maintained over time, suggesting durable therapeutic effects.

Comparative studies have also highlighted the unique advantages of EMDR. Unlike traditional exposure therapies, which can be emotionally taxing for patients, EMDR tends to be less distressing due to its use of bilateral stimulation. This feature makes EMDR particularly appealing for individuals who may be hesitant to engage in prolonged exposure to traumatic memories.

Challenges and Criticisms

Debates and Controversies

Despite its growing acceptance, EMDR therapy has not been without controversy. Some skeptics have questioned the necessity of bilateral stimulation, arguing that the therapeutic benefits of EMDR may be attributable to other factors, such as the structured nature of the therapy or the therapeutic alliance.

Critics have also raised concerns about the theoretical underpinnings of EMDR, suggesting that the mechanisms of action remain poorly understood. While neurobiological research provides some insights, the precise processes through which EMDR facilitates memory processing and integration continue to be a subject of debate.

Common misconceptions about EMDR further contribute to its contentious status. For example, some individuals mistakenly believe that EMDR is a form of hypnosis or that it involves erasing traumatic memories. In reality, EMDR aims to help patients process and integrate their memories, reducing their emotional impact and promoting adaptive functioning.

Addressing Critiques with Evidence

In response to these criticisms, proponents of EMDR point to the robust empirical evidence supporting its efficacy. Numerous randomized controlled trials (RCTs) and meta-analyses have demonstrated the effectiveness of EMDR in treating PTSD and other psychological conditions. Additionally, the therapy's structured protocols and standardized procedures ensure consistency and reliability in its application.

Efforts to elucidate the mechanisms of action are ongoing, with researchers exploring various hypotheses and conducting neurobiological studies. While further research is needed to fully understand how EMDR works, the existing evidence indicates that bilateral stimulation and other components of the therapy play a crucial role in facilitating therapeutic change.

Future Directions

Innovations and Future Research

As EMDR therapy continues to evolve, several emerging trends and innovations are shaping its future. Researchers are exploring new applications of EMDR beyond traditional trauma therapy, including its potential use in treating substance use disorders, chronic pain, and complex psychological conditions.

Technological advancements are also influencing the field, with the development of virtual reality (VR) and digital tools to enhance the delivery of EMDR. These innovations have the potential to increase accessibility and provide new avenues for therapeutic intervention.

Integration with other therapeutic modalities is another area of interest. Combining EMDR with approaches such as mindfulness-based therapies, dialectical behavior therapy (DBT), and psychodynamic therapy may enhance its effectiveness and broaden its applicability.

Ongoing research is crucial to further validate EMDR and address remaining questions about its mechanisms of action. Large-scale studies and longitudinal research will provide deeper insights into the long-term outcomes of EMDR and its potential for transforming mental health care.


Summary and Final Thoughts

EMDR therapy represents a significant advancement in the field of psychotherapy, offering a powerful and effective approach to treating trauma and a wide range of psychological conditions. Its structured protocols, robust evidence base, and growing acceptance within the psychological community underscore its importance in contemporary therapeutic practice.

By facilitating the processing and integration of traumatic memories, EMDR helps individuals reduce their distress, enhance their functioning, and improve their overall quality of life. As research continues to shed light on its mechanisms and expand its applications, EMDR holds the promise of further transforming the landscape of mental health care.

In summary, EMDR therapy is a valuable and versatile therapeutic tool that has brought hope and healing to countless individuals. Its ongoing development and integration into clinical practice will continue to enhance its impact, offering new possibilities for those seeking relief from the burdens of trauma and psychological distress.

Get in touch

Feel free to contact me if you have any questions about how counselling or psychotherapy works, or to arrange an initial assessment appointment. This enables us to discuss the reasons you are thinking of coming to counselling, whether it could be helpful for you and whether I am the right therapist to help.

You can also call me on 07549 165 155 if you would prefer to leave a message or speak to me first. I am happy to discuss any queries or questions you may have prior to arranging an initial appointment.

All enquires are usually answered within 24 hours, and all contact is strictly confidential and uses secure phone and email services.

© John Jeremiah Ahearne

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Angel Islington, Holborn, Bond Street, Wimpole Street, Oxford Street, the West End, and Marylebone.

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