Eye Movement Desensitization and Reprocessing (EMDR)
What is EMDR?
Eye Movement Desensitization and Reprocessing (EMDR) is the "gold standard" of treatment for trauma and post traumatic stress disorder.
It is a highly effective, evidence based, psychotherapy method for improving the lives of people who are struggling with the effect of trauma.
EMDR is an eight-stage method that uses bilateral stimulation to help people recover from trauma as well as other distressing life events. Eye movements are typically used, but sometimes tapping or noise will be used depending on the client’s needs. This method focuses primarily on the mind/body connection by addressing distressing memories that the client still feels stuck or frozen in. During a traumatic incident (referred to as a “target” in EMDR), different parts of the brain usually communicate with each other, allowing the person to properly process and resolve the incident, which also affects how the person remembers the incident. However, when this doesn’t happen, the person can become “frozen in time” and they aren’t able to reprocess the memory properly, leaving them with distressing emotional and physical associations with the memory. This is where EMDR can help.
EMDR is different from traditional talk therapy.
It can be used by itself or in addition to traditional talk therapy. EMDR allows the client to address traumatic memories without having to relive the memory or immerse themselves in the memory. Instead, the client is asked to use a brief clip or snapshot that represents the worst part of the memory. While the therapist guides the client through the stages, the client is essentially in control, using verbal and/or non-verbal ways to communicate when they need to stop or take a break. It is important to note that the memory is still present after successful reprocessing, but the fight, flight, or freeze response from the memory is resolved.
EMDR is also beneficial for more than just trauma. It has been used for anxiety, OCD, depression, anxiety, pain, grief, and many other things. Some clinicians are also exploring how EMDR might be used with transgender clients for gender dysphoria and other issues related to stigma this community faces. However, EMDR is not a good fit for everyone and it is important to know that the therapist will assess to see if you are a good fit before doing EMDR with you. Certain health conditions and even active substance use can be contraindicated for EMDR.
What an EMDR session looks like in eight steps:
1. History gathering and treatment planning
The therapist will begin gathering information to assess for previous traumatic events, mental and medical health history, support system, and internal and external resources. This is also where potential target memories will be identified.
In this stage the therapist will explain in more detail how EMDR works and what the client should expect during and in between sessions. The therapist will also work with the client to develop grounding and self-relaxation exercises for the client to use during and outside of sessions.
This is where the therapist assesses the memory to be targeted and how the client is most affected by the incident. A negative and positive cognition will be identified. A negative cognition is a negative belief the client holds about themself related to the target memory. The positive cognition is what they would like to believe about themselves now. The therapist can assist the client in identifying these If needed. How valid the positive cognition currently feels to the client and the level of disturbance the client feels about the target memory will be assessed at this point.
This is where the therapist will guide the client through bilateral stimulation to reprocess the incident. In this phase the incident and any other emotional or physical associations will be reprocessed.
In this phase bilateral stimulation will continue to be used to focus on and increase the belief in the positive cognition with the goal of replacing it with the negative cognition.
6. Body Scan
In this stage the therapist guides the client through a body scan to make sure there are no physiological sensations still attached to the memory remaining and if so, more bilateral stimulation will be used to target these sensations and reprocess them.
Each session ends this way regardless of whether the reprocessing was completed or not. The therapist will check in with the client to determine the client’s mental state. The therapist may guide the client through grounding and/or self-relaxation exercises before the session ends. These exercises can also be used in between sessions. The client will be briefed on what to expect in between sessions as well.
The therapist will open each new session by checking in with client to see how the client is feeling and to make sure the treatment plan is effective and up to date. Revisiting the target for reprocessing may be done if needed.
EMDR is exceptional in that the client does not have to tell the whole story in detail and is not required to relive the memory. EMDR can be very empowering for the client. Many therapists, especially therapists who take a strength-based approach with their clients, love EMDR because the client is doing the most important part of the work while an expert therapist guides the process. Essentially, the client’s brain is healing itself.
Currently, all of our therapists are knowledgeable about EMDR. Elizabeth Seabolt-Esparza is trained in EMDR and SJ Knowlton is currently going through the extra post-graduate training. If you think you could benefit from EMDR or would like more information about it please reach out to us using the links below.