Welcome to my blog series, where I will discuss therapy from a client's viewpoint. It's important to mention that, while my insights are drawn from extensive experience with clients from various backgrounds, all individuals, names, personas, businesses, locations, occurrences, and events depicted are entirely fictional. Any similarity to real-life individuals, living or deceased, or actual events is purely coincidental.
"Can you hear me?" "Yes, I can, it's good to meet you Sumaiya". So starts the first virtual session with Sumaiya, using a video platform to connect securely, confidentially, and conveniently. "I needed online therapy", she explained, "I work from home and it was the easiest way for me to carve out some time without having to factor in travel. Also, there was noone available locally and this feels safer".
Sumaiya had decided to reach out for online therapy after struggling with flashbacks and seemingly irrational emotional reactions to seemingly benign events in her daily life. Both are common in trauma survivors, and can leave people feeling overwhelmed and exhausted. "I find myself avoiding more and more places, just in case it happens. It feels like I'm back there, reliving it all, I feel sick, sweaty, and the feeling of panic is unbearable".
A few years previously Sumaiya had been on a night out with friends. As a teetotaller, she was designated driver, and after a meal and drinks, they had piled into her car to begin the journey home. But on the way there was an accident, and Sumaiya and her friends all sustained injuries. "We're fine, physically, now. But my mind keeps going back to that night. What could I have done differently? What did I do wrong? Then I think of how bad the outcome could have been and I can't stop crying. I can't be passenger in a car any more, and I can't drive at night. I've lost my confidence - not just driving. And the flashbacks are terrifying".
Flashbacks happen when the brain links an experience in the present (for example, a sight, sounds, smell, sound, or even a memory or emotion) with a traumatic memory of the past. The emotions from the past surge up involuntarily, and this can be so strong, it can feel as though the event is actually happening again. "It's not just in the car. It can happen when I'm walking down the road, or when it's cold and icy, or when I see my friends name flash up on my phone" Sumaiya's mind was linking the car accident with present triggers, causing her to react emotionally as if she was back at the time of the accident.
Luckily, trauma therapy can be carried out effectively online, including EMDR therapy, which is an effective form of trauma therapy. The therapeutic journey started with learning grounding and emotion regulation techniques, which helped Sumaiya shift her focus from the traumatic memory to the immediate environment. This included the 54321 technique and mindful breathing exercises to help her feel more in control of her emotions.
We could then move to using EMDR virtually, first to process the trauma memories so that that she could recall the events as they happened if she willed, but without the seemingly overwhelming and uncontrollable emotion, and also feel in control of putting them out of her mind. "It's like the volume has been turned down on the memories. I mean, they're not gone, but seem less intense, more just a thing that happened. And I know it wasn't my fault, and though it was horrible, we're all okay. Really, we are". From there, she could move onto processing current and future events which were acting as triggers for her. Sumaiya said "I already felt less anxious in day to day life. Our group chat didn't make me feel sick any more, and when my mum offered to drive me, I could go with it". As we moved through current and future potential events, Sumaiya's mind was able to let go of any remaining and unwanted anxiety. She kept a journal to identify any remaining anxiety that came up, and found herself feeling more confident even in unexpected scenarios: "I had a job interview - and I don't think I've ever felt as confident!". There is evidence that EMDR increases future resilience, leaving us feeling more able to manage future life challenges.
Many therapies, like EMDR, CBT and ACT, which are effective in processing trauma and reducing flashbacks, can also be used effectively online. Many clients, like Sumaiya, can find this convenient, flexible, and give a wider scope of choice amongst available therapists. If you would like to know more about therapy, virtual or in person, please do get in contact.
Please note that Sumaiya's story is entirely fictional, inspired by my years of working with adolescents and adults. The information about mental health, psychological therapy, and recovery from trauma is entirely based on current evidence-based knowledge and guidelines. Images are created using AI. If you would like more information or support please contact myself or any of the organisations listed on the Contact tab.
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