What is EMDR?
EMDR Therapy is a progressive psychotherapy tool used to enable people to heal from past trauma. It is a commonly misunderstood myth that “trauma” has to mean a life shattering experience, such as rape or war, when in fact the more subtle forms of aversive experiences can have equally or more negative and lasting effects. The trauma associated with incarceration of a parent, parental mental illness, parental substance abuse, emotional neglect, bullying, and divorce are often associated with long-term negative health, wellness, and economic concerns (for more information see the ACES Study). Another myth that is widely held is that significant emotional pain requires a long time or even years to overcome. Thankfully, EMDR therapy shows that the mind can in fact heal from psychological trauma, similar to how to the body heals from an injury.
A metaphor provided by the EMDR Institute on how EMDR therapy works, “When you cut your hand, your body works to close the wound. If a foreign object or repeated injury irritates the wound, it festers and causes pain. Once the block is removed, healing resumes. EMDR therapy shows a similar sequence of events occurs in the mind. The brain’s information processing system naturally moves toward mental health and wellness. If the system is blocked or imbalanced by the impact of a disturbing event, the emotional wound festers and can cause intense suffering. Once the block is removed, healing resumes. Using the detailed protocols and procedures learned in EMDR therapy training sessions, clinicians help clients activate their natural healing processes.”
Does it work?
More than 30 positive controlled outcome studies have been done on EMDR therapy. Some of the studies show that 84%-90% of single-trauma victims no longer have post-traumatic stress disorder after only three 90-minute sessions. Another study, funded by the HMO Kaiser Permanente, found that 100% of the single-trauma victims and 77% of multiple trauma victims no longer were diagnosed with PTSD after only six 50-minute sessions. In another study, 77% of combat veterans were free of PTSD in 12 sessions. There has been so much research on EMDR therapy that it is now recognized as an effective form of treatment for trauma and other disturbing experiences by organizations such as the American Psychiatric Association, the World Health Organization and the Department of Veterans Affairs. Given the worldwide recognition as an effective treatment of trauma, you can easily see how EMDR therapy would be effective in treating the “everyday” memories that are the reason people have low self-esteem, feelings of powerlessness, and all the myriad problems that bring them in for therapy. Over 100,000 clinicians throughout the world use the therapy. Millions of people have been treated successfully over the past 25 years.
What will happen in EMDR?
EMDR therapy is a model that moves through several phases. All people who participate in EMDR therapy will be asked to complete a few positive resourcing, such as identifying a relaxed state or a place or experience that feels calm and soothing. This is in preparation to be able to address more bothersome memories. Before we move into the processing those traumatic events, we like to ensure our clients have a “toolbox” of strategies to use to manage distress that arises. EMDR is focused on processing distressing memories that often we try to avoid, as they cause pain, discomfort or stress. Sometimes these memories can bring about feelings of sadness, anger and/or heartache. Once our toolbox is set to go, we move onto “reprocessing” those distressing memories.
As for a closer look into the full experience of EMDR “reprocessing”:
In the beginning the counselor will take a history of all of the relevant experiences that are related to your current distress. Then with your assistance, the counselor will prioritize them into what is most relevant to your current distress (most distressing to least distressing). Next the counselor will help you identify the negative thoughts you have about yourself in response to the event (ie: I have to be in control, I am not good enough, It was all my fault). As well as, how you would like to believe about yourself instead (ie: I can safely let go of some control, I am enough as I am, I did the best I could). And finally, how true that positive belief feels right now. It’s normal for that positive belief to feel closer to “totally false” then “totally true” in the beginning. That is okay and the goal is that the positive belief will feel true by the end of processing.
The counselor will ask what the most difficult part of the event was, how bothersome the memory is on a scale of 0-10, and where you hold the distress in your body (ie: throat closing, chest tightness, shoulders tense). Once all that information is collected, the counselor will ask you to hold that information in your mind for a moment, and then begin to add in a form of “Bilateral stimulation” or BLS. BLS is just a fancy term for saying movements from left to right that cross the midline of the body. The most common type of bilateral movements are eye movements but can also be done through tapping (by clinician onto client or client tapping themselves). BLS movements are believed to replicate REM sleep, or the deep stage of sleep, in which our bodies do most of its healing and repairing.
During BLS movements, your mind will then begin sorting through the relevant information. The process is similar to sifting memories through a strainer, where the traumatic memories are like big rocks that get stuck, and with that keep us stuck in unhealthy patterns of thinking and behavior. The BLS helps to break down these memories into smaller pieces that eventually pass through the strainer. The goal is to allow the brain to move through these “stuck” areas and into more adaptive or positive associations. It may take more than one session to fully process a traumatic event. When there is not enough time in the session to get through all the material, your therapist will move you through an exercise to contain any distress and put the information away until it can be completed at the next session (using those resources in our “toolbox” we mentioned earlier. A “completed processing target” would mean that: the negative belief is no longer there, the positive belief feels 100% true, there is no distress left, and there are no unusual sensations felt in the body (tightness or tension)!
For most clients they can move through to completion in a 1-2 sessions. Some individuals will need more work up front to prepare for facing those distressing memories and that is totally okay. There are no “supposed to’s” in this process, and there is no way for you to do it wrong. EMDR is your mind healing itself with the existing information and positive memories that you already have. Your therapist is just there to provide support and structure. Moreover: for some people their target memory is too difficult to share out loud. Luckily with this process you do not have to mull over the nitty gritty details with your therapist. It only takes what we like to call “a chapter title” and your therapist will tell you to allow your brain to just “Go with that”.