What is EMDR?
Eye Movement Desensitization and Reprocessing (EMDR) is an integrative therapy approach backed by neuroscientific research that has proven to be effective for treating a variety of symptoms and creating meaningful change for individuals who often feel stuck with other therapy methods. EMDR differs from traditional “talk therapy” in that it does not require you to talk about the traumatic event(s) you’ve experienced but rather, asks you to hold an image of these events in your mind.
The framework for EMDR is the Adaptive Information Processing (AIP) model. This model explains that your brain has a natural processing network with which it processes experiences and integrates them into your memory network. Oftentimes, this is done in an adaptive way that allows you to store the information needed and filter out what isn’t. However, this is not always the case. When you experience traumatic events, are struggling with high baseline levels of anxiety, or are maybe experiencing a number of other factors, your AIP system can become overwhelmed and unable to integrate adaptively. This information gets “stuck” and these memories get stored in maladaptive ways. Meaning, your nervous system can’t always tell the difference between the past and the present. Have you ever felt like you had a big reaction to a small trigger; or have found yourself in distress with seemingly no trigger? Maybe you have deeply held negative beliefs about yourself that you can’t quite seem to shake and feel like are stopping you from reaching your potential. This is likely because your AIP system has gotten stuck and needs some help.
How does EMDR work?
EMDR asks you to examine what maladaptive beliefs you have about yourself and find the memories attached to them. From there, you will hold an image of these memories in your mind while your EMDR therapist guides you through sets of Bilateral Stimulation (BLS) and asks you to focus on positive beliefs you’d like to have related to the memories instead. BLS is alternating (left/right) sensory input that can be in the form of eye movements, body tapping, or hand held buzzers, among other methods. BLS is key to EMDR therapy as it triggers your brain’s AIP system to reprocess the targeted memories in more adaptive ways. Much of the natural processing your brain does is during your REM sleep cycles. It is believed that, due to sleep disturbances often experienced with trauma and anxiety, our brains may not get the REM time needed to adaptively integrate experiences. BLS works to mirror the effects of REM in order to assist the brain in reprocessing these experiences. Additionally, BLS taxes your working memory which can lead to decreased intensity of the memory itself.
Phases of EMDR
EMDR is an eight phase modality with distinct steps; however, what you experience during these phases can differ from person to person.
- Phase One – History Taking and Treatment Planning
In this phase of EMDR, you will be building rapport and trust with your EMDR therapist. The goal is to build a genuine relationship you feel safe and seen in. Your EMDR therapist will learn about your history and current circumstances while helping you identify core beliefs and memories to target while you develop a treatment plan together.
- Phase Two – Preparation
In this phase, you and your EMDR therapist will be resourcing you for the phases to come. This can look like providing education on the process, answering questions and exploring hesitancies. This phase also focuses on reviewing current coping and grounding skills as well as building up this toolbox with you. There are a number of EMDR resourcing exercises you and your EMDR therapist will discuss and try out together until you’re feeling confidently resourced to move forward.
- Phase Three – Assessment
In this phase, your EMDR therapist will review with you the treatment plan you created together, identifying key components of target memories. These key components consider images, beliefs, emotions and bodily sensations connected to this memory, as well as what beliefs you’d like to have in connection to the target memory instead.
- Phase Four – Desensitization
In this phase, your EMDR therapist will ask you to hold an image of the target memory in your mind while guiding you through sets of BLS. This helps desensitize your brain to the emotional distress connected to the memory.
- Phase Five – Installation
In this phase, you will work on strengthening the desired positive belief in connection to the target memory. This is also done utilizing sets of BLS, while holding an image of the memory and the positive belief.
- Phase Six – Body Scan
In this phase, your EMDR therapist will guide you through a scan of any bodily sensations you may still be experiencing in relation to the target memory. These sensations are then desensitized further, if needed, utilizing BLS.
- Phase Seven – Closure
In this phase, your EMDR therapist will debrief with you about your experience and guide you through or remind you of resourcing tools, ensuring you feel stable and safe upon session’s end.
- Phase Eight – Reevaluation
In this phase (done at the beginning of a session following reprocessing), your EMDR therapist will check in on your experiences since reprocessing and ensure the memory’s disturbance continues to feel more manageable.
Does EMDR really work?
The short answer – yes.
Studies have shown that EMDR significantly decreases symptoms for participants, in a much quicker timeframe than traditional talk therapy modalities. There is no expectation for EMDR “homework” outside of sessions but rather, the modality focuses on your brain’s natural ability to heal itself. Many find that EMDR feels like the missing piece they’ve been searching for in their treatment that helps them move beyond understanding to true, embodied healing.
References
- Shapiro, F. (2018). Eye movement desensitization and reprocessing (EMDR) therapy: Basic principles, protocols, and procedures (3rd ed.). The Guilford Press.
