CHAPTER 1—Eye Movement Desensitization and Reprocessing (EMDR)
Often, when something traumatic occurs in a person’s life, it seems to get locked into our memory as images, sounds, thoughts, body sensations, and emotions connected with the event. It continues to be triggered whenever a reminder, or “triggering” event, occurs in the person’s daily life. This locked-in memory can be the basis for a lot of emotional and/or physical discomfort. Negative emotions often experienced include fear and helplessness that seem to be beyond the person’s control.
Trauma from the past can impact us in many ways, intruding on our current thoughts, feelings, and getting in the way of the life we want to have today. There are many aspects to healing and ways to treat trauma—through family support and friendship, faith, acupuncture, body work, and a number of kinds of psychotherapeutic treatment. A number of them will be covered in our blog in the coming weeks, the first of which is EMDR.
Prior to beginning any form of treatment, you and your therapist will evaluation and determine whether you are ready before moving forward. It is important that there is enough stability in your life for you to safely explore traumatic issues, through EMDR or any other method. If you were in a burning building, it’s not the time to learn the fine points of fire control—you first need to GET AWAY FROM THE FIRE. Trauma work is like that too. Your basic safety first and foremost. You should have a trusting relationship with your provider and be able to communicate openly with them. Healing from trauma is a unique experience that you map out as you go through it. No one’s way will be exactly like another’s since trauma impacts us in different ways. EMDR can be a tool to help you find your way out of the dark.
In 1987, Francine Shapiro, Ph.D., a psychologist and researcher, was walking in the park when she realized that her eye movements moving back and forth seemed to decrease the negative emotions associated with her own distressing memories. She assumed that eye movements had a desensitizing effect, and when she experimented with this she found that others also had a similar response. After looking into it further, she determined that eye movements by themselves were not enough to create comprehensive therapeutic effects, so Shapiro added other treatment elements, including a cognitive component, and developed a standard procedure that became the Eye Movement Desensitization and Reprocessing (EMDR) treatment of today.
EMDR is both a therapeutic tool and a trauma treatment. EMDR is a modern treatment therapy commonly used to treat trauma and PTSD-related difficulties. It is not classic psychotherapy or hypnosis. It helps a person to safely process traumatic events and negative emotions. EMDR has been used for decades and has helped thousands of people process and manage traumatic experiences so they do not get in the way of their quality of life.
EMDR can help by reducing reactivity to current situations that trigger the trauma response. These reactions can include over-reactive emotions, negative beliefs, unpleasant sensations, and intrusive memories. EMDR helps activate the brain’s natural healing process. EMDR takes advantage of the brain’s natural inclination toward positive mental health.
In EMDR, you focus on hand movements or tapping while you talk about the traumatic event. The idea is that the rapid eye movements make it easier for our brains to work through the traumatic memories. Focusing on hand movements or sounds while you talk about the traumatic event may help change how you react to memories of your trauma over time. Over time, EMDR can change how your react to memories of your trauma.
Prior to beginning EMDR activities you learn skills to help you relax and handle emotional distress. This is an important phase of trauma treatment. To keep the burning building metaphor going, this is you putting on protective gear, practicing fire drills, and hefting a fire hose filled with water before stepping near that house again.
EMDR has four main parts:
Identification of a target memory, image, and negative belief about the trauma for you and your therapist to explore and reprocess.
Desensitization and reprocessing: focusing on mental these images while doing eye movements, taps, or tones shown to you by your therapist. This is repeated until you aren’t experiencing stress while focusing on the trauma trigger.
Installing positive thoughts and images, once the negative images are no longer distressing
Body scan: focusing on tension or unusual sensations in the body, to identify additional issues you may want to address in later sessions
Often you would be asked to keep a journal to note any issues or setbacks. You also practice the coping skills you identified as being helpful before starting EMDR.
The research into EMDR is ongoing. Some professionals have criticisms or doubts. We don’t exactly know the mechanism of how it works or why. Despite being unconventional and relatively new (since the early 1990s), EMDR is backed by several significant organizations:
The American Psychiatric Association (APA) has noted that EMDR is effective for treating symptoms of acute and chronic PTSD. According to the APA, EMDR may be particularly useful for people who have trouble talking about the traumatic events they’ve experienced. The APA guidelines note that other research is needed to tell whether improvements from EMDR can be sustained over time.
The Department of Veterans Affairs and the Department of Defense have jointly issued clinical practice guidelines. These guidelines “strongly recommended” EDMR for the treatment of PTSD in both military and non-military populations. They also note that this approach has been as effective as other psychological treatments in some studies, and less effective in others.
If you have questions about local options for this form of treatment, please consult your primary care doctor or a therapist or counselor.
Compiled by Susan Ohmer, LCSW, for WAVE and Petersburg Mental Health Services as part of the Division of Behavioral Health’s Trauma Project.
For more information on EMDR, please refer to the following links: