what is EMDR ?

Whether you experienced long term adverse experiences as a child or a specific traumatic event as an adult, a common response is disturbing and disruptive memories that come up at the worst moments. Many clients come to trauma therapy looking for relief from these upsetting memories and the anxiety, depression, and hopelessness that accompanies them. Eye Movement Desensitization and Reprocessing (EMDR) is an evidenced-based treatment for all kinds of trauma or stressful experiences, and it focuses on these types of distressing memories. 

Francine Shapiro, PhD. was taking a walk through the woods in 1987, and just happened to notice her eyes moving back and forth across the scenery around her–and that if a distressing thought came up, she would begin to feel better the more she focused on these eye movements. She attempted to recreate this experience with clients and colleagues in her office, and EMDR was born. As the process was formalized, elements of other approaches were incorporated, such as mindfulness from Eastern philosophies and identification of negative cognitions from CBT, to formulate a manualized use of the eye movements. 

Since then, the back and forth eye movements, or bilateral stimulation, has come to be administered in many ways. Many therapists simply utilize a back and forth movement of their fingers, but it is also possible to use another object (such as a pen, or toy for children), a light bar, or telehealth platforms that display a moving shape on the screen for the client. Any sensory movement that crosses the body is considered bilateral stimulation and can include tapping, butterfly hug, drawing back and forth on a piece of paper, or even walking. 

What is trauma and does it affect the brain?

Trauma, as we’ve talked about here and here, can be thought of as any event that overcomes our normal ability to cope–but is more accurately the set of symptoms that occurs when a traumatic or stressful event does not get completely processed. 

When we experience something that overwhelms our stress response system, our natural alarm system turns off our logical brain to save all of our energy for survival, and pumps our body full of adrenaline and cortisol so that we can either run or fight to keep ourselves safe. 

That means that a traumatic event is often stored as sensory information, and without an appropriate time stamp. Instead of putting the information into a linear story that is now in the past (meaning we are safe and can relax), the brain remembers the events through the sights, sounds, smells, tastes and sensations it experienced during the trauma, and continues to believe that we are still in danger. 

How does it work

We’ve all heard that our left brain is more logical and the right brain is artistic. This is obviously a bit oversimplified, but it’s not wrong. Your left brain stores language and engages in problem-solving. It also understands linear time. The right side of the brain deals more in symbols and metaphor, and, along with the limbic system (where that alarm system is located) engages in emotions and memory making. 

Brain imaging has shown that when a traumatic event is brought to mind, the limbic system lights up, and after they receive EMDR therapy, it is the neocortex that lights up when the memory is brought up. EMDR is considered an evidence-based practice, but it is difficult to pinpoint how EMDR helps to process traumatic memories exactly. The main theory is that the bilateral stimulus helps to engage the two hemispheres in the brain in communicating with each other and integrating the poorly stored sensory information into a linear memory. EMDR can’t turn a scary memory into a happy one, but it seems to help the brain understand the event as having occurred in the past, and is now over. Meaning, that the event is not still happening and we are now safe. 

What happens in EMDR therapy? 

EMDR happens in phases. The first phase of EMDR is devoted to preparation. Your therapist will do some history taking and give you a chance to get to know each other. The therapist will then teach you regulation exercises and other tools to make sure the EMDR process feels safe and supportive. Following this, you and your therapist will identify the memories you want to target with the bilateral stimulus; and the negative cognitions, sensations, and images that relate to those targets. 

You will also choose what type of bilateral stimulus is most comfortable for you, whether it is tapping, therapist guided eye movement, or even using hand held buzzers that your therapist controls. As the therapy moves forward, your therapist will lead you in pulling the troubling memories to your focus, monitor your responses and provide guidance through processing. One way to think about EMDR is like driver’s ed. You are in the driver’s seat, but your therapist also has a wheel and a break. You’re in charge, but they’re not going to let you drive the car off the road. Just like any other therapeutic approach, EMDR requires a strong therapeutic relationship, trust and empowerment of the client.