If you’ve been to a therapist’s office in recent years, there’s a good chance you’ve heard of Eye Movement Desensitization and Reprocessing, or EMDR therapy.
EMDR commonly used to treat chronic and acute trauma is also proven help with some items of chronic pain.
A growing body of research shows that EMDR can be used effectively deals with a variety of situationssuch as substance abuse, specific phobias, and anxiety that occurs alongside symptoms stemming from trauma. More studies are needed, but the results so far are encouraging.
I am a psychotherapist who trained in EMDR in 2018. Since then, I have consistently used this approach with dozens of clients to address trauma and deeply negative core beliefs.
EMDR versus traditional therapy
Eye movement desensitization and reprocessing were developed in 1987 by Dr. Francine Shapiro after finding that moving her eyes from her left foot to her right as she walked—in other words, following her feet with each step—resulted in lower levels of negative emotions associated with difficult memories, both from her most recent disappointments day and deeper events from her past.
Conventional therapies, such as cognitive behavioral therapy or dialectical behavioral therapy, rely on extensive verbal processing to address the client’s symptoms and struggles. Such treatment can last months or even years.
Depending on the trauma, EMDR can also take months or years—but generally, resolves issues very more quickly and efficiently. It is effective for both adults and children and can be done remotely.
EMDR has the ability to work faster by targeting negative thoughts and feelings in conjunction with what is called bilateral stimulation – that is, using eye movements, tapping, auditory or tactile senses to process emotions.
The most common form of bilateral stimulation is when the patient holds their head still and uses their eyes to follow the therapists finger movements back and forth. Patients may also wear headphones that alternate ear-to-ear music or a tone that goes back and forth. Another common technique is to have the patient hold a small buzzer in each hand alternating the vibrations back and forth. Sometimes, therapists take turns tapping on each of the client’s hands or knees.
Some practitioners equate it with adding conscious thought to what the brain is trying to do during rapid eye movement or REM sleep. In this stage of sleep, the eyes move back and forth under your closed eyelids as you dream.
How EMDR works
Researchers are still working out exactly how and why EMDR is effective in helping patients heal from trauma.
Trauma is a physiological and psychological response to an event where someone perceives a threat for their safety – or someone close to them – this is so serious, it overwhelms their ability to cope.
The traumatic event can cause various symptoms that affect daily lifesuch as anxiety, depression, mood swings, intrusive thoughts, hypervigilance, difficulty sleeping, or changes in appetite or weight. Sometimes, the person has thoughts of self-harm or suicide.
Trauma can also leave one with various triggers – sights, smells, sounds, locations, phrases – that bring back memories of the event. This causes the person to relive the feelings or reactions they had when the trauma first occurred, as if it were happening again.
For example, on a walk through a busy mall, someone who had been assaulted months earlier might catch a whiff of the same cologne the assailant was wearing. As the smell of the cologne wakes them up, they suddenly feel like they are reliving the attack, including physical sensations and seeing images of the event.
Removal trauma
Memories of traumatic events often get stuck in the brain limbic systemwhere the fight, flight and freeze response resides. This is not the place where memories are to be stored. Here, the memory is triggered by various experiences in everyday life – a similar sound, smell, sight or feel – that can make the client feel as if the trauma is happening again at that moment.
Targeting the traumatic memory while engaging in bilateral stimulation during EMDR allows the brain to highlight and move the memory from the limbic system—where it cannot be effectively connected to other critical information or memory networks—to prefrontal cortex and other areas of the cerebral cortex where the Memory can be processed and supported better.
EMDR therapy it is a multi-step process. Together the patient and the therapist first identify the targets, that is, the specific traumatic memories to be addressed during the reprocessing phase.
The patient is then asked to associate the event with a negative thought about themselves associated with the trauma. For example, I might say, “And when you think about the worst part of this event, what is the negative thought you have about yourself?” Often something along the lines of ‘I’m unlovable’, ‘I’m worthless’ or ‘not worth protecting’ comes up. The patient is also asked to identify and locate any physical sensations they may have in the body.
The therapist will then ask the client to focus on all three of these things – the specific trauma memory, the negative self-thought, and where they feel it in their body – while applying some form of bilateral stimulation.
EMDR in action
Although trauma healing is a highly individualized experience, research shows that 80% to 90% of patients are able to process—meaning resolve—a single traumatic event with only three sessions of this treatment. In an original study from 1998, past experiences such as post-traumatic stress disorder from combat resolved in 77% of participants after 12 sessions. Other research shows that for patients who have experienced chronic trauma or abuse, more treatment time likely required to resolve symptoms stemming from trauma survivors.
In this context, resolution means that the target thought or memory has been cleared and the impact should be greatly reduced – not that the person will no longer have negative thoughts or feelings about it.
If a patient has multiple traumas, I will ask them to identify the memories that stand out the most. The therapist will start with the earliest of these memories and work up to the present. It focuses on one memory at a time, and once it has been fully processed – there is no longer any disturbance in the body when it thinks about the memory – then the therapist and the patient move on to the next one.
One of my patients had struggled with devastating childhood memories of verbal, emotional and physical abuse by his parents. This consistently affected their relationships with family and peers well into adulthood. After working with EMDR, the patient was able to process haunting memories, gain insight into setting boundaries with others, and provide comfort and guidance to the young child he once was.
Another patient was a high school student who was afraid to leave home after being attacked on the way home from school. Concrete, visible changes began after the second session. School attendance became more consistent. grades improved. “I don’t understand what’s going on,” said the patient. “It’s like magic. I’m not so afraid anymore.”
But EMDR is not magic. It is a unique strategy that allows the client to approach the trauma in a different way. The client is able to reflect on the events affecting them and engage with the therapist’s support without having to express every detail of their trauma.
Finding EMDR Specialists
If you are considering trying eye movement desensitization and reprocessing therapy, find a therapist who is trained or certified in this therapy. The International EMDR Association website has a list of themalthough there are many other qualified therapists who are not affiliated with this organization and you could ask about a clinician’s credentials before starting treatment with them.
If you struggle daily with past trauma or deeply negative self-beliefs, are willing to dig deeper into these difficult feelings, and want to try a different type of research-backed therapy, I would highly recommend giving EMDR a try.