Group online EMDR for breastfeeding trauma recovery

Student thesis: Doctoral Thesis


This research explored the phenomena of breastfeeding trauma and sought to assess the feasibility and acceptability of an online group psychotherapy intervention using Eye Movement Desensitisation and Reprocessing Therapy (EMDR/GTEP). Women who have a negative breastfeeding experience often describe how the impact of the memories have a lasting effect on their mental health. They describe feeling guilt and shame and often associate their experience with a sense of failure as a mother.

The aim of this research was to explore the feasibility and acceptability of an online group EMDR (G-TEP protocol) intervention incorporating a social media component for reducing breastfeeding trauma.

The research design was quasi-experimental using mixed methods with sequential phases. Phase one involved a systematic review to assess the effectiveness of online psychotherapy interventions for the treatment of perinatal mental health disorders. Phase two consisted of a cross-sectional survey to test the psychometric properties of the Existential Breastfeeding Difficulties Scale (ExBreastS), in women who had ever breastfed, as an instrument to screen for Breastfeeding Post Traumatic Stress Disorder (BF-PTSD). Phases three and four encompassed an explanatory sequential design to explore the feasibility and acceptability of the online EMDR intervention. This involved the design and implementation of an online EMDR Group Traumatic Episode Protocol (G-TEP) intervention with a social media component for breastfeeding trauma recovery and a qualitative focus group to explore participant’s experience of the intervention. Social Cognitive Theory was the theoretical framework underpinning the research.

The results of the systematic review demonstrated that online psychotherapy interventions for the treatment of perinatal depression and anxiety were effective in reducing symptomatology. The findings highlighted gaps in the current literature for interventions for other perinatal mental health disorders and interventions utilising online EMDR therapy in the perinatal period. The
results of the psychometric testing of the ExBreastS demonstrated the presence of BF-PTSD in 7% of the sample which consisted of 1074 women and the analysis supported the use of ExBreastS as a valid and reliable instrument for screening for BF-PTSD (AUC = 0.79 (95% CI0.74 – 0.85). The online feasibility study included five participants and demonstrated the potential of the EMDR/G-TEP intervention in reducing BF-PTSD and subjective distress (up to a 32% reduction in BF-PTSD scores). Furthermore, the intervention saw increases in breastfeeding self-efficacy (up to 62% increase in breastfeeding self-efficacy scores) and evidence of positive breastfeeding behavioural change. All study participants remained in the study for the duration with no attrition. Findings from the participant evaluation revealed the participant’s found the intervention to be helpful in aiding them to heal from their trauma and highlighted the acceptability of the online intervention. The social media, peer-support-group was found to be a helpful way to communicate with the research team. However, participants described a lack of interaction and suggested the addition of a smaller instant messaging group chat could have been more engaging.

The outcomes provide positive data indicating that the novel online EMDR/GTEP intervention can facilitate healing from breastfeeding trauma. To facilitate improved social connections an additional instant messaging group should be considered. The ExBreastS is a valid and reliable instrument for measuring breastfeeding trauma.
Date of AwardJun 2023
Original languageEnglish
SponsorsDepartment for the Economy
SupervisorMarlene Sinclair (Supervisor), Julie McCullough (Supervisor) & Paul William Miller (Supervisor)


  • Breastfeeding PTSD
  • Breastfeeding post traumatic stress disorder
  • Perinatal
  • G-TEP
  • Social media
  • Eye movement desensitisation and reprocessing

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