My previous articles have discussed what the broad category of trauma is. Now I will introduce you to an evidence-based method of trauma treatment that I use in my practice every day–EMDR. As an EMDRIA-Certified TherapistTM, I have advanced training in the use of Eye Movement Desensitization and Reprocessing (EMDR) to help my clients work through trauma.
So, what is this form of therapy that has such a clunky acronym?
In 1987, the founder of EMDR, Francine Shapiro, was on a walk and noticed that by looking side to side as she walked, she was able to more effectively process her thoughts. Thus, the idea of using eye movements to engage both hemispheres of the brain in memory reprocessing was formed. And we have the EM part of EMDR–eye movement.
As for the other letters of EMDR, D stands for desensitization. This is a goal of the process. Not to forget what happened, but to feel more desensitized to its impact and what it says about you. For example, I ask clients to rate their distress about a memory on a scale from 0 to 10. 0 is not distressing at all, and 10 is the most distressed you can imagine. As a client progresses through EMDR, we like to see that number approach 0. This indicates they are more desensitized.
And R is reprocessing. By engaging various structures in the brain and getting desensitized to the memory, it becomes reprocessed. Instead of thinking, “I’m a failure,” a client might now believe, “Even though I didn’t get the outcome I hoped for, I did everything I could.” Now, when the client reflects on the memory, they often report being less bothered, as if the sharp pain of the memory is now diffused.
This form of treatment was originally used with veterans for PTSD, but it is effective with everything from sleep disturbance to performance anxiety. I tell my clients that it can be used on any “stuckness,” whether that stuckness is regarding an image popping in your head, something someone said replaying in your mind, a negative belief about yourself that you can’t stop thinking about, a body sensation you keep having, etc.
What does an EMDR session actually look like?
EMDR is an approach with 8 Phases. The early phases are about gathering the history of the problem and ensuring you have the resources to cope when you get close to the pain the memory brings. These phases can look like traditional talk therapy, setting the stage for future sessions. A significant portion of EMDR is devoted to ensuring safety and stabilization before the memory is reprocessed. I often think of it as making sure we can swim well in the shallow end before going into the deep end. We create a treatment plan of memories we will focus on, ensuring you have tools both in session and in between sessions to help if you experience distress.
The eye-movement part of the process doesn’t come into play until phase 4. Personally, when I was an EMDR client, I liked being able to close my eyes to help me connect to the memory. For this reason, I incorporate other methods of bilateral (both sides of the brain) stimulation besides eye movements. I often use binaural music played through headphones or have my clients hold pulsers that vibrate in both hands. There are a plethora of mechanisms that achieve the same goal as eye movements, and finding something that feels more natural to my clients is crucial to positive outcomes.
After a few sessions, a client might report they have improved from a 7-8 on the distress scale to a 1-2. Once we get that number as low as we can, we build up positive thoughts that feel true authentic. EMDR isn’t just about decreasing the negative but also building up the positive, as we are able.
Every EMDR session starts with a follow-up on what the client noticed between sessions. That determines where we pick up the reprocessing next. Since EMDR is an alternative method of therapy, not a technique to intersperse, a client needs to go through all 8 phases to experience long-term benefits.
Common Misconceptions
- This is not a quick fix. Some therapists say clients feel better after 6-12 sessions, but that is heavily reliant on how well the client is resourced before starting EMDR. I might need to help my client build their support system or break down traumatic events into very small pieces because the memories are too overwhelming to think about. Similarly, reprocessing a lifetime of trauma is very different than reprocessing a moment of stuckness, and the length of treatment can vary drastically.
- This is not for everyone. Some people don’t like it. It can feel weird to sit in a session and process internally without much talking. The relationship with the therapist is critical to ensure the client feels comfortable enough to engage in the process.
Other resources to learn more:
- American Psychological Association (APA) endorses EMDR for PTSD treatment: https://www.apa.org/ptsd-guideline/treatments/eye-movement-reprocessing
- EMDRIA, the main accrediting body for EMDR therapists– https://www.emdria.org/about-emdr-therapy/
I would be happy to schedule a consult to determine if EMDR is right for you!
Written by Hannah Clark, MA, LPC
hannah@restorationcounselingatl.com, ext. 122
Hannah’s philosophy is that counseling is for everyone. Just like we take our cars to get the oil changed, mental health works the same way. The check engine light comes on, and we need to take a look under the hood. Hannah enjoys counseling individuals age 18 and up. She utilizes EMDR therapy to help with trauma and PTSD. She also sees individuals for issues such as grief, depression, anxiety, boundaries, life transitions, and spiritual or emotional abuse. Hannah previously worked for a college ministry and enjoys helping college students and women in (or formerly in) ministry.