EMDR

To understand EMDR therapy, we first have to examine how our brain stores memories in neural networks. When a memory is traumatic, it can become “stuck” in a dysfunctional way—limiting our ability to fully process and resolve traumatic stress. Those memories are often connected to our senses, emotions, thoughts, beliefs, or even people—but they’re disconnected from positive emotions.

Emotions tied to traumatic memories are primarily stored in the right hemisphere of the brain, while positive emotions are more closely linked to the left. Because these neural networks don’t communicate effectively across both hemispheres, we’re unable to heal traumatic memories simply by talking about what happened or by trying to reframe them in a more positive light.

What EMDR therapy does is bridge the gap between traumatic memories and reprocessing through bilateral stimulation—such as side-to-side eye movements, alternating tones, or tactile pulsars. It stimulates both sides of your brain, allowing you to integrate positive emotions, thoughts, and sensations into the traumatic memory. Over time, the memory no longer feels as overwhelming or triggering, helping you feel more in control and less stuck in the past.

Eye movements (or other bilateral stimulation) are used during one part of the session. After the clinician has determined which memory to target first, she asks the client to hold different aspects of that event or thought in mind and to use his eyes to track the therapist’s hand as it moves back and forth across the client’s field of vision. As this happens, for reasons believed by a Harvard researcher to be connected with the biological mechanisms involved in Rapid Eye Movement (REM) sleep, internal associations arise and the clients begin to process the memory and disturbing feelings.

In successful EMDR therapy, the meaning of painful events is transformed on an emotional level. For instance, a rape victim shifts from feeling horror and self-disgust to holding the firm belief that, “I survived it and I am strong.” Unlike talk therapy, the insights clients gain in EMDR therapy result not so much from clinician interpretation, but from the client’s own accelerated intellectual and emotional processes.

The net effect is that clients conclude EMDR therapy feeling empowered by the very experiences that once debased them. Their wounds have not just closed, they have transformed. As a natural outcome of the EMDR therapeutic process, the clients’ thoughts, feelings and behavior are all robust indicators of emotional health and resolution—all without speaking in detail or doing homework used in other therapies.

Phase 1:

The first phase is a history-taking session(s). The therapist assesses the client’s readiness and develops a treatment plan. Client and therapist identify possible targets for EMDR processing. These include distressing memories and current situations that cause emotional distress. Other targets may include related incidents in the past. Emphasis is placed on the development of specific skills and behaviors that will be needed by the client in future situations.

Phase 2:

During the second phase of treatment, the therapist ensures that the client has several different ways of handling emotional distress. The therapist may teach the client a variety of imagery and stress reduction techniques the client can use during and between sessions. A goal of EMDR therapy is to produce rapid and effective change while the client maintains equilibrium during and between sessions.

Phases 3-6:

In phases three to six, a target is identified and processed using EMDR therapy procedures. These involve the client identifying three things:

1. The vivid visual image related to the memory

2. A negative belief about self

3. Related emotions and body sensations

In addition, the client identifies a positive belief. The therapist helps the client rate the positive belief as well as the intensity of the negative emotions. After this, the client is instructed to focus on the image, negative thought, and body sensations while simultaneously engaging in EMDR processing using sets of bilateral stimulation. These sets may include eye movements, taps, or tones. The type and length of these sets is different for each client. At this point, the EMDR client is instructed to just notice whatever spontaneously happens.

After each set of stimulation, the clinician instructs the client to let his/her mind go blank and to notice whatever thought, feeling, image, memory, or sensation comes to mind. Depending upon the client’s report, the clinician will choose the next focus of attention. These repeated sets with directed focused attention occur numerous times throughout the session. If the client becomes distressed or has difficulty in progressing, the therapist follows established procedures to help the client get back on track.

When the client reports no distress related to the targeted memory, (s)he is asked to think of the preferred positive belief that was identified at the beginning of the session. At this time, the client may adjust the positive belief if necessary, and then focus on it during the next set of distressing events.

Phase 7:

In phase seven, closure, the therapist asks the client to keep a log during the week. The log should document any related material that may arise. It serves to remind the client of the self-calming activities that were mastered in phase two.

Phase 8:

The next session begins with phase eight. Phase eight consists of examining the progress made thus far. The EMDR treatment processes all related historical events, current incidents that elicit distress, and future events that will require different responses.

Many people assume that trauma only comes from extremely disturbing events, but it can stem from many different experiences. These may include gaslighting, abuse, medical issues, natural disasters, witnessing violence, and more.

In addition, you may not recognize you’ve been through trauma if it came from a series of day-to-day, seemingly “small” struggles that felt normal at the time—such as growing up with emotionally immature parents. These experiences can lead to attachment trauma, which EMDR therapy can also help address.

You may be experiencing trauma or PTSD if you’ve noticed signs such as:

• Anxiety, panic attacks, or hypervigilance

• Depression

• Mood swings, anger, or irritability

• Insomnia or night terrors

• Social withdrawal or difficulty in relationships

• Feelings of shame or guilt

• Quick heart rate or high blood pressure