What is EMDR?
Understanding EMDR
EMDR stands for Eye Movement Desensitization Reprocessing.
The central goal of EMDR is to stimulate the brain’s innate capacity to to self-heal.
It is widely known as an effective and research-backed treatment for PTSD and a growing list of other applications. The underlying mechanism of EMDR is somewhat shrouded in mystery and can be difficult to describe. Like so much of psychotherapy, effective implementation is part science and part art.
EMDR is based on the premise that much of our unwanted psychological disturbance is caused by dysfunctionally stored information. Given the right circumstances, we are naturally equipped to cope with and recover from intense levels of difficulty and challenge. Our built-in ability to cope is called the Adaptive Information Processing system (AIP). EMDR therapy recovers dysfunctionally stored memories and connects them to the AIP. For those that appreciate a more tangible explanation - the AIP requires a successful transfer of information from the lower threat detection centers of the brain up to the prefrontal cortex (PFC).
When the stresses and challenges of a situation overwhelm the nervous system, it loses the ability to connect to the PFC and gets stuck in its original state of disturbance. Disturbing experiences along with their nightmarish qualities, become embedded in the deeper base areas of the brain.
These embedded memory components can present in a variety of ways that may include:
Flashbacks
Nightmares
Panic attacks
Eating disorders
Chronic pain
Autoimmune disorders
Unexpected and overwhelming emotions
Social isolation
EMDR does not focus on the severity of the events but turns its attention to the ways in which your nervous system has stored the impact. Dysfunctionally stored information can include:
Physical sensations
Direct sensory inputs
Strong emotions
Distorted beliefs
Unlike some forms of traditional talk therapy, EMDR asks for the full participation of your physical body alongside emotions and thoughts. Processing a memory with EMDR does not require an inventory of all the details of the trauma. Forming a connection with a sensation, muscle memory, emotion and embedded thought is often enough to re-capture the memory and start the healing process.
Connecting with body sensations and emotions opens the door to internal discrepancies where you know one thing yet feel another. This can include times when:
You feel afraid, yet know you are safe
You feel strong emotions for no apparent reason
You know what to do but can’t follow through
Experiencing a disconnect between what you know and how you feel is often the working edge of therapy. An effective EMDR intervention can help you reconcile this internal conflict and move towards re-alignment and understanding.
EMDR Therapy Process
For reasons that we do not fully understand, bi-lateral stimulation (known as BLS movements) creates space for the brain to re-process intolerable feelings, sensations and thoughts. In EMDR the most commonly used BLS is a horizontal right-to-left motion of the eyes. Therapists can also use tapping, buzzers or auditory devices to create the same effect. This explains why you can sometimes find resolution to a problem or dilemma during a walk or swim – both activities are distinctly bi-lateral. It also explains the growing use of headphones and binaural beats for helping with focus and meditation. We also know that during REM sleep the eyes spontaneously move back and forth while dreaming.
The actual implementation of EMDR varies from client to client based on presenting issues. But the basic order of events is to
Identify and target the memories linked to your disturbance
Re-encounter the memory in a safe manner
Use BLS to re-process the memory
Connect with your innate intelligence and resilience
Place the memory in its proper context and move forward with your life
Following EMDR, the memory may still register as sad or upsetting but the debilitating side effects are lessened. You recover the ability to remember without re-experiencing. Clients often report a renewed ability to feel smart, aware and skillful alongside their strong emotions.
Practical Aspects and Benefits of EMDR
EMDR can be useful under a broad range of circumstances ranging from single events to ongoing persistent stress. It combines well with all the other therapeutic modalities. And can be an adjunct to talk therapy when a specific issue seems stuck and intractable.
For some clients the contained structure of EMDR reduces the pressure to figure out what they want to talk about in therapy. EMDR includes goals and metrics for improvement that provide a sense of closure and completion when a target is fully processed. This can be reassuring for clients that want to feel a sense of tangible forward momentum in therapy.
I am consistently stunned and inspired by the deep insight, courage and intelligence people show while processing via EMDR. It is an approach that positions clients to leverage their own inner resources and strengths rather than relying on the therapist for insight.
EMDR in Practice
EMDR can be done via telehealth or in-person. Session lengths can vary between one hour and 3 hours for an intensive. I personally prefer to see people in person so I can monitor their body language and provide a felt connection if they encounter a strong reaction.
I appreciate the humanistic aspects of EMDR. Rather than viewing people as problems and attaching diagnostic labels, it treats mental health symptoms as glitches in memory produced by earlier experiences.
Like all psychotherapy, EMDR is collaborative and relies on a good connection between client and therapist. For a client, there is no such thing as doing EMDR ‘wrong.’ The burden of proof is always on the therapist and the modality.
If you are interested in trying EMDR bear in mind that it is a non-linear multi-step process. And, depending on your circumstances, it may take some time to get results. As always, the gold standard for any form of therapy is whether it works for you and alleviates your symptoms safely and within a reasonable time frame.
Further Exploration of EMDR
Explore EMDR even further with these two videos, providing a visual understanding of its techniques and effects.
CRISTINA WAIT
Psychotherapy Services
