Eye Movement Desensitization and Reprocessing (EMDR): What It Is and How It Can Help You
We are not immune to the people and things that surround us. Our body reacts to our environment, taking in the stimuli and responding to it physically. When we internalize certain stimuli, such as the joy of engaging in pleasant activities, our nervous system stores the excited feelings that come up for us. Our body also stores certain negative experiences, whether they are one-time or repeated encounters, including being left out of a group, and/or constant exposure to being invalidated by someone around you. These experiences can affect our identities and how we see ourselves as individuals.
Our nervous system is not always aware of time. So, when we are activated, it can be hard to distinguish if our reaction is about the present situation or something historical. Our rational mind may be able to intellectualize certain things, but, in some situations (often those that may lead to seeking therapy), these intellectualizations do not always click emotionally.
Eye movement desensitization and reprocessing is one of the many modalities that allows the mind and body to connect, and clears the tension disconnection can cause.
What is EMDR?
Eye movement desensitization and reprocessing is a form of therapy where the therapist activates the client’s eye movements from left to right while the client recalls distressing memories or events.
The therapist may substitute eye movements with tapping on knees, auditory and/or tactile stimuli using a clicker.
The purpose of this process, called “bilateral stimulation” (BLS), is to allow for more communication between the logical left and emotional right parts of the brain. This leads to more natural processing of past events, which in turn leads to healing.
What conditions can EMDR treat?
EMDR was initially developed to treat trauma, but the use of EMDR has broadened to include conditions such as PTSD, anxiety, depression, and phobia.
Eye movement desensitization and reprocessing can be used to address effects of physical, emotional, and sexual assaults; past experiences of being bullied, and other types of negative interpersonal interactions and events that still affect us today.
EMDR also addresses somatic/physical sensations that we feel in our body for different emotions that come up, and/or different beliefs (such as “I am worthless,” “I have no values,” “The world is not safe) that affect us today.
There is a misconception that we have had to experience “horrific” experiences to be a candidate for EMDR, but that is not true. We could have internalized negative events from the past that seem small but, with repeated events that trigger similar emotions/bodily sensations/beliefs, the impact increases.
There may be individuals who want to work on their difficulties with dating, or feeling stuck/trapped at work. EMDR can help them clear up whatever may be blocking them from making the changes that they want to make.
What to Expect:
EMDR is a structured treatment with different phases. Each therapist adds their own personal style to it. Essentially, the treatment starts out with client’s history taking, in which the therapist and client build a rapport, get to know one another, and the therapist does their own assessment while gathering significant events from the client.
The therapist will also want to assess if EMDR is appropriate for the client, and do a preparation phase to make sure client will have the coping skills to proceed. The therapist will work on establishing more grounding techniques (this also includes “resourcing”), then begin to define more concretely what the client will want to work on. The subsequent sessions usually consist of working on the issue until it feels more resolved.
To begin, the therapist will make sure the client is ready for EMDR and put grounding techniques in place for when they might be needed.
A lot of therapists will also use this opportunity to help you do “resourcing,” which can be described as looking more at positive qualities, traits, and memories that you want to connect with and feel within you, such as identifying a peaceful calm place or feelings of empowerment.
It might be comforting to know that our brain can visualize and be connected with the scene. For instance, if we imagine we are running or actually run, our brain scans would look the same (however, the calories are not!).
Visualizing or connecting to positive qualities allows you to feel calm and grounded. This can be incredibly useful when we are working on triggering things and need to help regulate our body to feel more grounded.
Working on the “target”:
After the history gathering and resourcing, the therapist and client collaboratively decide on the “target” to activate their memory network and nervous system. The “target” can be the specific symptoms, issues, memories, feelings (emotionally or somatically), and/or beliefs that are currently impacting the client.
Once the target is identified, the therapist and client can look at how it is affecting the client, by narrowing down what this image looks like and the feelings and beliefs associated with it.
There are some cases where the therapist may work with the client on identifying an earlier target that seems familiar and similar to the current target. The purpose of exploring earlier but relevant targets is to help the mind and body processes the earlier target, and clear out any tension that we may feel and that may have contributed to the present impact. However, there are some situations that may not have a tieback to the past, therefore you may not need to explore earlier events for that specific target.
