Trauma and EMDR Therapy
Trauma-focused psychological therapy and EMDR with Dr Monika Wieliczko, Chartered Clinical Psychologist, Weybridge, Surrey, South East London and online.
Trauma doesn't always begin with one catastrophic event.
Sometimes it is very clear that something has happened which has overwhelmed our ability to cope — an accident, assault, frightening medical experience, traumatic loss or another event that leaves us feeling different afterwards.
But trauma can also develop much more gradually.
It can come from growing up around unpredictability, criticism, emotional neglect, conflict, addiction or abuse. It can develop through relationships in which you repeatedly felt unsafe, rejected, controlled or responsible for somebody else's emotional needs.
And sometimes people come to therapy saying:
“Nothing terrible happened to me. I don't understand why I feel like this.”
Part of trauma therapy is making sense of what happened, how you learned to survive it, and why some of those responses may still be operating now — even when the original danger has passed.
I specialise in working with trauma, PTSD, complex and developmental trauma, relational trauma and the impact of difficult experiences on relationships.
My approach combines EMDR with relational, attachment-based and psychodynamic psychotherapy, allowing us to work not only with traumatic memories themselves, but with the wider patterns that may have developed around them.
Understanding Trauma
Trauma is not defined simply by how objectively frightening an event looks from the outside.
What matters is also what happened inside us when we experienced it.
When something overwhelms our ability to process what is happening, the brain and body can remain organised around the expectation of danger long after the event itself has ended.
For some people there is a clearly identifiable traumatic event.
This might include an accident, assault, traumatic birth, serious illness, sudden bereavement, medical treatment, violence or another frightening experience.
For others, there isn't one event to point to.
Instead, difficult experiences accumulated over months or years.
Perhaps home was unpredictable. A parent was frightening, emotionally unavailable or struggling with their own difficulties. You had to become independent too early. You learned to monitor other people's moods. Conflict felt dangerous. Your emotional needs weren't responded to consistently.
None of these experiences necessarily produces one dramatic traumatic memory.
But together they can shape how safe we feel in ourselves and with other people.
This distinction is important because trauma therapy isn't always about finding one memory and processing it.
Sometimes we need to understand an entire system of experiences and adaptations that developed over time.
PTSD and Trauma Symptoms
After a traumatic experience, the nervous system can continue responding as though danger is still present.
People may experience:
intrusive memories, images or nightmares
feeling as though an experience is happening again
anxiety or panic
hypervigilance or constantly scanning for danger
being easily startled
avoiding reminders of what happened
difficulties sleeping
physical tension or bodily sensations associated with the trauma
irritability or anger
emotional numbness or disconnection
difficulty concentrating
guilt or shame
These are commonly associated with post-traumatic stress disorder (PTSD).
But trauma doesn't always fit neatly into a diagnostic category.
Sometimes its effects are most visible in relationships, self-esteem, emotional regulation or the ways we respond when we feel rejected, criticised, trapped or abandoned.
Complex Trauma
Complex trauma usually refers to the effects of repeated or prolonged traumatic experiences, particularly when they occur within relationships or during important developmental periods.
Instead of experiencing only memories of something that happened, people may develop broader difficulties with how they experience themselves and other people.
You might find that you:
become overwhelmed very quickly
struggle to calm yourself once something has triggered you
disconnect or shut down
feel persistently ashamed or “not good enough”
find it difficult to trust people
fear being abandoned or rejected
become intensely self-reliant
struggle to recognise your own needs
feel responsible for other people's emotions
repeatedly find yourself in relationships that become painful
understand your patterns intellectually but still feel unable to change them
Many people with these difficulties are highly functioning in other areas of their lives.
They may have successful careers, friendships and families and still find that certain situations — particularly intimate relationships — activate responses that feel surprisingly powerful.
This is one reason complex trauma can remain unrecognised for a long time.
Relational and Developmental Trauma
Some of our earliest experiences teach us what to expect from relationships.
We learn whether other people are likely to respond when we need them. Whether expressing emotion brings comfort, criticism or withdrawal. Whether disagreement is safe. Whether we can depend on somebody without losing ourselves.
When important relationships are repeatedly frightening, unpredictable, rejecting or emotionally unavailable, we adapt.
A child may learn:
I need to keep everybody happy.
I shouldn't need anybody.
If somebody pulls away, I need to get them back.
My feelings are too much.
Conflict means the relationship is in danger.
These aren't conscious decisions.
They are ways of maintaining safety and connection.
The difficulty is that strategies developed in one environment can continue operating in completely different relationships many years later.
