EMDR

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Eye Movement Desensitization and Reprocessing (EMDR) Therapy (Shapiro, 2018) was initially developed in 1987 for the treatment of posttraumatic stress disorder (PTSD). Now widely accepted as a gold standard for treatment of all types of trauma, EMDR is a highly effective individual therapy delivered by a therapist who has received specialized training and certification.  

The Adaptive Information Processing model considers symptoms of PTSD and other disorders related to trauma (such as anxiety and depression) to result from past disturbing experiences that continue to cause distress because the memory was not adequately processed. These unprocessed memories are understood to contain the emotions, thoughts, beliefs and physical sensations that occurred at the time of the event. When these memories are triggered (either by recalling the initial trauma, or more often, by something that is happening presently that is causing distress) these stored disturbing elements are experienced in present day. Unlike other treatments that utilize talk therapy to explore the emotions, thoughts and responses resulting from traumatic experiences, EMDR therapy focuses directly on the memory, and is intended to change the way that the memory is stored in the brain, thus reducing or eliminating the problematic symptoms for good.  

Breaking it Down: How Does it Work?  

When a disturbing event occurs, it can get locked in the brain with the original picture, sounds, thoughts, feelings, and body sensations. EMDR therapy stimulates the information stored and allows the brain to reprocess the experience. It is similar to what happens in REM (dream) sleep. The therapist will develop the initial plan with you based on guidelines that have been developed and refined over three decades; then when you are ready to begin EMDR, he or she will guide your eye movements while you are in the session. The eye movements in EMDR help reprocess the memory and other associated experiences. It is your own brain that will be doing the healing – you are the one in complete control.  

Components of memory:  

1.) Sensory Input (images, sounds, smells, tastes)  

2.) Thoughts  

3.) Emotions  

4.) Body sensations  

5.) Beliefs about self 

The Science of Memory:  

Memories with similar information are linked by channels of association. These channels may be adaptive (healthy) and are the primary basis of learning concepts such as self-esteem, self-worth, confidence, and resiliency. Memories may also be maladaptive (dysfunctional, unhealthy) and often  manifest in negative patterns of behavior, low self-esteem or self-worth, and pathology such as depression, anxiety, and other disorders.  

When an experience is successfully processed, it is adaptively stored. It is linked with other positive associations about self and others. When an experience is negatively processed, it may be stored maladaptively in a state-specific form (high anxiety feelings, fear, anger, shame, etc.) As new information is gathered present-day, these inadequately processed memories can trigger a reaction in the present as if it were the same as the past, even if this is not true. The critical component of EMDR: “THE PAST IS THE PRESENT” (Shapiro, 2018).  

The Mechanics:  

An experience is selected as the “Target Memory” from which the client and therapist will begin the work. The therapist completes a highly structured interview to activate as many components of the target memory as possible. Then, using bilateral stimulation (BLS), the memory is desensitized and finally reprocessed into helpful, more adaptive memory networks. While the processing is occurring, it is common to experience some discomfort in recalling painful parts of your past. This is normal and will be discussed more thoroughly with your EMDR therapist, along with other mechanics to properly calibrate and prepare for BLS. 

How long does it take/how many sessions? 

Like talk therapy, it is difficult to know initially how long it may take to work through a particular problem, issue, or trauma. For an isolated event, results may be seen in as few as 1 or 2 sessions. If the trauma was over an extended period of time, or there are multiple traumas to address, this may be discussed with your therapist so you have an understanding of the process and expectations for your particular situation.  

Shapiro, F. (2018). Eye Movement Desensitization and Reprocessing [EMDR] Therapy, 3rd Edition. Guilford Press, NY, NY.