Eye Movement Desensitization and Reprocessing (EMDR) is a treatment technique that was originally designed to help process Trauma, including Post-Traumatic Stress Disorder . Trauma is the result of a stressful event like abuse, sexual assault, combat, a natural disaster or a variety of other high-stress events getting stuck in the mind and remaining unprocessed. This can lead to symptoms such as nightmares, flashbacks, avoidance of things which are related to the event, agitation, being angry, being depressed, being easy startled, and other symptoms. EMDR treats trauma by helping the person integrate the memories, emotions and physical sensations associated with the trauma. This helps change negative thoughts about the event and reduces anxiety and other negative emotions associated with the memory. While processing using EMDR, the event is remembered while at the same time being aware of being in the present and being safe. Additionally, EMDR adds what is called Alternating Bilateral Stimulation (ABS). There are several forms of ABS that are possible: watching an object move back and forth with your eyes, listening to alternating tones from one side then the other with speakers or headphones, or feeling tactile pulsing/buzzing using a therapy tool like the TheraTapper (TM). Combining the elements of remembering the event, being aware of the present and, experiencing alternative bilateral stimulation allows the mind to be desensitized to the trauma of the event and reprocess the event as a manageable memory. This takes the previously stuck memory and integrates it, helping the body and mind know the event is over.
There are a variety of theories as to how EMDR works. We do not at this time fully understand how EMDR works and why it is effective with helping people manage challenging events and increase their well being. What we do know is that it does work and people feel better and are more functional as a result of EMDR therapy. Incidentally, this is also true of what we know about medications used to treat mental heath issues. We do not know exactly how they work either, just that they do.
One major difference between EMDR and traditional counseling is that the person receiving help does not need to verbalize anything of their experience. With talk therapy, the person will usually describe the event that happened out loud. With EMDR this is not necessary. As a client, you will be asked to remember the memory yourself, but you will not need to talk about the event to the counselor if you don’t want to. Some clients find it helpful to talk out loud as they are processing the memories they are working on, but the choice is yours.
Regarding choices, the control of directing the therapy is always in the hands of the client. One of the major issues that is frequently associated with trauma is a lack of control. With EMDR therapy, you will be asked to re-experience the event in your mind, but how long you spend working on the memory and what parts of the memory you bring up in your mind is up to you. The counselor is there to assist you, but if you need to stop or take a break you absolutely can. Working through trauma and challenging thoughts and emotions is tiring. Consider the work like an exercise routine, it can be hard and it will make you tired, but the results are greater health and greater strength.
How frequently and how long treatment takes place is also up to you. Some information to consider is that individuals who have experienced a single incident of trauma will likely not need as much therapy as an individual who has experienced multiple traumas throughout their life or over a prolonged period of time. Like physical healing, if there are more wounds that are more severe or chronic, more healing will be needed than for a single trauma.
One way to describe EMDR therapy is that it is like a guided day dream. You will be asked to imagine in your mind while also being aware of remaining in the counseling room. For processing traumatic memories, the awareness of the present moment and place is important. Going too far into the memory or into your mind is called dissociation and can bring back all the negative experiences of the memory too strongly and in a way that is not helpful or healing. You will be asked to balance between experiencing what is going on in your mind and remaining grounded in the counseling room and with your counselor.
Prior to working on challenging memories, you will practice guided imagery around positive subjects. First, this to give you the experience of working in your imagination and how that feels. Not everyone is able to experience sensations in their imagination the same way and this is practice to see how well that works for you prior to trying to work with more challenging material. More importantly, this work is to help you use your imagination to create positive resources. These resources can be used while processing traumatic memories or at any time you think they would be helpful, whether during a counseling session or anywhere else. It may seem silly to spend time thinking about imaginary resources, but the mind is a powerful tool and these resources can be a different and positive way of interacting with what goes on in your mind and memory.
The work of addressing challenging memories is similar. There will be three elements being combined in the work around traumatic memories: experiencing the memory, remaining grounded in the present and experiencing Alternating Bilateral Stimulation (ABS) through your senses. You will be able to chose the traumatic memory you want to work on. It is recommended to start with the first or worst traumatic memory you have as the positive work done on those memories is more likely to transfer to other memories which are less severe or later on in time. You will be asked to recall the experience of the memory using your recall of physical sensations and emotions. Then, you will allow your mind to move where it will after starting with the traumatic memory. Common experiences are to recall the events of the traumatic memory or the emotions which are connected with the memory. Everyone’s experience will be different. You will be encouraged to experience the memories as an observer without judgement and let them go by. The theory is that the mind and body know what they need to do to heal the traumatic memory and to not hold on to any particular part of the memory. This may be a challenging and unpleasant experience as the memories and emotions connected to trauma are generally difficult and painful. You may take a break at any time and your counselor will continually be present with you as you work.
As you are recalling the memory, you can consider what did happen or what you wish had happened. You can modify in your mind the experience of the memory to consider other possibilities and angles of what happened. The original memory will remain, you will not forget what really happened. As you are thinking about the memory, you will be reminded by your counselor that you are still in the counseling room, to continue breathing and to remain grounded in the present.
The device shown in the pictures is used for Alternating Bilateral Stimulation. It is called a TheraTapper. It consists of a control box which your counselor will hold and two pulsing paddles which you will hold. The paddles vibrate gently, similar in sensation to the vibration of a cell phone. You can hold the paddles in your hands, sit with them under your legs, or put them in your socks (yes, I’m serious). The pulsing of the paddles alternates from one side to the other. This engages both sides of the body and brain and helps the body remain engaged with the process and grounded in the present. Traumatic memories impacted the entire person, body and mind and we are going to engage all of those pieces in the healing of that memory.
EMDR is one tool to help a person heal from traumatic memories. It is not the only way to address trauma. Your counselor will talk to you prior to starting EMDR therapy so the both of you can determine if you are ready to try EMDR. EMDR can bring up memories which you may not have thought about or tried not to think about for a long time. As with other forms of therapy, it may feel more uncomfortable at first before it gets better. Your counselor will work with you to make sure you have enough coping skills and resources to handle any unpleasant feelings, memories, or experiences which may come up while doing EMDR therapy or afterwards. If you feel you want to take a break from EMDR therapy, you are welcome to do so whether that is for a couple minutes, the rest of the session, or for several sessions. Some people choose to spend one session doing EMDR therapy and the next session talking about their experience of the therapy or other things which have come up for them between sessions.
This is not all there is to know about EMDR therapy, but hopefully it answers some questions about what it is like. If you have further questions, please feel free to reach out to us.
We look forward to talking to you.