EMDR – How does it work?

I have written about EMDR (Eye Movement Desensitization and Reprocessing) quite a bit on this blog. It is one of several counseling techniques I use at my practice in Monterey, but is probably my favorite one. The technique was first developed to help people suffering the aftereffects of trauma, but it is also very effective with people who suffer from anxiety for a variety of reasons. See this story for a vivid example where EMDR made a big impact in one of my young clients.

One question I often get is, how exactly does this work? What explains why this technique would be able to make such an impact in such a relatively short amount of time?

It helps to first look at how the mind reacts when experiencing a traumatic event.

We all experience traumatic events at one point or another in life. Some of these would be considered major Trauma, like experiences in war, serious accidents, domestic abuse, and other. We call these the ‘Big T’ traumatic events. ‘Little t’ traumatic events seem relatively minor in comparison. For instance, an incident at school where we felt a bit humiliated; being disciplined unreasonably by a parent; or choking on a piece of food.

Regardless of whether the event was major or minor in terms of intensity, we react to them in similar ways. Our brain interprets the event as a threat to our well-being and immediately tries to protect us in an emotional and physical way. Then, once the event has passed, it tries to make sense of it. It tries to find a rational explanation for what just happened. If that succeeds, the traumatic events become unpleasant memories, but they do not create excessive discomfort or trigger emotional upheaval when revisiting them.

We call this normal brain activity processing. It is processing the information, categorizing the elements into chunks that make sense. Yes, the shouting match that just happened between my mother and I was traumatic and it scared me. But, I understand that she is stressed out at the moment and I did provoke her when I played my music too loud, again. Now we have context, understanding, some way to explain.

But what happens when the brain fails to process the event properly? What if what we just experienced is simply too scary or threatening to think about? In these cases the brain tends to wall off the memory, stuff it away in a corner and leave it there, preferably never to visit it ever again. It’s a little like when an infection in the body gets walled off to prevent it from spreading to the rest of the body. This abscess may be painful, but at least it’s local and doesn’t affect the rest of the body.

Even though this approach may be a practical and effective protection mechanism, it isn’t a good long term solution. It doesn’t fix the problem. The memory stays in the mind and occasionally gets revisited, triggered by a smell, a sight, a word, a piece of music. And when it is, the emotions  tend to come roaring back with it, in full intensity as if it happened just yesterday. Unfortunately, this also tends to reinforce the brain’s determination never to visit that place again. It’s simply too painful. It still doesn’t make sense. And so we keep going, for years and years repeating the same cycle again again.

Francine Shapiro, the developer of EMDR, observed in 1987 that the act of moving her eyes while walking in the park appeared to decrease the negative emotions associated with her own distressing memories. She assumed that eye movements had a desensitizing effect on the memories. Later experiments confirmed this to be the case and showed that the therapeutic effects were most pronounced when combining the eye movements with other treatment elements, including certain cognitive components.

In other words, moving the eyes from side to side seems to be body’s way to help process painful memories. It is hypothesized that the eye movements that are seen during the REM phase of sleep (REM = Rapid Eye Movement) serve the same purpose – the brain is processing the memories of the previous day.

Researchers and clinicians continued to perfect the technique in the years that followed and found that any bilateral sensory stimulation would create a similar effect to moving the eyes. Most clinicians now use tapping or small handheld vibrators to deliver sensory stimuli alternately to the left and to the right side.

A specially trained psychotherapist credentialed in the use of EMDR will first try to identify the root of the current problem, the memory behind the current anxiety.

Second, the associated wrong beliefs are uncovered and exposed. (I am not beautiful, I’m all alone. Nobody likes me. I’m not safe.)

At this point in the therapy, the clinician will introduce the bilateral stimulation while guiding the client through subtle questioning to reevaluate those beliefs. (Are you in fact alone? Are you really unsafe?) This helps detach the original trauma from the protective actions and thought patterns that followed.

The bilateral stimulation at this point is critical. Through it the brain is coaxed into processing mode to try to deal with the very cause of the current problem.

At some point, the original traumatic event is explored in the same manner, often with the help of other cognitive techniques to help make sense of what happened.

Regardless of whether you suffered a ‘Big T’ or ‘small t’ event, help is available. EMDR is often a very effective technique to help you deal with the after effects of the trauma. You do not need to continue in your present suffering!

Contact me for a free counseling consultation today. My counseling practice is situated in Monterey and my contact number is 831-444-1747.

PS: I accept payment from several insurances and payers: Aspire, Coastal, MBIPA, MHN, HMC Healthworks, Victims of Crime. Check on your insurance card under Mental Health benefits to verify what coverage you have.

Many clients pay cash for their sessions (my fee is $125 per session or lower negotiated rate in special circumstances) and then submit the superbill provided by me to their insurance for possible reimbursement. See here under the FAQ section for some more information.