What Is Eye Movement Desensitization and Reprocessing (EMDR) and How Can It Help You?
Why I Integrate EMDR in My Practice
I was initially exposed to EMDR when I was in graduate school at the Manchester VA Medical Center. I worked with people who had histories of trauma and learned about the merits of how the VA was using EMDR in their treatment. Given my work with patients, my vast reading of works such as Bessel van der Kolk’s (2014) revolutionary book, The Body Keeps the Score, and in speaking with friends, family and colleagues, I have learned that sometimes people can feel blocked in accessing what they need to heal through talk therapy alone.
Because of the way trauma memories are stored in our nervous system, when we experience a significant adverse life event our bodies can internalize the associated feelings, which can leave us feeling “stuck” long after the trigger has passed. This stuckness can adversely affect our relationships, how we regulate our emotions and can create a sense that the “past is present."
Thus, the feelings from these past experiences can be triggered by stimuli in our present lives — sometimes leading to problematic and even distressing re-experiencing of those past trauma(s). Eye Movement Desensitization and Reprocessing (EMDR) is a therapy technique that connects the mind to the body and allows for the clearing and healthy processing of these stuck memories in order to help people move forward in their lives.
More specifically, Brionna Murray (MSW, SWC, CLC), a fellow therapist who runs Wholly Healing Therapy, explained her interest in augmenting therapy with EMDR by stating: “I find that EMDR is able to enhance traditional talk therapy because it is grounded in the notion that our brain naturally wants to heal and it is able to do that in the background (without even using our words to describe what we are noticing). In reprocessing, my clients find so much relief in knowing that they don't need to express everything they notice between sets because they know their brain is doing the work for them. This not only increases the time available for reprocessing in session with using less words, but it gives the client the opportunity to attune to their body and start to trust it, which can be a foreign thing if they have experienced trauma.”
With this interest in mind, I completed my EMDR Basic training with EMDR Professional Training, an amazing organization that emphasizes the research behind this approach and how using EMDR can make a significant positive impact in someone’s treatment.
What Is EMDR?
The theory behind EMDR is explained by the adaptive information processing (AIP) model, which argues that because trauma memories get processed differently, they remain accessible in a way that can prevent people from living their life in the present.
When learning EMDR, I became fascinated by the idea that just as the body has a natural healing mechanism when we get a cut, so does our brain. However, the way traumatic events are stored in our bodies can prevent us from accessing this natural healing mechanism; and this is where EMDR can help.
Trauma is defined as any past experience that negatively impacts your life and creates stress in the body and mind. It can involve events that impact your physical, emotional or spiritual self, threatening your own sense of safety or from witnessing a threat to someone else. Trauma can be big or small, and it can often leave people in a state of distress that they are unable to process.
The impact of trauma for some can be long-lasting, with varying symptoms, including difficulty concentrating, sleep problems and nightmares, hypervigilance, irritability, flashbacks, recurrent and intrusive thoughts, as well as many other difficult symptoms. While the body’s stress response in the moment is natural and necessary, sometimes distress from the past continues to provoke upsetting thoughts, images, and feelings that can make one feel like her or she is frozen or stuck in that time. It is these experiences and memories that need help being processed.
In a 2012 study, EMDR was found to be beneficial for 77% of clients with PTSD and psychotic disorder, whereas other studies have found that the benefits of EMDR can be maintained long after treatment is complete. Many national and international organizations — including the American Psychiatric Association, the American Psychological Association, and the International Society for Traumatic and Stress Studies — recognize EMDR as an effective modality of treatment.
A big advantage of EMDR is that for many clients, therapy can be completed in fewer sessions than with other methods. More than 100,000 therapists across the globe use EMDR, and millions of people have found relief using this therapy over the past 25 years.
How does EMDR work?
EMDR therapy focuses on the past, present, and future with the goal of reprocessing disturbing past events that continue to affect you in your present life, addressing current situations that trigger similar distress, and developing the approaches and skills you’ll need for moving forward with your life.
When using EMDR, a therapist helps to guide a client’s eye movements from left to right while they recall memories or events that are causing distress. Other stimuli, like a clicker or tapping, might also be used.
This process of bilateral stimulation (BLS) enhances communication between the left and right hemispheres of the brain, connecting the logical with the emotional in order to reprocess these past experiences and promote healing.
