What is EMDR?
I remember the first time I heard about EMDR—it was during my Abnormal Psychology course, where our professor told us about this innovative treatment. EMDR involves eye movements to treat symptoms of PTSD. He was very much from the old guard of psychotherapy and treatment, and his bewilderment was palpable. Nonetheless, I was intrigued.
Many years later, I am in clinical practice, and I had the opportunity to be trained in this modality. Being a skeptic by nature and remembering the wry way my professor described EMDR, I was guarded but tried to remain open to this interesting, and sort of odd-sounding, treatment approach. After processing and resolving a lifelong phobia of mine, and experiencing breakthrough and change with clients in ways I never imagined, my skepticism was satisfied and I can say, with full confidence, EMDR is a powerful and effective treatment for trauma and the tendrils of symptoms it twists.
EMDR, which stands for Eye Movement Desensitization and Reprocessing was developed to help individuals process and heal from traumatic experiences. Initially developed by psychologist Dr. Francine Shapiro in the late 1980s, EMDR incorporates elements of cognitive-behavioral therapy (CBT) with specific techniques involving eye movements or other forms of bilateral stimulation, such as hand taps or auditory tones.
The underlying theory behind EMDR posits traumatic experiences can become "stuck" or improperly processed in the brain, leading to distressing symptoms and emotional disturbances. This ‘glitch’ of sorts makes us more fearful and vigilant to future harmful events sp we can avoid the distress we expect. EMDR aims to facilitate the reprocessing of these memories, allowing them to be stored in a more adaptive and integrated way.
The process of EMDR typically involves several phases:
History and Preparation: The clinician gathers information about the client's history, current symptoms, and identifies specific target memories or events that will be the focus of EMDR treatment. The client is also prepared for the processing phase by learning various coping strategies and relaxation techniques. This is typically done in 2-3 initial sessions.
Assessment: The therapist works with the client to identify the negative beliefs, emotions, and physical sensations associated with the target memory. They also identify a positive belief that the client would like to replace the negative belief with.
Desensitization: The client focuses on the target memory while simultaneously engaging in bilateral stimulation, such as following the therapist's finger movements with their eyes. The bilateral stimulation facilitates the processing of the traumatic memory by taxing the attention span of the client, reducing its emotional intensity. In this way our brain processes bite-sized chunks of material that are much less likely to overwhelm the individual.
Installation: During this phase, the client identifies and strengthens the positive belief they would like to have instead of the negative belief associated with the target memory. The therapist guides the client in repeatedly pairing the positive belief with the target memory to help integrate it.
Body Scan: The client scans their body for any residual tension or discomfort associated with the target memory. If any sensations are present, additional desensitization is conducted to further process those sensations.
Closure: At the end of each session, the therapist ensures that the client is in a relatively stable state before concluding the session. This may involve techniques to help the client relax and return to a more grounded state.
Reevaluation: At the beginning of subsequent sessions, the therapist assesses the progress made since the last session and identifies any new target memories or related issues that may need to be addressed.
EMDR is an evidence-based treatment with over 20 years of research strongly supporting its use as a time-effective and effective treatment for PTSD and other trauma-related conditions. I have successfully used EMDR with clients from diverse backgrounds of trauma, culture, and mental health history, and have trained many other clinicians in its use. Revisiting the previous distressing events that have unknowingly shaped our lives is inherently painful and uncomfortable; EMDR is one of the best ways we know today to revisit and redefine these elements of our story.
