Eye Movement Desensitization and Reprocessing (EMDR) is an integrative psychotherapy approach that has been extensively researched and proven effective for the treatment of trauma. EMDR is a set of standardized protocols that incorporates elements from many different treatment approaches. To date, EMDR therapy has helped millions of people of all ages relieve many types of psychological stress. Below is a Brief Description of EMDR Therapy.
What is an actual EMDR session like?
As EMDR’s popularity has been increasing so has the depiction in mainstream media. From TV shows to movies and online I have witnessed EMDR being depicted as something it’s not. EMDR is an 8 phase treatment approach to working with traumatic events that get “stuck” or “frozen in time” in people’s lives. When an event gets “stuck” or “frozen” the event and the corresponding sounds, images and most importantly thoughts and body sensations do not get stored in our mind as “past” but rather continue to be lived out in the present haunting and paralyzing the individual until they can be resolved.
Before any traumatic reprocessing is done the client’s safety and stabilization should always ensured. This can take 2-50+ sessions for this to occur depending on the length and type of trauma and when it occurred developmentally. EMDR as a treatment approach is MUCH more than just eye movements and proper traumatic memory reprocessing can only be accomplished after sufficient safety and stabilization is determined. When a client is sufficiently stabilized, per the agreement of the therapist and client, the client can then move into traumatic memory reprocessing.
Common questions I get asked prior to the traumatic memory reprocessing or about EMDR in general:
- Will I by hypnotized? No. EMDR cannot be done against your will.
- Can you erase my memory? No. However, as we process the traumatic memory and provide the capacity for integration to be possible the nature of the memory will change. Our goal is to not only help you have less of a distressing response to the memory both cognitively and somatically but also have the ability to take away an empowered or positive cognitive and somatic experience. If you are involved in a legal proceeding regarding your traumatic experience I would encourage you to speak with your provider about how doing EMDR can change the nature of memory and how this may impact the legal proceeding.
- So you are telling me that this “thing” that is a 10+ in my system right now I will be able to look back on and feel neutral or very little disturbance around? Yes! And not only that it will be cleared from the past but a complete treatment plan clears disturbance from the present and also future concerns.
- Can I do EMDR on myself? No. However, you can and should use the resourcing and stabilization tools on your own.
- Will just talking about it make it better? No. The nature of traumatic memory is such that for events or periods of time that get “stuck” talking about it doesn’t serve any justice in integrating traumatic memory.
- Is this similar to prolonged exposure therapy? No. Prolonged exposure therapy has been shown to have much higher drop out rates due to intense emotions and retraumatization. EMDR done properly can bring up intense emotions, but emphasis is given to it’s ability to provide integration of traumatic memories not just desensitization.
- Can EMDR be used on anything else besides trauma? Yes. EMDR has been shown to be effective with many different challenges and also for performance enhancement and sports psychology.
- What if I my eyes are sensitive and I don’t want to follow the lightbar that helps facilitate eye movement? No problem. We have many forms of bilateral stimulation that can facilitate integration including tappers which provide alternating vibration in your hands instead of having to move your eyes back and forth.
- What happens if I don’t have a detailed memory for large portions of time? No problem. In fact, this is very common. In order for EMDR to be effective we don’t need, and don’t ask for, detailed accounts of what happened as that is not where the healing power of EMDR takes place. Instead memories can be processed one at a time or in large chunks of time if that feels more supportive for your system. For example, if someone has been in a car accident the car accident can be processed on it’s own, but if someone is a survivor of physical abuse for a period lasting several years they don’t need to process each individual incident no their own.
- How does it work? Well, there is the long and the short answer to that. The short answer is that we don’t have a definite answer, which we don’t know why Prozac works either! The long answer is that there are several theories as to why bilateral stimulation work, in particular eye movements (16 the last time I checked). I will offer five prominent ones below:
- Rapid eye movement is also found in REM sleep which is where our brain naturally processes and integrates material and therefore EMDR’s eye movements could be helping to facilitate this process.
- The orienting response that is engaged when a person is moving their eyes back and forth can help to facilitate integration of the traumatic material.
- Doing a dual-awareness task (i.e. following the hand and performing eye movements at the same time as thinking about something that happened in the past) helps to facilitate a desensitization response versus a flooding response that is typically seen in traumatic memory.
- Bi-lateral stimulation helps to facilitate a calming response in the central nervous system.
- Bi-laterla stimulation helps to facilitate a “whole” brain response to the traumatic memory versus traditionally getting stuck in the right hemisphere.
Many of my clients that have had bad experiences with other clinicians or have heard about it hyped up from the media or elsewhere often comment that while it is sometimes tiring it is a very empowering, eye-opening experience that wasn’t “traumatic” at all. Many clients I talk with assume that in order for trauma to be healed you have to be retraumatized. NOT TRUE!
Me personally, I never ask my clients to climb a mountain I myself have not attempted. I first became interested in EMDR right out of grad school and have since received my own EMDR therapy on several different occasions. I believe it is a hugely important piece to the puzzle when working with trauma and I haven’t seen anything else like it out there when it comes to integrating traumatic material. However, that being said, it is only one piece of the puzzle in what I see as sometimes a very complex mosaic of presenting symptomatology.
Buyer beware! There are some clinicians out there who have taken a basic introductory course and have not completed and EMDRIA approved basic training course and are performing EMDR. I would encourage you to check the EMDRIA website to ensure your clinical is a certified EMDR clinician.
If you are looking for a more detailed overview of the 8 phases of EMDR Therapy or if you are looking for more information regarding research or clinicians in your area I would encourage you to visit EMDR International Association.
In my practice EMDR is incorporated into the overall treatment plan of integrated mental health.