Demystifying EMDR
First, why the hell is it named that?
I will start by emphasizing that EMDR is highly efficacious. When it comes to treating trauma, it has earned its place on the Mt. Rushmore of therapeutic modalities. Like many interventions, the person who developed it went big with the name and heavy on the jargon. The creator of EMDR, Francine Shapiro, admitted in an interview that she would change the name to "reprocessing therapy" if she had a time machine. Eye-movement desensitization and reprocessing therapy…. it's a mouthful. But let's break it down.
Eye Movement
The eye movement part refers to bilateral stimulation that is implemented during exposure. The therapist holds their finger up (or uses tapping or sounds), and the client follows it with their eyes after bringing up the memory. This is the most talked about part of the therapy because it is unusual (and the first part of the name). But this part of the process is WAY over-emphasized.
The theory behind bilateral stimulation is that it activates different brain parts and helps “unstick” traumatic memories. Let's think about trauma as a miscommunication between the memory part of our brain and the emotional part of our brain. The BLS theoretically creates activation that facilitates desensitization faster than just exposure alone. This part is controversial but mostly an academic debate because we know this therapy works.
Desensitization
Desensitization is a fancy word for taking the charge out of the memory. This is where the strengths are with EMDR. The therapist exposes you to the memory and then invites the client to observe bodily sensations and thoughts that emerge when they think about it. Priming the client with disturbing material and observing what comes up for us leads to desensitization. If I were to show you the scariest movie ever made, it would make your heart race, create dread and anxiety, and, overall, be a profoundly unpleasant experience. If I had watched that same movie with you every day for a year, you would have been bored when we turned the film on next. This is the same principle, but we also observe thoughts and beliefs around the material and resolve them throughout the process…. Which brings us to the reprocessing part.
Reprocessing
Reprocessing is a broad term encompassing several aspects of the therapy, and these elements are another aspect that takes it past exposure alone. We can resolve the distressing physical sensations of the trauma with exposure, but if the belief that “I am not safe” (or insert other maladaptive beliefs here) is not dealt with, we are still going to have all kinds of nasty symptoms. So, we identify and engage with those beliefs to resolve the symptoms. We are changing the relationship the individual has with the traumatic memory. Rinse and repeat until the distressing symptoms are extinguished.
From the bottom up
EMDR hits trauma symptoms from multiple angles, resolving sensations, thoughts, and core beliefs that cause impairment. I love using it because it is well structured, well tolerated, and works without the burden of homework. If you are nervous about starting, know you will be in the driver’s seat the entire time. We develop a pace that you can tolerate and develop strategies to manage some of the challenges that can emerge in between sessions. This is the Spark Notes version of the process, which is a comprehensive modality.
Does it work?
We debate why EMDR works, but the American Psychological Association regards it as a gold standard therapy for post-traumatic stress disorder. The World Health Organization, the UK National Institute for Health and Care Excellence, the Australian National Health and Medical Research Council, and the US Departments of Veteran’s Affairs and Defense also recommend it for PTSD. The evidence of its benefits is overwhelming. So, don’t let yourself continue to suffer with treatable symptoms of trauma. Reach out to regain your sense of peace!