The therapy consists of eight phases:
- History taking/treatment planning: you’ll work with your therapist to identify your targets for EMDR, which may include memories or current situations which cause distress, and you’ll discuss how these problems and the resulting symptoms and behaviors are affecting you. In developing a treatment plan, you’ll work with your therapist to identify the skills and behaviors you’ll need to develop for your future well-being. With EMDR, you don’t have to discuss in detail any disturbing or distressing memories – a general outline typically suffices.
- Preparation: your therapist will answer your questions about EMDR and will teach you a variety of stress-reduction techniques you can use between sessions should any disturbing emotions arise.
- Assessment: you’ll choose a statement that reflects a negative self-belief — such as “I’m bad” or “I fail at everything” — that is associated with the problem you’re working on. You’ll also choose a positive statement you’d rather believe instead, such as “I’m a good person” or “I can succeed.” You will work with your therapist to identify the physical sensations and emotions that are associated with the target problem.
- Desensitization: you will then move into the first of the reprocessing phases. In this phase, your therapist will guide you in revisiting the disturbing memory and invite you to engage in bilateral stimulation (i.e., eye movements, tapping, or sound). The bilateral stimulation serves multiple purposes, it keeps you present in the moment and connected with your therapist, it activates different parts of your brain and it is hypothesized to stimulate a relaxation response (Shapiro, 2018). Your therapist will be there to support you through this process..
- Installation: you will be "installing" your positive cognition in this next phase. Your therapist will help you focus on what you want to feel as opposed to the negative cognition that may have contributed to your reason for seeking treatment.
- Body Scan: since trauma memories can be stored in the body, an EMDR-trained therapist will invite you to explore your bodily sensations to determine if there is anything missed in earlier stages. One of the many things I love about EMDR is that it not only addresses the mind, but also the body.
- Closure: all EMDR therapy sessions end with self-calming techniques to help you regain a sense of balance to ensure you’re prepared for what could come up between sessions.
- Re-evaluation: you’ll work with your therapist to re-evaluate the target problem, make any adjustments as needed, and conclude your EMDR treatment.
What Conditions Can EMDR Treat?
While EMDR was used initially to treat trauma, over time this therapy has been successfully applied to other concerns.
More specifically, EMDR therapy can help children and adults who are dealing with a wide variety of challenges, including anxiety, depression, chronic pain, chronic illness, sexual assault, phobias, grief and loss, performance anxiety, addictions, and eating disorders.
For example, someone who experiences intense anxiety when having to meet with their boss or other authority figure could be an excellent candidate for EMDR, as would someone with PTSD or panic disorder. This therapy can be used to address many types of negative experiences and personal interactions that continue to affect you today.
Moreover, Brionna Taylor explains, “The biggest sign for me to incorporate EMDR into someone's treatment is if their treatment goals are around resolving trauma and triggers associated with their trauma. If they mention their past getting in the way of their present, I will likely recommend using EMDR in their treatment plan. However, I use EMDR for more than just trauma. For example, if a client wants to work through their anxiety or old stories from the past that interfere with their self-esteem (e.g., I am unworthy, I am not good enough), then I will also recommend EMDR in treatment, because it is a great way to see where these stories began and start to replace them with adaptive ways of thinking.”
What To Expect in an EMDR Session With Me
I follow the eight stages outlined above and always begin EMDR work with my clients by discussing their history and concerns so we can develop a treatment plan together. The next step involves making sure my clients have everything they need to process traumatic memories and experiences, which includes resourcing — looking at the more positive memories and empowering associations that the client wants to connect with — and developing coping skills.
Once these preparatory steps are complete and questions have been answered, we can begin the work of addressing and reprocessing the target concern. The client is free to stop at any time as needed. The mind and body will lead in the direction of healing, and it’s my job to guide my clients through this process. While EMDR can be used in conjunction with traditional talk therapy, I have found that EMDR can provide more effective and long-lasting results that are widespread, due to the gentle, natural shift in the client’s personal narrative and the way they think, feel, and interact with the world.
Dr. Rebecca Hoffenberg is a Clinical Psychologist at NY Health Hypnosis & Integrative Therapy. For questions or to learn more about how mindfulness & hypnotherapy can help you, please contact us here.
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