What is EMDR?
Eye Movement Desensitization and Reprocessing Therapy (EMDR) has been en vogue recently. You may know it as the wacky therapy where the therapist waves their fingers in front of your face. You may have heard of it because Miley Cyrus talked about her EMDR experience on Tik Tok. It seems to be the new hot treatment on the market. If you’re anything like me, you might find yourself skeptical about anything that seems to be a fad!
What is this treatment? Can I trust it? Is it right for me? I’m hoping to share both some research and my own clinical experience with EMDR to help you answer these questions for yourself!
While seeming to be having a moment of late, EMDR has been around since the late 80s. It was developed by Dr. Francine Shapiro, an American psychologist who noticed one day on a walk in the park that moving her eyes back and forth seemed to decrease the intensity of negative emotion associated with a disturbing memory she was recalling. From here, Dr. Shapiro began conducting experiments to see if others had her experience, and found that, while not sufficient in themselves, eye movements did seem to have this effect for others as well. Eye movements are one form of what is referred to as “bilateral stimulation”, or more recently, “dual-attention stimulus”, terms which refer to alternating sensory input on either side of the body. This can be achieved through tapping or auditory tones as well.
The first controlled studies of EMDR examined its efficacy for the treatment of PTSD, and it has since become one of the most empirically validated treatments for PTSD and is recommended as a first line treatment by the American Psychological Association. However, research also demonstrates its efficacy with a range of other presenting challenges, including anxiety disorders, addiction and depression.
EMDR is a treatment based on a theoretical framework called the Adaptive Information Processing model, which posits that our brains have an innate capacity to process information in an adaptive way, but traumatic and overwhelming experiences interrupt this capacity, causing memories to be stored in fragmented, maladaptive ways that are resistant to change with new information. EMDR allows us to go back to these stuck experiences, and access the brain's innate capacity to integrate new adaptive information.
What does it actually look like to be an EMDR client? What can you expect?
In EMDR, you will be invited to recall memories and experiences from the past which contribute to the core negative beliefs and stuck emotions creating current symptoms. You will be asked to focus on one memory, or “target” at a time, and notice your emotional and somatic experience in the present moment upon recalling the event. The therapist then begins the dual attention stimulus, using either eye movements or tactical approaches, as you notice the images, thoughts, emotions and sensations that arise. EMDR may feel very different from the talk therapy approaches you are used to. Rather than responding and asking questions, the EMDR therapist will often stay silent during processing, intervening only when something is stuck. EMDR relies on your brains innate capacity, and requires trusting your own nervous systems’ process. By the end of processing a target, you can expect to feel decreased distress when recalling the memory, as well as stronger positive beliefs about yourself.
While sometimes it seems to be marketed as one, EMDR is NOT a miracle cure! For those with relatively straight forward, single incident traumatic experiences, it can resolve symptoms quickly— you even may experience improvements within the first processing session. But for those with more complex trauma histories, appropriate use of EMDR will involve ample time for preparation and integration with other theories and techniques to work with the complexities of attachment and early childhood trauma. Attachment trauma in particular simply takes time and consistency to heal, even with an EMDR approach. An effective EMDR therapist will work with you to find the appropriate pace of treatment and use the model flexibly to fit your needs, integrating other therapeutic approaches where appropriate.
The thing I love the most about using EMDR as part of my practice is witnessing how every client moves through the process differently, and being able to join with the client in trusting their own nervous system to move toward healing. In my own experience, clients have found it very helpful to process in a completely different way than just describing things they’ve been through, and have been able to make many connections between seemingly disparate aspects of their experience.
During the process of healing, we often find ourselves stuck in frustrating paradoxes. We know what is true: that we didn’t deserve to be hurt; that we are good enough; that we are lovable; that we are safe now. But we find that these things don’t feel true. We know that making certain choices will benefit us, and others will harm us, but find ourselves somehow unable to make the choice we know will feel good. We know the coping skills, that we should take deep breaths and ground ourselves, but in the moments where these skills are most needed, it’s suddenly as if we never knew them.
In my own practice, and my own therapy experiences, EMDR has been a game changer for addressing this paradox by going deeper than what we know on a conscious level, and creating shifts at a nervous system level. If you’ve found yourself stuck in these paradoxes, EMDR may be a next step for achieving deeper, long lasting change.
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