EMDR
Eye Movement Desensitization and Reprocessing
WHAT IS EMDR?
If you’re considering EMDR therapy, you may have lots of questions - especially if you’re newer to the therapy world in general. It’s a very different type of therapy compared to what we traditionally see or think of as “talk therapy,” so my goal in providing this info is to take out some of the fear and uncertainty about trying something new and present it in a way that makes it easy to understand how this type of therapy can help get you unstuck!
EMDR is a trauma-focused therapy designed to help you brain become “unstuck” and fully process memories that were originally overwhelming at the time that they occurred. It’s theoretical model is based on the following principles:
Just like the physical body, the brain is designed to naturally heal
We store information in interconnected networks of thoughts, emotions, images, and sensations.
In EMDR and other trauma-focused or somatic therapies, we are often using the term “trauma” much more loosely that what many people may typically think of as a traumatic event or an incident that could lead to posttraumatic stress disorder. Here, we are defining it as follows:
Trauma (noun): A significantly stressful experience that overwhelmed the nervous system and remains unresolved or unprocessed. It is about how the experience was stored in your body and brain, not about what actually happened.
We experience a range of experiences throughout our lives that may have been stressful enough to have an impact, and these experiences are subjective and different for every person depending on their history. Experiences can range from more emotionally overwhelming experiences that have affected one’s confidence, self-esteem, self-worth, or identity (e.g. divorce, job loss, dismissiveness by peers or authority figures, or stressful medical procedures) to more acute or chronic incidents that are life-threatening or could lead to serious bodily harm (e.g. witnessing a violent act, an assault, history of physical, sexual, or verbal abuse, car accidents, serious injuries, or painful medical procedures or emergencies).
HOW DO WE HEAL?
Healing from trauma (or any significantly stressful experiences) usually involves a combination of the following:
Psychoeducation
Orienting to Safety
Skill Building: Nervous System Regulation & Distress Tolerance
Body Awareness and Reconnection
Completing Stress Response Cycles
Guided Exposure and Processing of Traumatic Memories
Meaning-Making and Integration
Empowerment and Confidence-Building
In our “normal” daily lives, we integrate new information coming in into existing memory networks. Think about this as a tree: Seeds are planted when we are young. As we grow and interact with the world, we take the new information coming in and merge it with the existing trees, building more branches that lead to learning and help us build confidence in our ability to move through the world in a healthy way.
Our bodies and brains are naturally wired to keep us physically and emotionally safe, so when we experience something stressful or threatening, certain parts of our brain “turn off” so that more energy can go toward the other parts that deal with threats and survival. When we experience these stressors, it interrupts how our brains naturally process information, leaving the event “unprocessed.”
In those moments, we’re not able to create new branches on our existing trees and learn from them in a healthy way, so a new seed is planted. The problem is that the new seed is only carrying the information from the stressful event, and over time, more new experiences are added to this tree, reinforcing the stressful feelings, negative beliefs, and uncomfortable physical sensations or body responses that are connected to it.
THE EMDR PROCESS
You don’t have to talk through the details of what happened to benefit from EMDR therapy. Instead, you’ll focus on how the memory shows up in your mind and body in the present moment while engaging in techniques that assist your brain in resolving the lingering emotions, sensations, beliefs, and images attached to it. Bilateral stimulation (BLS) is the primary technique used here, facilitating communication and information processing in the brain, while encouraging something called "dual attention,” which keeps you grounded in the present while re-experiencing stressful experiences from the past.
The EMDR process includes an 8-phase protocol that can be grouped into the following categories. While it is possible to move through these phases quickly, they generally span a minimum of several sessions and can vary greatly based on existing coping skills, the nature of the trauma we are working on, how early the trauma happened, and whether there are current stressors or instability that may also need to be addressed in sessions. That said, regardless of how far we are able to get in this protocol, many clients report positive shifts and can find relief in just one session.
Phases 1 & 2: History-Taking and Preparation
We will discuss the current symptoms that are creating the most stress in your day-to-day life and explore related past experiences. As we’re building rapport and trust within the therapy relationship, we’ll start to narrow down the memories, beliefs, emotions, and physical sensations that may be most helpful to focus on.
Before we begin the reprocessing phases, we’ll want to build confidence in your ability to manage uncomfortable feelings that may emerge. We’ll discuss and practice a range of skills, focusing on strategies to relax and soothe your body, find healthy distractions, and empower you in your abilities to regulate your nervous system and emotional responses.
Phases 3 - 6: Desensitization and Installation
To begin the “reprocessing” phases, we’ll spend a minute naming the images, beliefs, emotions, and sensations attached to the stressful memory to bring them front and center into your working memory.
You’ll be asked to focus on this information while introducing the bilateral stimulation until we check-in, at which you’ll be asked what you notice and then encouraged to continue with the BLS. During this process, clients generally notice a gradual decrease in the intensity of the previously stressful feelings or sensations and an increase in calmness.
Once the memory has been fully desensitized, we will continue sets of BLS with the focus on strengthening more adaptive and empowering beliefs that promote safety, security, and confidence in the ability to manage stressors in the future.
Before leaving these phases, we’ll use body scans as a way to check-in for any remaining stress in the body and use BLS to continue processing or release any lingering tension.
Phases 7 & 8: Closure and Re-evaluation
Each session will end with a check-in and calming or grounding strategies that allow you to leave the session feeling safe, present, and resources.
At the next session, we’ll check-in to see what has shifted and if anything still needs processing.
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