What is EMDR?
EMDR is a state of the art therapeutic approach that has exploded in popularity. It is a powerful technique that rapidly helps to heal emotional pain and the negative beliefs that accompany it. It is the first line therapy for trauma. Research has also shown it to be highly effective in the treatment of depression, anxiety/panic, gambling addiction, and drug and alcohol addiction, and many other behavioral health issues as well.
Literally, EMDR stands for eye movement desensitization and reprocessing. It draws on the understanding that rapid eye movement (REM) sleep is a time when memories from the day are processed. It recognizes that traumatic memories are unable to be processed effectively during REM sleep as they overwhelm the brain and are not stored in the same way. This leads the traumatized person to relive the traumatic experience. Using eye movements or some other form of what is called bilateral stimulation, an EMDR therapist uses the brain’s natural adaptive information processing (AIP) system to enable it to work through traumatic memories that have gotten “stuck.” In effect, the therapist is manually doing what the overwhelmed brain could not do at the time: processing and storing the memories. EMDR is appealing to clients because it doesn’t require recounting every detail of the trauma, rather simply bringing it to mind so it can be processed.
Let’s break down two of the primary phases: desensitization and reprocessing (the “DR” of EMDR). First, the traumatic memory is desensitized, meaning that it is no longer upsetting to remember. The emotional charge it once held is gone, freeing the person to view the memory objectively and separated from her in time and space. In the treatment of addiction, the desensitization phase lessens the potency of the relapse fantasy (urge) so that the drug or behavior loses its appeal. Next, during the reprocessing phase, the negative belief associated with the trauma is replaced with a positive belief. The “installation” of this belief occurs by using bilateral stimulation to link the traumatic memory with the positive belief. By the end of the process the person is able to remain calm when thinking of the formerly upsetting memory while holding the positive belief in mind. In the case of an addictive behavior, the image of the trigger to use or gamble, now desensitized, is reprocessed by pairing it with the positive body sensations of an addiction-free day in the future.
Can you provide an example?
Sure. Let’s say a man has been feeling depressed ever since he was in a car accident 4 years ago in which his son died. He has avoided driving since the accident and images from the event have bothered him every day since it happened. Thinking of the accident, he reports feeling upset at a “9/10” level, with 10/10 being the most distress possible. He has the following negative belief related to the event: “I can’t keep my family safe.” We set this accident up as the target, then use short sets of eye movements to decrease how upset he feels when thinking of the event. Sets are typically 10-15 seconds each with breaks between each set. After processing for 30 minutes, he is now bothered at a “0/10” when thinking of the event. This transformation is incredible to witness! It is the brain’s adaptive information processing system at work. The trauma has been desensitized.
Now, the event is reprocessed by linking the positive belief that he can keep his family safe with the memory of the car accident. We install this link by doing short sets of the eye movement protocol for 10 minutes. By the session’s end, he is able to think of the accident without feeling upset and hold the belief that he can keep his family safe even while thinking of the trauma!
Does this change always happen in a single session?
No. Each person’s experience is different. Part of the reason that a single memory might take more than one session to be fully desensitized and reprocessed is that it is part of a neural network of similar life experiences. Depending on the depth and breadth of these experiences, and the age at which they were experienced, a memory may take longer to process. Complex and chronic trauma require more time but can often be fully resolved using this technique.
Will we start processing trauma or addiction urges during the first session?
No. There are several phases for the EMDR protocol that precede actual processing using eye movements. I also incorporate person-centered and mindfulness-based approaches, meaning that I view you as the expert on your life and in charge of how counseling proceeds. We will work at your pace with my guidance.
For more information on EMDR, please visit EMDR International Association