EMDR - An effective treatment for trauma and PTSD
Eye movement Desensitization and Reprocessing (EMDR) is an internationally recognized treatment for trauma & PTSD. It’s also known for its effectiveness in treating depression and anxiety. It helps people to process painful memories, get better, and move forward. This blog post, explains how EMDR works, what you can expect in a session, and who is a good fit for EMDR.
When John was 16, he was involved in a car accident; both he and his dad were in the ICU and had a couple of surgeries. His dad’s leg never fully recovered; he is in pain and walks with a crane. John missed a few weeks of school, but he recovered, at least physically. John felt responsible for the accident because he distracted his dad by showing him the new Spartans billboard next to the road. Through the years, John’s dad also noticed his son is more reserved, doubts himself, and doesn’t take as much initiative anymore. They used to be very close, but after the accident, John was distant. John secretly used alcohol, and at the age of 23, he was charged with a DUI. Late night parties, getting shitfaced and unsafe sex was common for him. He did anything he could to forget about about the pain he caused his dad, but he couldn’t get the image of his dad’s wounded leg on the accident scene out of his mind. It haunted him, in the classrooms, while driving, and in his dreams. It was everywhere. John’s career counselor picked up his risk-taking behavior was related to the car accident and referred him to an EMDR therapist.
The past drives the present.
Painful unhealed memories affect your relationships, actions, and decisions. For example, if you have a splinter in your finger, your body automatically wants to heal the injured area. However, your body can’t heal the area naturally until the splinter is removed. Until then, it affects your day-to-day functioning. In an attempt to protect the wounded area, you have to change the way you wash your hair, hold your cellphone, or sign your name. Similar to how the splinter affects your life, unresolved painful memories such as bullying, job loss, divorce, abuse, or serious illnesses (to name a few) will affect your behavior, relationships, and the way you see yourself. EMDR helps your brain heal and process the memory, which means your behavior, interactions, and decisions, won’t be based on an effort to protect the “wounded area” but on a healthy and logical observation of your present circumstances. You will still remember the incident, but it will be less disturbing, and it won’t affect your day-to-day life.
The theory behind EMDR.
Your brain can process and resolve painful memories. But during traumatic incidents, your brain gets flooded by feelings and needs extra support processing painful memories. I use the analogy that your brain is a file room with many cabinets. Usually, your brain can successfully file memories in the cabinets, but after trauma, your brain is so overwhelmed, it dumps the memory right in the middle of the file room. Whenever you access other files, you trip over the memory that’s dumped in the middle of the file room. It affects how you access and file memories, and it gets in the way of doing your day-to-day tasks. For instance, every time John sees a Spartan sign or a black SUV, he remembers the accident and feels flooded.
If your brain dumps a memory in the middle of the file room, you might have trauma responses such as flashbacks, nightmares, anxiety, depression, and avoidance behaviors. For example, John tried to avoid the memories of the accident by drinking too much, and he never drove past the area the accident happened. John believes the car accident was his fault. His dad told him multiple times it was an unforeseeable accident and it could have happened to anyone, but John blames himself and feels ashamed. Although it’s been years since the accident, John still feels powerless, depressed, and worthless. When the accident happened, John was overwhelmed with shock and fear, his brain could not fully process the memory, and it was dumped right in the middle of the file room- affecting his whole life. After several EMDR sessions, John realized the accident was not his fault, the nightmares stop and he felt better about himself. EMDR helped his brain to file the painful memory in the cabinets where it belongs.
The research.
Establish international associations recommend EMDR as an effective treatment for PTSD and trauma, based on clinical trials, meta-analysis, and other research studies. These associations are:
How do eye movements help the brain to process painful memories?
The eye movements and other bilateral stimuli (BLS) help your brain process information and “file the memories” in the cabinets. There are currently three hypotheses as to what happens on a physiological level during EMDR. Researchers believe it is a combination factors that makes EMDR an effective psychotherapy.
It taxes the working memory.
According to the working memory theory, your brain will predominantly focus on one task during multitasking, normally the less primary one. During EMDR, you are asked to focus on the painful memory and the bilateral stimuli. Your brain will automatically focus on the less primary task - the bilateral stimuli- which means the intensity and vividness of the painful memory will decrease.
It helps your body to relax.
EMDR activates the “rest and digest” response (know as the parasympathetic nervous system) and represses the “fight and flight” response (sympathetic nervous system). Studies support the notion that the activation for the rest and digest response decreases trauma symptoms.
It mimics REM sleep.
Rapid Eye Movement (REM) sleep is one of two sleep cycles; the other is called non-REM. Some studies support the hypothesis that EMDR triggers the memory consolidation process similar to REM sleep which plays a role in memory consolidation. REM sleep is recognized by vivid dreams and the back and forth movement of the eyes.
What to expect.
The first few sessions focus on preparation for memory reprocessing. We will talk about goals, medical history, relaxation skills, and we’ll do a few practice rounds of the bilateral stimulation (BLS). Usually, you can choose between eye movements, tapping(audio), or buzzers (tactile). The tactile BLS is only available for in-person sessions, but the eye movements and tapping can successfully be administrated online and in person. We will also identify specific memories to reprocess. This “preparation phase” can take a couple of sessions (3+) depending on the severity of the trauma. Once the prepping is done, we will start reprocessing the memories. I will ask you to think about the specific memory while applying your preference of the BLS. You’ll notice different body sensations, images, thoughts, and other memories pop up during the BLS. This is your brain’s way of processing the memory. Sometimes, I might change the BLS or ask you questions to fully process the memory in the shortest amount of time. Typically, the reprocessing will take most of our time together, and the session will close with relaxation exercises and time for you to ask questions. The sessions are usually 60 -90 minutes long, but I also offer extended EMDR sessions of three hours. The insurance does not cover these extended sessions.
Who is a good fit for EMDR?
Most people are a good fit for EMDR; however, I consider a few things when deciding on the best treatment plan for you. Factors that I take into consideration are:
upcoming legal proceedings
dissociative disorders
high-risk behaviors (Are you a danger to yourself or others?)
I might ask you to get medical clearance from your doctor if you have:
A traumatic brain injury
Stress-related illnesses
Epilepsy or pseudoseizures
Heart conditions
A high-risk pregnancy
or high-risk drug and alcohol use or withdrawal
Eye and vision conditions.
You can do EMDR if you have eye or vision conditions. I might ask you to get medical clearance, but if you can’t do the eye movements, we can use the tactile (in-person only) or the tapping (in-person and online) as alternatives. Most of the research has been done on eye movements, but the tactile and tapping show promising results in research studies. Many of my clients prefer tactile or tapping, and we’ve seen significant progress. I recommend that you wear glasses instead of contact lenses while we do the eye movements.
EMDR is an effective treatment for PTSD and trauma. With the guidance of an EMDR therapist, John processed the painful memory of the car accidents. The image of his dad’s injured leg was replaced with one of his dad inviting him to come closer. The nightmares and flashbacks stopped, and with the help of AA groups, John became sober.
Information on this website is provided for information purposes only and is not intended as a substitute for the advice provided by a mental health therapist or other healthcare professional. No information offered here should be interpreted as a diagnosis of any disorder, nor an attempt to treat or prevent or cure any disease or condition. Names, characters, places, and incidents on this website are for illustrative purposes only. Any resemblance to actual events or locales or persons, living or dead, is entirely coincidental.
