What is EMDR and why use it?
Have you ever had trouble making a decision or processing an experience, then gone to sleep and woke up with a solution? When we dream during Rapid Eye Movement sleep (REM), our eyes move back and forth while we are unconscious; while we can’t intentionally move our bodies, our mind is active, processing our thoughts and feelings differently than when we’re awake. This is how EMDR (Eye Movement Desensitization & Reprocessing) works, too.
According to Dr. Francine Shaprio, when we use both sides of our body, like when we’re walking or listening to music that comes into headphones alternating from one side to another (formally called “Bilateral stimulation”), we can activate our body’s adaptive processing network in our mind that allows us to view experiences from a different perspective.
Dr. Shapiro learned over 30+ years of research that this method of activating our body’s Adaptive Information Processing network through BLS can be healing for many negative experiences (little t or big T trauma), and has been found to be especially efficacious for supporting folks experiencing PTSD (Post-traumatic Stress Disorder) (learn more at EMDR Research Foundation website).
In my EMDR trainings, the advisors stated “the past is present” and this feels true with negative past experiences we haven’t fully integrated. When we are not able to properly integrate disturbing memories, they can become stuck and pop up at times that are related to this memory (e.g., flashbacks, negative beliefs about yourself feel reinforced by life experiences). EMDR helps use your personal Adaptive Information Processing network to work through these memories to allow you to integrate a more adaptive perspective, so the past no longer feels present.
What is the process?
EMDR works with the past, present, and the future - I learned to think of these layers as the roots (past that sets the stage for growth), trunk (present that is determining where you head), and branches (the future you are headed towards) of a tree.
You can tackle any of these pieces first (past, present, or future), but most EMDR protocols start with tackling THE PAST first (since it needs to be cleared up to help the rest of the tree grow healthily).
There are 8 phases:
Phases 1 & 2 are normally what start with. This involves doing some history taking and exploring if EMDR feels like the right fit for you, assessing for dissociation, and providing you with some resources/showing you what EMDR can be like by installing some internal resources that you already use regularly.
Phases 3-8 are what you’re going to experience most in the process until you’ve fully reprocessed your memory (no more/adaptive distress, your chosen positive cognition is rated as very true).
When you pick a memory in Phase 1, you’ll break it down more in phases 3-6 through thoughts/cognitions, images, feelings, and physical sensations to activate your memory (sometimes you’ll also be asked how disturbing the memory feels from a 0-10 scale). When you activate your memory and use your Adaptive Information Processing network to process your memory, you will find your ratings of distress go down after some Bilateral stimulation sets (this can look like eye movements by watching someone’s hand or a light bar, using little buzzers that will vibrate randomly in your hands, hearing sounds that make noise in one ear and then the other, tapping your hands on alternating knees, for example).
Once you’ve fully reprocessed the past memory, you’ll reprocess a present experience you felt was linked to the past memory and will run a mental movie of the future to see how you’ll act differently now that you have a different perspective.
Phases of processing:
History taking and Treatment planning
Preparation and Stabilization (resource development)
Target Assessment (picking a target memory to start processing)
Desensitization (decreasing your distress)
Installation (working with your positive cognitions)
Body Scan (checking the body to see if there is more to explore)
Closure (how we end session if we don’t finish processing the memory yet)
Re-evaluation (how we start sessions where the memory hasn’t fully been processed yet; helps us see where to go next)
A tree with roots digging into the sand near the ocean, a strong trunk with foliage in the center and empty branches at the top.
Why EMDR Therapy?
EMDR not only tackles thoughts and feelings, but also works somatically to allow you to reprocess trauma through your body’s sensations.
It works with memories and does not require you to provide detailed descriptions of the event and does not involve direct challenging of beliefs, detailed exposures, or homework; which is different than more narrative forms of trauma work, like TF-CBT (Geneva: World Health Organization, 2013).
It provides opportunities to incorporate and strengthen one’s personal resources (positive personality traits, calm/peaceful/healing visualizations, ways you can work with feelings in the body).
You can work through a past that’s holding you back in the present, so it does not continue to impact you in the future.
Some potential cons of EMDR Therapy:
You may experience heightened distress during reprocessing, since you are working on a distressing memory. Trauma work is difficult and requires a willingness to face difficult thoughts, feelings, and sensations. It is your therapist’s job to give you the tools you need to get through these moments together. Often my EMDR training used the metaphor of EMDR phases 3-8 as being in a car driving through the tunnel - you can always stop the car if it is difficult to drive, but the faster you can drive through the tunnel, the sooner you get to the light at the end.
Once you start, it’s important to finish all phases of the process - you will continue processing outside of session until you can get through phases 4-6 (goal is to reach the point of no distress, recognize your chosen positive belief as true).
It might not be for everyone (e.g., dissociation can make it difficult to do reprocessing and sometimes doing trauma work can make dissociation stronger, so we want to tread lightly if you experience dissociation).
Overall, EMDR can be a great source of healing for those wanting to work through a past that is holding you back, feeling stuck where you are, and a willingness to use your own mind and body to process your experiences in a different way.
Any questions? email carly@exploringustherapy.com to learn more.