What is EMDR Therapy?
EMDR is a comprehensive therapeutic approach that focusses on the memory and the brain’s ability to process information. EMDR Therapy is based on the idea that current distressing symptoms can be linked to memories of past traumatic experiences that were not adequately processed or stored in the brain.
EMDR aims to help individuals process and reprocess these memories to alleviate the associated symptoms and distress. It is considered to be an “A” level treatment for trauma and is recommended by the World Health Organization for treatment of posttraumatic stress disorder (PTSD).
EMDR views our present symptoms as a result of the activation of memories that have been inadequately processed or stored in the brain. Memories encompass various elements from the time of the event, including information about the event, perceptions, cognitions (thoughts and beliefs), emotions, and sensory information.
When these memories are experienced in a heightened state of arousal or a lack of arousal which is associated with fight-flight-freeze response, they remain associated with the internal and external stimuli present at the time of the trauma. This includes images, negative beliefs, emotions, and physical sensations.. When individuals recall traumatic memories, they may re-experience the heightened emotional and physiological responses that occurred during the traumatic event. In essence, the earlier experience is held in a state-specific form.
This means that when something in the present triggers a recollection of a past traumatic memory – and it doesn't have to be significant; it could be anything like a smell, a sound, or how you interpret someone's comments – the person is effectively transported back to when they initially experienced the traumatic event. Furthermore, their coping mechanisms often mirror how they dealt with it originally (e.g., dwelling, anger, anxiety, etc.).
In essence, current symptoms are triggered in the present by similar internal and external stimuli experienced during the trauma. Traumatic experiences become frozen in time when not adequately processed.
However, when these memories are processed, they have a reduced impact on our present lives. EMDR's goal is to diminish the influence of these memories by allowing the brain to perform its natural function, which is to connect adaptive information to these memories.
Why would someone see an EMDR therapist?
People who have experienced traumatic events (this could be big “T” trauma, or little “t” trauma) and as a result experience these symptoms: troubling images, negative beliefs, emotions, and physical sensations etc.
EMDR therapy is commonly used to address the following symptoms and conditions:
Post-Traumatic Stress Disorder (PTSD): EMDR is well-known for its effectiveness in treating PTSD. It can help reduce symptoms such as flashbacks, nightmares, hypervigilance, and emotional numbing.
Trauma: EMDR can address the effects of various traumatic events, including physical or sexual abuse, accidents, natural disasters, or witnessing violence.
Anxiety and Phobias: EMDR can be used to alleviate symptoms of anxiety disorders, specific phobias, and panic attacks that may have roots in past traumatic experience
Depression: EMDR can help individuals with depression when it's related to unresolved past traumas. By processing these traumas, depressive symptoms may improve.
Addictions: Some people turn to substances or behaviors to cope with unresolved trauma. EMDR can be part of a comprehensive approach to treating addiction by addressing the underlying trauma.
The end result of EMDR therapy is typically a reduction in the intensity and impact of trauma-related symptoms. This may include a decrease in distressing thoughts and memories, a reduction in emotional and physiological reactivity, and an overall improvement in the individual's well-being and quality of life. The therapy aims to help individuals process traumatic memories so that they no longer interfere with their present-day functioning and emotional health
What would an EMDR therapy session look like?
EMDR is relatively structured when compared to other therapeutic modalities. It involves eight phases in the treatment process. While not all of these phases are covered in every session, their order is essential.
The first phase is history taking and case planning, where we determine the therapeutic direction. This involves deciding if EMDR is suitable and, if so, which memories should be processed.
The second phase involves enhancing internal and external resources to ensure that you can connect with adaptive information while processing traumatic memories. During this phase, we may introduce various skills, techniques, or exercises. For example, a client might choose to participate in trauma-sensitive yoga for better mind-body connection, or we could employ mindfulness techniques, such as those found in ACT or MBCT. The primary goal is to assist the client in regulating emotions during and after the processing phase.
With sufficient support and resources in place, we progress to the third phase, which is the assessment. Here, we activate the memory network for reprocessing, leading us to phase four, where we start desensitizing the memory. This is achieved using bilateral eye stimulation (BLS). Additionally, we ask specific questions that expose and highlight maladaptive beliefs that may have remained hidden. In this phase, we can also utilize the resources from phase 2 to reduce distress levels.
Once the memory is no longer distressing, we move on to phase five, where we introduce positive or adaptive information to replace the old traumatic responses. The client is encouraged to believe in these positive beliefs about themselves. Once the client genuinely feels that the positive belief is valid, the therapy progresses to the "body scan phase. If this proves challenging for clients, we can draw on the resources introduced in phase 2.
In the body scan phase, the client focusses on physical sensations that are associated with the traumatic experience. These sensations may exist even though the memory itself there's no longer distressing. At this point (in the seventh phase), the sensations are addressed as part of the therapy to resolve the impact of the memory. Finally, the session is concluded, often with a mindfulness exercise or technique to help individuals return to an emotional equilibrium.
In the final phase, phase 8, the client takes time to re-evaluate their progress since the last session and determine what aspects still require attention.
How does EMDR therapy work? What is the science underlying the process.
The creator of EMDR (Francine Shapiro) incorporated psychodynamic therapy, behavioural therapy and cognitive therapy when she developed her adaptive information processing model (AIP).
For the purposes of this very brief summary, the important point to highlight from this model is its view that humans inherently move towards health, but traumatic experiences disrupt that course of action. As result, we want the body to do what it does best, which is to utilize the adaptive information to move towards physical and psychological healing.
We achieve this by processing specific traumatic memories and link them to more adaptive networks and facilitate information processing. This enables the person retrieve other information when these memories are triggered. So in phase 2 when we are buffing the internal and external resources, that’s where we can ensure that adaptive information is available for you to connect with.
EMDR uses Bilateral Stimulation (BLS) to aid reprocessing. This involves the client tracking a moving finger or light with their eyes (or using tapping if needed). As they focus on the memory, the eye movement challenges the working memory containing their trauma recollection. Clients split their attention between BLS and the memory, overwhelming the working memory. This creates psychological distance, enabling the individual to view the memory objectively instead of reliving it. It also reduces the memory's intensity and emotional impact.
The installation phase of EMDR is used to facilitate connections with more positive and adaptive thought patterns. The focus now shifts to the desired or preferred beliefs that the
individual would like to have. In essence, it involves reprogramming or changing the way the individual perceives and relates to the memory, replacing negative beliefs with more positive ones.
See www.emdria.org for updated research references.
What Can EMDR Therapy Help With?
- Alleviates PTSD symptoms such as anxiety, depression, and flashbacks
- Reduces the impact of past distressing events
- Encourages a shift in self-perception and outlook on life
- Facilitates natural integration of past experiences into the present
- Weakens the hold of traumatic memories, empowering individuals
- Illuminates a self-chosen path to living, free from the constraints of trauma