FAQ’s About EMDR

As a certified EMDR therapist, I am often asked to explain what EMDR is, how it works, etc., so here are some helpful FAQ’s about EMDR:

What is it?

EMDR stands for Eye Movement Desensitization and Reprocessing therapy. (Don’t worry, it took me a good couple of weeks to remember what all the letters meant and to get the order of the acronym right!) EMDR a relatively new treatment, first developed by Francine Shapiro in the late 1980’s-early 1990’s, that has gained much recognition for its ability to heal trauma.

So how does it work?

EMDR relies on the brain’s natural ability to heal from traumatic events and memories. EMDR uses what’s called the Adaptive Information Processing (AIP) model which provides a framework for and a hypothesis of how we believe trauma affects the brain. When we are exposed to a fearful stimulus, information about that stimulus is sent to our amygdala which in turn sends out a signal for the fight, flight, or freeze response. When the distress from that traumatic event remains, the thoughts, images, emotions, and body sensations that surface can become overwhelming and cause us to feel as if we are back in that moment or that we are “frozen” in that moment. EMDR helps the brain to process these memories and bring down the intensity of the emotions, the negativity of the thoughts, and soothe the sensations felt in the body when we think of that thing that happened to us thereby resolving the original fight, flight, freeze response.

What’s with the eye movement thing?

The “eye movement thing” is called Bilateral Stimulation (BLS). Francine Shapiro found that when she moved her eyes from side to side, she was better able to process and reprocess distressing thoughts and emotions. BLS is similar to the eye movement that occurs during REM sleep and it allows us to access the distressing memory and reprocess it on an emotional level until resolve and healing are achieved.

What does the treatment of EMDR look like?

There are eight phases in EMDR. Phase one involves history taking where the clinician completes an intake to gather specific information (i.e. current symptoms, triggers, past adverse life events, etc.) needed for treatment. This phase can usually be completed within one counseling session. During phase two, you and your clinician will discuss your EMDR treatment plan and decide what specific event or memory you will target first in your EMDR work. Then, the remainder of phase two is devoted to building coping skills and resources. Because you are preparing to do some potentially difficult and emotional work, we want to be sure that you have the skills needed to manage the emotional work and stay within the window of tolerance. The window of tolerance is that sweet spot where we can experience an elevated level of emotion and still work through it without becoming hyperaroused (i.e. feeling completely overwhelmed, abreacting, experiencing an increase in self-harm, suicidal thoughts, addiction, etc.) or without becoming hypoaroused (i.e. feeling numb, shutting down, dissociating). So, the resources and skills learned in phase two can help you cope with the things that come up during your EMDR sessions as well as anything that may surface related to your work outside of the session. During phases three through seven, you will target the specific event or memory and use BLS to begin to reprocess it. You will most likely spend the majority of your EMDR sessions within these phases until that original fight, flight, freeze response is resolved and the memory feels as close to neutral as possible. At the beginning of subsequent sessions, your clinician will begin with phase eight to check in and see what thoughts, emotions, insights, new memories, etc. have come up since your last session. Then, you will return to phases three through seven to continue reprocessing. Once the memory is neutral or as low as it can go, the clinician will move with you into some future oriented work. I consider this part of EMDR to be the “cherry on top”. We could just let you go on your merry way from here but instead, we take a look back at the information gathered during phase one and check to see where the distress of the original triggers you mentioned sit now. If any level of distress still exists when you think about encountering those triggers in life from here on out, then you’ll do some more BLS until you feel you’ve got the skills and insights needed to manage those situations successfully.

How long does the treatment take?

Each person heals in their own time so this is a difficult question to answer. I’ve worked with some individuals in EMDR who have experienced relief and healing after two months and there are others with whom I’ve worked for two years. The more complex the trauma, the more time it may take to reach a point of healing.

Am I a good candidate for EMDR?

Sometimes I hear clients tell me “Well, I wasn’t abused or anything so I don’t really have any trauma’”. EMDR is an evidenced based practice that is effective in treating both big “T” trauma related issues as well as little “t” trauma. The fact of the matter is we all have trauma. Any distressing experience – a bad breakup, the death of a loved one, a medical issue, your parent’s divorce, that mean girl in middle school who teased you relentlessly and made your life a living hell – that happened to you and continues to affect your life in a negative way or hold you back from being your best self is worth taking the time to work though and heal. So, yes, chances are you are a good candidate for EMDR.

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