EMDR was first developed as a treatment for Post-Traumatic Stress Disorder (PTSD) in the late 1980’s by Dr. Francine Shapiro. EMDR therapy supports clients in alleviating distressing symptoms of trauma including emotional disturbance, flashbacks, somatic symptoms, and intrusive thoughts that interfere with daily life functioning. EMDR utilizes bilateral stimulation (activation of both right and left brain hemispheres) to process traumatic memories, generally in the form of rapid lateral eye movements but also through the use of hand tapping or auditory tones. Learn more about EMDR and for support with finding the therapist that’s the best fit for you, book online for a complimentary service where we’ll guide you through the process of how to choose a counsellor that’s the best fit to get you started. Call now or book online.
EYE MOVEMENT DESENSITIZATION AND REPROCESSING (EMDR)
What is EMDR and How it Can Help You
What is the theory behind bilateral stimulation and how does it help to process traumatic memories?
There are several theories as to why bilateral stimulation is effective in eliciting adaptive resolution of traumatic memories. First, rapid eye movements are thought to mimic what we experience during REM sleep, where new internal associations are formed allowing for novel insights and information to be processed and appropriately stored in memory networks. It is also suggested that the dual attention prompted by the use of bilateral stimulation while simultaneously thinking about a traumatic memory pairs the memory with a grounding response, which reduces physiological arousal and promotes the resolution of traumatic material. Similarly, the process of reciprocal inhibition (pairing a soothing or relaxing stimulus with distressing memories) helps to systematically desensitize the memories while reducing avoidance of traumatic content.
What is the Adaptive Information Processing (AIP) model?
EMDR is based on the adaptive information processing model (AIP), which suggests that psychopathology and prolonged symptoms of trauma are due to maladaptive memory encoding or incomplete processing of traumatic experiences. For some individuals, a traumatic event may have happened months or even years prior, but they continue to re-experience aspects of the memory as if it was occurring in the present time; the brain and body have not processed that the experience is over and the emotions, images, beliefs, physical sensations, and/or thought patterns from the trauma continue to affect the person. The AIP model is based on the foundation that humans have an innate capacity to heal provided that the conditions for healing are available. Put another way, EMDR helps by removing blockages to healing, allowing the brain to resolve traumatic experiences, and come back into a state of homeostasis and regulation.
Normal Memory vs Traumatic Memory:
When a negative experience occurs, the brain is designed to process that event to a point of adaptive resolution where it becomes a historical fact that does not cause excessive emotional disturbance when recalled and is desensitized over time through processes of rumination, dreaming, and discussing the event with others.
- Trauma memory is stored in a “state specific” way; the emotions, arousal level, smells, sounds, negative beliefs etc. experienced at the time of the trauma can be re-experienced when the event is recalled, even after a prolonged length of time.
- Trauma memories can feel intrusive and become activated without our conscious awareness leading to emotional distress.
- It is not the magnitude of the event that determines whether it is traumatic, but instead in the way our nervous system stores the memory.
There are five components of memory that EMDR targets, and can be understood through the acronym “TICES”:
EMDR therapy integrates all the above components of memory in the reprocessing phases, rather than only focusing on one component such as thoughts or emotions, as is commonly seen in other therapeutic modalities that address trauma. This is important because the experiential aspects of traumatic memories, such as bodily sensations and nervous system dysregulation, are often difficult to fully encapsulate through talk therapy.
Who would benefit from EMDR therapy?
Although EMDR therapy was originally developed as a treatment for PTSD, numerous research studies have demonstrated its efficacy for a variety of other presenting concerns listed below. Individuals who have experienced trauma(s), including:
- Post-Traumatic Stress Disorder (PTSD)
- Complex PTSD (C-PTSD)
- Developmental trauma
- Single incident or acute trauma
- Chronic trauma or stress
- Obsessive Compulsive Disorder (OCD)
- Chronic pain
- Substance use
- Children, adolescents, adults, and older adults (research supports the efficacy of EMDR across the lifespan)
Frequently Asked Questions About EMDR:
EMDR is composed of a structured eight-phase, three-pronged approach.
The three-pronged approach: a) past experiences, b) current triggers, and c) potential future challenges.
Structured eight phases:
- Phase 1: History taking and treatment planning
- Phase 2: Preparation – the therapist explains the process of EMDR and teaches the client coping strategies for managing stress (relaxation techniques, breathing, etc. and ensuring client readiness for processing).
- Phase 3: Assessment – a target memory is identified that will be the focus of reprocessing.
- Phase 4: Desensitization – bilateral stimulation using side to side eye movements, tapping, or auditory tones while focusing on the target memory.
- Phase 5: Installation – preferred beliefs regarding the trauma memory are integrated using bilateral stimulation.
- Phase 6: Body-Scan – the client is guided to focus on physical sensations to evaluate whether there are any residual, unprocessed sensory experiences associated with the target memory.
- Phase 7: Closure – the therapist will ensure that the client is grounded and feels confident in using coping strategies for potential stress that may arise over the week.
- Phase 8: Re-evaluation – in each subsequent session the therapist will check-in on client progress and identify whether the target memory requires further processing.
EMDR on average takes between 6-12 sessions, however, the length of each phase may be altered based on individual differences and the complexity of each client’s presenting concerns. For example, the preparation phase may take place over a greater number of sessions for some clients to ensure safety, stabilization, and regulation during the later processing phases. Similarly, there may be interindividual differences in the number of sessions it takes to process memories using bilateral stimulation.
EMDR therapy is unique in that it is not categorized as a “talk therapy”. Of course you will engage in a variety of discussions with the therapist throughout the eight phases, but the EMDR therapist does not evaluate or provide their own insights into your experience as one might do in talk therapy. This is due to the EMDR therapist’s understanding that the client has the innate capacity to resolve their traumatic memories, and the insights necessary for adaptive resolution must come from the client rather than the therapist. The client is the expert of their experience, and the therapist provides the container and techniques to support the client in removing blockages to healing. Furthermore, EMDR does NOT require the client to systematically revisit each detail of a traumatic event the way one would do in Prolonged Exposure Therapy (PE). Instead, the EMDR therapist will ask you to hold in mind a specific aspect of the memory or event – a kind of snapshot – and during the reprocessing phases using bilateral stimulation your brain will free associate, allowing you to make novel connections and insights to adaptively process information in a way that desensitizes and eventually extinguishes the emotional charge associated with the traumatic memory.
Each client will have their own experience of receiving EMDR therapy, however, clients often describe that the emotional charge of the memory has diminished significantly or disappeared. Similarly, some details that were once vivid may feel that they have softened around the edges. One can observe the memory from a distance without emotional distress, understanding that its chronological place is in the past and no longer happening in the present. Clients may describe feeling “lighter” and having a deeper sense of connection and understanding for themselves as a result of new insights. Client’s also reports feeling more present with themselves and loved ones, leading to greater feelings of social connection and emotional health.
EMDR is a rigorously tested therapeutic modality with significant evidence supporting its efficacy in treating trauma and trauma related disorders in addition to myriad other presenting issues. See literature below for a deeper exploration into the research behind EMDR therapy.
EMDR at Our Clinic
Our trauma therapists specialize in EMDR. For in-person sessions for EMDR, please see Anna’s bio. Anna is located at our downtown Vancouver location, and her warm approach and extensive experience in trauma, depression, anxiety and ADHD have allowed her to integrate her therapy with DBT and ACT modalities as well. Anna has also been a client herself of EMDR and knows what it is like to be on the other side of the therapeutic modality.