EMDR

Eye Movement Desensitization and Reprocessing (EMDR) has been around since the early 1980’s. Francine Shapiro noticed that while walking in the park, thinking of her stresses, her eyes were moving back and forth. She recognized that she felt better afterwards. She tried it again on herself and then her friends and colleagues, they experienced the same results. Over the next few years, she fine tuned the protocol and completed the first randomized control study. Her protocol was further flushed out and the protocol was published in her first book. You can access her articles here.

The fact of the matter is that we’re not quite sure! Someday we’ll have technology to evaluate that! There are a few theories:

• The eye movement component stimulates the brain in a way that’s similar to REM sleep phase, we are activating a dream state while you are conscious and allowing the brain to process naturally.
• The combination of bi-lateral stimulation (BLS; eye movements, audio sounds, tapping, buzzers) and recalling a painful memory doesn’t allow the brain to attend to both at the same time. Our body learns to habituate once it recognizes that there is not current danger.
• Working memory is necessary to both notice the memory and the BLS, it is not capable of holding both simultaneously. The BLS actively disrupts working memory and reduces the vividness and emotional intensity of the targeted experience.

EMDR processing can be very fast, at times it can take multiple sessions. Because everyone’s situation is a little different, in terms of extent of/type of trauma, availability of coping skills, and current life situation, there is no magic number of sessions. It is the therapist’s responsibility to make sure you are emotionally ready to address difficult, emotional experiences of your past, which also varies from person to person.

There is also no way to predict how long it will take to process a memory. Sometimes seemingly benign memories take several sessions to work through, whereas troublesome memories may process in one session.

EMDR is an effective therapy for many, many diagnoses. People often view it solely as a treatment for trauma, but that’s a misconception. EMDR is appropriate with:

• Anxiety
• Depression
• Trauma
• Obsessive – Compulsive Disorder
• Phobias
• Chronic Pain
• Addictions (drug, alcohol, gambling, pornography, sex, technology)
• Eating disorders

It is conditionally effective with:

• Psychosis (such as schizophrenia, it will process a past psychotic episode)
• Traumatic Brain Injuries (will not restore lost functioning, but will address trauma that caused TBI)
• Organic diagnosis such as bipolar (it will not regulate moods, but will process experiences caused by a mania)

Preparation:

The therapist begins an EMDR processing session by reviewing the memory chosen in advance. Your therapist will ask you specific questions about that memory, this helps activate your brain and laser focus it on the problem areas.

Processing:

The Bilateral Stimulation (BLS) will then start, either with eye movements, audio tones, tapping, or using buzzers. How your body responds varies person to person and session to session. Often, you will experience an increase in intensity in your emotional and physiological response to the memory. This is because your brain is looking at it in a different way. It’s not just seeing a visual representation of it, it now includes the emotions, somatic sensations and what you believe about yourself. Often this increase is uncomfortable yet manageable.

Other factors:

At times you may need to pause Processing to build self-regulation skills. Other times, your body might shut down your emotions, necessitating calming support. Before EMDR processing, your therapist assesses your emotion tolerance and teaches tools and exercises so that you can manage the process.

For a phase-by-phase description of the protocol, please click here.

EMDR stimulates your brain in a unique way. This stimulation doesn’t stop when you leave your therapist’s office. It continues to work for another 48-72 hours. For many people, they won’t experience the aftereffects in any significant or disruptive way. Other people will notice feeling fatigued, irritable, having strange dreams, or other memories coming up to the surface in the day or so following the processing session. If you find it difficult to return to your life after an EMDR session, please alert your therapist so they can take more steps to contain the side effects.

EMDR is regularly considered a new approach, it has been around and studied since the early 1990’s. Research findings are so overwhelming that many national and international organizations recognize EMDR as an approved and effective treatment. You can find these treatment guidelines here and copies of research material here.

EMDR is just as effective when done via telehealth as in person. Your therapist will have modifications to ensure you get the same bi-lateral effects of EMDR. They will also take additional steps to keep your emotions and affect with-in a comfortable window.

The majority of EMDR trainings for therapists are now done on-line. Credentialed and reputable training programs require therapists to practice EMDR with other participants and review appropriate and helpful modifications. Often, therapists are more comfortable with EMDR online and take some practice to get used to doing it in person.

Your memories will not be erased. You will still have your memories. EMDR changes how the memory is stored. What was once a painful and emotional memory is processed into something that no longer activates an uncomfortable response.

At times, forgotten memories or pieces of memory may come up. It is a normal part of processing if this happens. The goal is not to find any repressed memories, rather to work through what is there.

Your therapist will complete a thorough intake assessment with you. This allows them to get a sense of what prior experiences are contributing to your symptoms today. EMDR often worked backwards, starting with your present symptoms and looking to your past to identify where they started. There are specific techniques that will be used to identify which memories are most important to address and in what order.

There are a number of benefits to using to EMDR. The first one being that it is not used in a vacuum. Your therapist will pull from a number of different modalities, as needed, to work on your therapeutic goals. EMDR itself is a culmination of a number of approaches, CBT is used to identify negative self-beliefs, somatic processing is used to address physiological responses to the memory, and free association is pulled from the psychoanalytic approach. Drawing from so many disciplines allows for full processing of the whole memory, often much faster than traditional talk therapy.

All processing with EMDR is done internally. Your brain does the work while noticing the Bilateral Stimulation. There is no need to retell/relive the experience over and over. In fact, your therapist may never know all the details of what happened. You also will not have to do any homework, except noticing any changes you may be experiencing. All work is done in session.

Studies show long term treatment effectiveness, if treatment is completed. Often clients leave therapy once they start to feel better, or don’t process through everything. In these cases, treatment effects tend to be short-lived. Think of it as an infection, like strep throat. If you stop taking antibiotics when you start feeling better it is likely to return; if you complete the treatment it is unlikely to resurface.