To be on Both Sides: Thoughts on EMDR Therapy

Eye Movement Desensitization Reprocessing (EMDR) therapy as a name is a mouthful to say the least. But really, it is a name full of love, of grief, of sadness, of life. EMDR therapy amazes me every single day. The way that networks change and pathways shift - these are unbelievably beautiful moments.

Francine Shapiro discovered EMDR therapy in 1987 through work on her dissertation. In 1989, there were initial trials that allowed further work to be done to explore this mode of therapy. Then into the 1990s, the therapy became more well-known, including being used as Francine Shapiro took a group of individuals trained in EMDR therapy to Oklahoma City after the bombing in 1995. Much research has been done in the last 30+ years on this therapy, and more and more people are becoming aware of how incredible it can be.

How it works (**Please note: do NOT try to do EMDR therapy without a trained professional**):

Dual Attention Stimuli - Being in the present and the past at the same time. In doing this, the body is able to physiologically calm down. EMDR therapy is one of the only therapies that can access parts of the brain, such as the amygdala and the hippocampus, which are both activated in trauma responses. You might have heard of fight-flight-freeze-fold, which is a common way of describing the body's response to stress and panic. The idea is that with the dual attention stimuli, we can be thinking about these images/memories/events to process them while activating a state of calm, a connection to the present so that we are not brought back into the past in a way that is not controlled.

Connection to REM sleep - In REM sleep, which is the stage of sleep during which we dream, our eyes move back and forth. It has often been noted that our dreams can have symbolic meaning. What I have shared with clients is that more often than not, our bodies are in a state in which we are calm enough to bring up "unprocessed emotional material" (aka dreams) to try to "work out" past experiences or unresolved concerns.

Core Beliefs - If you are familiar with Cognitive Behavioral Therapy (CBT), you will likely be aware of the term "core belief" - it is a lens through which we see the world. Some positive core beliefs might be "I am loved" or "I am enough" -- but the opposite beliefs, such as "I am unloved" or "I am not good enough" also are lenses through which we can see the world. One way that we develop these negative core beliefs is through trauma. From an EMDR standpoint, we have developed this core belief and then filtered all of our experiences through that lens. Then information and memories that would otherwise be stored without that tint to it, suddenly have been filtered through that lens and therefore experienced and remembered that way. What we aim to do in EMDR therapy is to pull those memories out and reorganize them into the correct space.

Here's an example, not based on any one person in particular. A young woman comes into therapy and reports that she has a core belief of "I am unlovable" after an abusive romantic relationship. She reports that she is now in a positive relationship, but she cannot seem to believe her partner when they tell her that they love her. She reports, "I logically know that it's true, I just can't feel that it's true" -- this is a common response I hear. Our bodies keep the score (see back a few posts about how trauma is remembered in the body), and this can explain how sometimes our bodies can still respond in ways that our minds are more successfully able to reason out. We would try to bring out particular images and memories that may have laid down that foundation of "I am unlovable" (either from the abusive relationship or more likely from an earlier relationship/message), separate them from the "I am unlovable" negative belief, and then route them through a more positive/neutral lens.

What to expect in processing phase:

1) EMDR therapy is not hypnosis. You are awake the whole time.

2) You will be given options for bilateral stimulation of:

a. eye movements: following the therapist's hand, a light bar, or a virtual dot back and forth

b. tactile buzzers that will alternate vibrating in your left hand, then right, then back

c. tapping: you or the therapist tap either side of your body (most often the knees, hands, or arms)

d. audio: you put on headphones and hear a buzz or sound alternating in each ear

3) As a check-in throughout processing, you will be asked periodically to rate the distress of an image associated with a traumatic memory and a negative core belief.

4) It usually gets worse before it gets better. We are rerouting some of this information, which means that we need to wake it up before we can move it. Some of these memories may have been dormant for awhile.

5) Hopefully what happens is that your own brain brings up the emotions, memories, and thoughts that are there, that are positive or neutral, such as "hey, I just thought of my best friend" - which is your brain giving you flashes of times in which you were/are loved. -- This is what I love most about EMDR therapy - the resilience of the brain, of us creatures as humans, and how we adapt within ourselves.

6) After EMDR therapy, you might report your brain feeling "wrung out" or you may feel easily overwhelmed, or you may experience nightmares (see above re: REM sleep). All of these are normal experiences.

I will likely write many a post on EMDR therapy, as a think it is one of the most magnificent aspects of being a therapist. Being able to see how the brain can transfer and rewire in real time is an incredible gift. It is brutally hard sometimes, but it is then wonderfully beautiful.

Below is what I wrote in my hotel room after attending my 5-day, 50-hour EMDR retreat to learn how to [start to] be an EMDR therapist. In doing this, we had to work through some of our own EMDR therapy with a total stranger - someone we had never met before and would never see again. "I didn’t think it would be a big deal, just being trained with a new model. I wasn’t prepared for the way that EMDR asks you to pull at your insides, analyze them internally, and organize them into process. It asks you to challenge beliefs about yourself while at the same time making your brain and memories physically vulnerable. Unrestricted EMDR can almost freeze networks of long-standing defense mechanisms. While it is a strange concept to be so vulnerable among strangers, the dialogue, emotions, scenes played out, are all almost entirely internal for the person. But truly, what keeps coming up for me is overwhelming gratitude. Sure, also sadness, confusion, excitement, and many other emotions... but with each breath, I’ve been ending on gratitude and love. I been sitting in the love I’ve been able to experience, and I feel wordlessly fortunate to have loved, to have been loved, and to keep loving. I recognize just how privileged/lucky/fortunate I am to have these themes arise and to have had the people cross my paths as they did, today I feel that more than ever. My mind and body feel almost foreignly connected, feeling secure on the ground but being pulled across landscapes."