You may desperately want closeness but become frightened when somebody gets too close. You may fear abandonment while simultaneously choosing emotionally unavailable partners. You may shut down during conflict or become overwhelmed by the possibility that somebody is withdrawing.
This is what I mean when I talk about relational or developmental trauma.
Therapy involves understanding these patterns without reducing everything about you to what happened in childhood.
The question becomes not only “What happened to me?”, but also:
“What did I have to learn in order to cope — and do I still need to live that way now?”
What is EMDR?
EMDR — Eye Movement Desensitisation and Reprocessing — is an evidence-based psychological therapy used in the treatment of trauma and PTSD.
During overwhelming experiences, memories can sometimes remain insufficiently processed.
This can mean that something which objectively happened years ago continues to trigger powerful emotions, images, thoughts or physical sensations in the present.
EMDR aims to help the brain process these experiences so that they become integrated as memories of something that happened then, rather than experiences the nervous system continues to respond to as though they are happening now.
One of the distinctive features of EMDR is the use of bilateral stimulation.
This often involves following the therapist's fingers from side to side with your eyes. Other forms of alternating bilateral stimulation may also be used.
You remain awake, aware and in control throughout the process.
EMDR does not erase memories or make you forget what happened.
The aim is for the experience to become less emotionally and physically overwhelming when you remember it.
How Does EMDR Work?
EMDR therapy begins well before any eye movements take place.
We first spend time understanding what has brought you to therapy, your history, current difficulties and the experiences that may be connected to them.
We also consider how you currently manage difficult emotions and what helps you feel grounded and safe.
When we begin processing a traumatic memory, you may be asked to notice different aspects of the experience — for example an image, emotion, physical sensation or belief about yourself.
I then guide you through short sets of bilateral stimulation, commonly by asking you to follow my fingers with your eyes.
Rather than repeatedly describing the traumatic event in detail, you are encouraged to notice what comes up as the brain begins making connections.
Memories, thoughts, emotions and physical sensations may change during this process.
Over time, the original memory can become less disturbing and beliefs that developed around the trauma — such as “I am powerless,” “I am unsafe,” or “It was my fault” — may begin to shift.
EMDR for Complex Trauma
EMDR can also be used when trauma is complex or developmental, but the work can look different.
If your difficulties developed through many experiences over many years, there may not be one obvious traumatic memory to target.
There may instead be networks of experiences connected to rejection, humiliation, fear, abandonment, criticism or emotional neglect.
We therefore need to understand which experiences are connected and what patterns they have created.
Sometimes we spend more time initially developing emotional regulation, identifying resources and strengthening your ability to remain present when difficult material emerges.
EMDR processing may then take place gradually alongside relational psychotherapy.
This is particularly important because moving too quickly into traumatic material is not necessarily therapeutic.
The aim isn't to see how much distress you can tolerate.
It is to work at a pace that allows traumatic experiences to be processed without repeatedly overwhelming you.
People sometimes contact me specifically asking for EMDR because they have heard that it can work quickly.
Why EMDR Isn't Always the Whole Therapy?
For some relatively circumscribed traumatic experiences, EMDR can indeed be focused and comparatively brief.
But EMDR is not always the whole answer.
If somebody has experienced relational or developmental trauma, the difficulties may not exist only within traumatic memories.
They may also exist in the way that person relates to themselves and other people.
Perhaps you struggle to trust.
Perhaps asking for help feels dangerous.
Perhaps you automatically take care of everybody else.
Perhaps you disconnect when somebody gets emotionally close.
Or perhaps you become overwhelmed when you sense somebody pulling away.
Processing individual memories can be important, but these patterns also need to be understood within relationships.
This is why I integrate EMDR within a broader psychological formulation rather than assuming that everybody who has experienced trauma needs exactly the same treatment.
My Relational and Attachment-Based Approach
My background is in Clinical Psychology and relational psychotherapy, and this shapes how I use EMDR.
I am interested in understanding symptoms within the context of the person experiencing them.
Rather than asking only:
“How do we get rid of this symptom?”
I also want to understand:
Why might this response have developed?
What was it protecting you from?
When does it appear?
What happens in your relationships when you feel threatened or vulnerable?
What do you expect from other people when you need them?
Sometimes the very strategies people dislike most about themselves were once remarkably effective ways of surviving difficult environments.
Therapy isn't about stripping those defences away.
It is about understanding why they developed and gradually creating enough safety and flexibility that they are no longer your only available response.
Depending on what you need, my work draws on EMDR, attachment theory, relational and psychodynamic psychotherapy and trauma-informed psychological approaches.
