EMDR
EMDR stands for Eye Movement Desensitization and Reprocessing. EMDR is an evidence-based therapy that has been used to successfully treat PTSD. Early research showed profound improvement in war veterans and sexual assault victims. Today we know that anyone hoping to improve their mental health can reap the benefits of EMDR. Read on to learn more.
A Walk in the ParkIt all began in a walk in the park in the late 1980s.
On a hike, Francine Shapiro discovered that any disturbing emotions and thoughts were significantly lowered. Through her research, she learned that as she reflected on the stressors of her day while her eyes moved back and forth to take in her surroundings, the intensity of her stress decreased.
FAQs
What does EMDR treat? And how does it work?
EMDR stands for eye movement desensitization and reprocessing. It is used to desensitize our reactions to triggers and to help us reprocess disturbing emotions, thoughts, memories, and physical sensations. When we experience a stressful life event, our sympathetic nervous system gets activated (fight or flight) and we can get stuck and feel as though that event is still happening even though we might be safe. EMDR helps us engage our parasympathetic nervous system (rest and digest) by helping us create new neural pathways and relearn a sense of safety in our bodies.
EMDR works through something called bilateral stimulation (BLS) wherein we use side-to-side eye movements to stimulate the two sides of the brain and activate the nervous system. The left side of the brain is in charge of logic and language and the right side of the brain is in charge of emotions. So when we experience a traumatic event, we can get stuck in a loop on either side of the brain. This can manifest within us as “I know I’m good enough” but “I feel like I’m not good enough”. EMDR seeks to re-establish the connection between the two sides of the brain and bridge the gap between what we know to be true and what we feel (logic and emotion).
EMDR also stimulates our body’s natural healing mechanism which occurs when we are in the REM (rapid eye movement) cycle of sleep. The REM sleep cycle is a phase when the brain consolidates, organizes, and discards information and memories. EMDR utilizes the same eye movements in our unconscious state (REM sleep cycle) and the difference is that in session, we get to target and reprocess disturbances in a conscious state. In other words, EMDR can be seen a tool that strengthens a healing mechanism that already exists in every one of us.
Why choose EMDR?
As with all therapeutic modalities, EMDR seeks to help clients come back into their “window of tolerance” and feel less disturbed by stressful or traumatic memories. Life is hard and it is impossible to be stress-free or anxiety-free. Thus, the goal is to strengthen or develop the ability to feel big emotions and be able to tolerate them. EMDR is a special tool that helps clients develop a baseline of distress tolerance in order to handle challenges in life. This can happen with EMDR in three ways: (1) decreasing the frequency of emotional disturbance from a trigger (2) and/or decreasing the intensity of emotional disturbance from a trigger (3) or completely eliminating our emotional / physical reactions to a trigger. As emotional wounds heal, scars may form, and while scars no longer hurt, they do tell a story of what we have experienced and the pain we have overcome. When we are able to talk about a painful memory and not feel the painful emotions to the intensity that we once felt them, then we know healing has taken place or is taking place.
What can I expect in EMDR sessions?
In general, EMDR therapy follows a structured protocol of 8 phases. Traditionally, sessions do not veer from the protocol. However, because we know that healing is not a linear experience, my integrative approach ensures that we make EMDR work for you and your needs and not the other way around. We don’t work to fit you into the protocol; rather, we utilize it as a tool to enrich the work that you’re already doing in therapy.
Once you’ve decided to integrate EMDR into your sessions, you can expect to go through the following:
Phase 1 - History taking - Integral parts of client history is shared with the clinician.
Phase 2 - Preparation - Clinician works with client on “resourcing” and building the client’s toolkit for emotional regulation and distress tolerance.
Phase 3 - Assessment - Client and clinician work together to identify a target (disturbing emotions, memory, physical sensation) to focus on.
Phase 4 - Desensitization / Reprocessing - Eye movements or bilateral stimulation gets introduced for the client to begin reprocessing.
Phase 5 - Installation - Client begins to create a new neural pathway for a more helpful, adaptive, positive belief system that replaces the old one.
Phase 6 - Body scan - Client focuses on the original target and notices any shifts in physical sensations to assess desensitization / reprocessing. If intense sensations remain, we go back to Phase 4.
Phase 7 - Closure - Clinician guides client through resourcing exercise to ensure safety and stability.
Phase 8 - Reevaluation - Client goes back to initial target to determine progress and / or identify brand new target. Client may decide that sufficient reprocessing has happened to take a break from sessions or end treatment.
Note: Even though EMDR follows a protocol, treatment is often not linear. It is common for clients to move back and forth through phases in order to assess progress and fully ensure that reprocessing and desensitization is complete.
How long does it take?
As with all therapy modalities, a lot can happen in a matter of a few sessions! Many of my clients experience significant shifts and reprocessing between 3 to 8 sessions. When clients come into therapy to treat acute traumatic experiences, they might work on a single target and experience enough of a shift that brings them back into their window of tolerance for distress.
For more complex cases (PTSD or CPTSD), clients may choose to do EMDR regularly as a way to maintain their health. The deeper the wounds, the more complex the targets and the treatment might be for getting back to a manageable baseline.
Is it safe? What are the side effects?
Safety is central to EMDR. The first two phases which set the foundation for EMDR are focused on “resourcing”. In other words, we do not move on to the next phases until the client has sufficient skills to manage emotional distress.
If we compared therapy to fitness, one might say that talk therapy is like walking on a treadmill with some incline or no incline at all. It is effective for promoting mental health and that may be all we need to feel better. And we can think of EMDR as more like resistance training and lifting weights. EMDR can often feel more intense than talk therapy because we’re “tearing the muscles” to create strength. We can expect to feel more tired after an EMDR session than a talk therapy session. Recovery in between sessions is critical in order for the brain and nervous system to integrate the work that was done in each EMDR session.
Some common side effects include fatigue and vivid dreams. Sometimes we might feel distressing emotions more intensely during EMDR treatment because we might be feeling emotions that have been repressed for a long time. Just as we might feel sore after an intense workout, side effects from EMDR are normal “soreness” we can expect to feel when we commit to that work.
Is EMDR meant to replace talk therapy?
No. EMDR is not meant to replace talk therapy even though it certainly could. Talking is still part of EMDR therapy, but there is less of a focus on talking with an increased focused on the bilateral stimulation and reprocessing exercises. Phase 4 is when conventionally talking through disturbances might decrease in order to focus on the target. However, I do not make the client fit the protocol; rather, we work to use the EMDR protocol to fit your therapeutic goals and needs. Therefore, depending on the circumstances, we might flow back and forth from talk therapy to EMDR to do “what feels right”.
I practice EMDR in conjunction with Internal Family Systems, and you read more about IFS here!