Once the therapist and client have established the target, the therapist uses bilateral stimulation to allow for the processing to occur. The therapist guides this exercise, helping the client explore ways to allow for the processing to continue when they become stuck.
In EMDR, your mind and body will lead you in the direction of healing from these targets/events. The therapist’s role is to guide you through the process, helping with the momentum to reduce the negative intensity of these targets.
What does progress look like?
Progress in EMDR is measured by your reaction to the targets that you are unpacking, and how much charge they hold for you.
When there is less charge, it allows you to change your perception, which then affects your reactions, thoughts, feelings, and behaviors. When the charge becomes lessened, the client has an opportunity to pair that target with a more positive belief.
The overall image of the target may have changed too, which can be normal as we are processing and re-processing, and giving a different meaning as the target starts to have a different effect on us. What is happening here is that the body has time to slow down, look at things associated with the event, recognize that it’s in the present moment and not in the moment when the target took place, and do what it needs to do to heal. This allows the mind to to change the meaning of the situation. Essentially, EMDR has helped rewire the brain to change the effect the target has on you and your viewpoint of the situation.
How do I know if EMDR will work for me?
EMDR can be used to treat a variety of presenting issues. However, a therapist will need to assess your situation to determine if EMDR would be appropriate.
It is also very important to look at your expectations of what EMDR will do for you. EMDR is not a quick fix. it can still take time to even complete the preparation phase. The processing phase of EMDR, also known as the desensitization and re-processing, can also take time and more than several sessions.
Everyone processes things differently and at their own pace. We’ve all been impacted differently by events, and will need time to allow for the healing. As with all therapy, Eye Movement Desensitization and Reprocessing still takes time and investment.
While talk therapy by itself can provide clarification, validation, and relief, it can be helpful to add EMDR to your treatment, or to use standalone EMDR. Clients often make more connections to things as they go through the process, almost as free-associations, discussing things that they may not have thought would be relevant or needed in talk therapy, and providing their own validations.
As an EMDR practitioner myself, I have experienced the process from the client’s perspective. I’ve also seen my own clients’ reactions. There were several cases where clients were processing a traumatic event or a negative belief that traced back to their childhood. After a few sessions, they were able to apply compassion to the situation, and clear out the tensions from their body and the disbelief that they were not affected by that situation any longer. The clients were able to report a gentler approach to their life.
One example is a client processing a traumatic event that had happened years prior. At the beginning of the treatment, the client was struggling to feel grounded. A lot of negative self beliefs came to light, including “Am I doing this right?”
This is a common feeling that clients may experience, as EMDR has a different structure than many other therapy modalities. There isn’t a right or wrong form, EMDR is just a different experience and takes time to adjust to a new structure.
With this client, we worked on establishing different resourcing and grounding skills before proceeding to the target. The target was very specific to a particular event, so there was no reason to track for an earlier event that could have contributed to the negative beliefs. The client was able to identify the target, the worst moment that had an impact on them, and start BLS. After a few sessions, we were able to have the client apply compassion to their younger self, and, from there, the client was able to see the traumatic event from a different perspective (“I was young! What was I supposed to do? How was I supposed to know what to do?”), and allow for more empathy for their younger self. They were also able to interpret the event from a different angle (“Maybe I can look at it this way, maybe I don’t need to beat myself up and instead not see this as a bad thing”).
This is not what will happen with everyone, but it was this person’s process. It was what they needed to do to allow themselves to heal. As a result, that client felt a lot of their other challenges in other areas of their life took on different meanings, and they became more compassionate toward how they approached those situations.
In a nutshell: EMDR therapists use eye movement desensitization and reprocessing to activate the memory, focus on the target, and use BLS to allow for processing. Therapists guide this experience until the target loses its emotional charge. As a result of processing the target, many people find their symptoms lessen, enabling them to move on.
Experts say that EMDR can be quicker than “talk” therapy, but the results can be subtle. Clients may feel more empowered as the way they change their narrative through EMDR can feel more organic by changing how they think, feel, and behave after the processing. Eye Movement Desensitization and Reprocessing can be considered a way to connect the mind and body, heal in a gentler way, and strengthen ourselves and our narrative of our experiences.
Shama Goklani, LCSW, is a therapist at Cobb Psychotherapy. If you would like support in incorporating self-care into your life, contact Cobb Psychotherapy and see how therapy can help.