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Weird, but it works.
That seems to be what most people say about their experiences with EMDR. And we hear you. Everything about it seems strange. After our own experiences with EMDR (as clinician and client), we can tell you it’s NOT bogus – it really does lead to change.
EMDR stands for Eye Movement Desensitization and Reprocessing. A mouthful.
Basically, when Francine Shapiro (a psychologist) was walking one day, thinking about different issues, she realized her eyes were moving back and forth. So she brought this “bilateral stimulation” (activating both sides of the brain) to her work. Now, some therapists and clients will to use eye movements, some tapping or tactile (like “buzzers”), and some audio.
Why would something that appears this wacky work? Trauma is like a mirror being hit by a hammer – you end up with fragments that are difficult to put back together as a mirror. The fragments are made up of the thoughts or beliefs, emotions, and physical sensations from the time of the event.
If we aren’t able to put these into a story that can be left in the past, these things will flare up and “poke” us, like a mirror shard would, usually at times when we least expect it and really don’t want them to. The frontal lobes in our brains love for things to be whole – they don’t like unsolved puzzles. That’s why we end up fixating on something we don’t understand; our brain is trying to solve the puzzle.
What EMDR does is link negative beliefs, emotions, and physical sensations from past events so we can put them together in a way that makes sense and becomes healthy for us, solving the puzzle. The bilateral stimulation mimics REM sleep, which is where we process the events in the day that we didn’t have time to think about or pay attention to. The emotional center of the brain and the story part of the brain have to work together, even though they aren’t so great at it (Have you ever tried to be rationally angry? Oy!). Basically, EMDR helps your brain heal you.
Cool!
There is A LOT of research on EMDR, so if you’d like to see the pros and cons, you can do a Google search for EMDR and you’ll see all of the great sites that come up.
1. Preparation: Because we do part of your history when we first meet, we can move straight to resource building. This is where we figure out what emotional resources you already have (like can you move from really angry to calmer) and what other resources we might need. We also do any assessments (to see what might be barriers to the process) and some education about realistic expectations for EMDR.
Some clients like to try to skip this step. And we get it. You want it fixed and you want it now. BUT, without paying attention to this step, we risk making things worse. Sorry, not gonna do it.
2. Client History: Here, we take a thorough history of the issues you might want to tackle with EMDR. From there, we narrow it down to the first target (incident or memory) you’d like to address. Once we identify that, we do what’s called a floatback to get to the earliest or worst memory. That becomes our first target to process.
3. Assessment: Next, we identify the picture, negative cognition, emotion, and body location of the issue. At this time, some therapists also bring in the positive cognition/belief, but some wait until the negative one has been resolved so you can stay more in the moment. There must be some emotional response in the present, or EMDR isn’t as effective. Good news though, coping with these is why we do the preparation phase!
4. Desensitization: This is where you will be prompted to follow a light or hand, use the buzzers (that vibrate in each hand), or listen to a tone that alternates from one ear to the other. After some time, we check in to see what is coming to the surface. If all goes well, we move on to step 5.
5. Installation: Once everything seems to be clear, we move to “installing” the positive cognition. No, you are not a computer. This just means we take the original incident and pair it with a positive belief that fits where you are at with the situation now.
6. Body Scan: Here, you will pay attention to your body sensations, working from the top of your head, down to your toes. Any sensation, whether positive or negative, you tell us about and we do more processing. Once that is clear, we move to step 7.
7: Closure: We wrap up the session with a containment (soothing) exercise and a reminder that processing could continue outside of the session. This is another reason for the preparation phase; so you can soothe yourself if you are triggered while your brain is continuing to work. It is also important for you to have supports you can rely on in case you are having a harder time between sessions.
8. Reevaluation: At our next session, we look at the original target and make sure it has remained clear (nothing new has come up and there are no residual feelings or body sensations related to the target). If so, we move on to a new target.
A typical EMDR session is one and a half (1.5) to two (2) hours weekly or bi-weekly. This usually gives enough time to complete one target. However, hour-long weekly sessions are possible, with the awareness that the process may require more sessions to work through one target.
EMDR is great for you if you have supports in your life, when your environment is stable (meaning not worried about food, shelter, or survival), and when you are able to move from an activated emotional state (like anger or fear) to a more regulated state (soothed).
It is used for:
After EMDR, you may find you:
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