What Happens When You Start Trauma Therapy?
You don't need to arrive knowing whether you have PTSD, complex trauma, relational trauma or anything else.
And you don't need to decide beforehand whether EMDR is the right treatment for you.
We start by talking.
Our initial sessions give us an opportunity to understand what is happening now, what has brought you to therapy and the experiences that may have contributed to your current difficulties.
We think about what you would like to change and begin developing a shared understanding — or psychological formulation — of what may be happening.
From there, we can decide together how to approach the work.
For some people EMDR becomes a central part of therapy relatively quickly.
For others, we spend more time establishing safety, understanding relationship patterns and developing ways of managing overwhelming emotions before beginning trauma processing.
And sometimes, having considered everything together, another form of psychological therapy makes more sense.
Trauma Therapy in Weybridge, Surrey, South East London & Online
I offer trauma-focused psychological therapy and EMDR to adults in Weybridge, Surrey, South East London and online.
My work includes people experiencing PTSD, complex trauma, developmental and relational trauma, traumatic bereavement and difficulties in relationships connected to earlier experiences.
My Surrey practice serves people from Weybridge and surrounding areas including Cobham, Esher, Walton-on-Thames, Addlestone and Chertsey.
I also work with clients from Beckenham, Bromley, Crystal Palace, Penge and surrounding areas of South East London.
Online EMDR and psychological therapy are also available where clinically appropriate.
Trauma Therapy & EMDR in Weybridge and Surrey →
Book an Initial Consultation →
Frequently Asked Questions About Trauma & EMDR
How do I know if what happened to me was trauma?
You don't need to decide whether your experiences qualify as “traumatic” before coming to therapy.
Sometimes people minimise what happened because other people appeared to have experienced something worse, or because there wasn't one dramatic event.
What matters is how your experiences affected you and whether they continue to influence your emotions, relationships or sense of safety now.
We can think about that together.
Is EMDR only for PTSD?
No. EMDR is particularly well established as a treatment for PTSD, but it can also be incorporated into psychological therapy where distressing past experiences contribute to current difficulties.
Whether EMDR is appropriate depends on the individual and is something we consider as part of the assessment and formulation.
Can EMDR help with childhood or relational trauma?
It can.
When difficulties have developed through repeated childhood or relational experiences, however, EMDR often needs to be used differently from treatment for a single traumatic event.
There may be several interconnected memories and relationship patterns to work with, and preparation and stabilisation may form a more substantial part of therapy.
Will I have to tell you everything that happened?
Not necessarily.
EMDR does not require you to describe every detail of a traumatic experience aloud.
I do, however, need enough understanding of your experiences and current difficulties to work with you safely and develop an appropriate treatment plan.
Do I have to relive my trauma during EMDR?
EMDR involves bringing aspects of traumatic memories into awareness, so difficult emotions or physical sensations can arise during processing.
However, you remain in the therapy room, aware of the present and in control. We work carefully with your ability to move between the memory and the safety of the present rather than simply asking you to relive what happened.
How many EMDR sessions will I need?
There isn't one standard number.
A single traumatic event may require a relatively focused piece of work. Complex or developmental trauma often involves a longer process because there may be multiple experiences, relationship patterns and current difficulties that need attention.
I would rather develop an individual formulation with you than promise a predetermined number of sessions.
Can EMDR be done online?
Yes. EMDR can be delivered online where it is clinically appropriate.
We would discuss your circumstances, privacy, emotional safety and how bilateral stimulation will be used before deciding whether online EMDR is suitable for you.
What is the difference between trauma therapy and EMDR?
EMDR is a particular psychological treatment that can form part of trauma therapy.
Trauma therapy is broader. It may involve understanding traumatic experiences, regulating difficult emotional and physiological responses, exploring relationship patterns and processing memories.
In my practice, EMDR sits within this wider psychological understanding rather than being offered as an isolated technique.
Do you work with complex PTSD?
I work with people experiencing complex and developmental trauma as well as PTSD.
Because complex trauma can affect emotional regulation, relationships and a person's sense of themselves as well as traumatic memories, the therapy often integrates EMDR with relational and attachment-based psychological work.
Starting Therapy
If you are considering trauma therapy or EMDR, an initial consultation gives us an opportunity to understand what has brought you to therapy and whether my approach is likely to be appropriate for you.
You do not need to know what type of therapy you need before getting in touch.
Dr Monika Wieliczko
Chartered Clinical Psychologist
Trauma · PTSD · Complex & Relational Trauma · EMDR
Weybridge, Surrey · South East London · Online
