What is EMDR?
EMDR stands for Eye Movement Desensitization Reprocessing. What makes EMDR so different from other types of therapies is that it uses specific techniques, like moving your eyes back and forth or listening to sounds that alternate between your right and left ears, to help heal you from painful memories. This process allows you to reduce the distressing feelings around these memories (also known as desensitization) and gain helpful insights that can support healing (also known as reprocessing).
The therapy was developed in the 1980s by Dr. Francine Shapiro, who discovered that eye movements could help people process memories more easily and talk about them without feeling overwhelmed.
You might be wondering, how do eye movements actually help with this? The answer is two-fold. To understand why EMDR works, let’s first explore the theory behind it.
The theory behind EMDR Therapy
EMDR therapists believe that all day everyday as we think and experience life, our brains are processing what is happening and storing what we need and letting go of what we don’t. Can you imagine if you remember every single thing that you have ever seen, heard, or thought? Instead, our brains are good at holding on to what it finds important because we might need it for the future.
For example, knowing that turning on a stove makes it hot. We use this information to cook or avoid putting our hands or flammable objects near the stove. We also need to learn and retain what is flammable and what isn’t. And so on. This is known as the Adaptive Information Processing model (AIP).
Okay, while we don’t know exactly why eye movements work in EMDR therapy, studies continue to show that they do. So we have some theories...
We’ve known that during REM sleep, our brain is processing and storing memories and in this stage of sleep our eyes move back and forth all on their own. It’s possible that mimicking this while conscious helps kickstart the same process.
Dual attention: The part of our brain that pulls up memories is different than the part that follows the bilateral stimulation of eye movements. It’s possible that desensitization occurs because both these areas are engaged and so it helps you not get overwhelmed by the memory and can more accurately process it.
It’s important to note that although Dr. Shapiro’s discovery started with eye movements, she quickly learned you can use almost any stimulation as long as it’s bilateral (meaning affects both the right and left side of the body). We call this Bilateral Stimulation (BLS). BLS can be sounds, tapping on knees, or some therapists have buzzers you can hold in your hand. In EMDR therapy the important part is that the BLS switches from your left and right side.
Why does EMDR use eye movements?
With AIP, it makes sense that our brain & body would want to hold on to traumatic memories. These memories hold important information about the world, people, or even ourselves. But when we experience negative effects from these memories (such as flashbacks, difficulty sleeping, anxiety, depression etc.), it’s usually because we developed excessively negative beliefs from them. Here enters EMDR therapy, to help us RE- process and break these beliefs.
We also know that when negative memories affect us so strongly, it’s often too uncomfortable to think about. Unfortunately this means it can get difficult to break those negative beliefs with traditional therapy, but not when we use eye movements and stimulation used in EMDR therapy.
EMDR in Practice
Okay so now you have learned a little about the origins of EMDR, the AIP model it operates from, and how BLS factors into it. This gives you a solid foundation to understanding the why behind the method of EMDR. To fully understand what a session of EMDR therapy looks like, let’s take a look at the specific process it uses.
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History taking: The EMDR therapist will ask questions relating to your triggers, memories, and goals. In this session you and your EMDR therapist will decide what memories to work on first.
Example
Current trigger: Driving
Related Memory: An accident
Future Goals: Relaxation when driving
Preparation: The EMDR therapist will spend time providing tools and practice in coping with uncomfortable feelings before moving forward.
Example
Client learning how to deep breathe
Assessment: The EMDR therapist will assess thoughts, emotions, and body sensations related to memory being worked on.
Example
If the memory discussed is having been in an accident, the client may have the thought “I am not safe”, the emotions of fear, and the body sensations of a racing heart.
Desensitization: Bilateral stimulation, (BLS) is used to desensitize and process the targeted memory. BLS is used for about 30 second periods with the EMDR therapist checking in between sets on what thoughts, emotions, or body sensations come up.
Example
Therapist: “What are you noticing now?”
Client: “I feel fear thinking about it. My heart is racing faster. I also feel confused about how it happened”
Installation: The EDMR therapist will continue to use BLS to help increase positive thoughts and feelings.
Example
Client: “I am safe now. I know better. feel relaxed and confident.”
Body scan: The EMDR therapist will prompt you to connect with your body and see if there is any negative body sensations. If yes, we continue from phase 4. If no we close out the target.
Closure: Whether a target was fully processed or not, an EMDR therapist will ensure you are stable before ending a session.
Reevaluation: Following sessions open with reevaluation. Here the EMDR therapist measures strength of negative or positive beliefs related to the processed memory. If negative beliefs continue, the session will resume from phase 4. If a memory is fully processed with strong positive beliefs now associated, the EMDR therapist will then move on to phase 3 with the next memory to target.
If the mind is a cluttered house, the goal with EMDR is to deep clean the whole house.
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EMDR integrates, or pulls from, what we see that works from several other popular types of therapies.
Like psychodynamic therapist, the EMDR therapists care about where a problem started.
Like behavior therapists, EMDR therapists care about what behaviors get positively reinforced. Do these behaviors really help us? For example, people pleasing.
Like cognitive therapists, EMDR asks clients to explore their core beliefs.
Like somatic therapists, EMDR therapists ask clients to pay special attention to body responses throughout treatment (such as muscle tension, tightness in the chest, and knots in your stomach.)
Like experiential therapists, EDMR therapists understand the power of experiencing emotions and memories fully.
Like hypnotherapists, EMDR therapists use imagery work to pull up memories. (However, please note that although EMDR may use eye movements, it is not for the purpose of inducing a trance state such as in hypnotherapy).
Like systemic therapists, EMDR therapists understand humans don’t exist in a vacuum. We live in families and communities that affect treatment too and must be taken into consideration.
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A main way EMDR differs from other therapies, is the structured approach and the internal processing work.
In traditional talk therapy, clients are asked to open up and externally process their thoughts. Therapists then provide psychoeducation and differing perspectives as they feel is needed to assist the client in healing work.
With EMDR’s more structured approach, EMDR therapists provide a safe space for clients to internally process. EMDR therapists check in but allow clients to shift their perspectives through intuitive processing and free association. The EMDR therapist believes change is most impactful if it comes from within. This method may also support why EMDR appears to have more rapid results than traditional talk therapy.
To summarize, EMDR uses bilateral stimulation to help clients desensitize a memory, process it, and become “unstuck”. In the safety of the therapy office and after preparation, a client will sift through their negative beliefs. Through creating new associations, pulling other memories, and fully feeling all the emotions which come up, clients will find the adaptive (or helpful information) they need to increase their wellbeing. EMDR therapists help guide and support this journey.
