You may have heard of a psychological therapy called ‘EMDR’ and are wondering what exactly is this strange sounding treatment? This blog will hopefully explain EMDR in a nutshell, help you to understand it and help you think if this might be something that could help you or someone else. EMDR has been around since the 1980’s and many research trials have helped it achieve a large ‘evidence base’ which means that it’s been shown time and time again to be an effective treatment for numerous difficulties. Such difficulties range from trauma reactions, anxiety, depression, pain, grief, addictions, phobias and many other presentations. EMDR is a therapy model with ‘8 phases’ that are worked through by the client and therapist together in a systematic way and these are described in more detail later in this blog.
EMDR stands for ‘Eye Movement Desensitisation and Reprocessing’ which is a bit of a mouthful but captures some of the essential components of EMDR, mainly that it aims to reduce high levels of sensitivity to particular traumatic or difficult memories and beliefs in addition to ‘processing’ them. Processing memories essentially means helping your brain to file tricky and traumatic memories in the proper place so they no longer interfere in your life as much.
EMDR does this by asking you to connect with something like a difficult memory or future fear while focusing on stimulation that you can feel, see or hear across both sides of your body. This is called ‘bilateral stimulation’ and a common form of such stimulation is back and forth eye movements. Despite the therapy being called ‘eye movement’ desensitisation and reprocessing, there are various forms of bilateral stimulation including watching your therapists fingers move back and forth across your visual field, tapping your own body in a specific way (such as ‘butterfly hugging’ as shown in the photo below) listening to alternating auditory noises, in addition to many other forms of stimulation. This means that EMDR is a therapy that lends itself well to both online and face to face therapeutic work.
It is very important to highlight that a fundamental part of EMDR is to work with a therapist who is specifically trained in this technique and who has relevant clinical experience which will enhance the overall process. It also goes without saying that your therapist should be someone with whom you have a positive, safe, and trusting therapeutic relationship with, who can fully explain the process and who you feel confident will help keep you emotionally safe throughout the process.
(‘Butterfly hugging’ as shown above is a commonly used form of bilateral stimulation)
So how does EMDR actually work?
It’s hard to pinpoint the exact mechanisms for how EMDR works but theories believe that it is based on helping our brains to process difficult thoughts, memories, and fears by unblocking them from the emotional centre of our brain and helping them to move to the more adaptive area of our brain that deals with thought, logic and words and making sense of things. Trauma memories tend to be stored in our emotion centre and are therefore associated with significant emotional responses rather than logic or thought and may have big gaps in the memory where you can’t remember what happened and when. Trauma memories tend not to be ‘time tagged’ so they don’t feel like they have a beginning, a middle and an end or a time attached to them, and are a bit like a jumbled up jigsaw with pieces all over the place. Therefore, flashbacks can often feel like the trauma is happening again NOW even though it may have happened months or years ago. Often people who have had traumatic experiences have memories that are ‘stuck’ in this emotional part of their brain and therefore become very sensitive to things that take them right back to the trauma e.g., loud noises, smells, sights, certain behaviours and so on.
More normal everyday memories on the other hand are stored in a different part of our brain that help make sense of things, are ordered, have a timeline, have a clear beginning, middle and end, tend not to feel overly emotional, and are like a completed jigsaw puzzle. EMDR therefore aims to help unblock, put back together and move traumatic or tricky memories from the emotional centre of our brain to the more logical and verbal centre so that they can start to make sense and reduce levels of distress. The aim being that the impact from the past can reduce and our negative beliefs about the past, present and future can also change.
Theories believe that the ‘bilateral stimulation’ which is central to EMDR helps this processing. It is thought that it is similar to what occurs when we dream during rapid eye movement (REM) sleep. During this phase of sleep our eyes rapidly move from side to side under our eyelids and this helps our brains process the day’s events. In a similar way, EMDR is thought to help shift stuck memories by using the brains natural healing and adaptive mechanisms to help us process memories, sensations and fears.
What does an EMDR session look like?
Your EMDR therapist would at first meet you for a few sessions to start to form a positive therapeutic relationship with you, take a history to gain an understanding of your difficulties and to jointly discuss and consider with you what psychological therapy / therapies would be most helpful to you. If you wished to have EMDR your therapist would then explain what EMDR is all about to help you make an informed decision if it was a therapy you’d like to do.
If you decided to have EMDR, your therapist would initially do some exercises with you to help teach you some psychological soothing and calming ‘resources’. This ‘resourcing’ part of therapy is very important as it helps you prepare for the more active ‘processing’ part of therapy by giving you some psychological tools to help manage possible distress and soothe yourself at the end of and in between sessions.
EMDR is a fairly protocol driven therapy which means that EMDR therapists follow a particular order of steps (or ‘phases’) and ask questions which research has been shown to help the effectiveness of EMDR. EMDR also takes a three pronged approach by focusing on your past events, your present issues and future situations.
It has eight phases as follows:
1. Taking a history:
Your therapist would ask various questions to get an understanding of how your past experiences are impacting on your current presentation.
2. Preparation for EMDR:
As outlined above, your therapist would show you methods of psychological ‘resourcing’ as outlined above in order to help prepare you during and between EMDR sessions.
Assessment of a particular difficult memory / future fear (for example, your therapist would ask you what the worst part of a particular memory was and how distressed it makes you feel now, what negative beliefs about yourself this brings up for you now and what is the positive belief that you would prefer to hold).
This the active processing phase where the bilateral stimulation helps process whatever memory / fear / belief is being targeted by EMDR. In this phase the therapist will ask you to do bilateral stimulation (e.g., by following their fingers, by asking you to tap your body etc) and intermittently ask you what you notice. This may be thoughts and memories going through your mind, noticing sensations in your body, or your mind might feel like it’s blank. There is no right or wrong with EMDR and how you respond should be seen in a curious and non-judgemental way. Our minds have a way of adaptively processing memories and the bilateral stimulation aids this process. Just like your body heals itself if it’s physically hurt, EMDR can help your mind heal your past traumas.
This phase aims to increase the strength of more adaptive and positive beliefs by continuing the bilateral stimulation but while focusing on a more positive belief.
6. Body scan:
In this phase you would be asked to mentally scan your body for any physical sensations that may still remain after EMDR. A physical response can indicate that that there are still memories to be processed. Bilateral stimulation would continue to help you process memories until your body feels cleared of difficult sensations.
This ensures that there is an ending to the session in a way where you feel settled and safe. This is important even if you haven’t fully processed a memory in the session.
In the next session, your therapist would see how you have been since the previous session and agree on what to focus on next.
It can be quite hard to describe how EMDR works without actually experiencing it or observing it. One of the main things about how EMDR differs from more traditional talking therapies however is that the therapist takes more of an observing but encouraging role rather than an active talking role. It is therefore quite different to other talking therapies where you would primarily talk through your difficulties together. It can feel a bit nerve wracking having EMDR for the first time but it’s helpful to think of it as having ‘one foot in the past and one foot in the present’. Your therapist will be beside you observing and encouraging and helping you to ‘just notice’ what is happening, throughout each session. It is also important to remember that you are still fully present and in control in a session and it is not like hypnosis where you may not feel as in control.
There are several therapists at The Wellbeing Rooms who are trained in EMDR and who have used it for a wide variety of difficulties. If you wish to know more about EMDR this is a helpful video and you can also ask your therapist for further information if this is a therapy you are interested i
We also have the above information in a free downloadable document within our website resources section, feel free to share with anyone who you think it may help!
Jo, Jan & Catherine