I first discovered Eye Movement Desensitization and Reprocessing Therapy, better known as EMDR, while in grad school. At the time I was working as an intern at a residential mental health facility for individuals in recovery from acute distress associated with mental health disorders. Our type of therapy was short-term, providing patients with tangible skills to help them regain stability and return to their lives as quickly as possible. Even though we were focused on the short-term, we heard their stories of trauma on a daily basis, as they were often the root of their depression, anxiety, and complex emotional, relational, and personality structures. I initially felt powerless but over time I became motivated to find an intervention that wouldn’t just temporarily stabilize a traumatized system, but also actually restore and heal it.
EMDR is a bizarre and wondrous treatment developed by Francine Shapiro for processing experiences that were overwhelming to the brain, like trauma. To understand how EMDR works, you first have to understand memory processing and the way trauma disrupts it. The brain stores memories in a fashion similar to a complex filing system. This is where all new experiences are processed and transformed into stories and helpful narratives that help us make sense of the memories and orient ourselves to our world and relationships.
How does trauma work?
A traumatic experience becomes trauma when our body’s fight or flight response system, that turned on to protect us from the threat, fails. The memory jams, stuck in short-term working memory instead of long-term memory. Lodged beyond where language can reach, it’s no longer just a simple story that you can tell or explain to someone. It’s instead about your body having been reset to a world that no longer feels safe and cannot be trusted in the same way. Now when you experience something that looks like, feels like, or even smells like that traumatic memory, you relive that trauma – experiencing the same images, sounds, beliefs, body sensations, and emotions as the original experience.
Bessel van der Kolk, a psychiatrist, researcher and educator specializing in post-traumatic stress, explains in his book The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma, “Trauma victims cannot recover until they become familiar with and befriend the sensations in their bodies. Being frightened means that you live in a body that is always on guard. Angry people live in angry bodies. The bodies of child-abuse victims are tense and defensive until they find a way to relax and feel safe. In order to change, people need to become aware of their sensations and the way that their bodies interact with the world around them. Physical self-awareness is the first step in releasing the tyranny of the past.”
Typically when we face adversity, overwhelm, and confusion, we leap to address it by talking, especially in traditional psychotherapy. But these “stuck” trauma-induced memories cannot be addressed and made sense of as simply through talk therapy. My clients often tell me “I know I’m not at fault,” or “I know I’m not in danger anymore… but I feel like I am.” This is where EMDR can be incredibly helpful for those processing trauma memories because it speak’s our body’s language and enhances it’s natural healing process.
How does EMDR work?
If trauma is acting like a jammed memory in our brain’s neural network – frozen images attached to negative sensations, emotions, and beliefs – EMDR’s goal is to add adaptive beliefs, emotions, and sensations onto those same images. First, we desensitize and relieve the distress associated with that memory. Next, we reprocess it in adaptive ways, bringing resolution by integrating new information into a moment where your system was overwhelmed and could not think rationally. So in contrast to more typical psychotherapies that focus on briefly stabilizing a triggered system with coping skills, the EMDR process actually restores your body’s threat response system so it no longer responds as intensely to triggers in the first place.
The mechanism to stimulate this healing process is bilateral stimulation through eye-movements, tactile stimulation, tapping, audio stimulation, or body movements. Bilateral stimulation of the brain helps to access the stored trauma and create new neural pathways. Unlike traditional psychotherapy which interacts with a client’s rational mind, EMDR can tap into the client’s instinctive mind, working with trauma at its source, not just the thoughts but rather the feelings surrounding what happened. Instead of continuously getting re-lived, the stuck trauma memory will now get integrated into the larger context of a story and the client’s overall life narrative.
EMDR in Practice
Francine Shapiro discovered in 1987 that moving her eyes from side to side seemed to decrease the negative emotion attached to her own distressing memories and since becoming trained in EMDR, I’ve had the same privilege of witnessing intense distress decrease for each of my clients engaged in this incredible therapy. Before beginning treatment, I encourage my clients to simply trust the process, that whatever comes up for them is meant to be there. They can trust that their brain already has everything it needs to heal.
The EMDR process explores trauma memory by memory, image by image starting with the earliest and working forward until the entire memory network associated with the trauma is clear of all distressing body sensations and negative beliefs. As I move my fingers back and forth quickly and steadily, facilitating short sets of bilateral stimulation through eye movements, I watch my clients relive some of the worst moments of their lives. We pause in between the sets and I’ll ask “What came up for you?” or “What are you noticing?” and they’ll tell me about the images, sounds, and sensations they noticed or the new thought they just had. To be clear, this is not hypnosis and the client is in control and rooted in the present moment the entire time.
It takes so much bravery for my clients to connect with these younger, scared, ashamed, or powerless parts of themselves and it often brings tears to my eyes to see the empowerment and creativity they channel to free themselves from the weight of their trauma. All of a sudden, they’ll say “I’m safe now,” “I deserve so much more than that,” or “I don’t have to perform to be accepted” and for the first time, they’ll mean it. They’ll feel it.
We’ll go back to the original trauma memory and client’s will find that it’s harder to access, it will feel farther away or when they think about it, it will feel far less distressing than it once did.
This is my favorite part. The client makes the physical, tangible connection in their bodies that they are resilient; they are capable of tolerating immense overwhelm, pain, fear, grief, shame, etc. as well as healing from it and restoring a balanced view of themselves and the world around them.
Is EMDR the right therapy for you?
EMDR is perhaps the best fit for adult-onset, one-time traumas because of the limited nature of the associated memory network. However, it is far more common for individuals to come into therapy not with major traumatic disturbances, but even seemingly minor events from childhood that have a large impact and create complex webs of core beliefs that continue to inform the way they feel about themselves, their relationships, and their place in this world. EMDR can still be incredibly helpful for these situations and everything in between, but the process may take longer.
When you’re living with unresolved trauma, you’re living with very limited choices. You’ll notice that your beliefs, behaviors, personality, and relational patterns feel more rigid because they revolve around the things that make you feel safe. The EMDR process helps to restore your sense of choice and increases your options in all of these categories because your body, not just your mind, is now intimately aware that there are many ways to feel safe. If you’d like to hear more about how EMDR could increase your choices or heal traumas in your system, reach out to us for a consult or to schedule a session.
The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma by Bessel Van Der Kolk