What is EMDR and how does it work?
EMDR (Eye Movement Desensitization and Reprocessing) is a well-documented, evidence-based therapy used in the treatment of psychological trauma. First discovered and developed by Dr. Francine Shapiro in 1987, this powerful therapy uses bilateral stimulation of the eyes and/or body to help calm the patient’s nervous system. But how exactly does this therapy work? And who might be a good fit for it?
This article will provide a concise, practical explanation of this excellent psychological treatment, and provide direction on where to find the help you need.
Where was EMDR first discovered?
Dr. Francine Shapiro would first have the inspiration for EMDR through happenstance while walking through a park in 1987 during a particularly difficult time in life. Francine found that moving her eyes back and forth while holding troubling thoughts in her mind had a calming, comforting effect. As we all know, negative thoughts and painful memories naturally bring up uncomfortable, distressing emotions. But Shapiro found that if she moved her eyes back and forth while thinking the negative thoughts, her resulting emotions were not as strong. She underwent a 2 year process of studying this phenomenon, and the results of her studies proved repeatable and effective. From this accidental discovery, we now enjoy the benefits of a fully formed treatment protocol.
Dr. Francine Shapiro, founder of EMDR Therapy
How does EMDR work?
In short, EMDR addresses thoughts and memories that the brain has labelled as “threatening”. The therapist will help the client to bring the threatening memory into the forefront of mind - what we refer to as “working memory”. Then, using bi-lateral stimulation, the client is able to rapidly process that memory and all the associated thoughts around it much quicker than if they were simply talking about it.
To better understand the nuts and bolts of this therapy, it is helpful to cover how the brain operates when responding to threats. One of the first things to happen in times of extreme stress is the shut down of the prefrontal cortex, which is associated with language and communication. This is why traditional talk therapies may not be enough when treating severe cases of trauma, because the brain is continually shutting down the ability to communicate and take in new information. In order to give a patient the chance to process what is happening for them, the brain will first need to calm down. There are several ways to calm the threat response, and EMDR is one of the quickest and most powerful.
What does EMDR practically look like?
In short, traditional EMDR uses eye movement to calm the brain. An EMDR therapist will ask the client to recall a painful memory and the belief that has formed because of that experience. The client will then rate their level of distress on a scale of 1 - 10 (10 being the most distress they can possibly imagine, 1 being no stress at all). Then, instead of encouraging the client to speak further about their distress, the therapist will hold up two fingers and ask the client to focus their eyes on the therapist’s hand. Quickly moving their hand back and forth along the client’s field of vision, the therapist will allow a period of 15 - 45 seconds to pass before stopping and ask the client to take a deep breath. After that they will be asked to rate their level of distress again.
Some forms of EMDR will involve the client rating their level of distress after the bi-lateral stimulation for the majority of the session. Other forms of treatment may involve making associations and observations about what they are processing. For instance, a client dealing with intense grief may find that the more they process through eye movement, the more they notice how many wonderful memories they have to cherish with their late loved one. Or if they have been through an abusive relationship, they may begin to see how strong they are to have survived the abuse and to still be moving forward. These realizations can’t change the past, but they can take the emotional “charge” out of the trauma and help the brain adapt despite the hardship.
Other forms of bilateral stimulation have recently been studied and implemented by EMDR experts, making it possible to process traumatic material without solely using the eyes. These other forms of bi-lateral stimulation can include back-and-forth tapping of the legs, shoulders, or feet. It can even include buzzers held in each hand, depending on the clinician.
Here are two video clips that demonstrate different ways EMDR can look in session:
School of Life on EMDR Therapy
Prince Harry opens up about EMDR sessions (virtual)
Who is EMDR right for?
Whether EMDR is the right therapeutic “fit” will ultimately depend on each patient and how they prefer to communicate, but here are some guidelines to keep in mind when making the decision:
Are some experiences too painful or triggering to speak about?
EMDR can be a helpful therapy for anyone who has traumatic experiences in their past. To be more specific - anyone who has experienced moments of overwhelm, helplessness, or isolation. Some traumatic experiences might be easier to pinpoint, while others might be more of an internal wound built up over years of neglect. If these moments are too difficult to speak about without the nervous system shutting down into a flight, flight, freeze, or fawn response, a more intensive trauma therapy such as EMDR may be in order.
2. Have you tried traditional “talk therapies” and found them unhelpful so far?
To be clear, talk therapies have been proven to be very effective in treating psychological trauma just as EMDR does. However, if you have difficulty opening up about certain parts of your life in the therapy room, or if you continually feel “on-edge” or unsafe even after several weeks of working with a good therapist, EMDR could provide the missing piece. As stated before, the brain can process and heal only after the nervous system has been effectively calmed, not before. Consider if a somatic-based (body based) therapy such as EMDR could be the next right step for you.
How to find an EMDR therapist
EMDR-trained therapists can be found using online directories such as EMDRIA, PsychologyToday, or even using a Google search. Click the links provided to check your local listings.
Cedar River Counselling provides EMDR treatment for clients residing in Canada. Consider booking a consultation if you are looking to take the next step toward healing.