Eye Movement Desensitization and Reprocessing (EMDR) is a therapeutic approach utilized to help individuals move past traumatic events.
Whether the trauma is a little “t” or big “T” event, traumatic occurrences have the potential to reorganize the nervous system into a constant state of hyperarousal (panic attacks) or hypoarousal (numbed out, disassociated).
Most of the time, the mind-body-brain routinely manages new information and experiences without issue. However, when something out of the ordinary occurs, and the event is too overwhelming, such as a car accident or being subjected to chronic adverse experiences like childhood abuse/neglect, our adaptive information processing system (AIP) can become overloaded. These types of events can result in disturbing experiences remaining frozen in the brain or remaining “unprocessed.”
The nervous system becomes hypervigilant, on edge, and overly sensitive to external stimuli. Sight, sound, taste, touch, and smell become powerful triggers that warn the nervous system of danger. Even in the most benign environments, the body can feel unsafe and out of control. The mind will also create a story about the events, often a negative belief (I am responsible, unlovable, unworthy, unsafe). Individuals with unprocessed trauma can appear detached, numbed-out, zoned-out, or struggle with panic attacks, nightmares, flashbacks, intrusive memories/thoughts/images, and become irritable or easily agitated.
These symptoms of PTSD are frightening and can become debilitating to an individual if untreated. Without the proper treatment and coping skills, a person will implement any strategy for some relief often turning to alcohol, drugs, over-exercising, over-eating, and isolating behaviors to name a few. These strategies often create more issues and even more traumatization.
How EMDR Can Help
EMDR posits that the brain has a natural adaptive information processing system (AIP) that under normal circumstances works seamlessly. However, when overwhelming experiences occur, the information from the trauma (images, sounds, feeling states, emotions, and cognition) is not allowed to process or integrate from the Limbic system (home of the fear response) to the prefrontal cortex (home of higher thinking/executive functioning).
The eye movements or bilateral stimulation (audio or tactile can be used) assist the brain in reprocessing and integrating the memory. Full integration of the memory from the Limbic system to the prefrontal cortex moves the memory from implicit memory to explicit memory storage. The integration of the memory allows the individual to begin feeling less overwhelmed by external stimuli (sound, smell, taste, touch, sight) and internal stimuli (memories, thoughts, emotions, feeling states) that trigger the fear response (fight or flight).
What to Expect With EMDR
A typical session of EMDR lasts between 60-90 minutes with the individual fully awake and in control of the process. The clinician collaborates with the individual to identify target memories, level of disturbance, and validity of negative core beliefs. Bilateral stimulation (eye movements, audio or tactile) are implemented for 20-30 seconds. Once the bilateral stimulation has ended, the client reports any images, emotions, body sensations, and cognitions. The memory is considered integrated and reprocessed when the client reports a SUD (subjective unit of disturbance) of 0-1/10, a VOC (validity of cognition) of 7/7 for positive belief, and a clear body scan (no activation in the body).
Although the memories are not forgotten, the experience of remembering no longer has the power to create PTSD symptoms. The flashbacks, intrusive images, hypervigilance, disassociation, and negative core beliefs begin to subside. More importantly, the individual can engage in life once again without fear of suffering from a PTSD symptom.
In addition to PTSD therapy, EMDR has been successful in treating the following:
Anxiety, depression, stress & trauma, phobias, sleep problems, complicated grief, addictions, pain relief, phantom limb pain, self-esteem, and performance anxiety.
Further information on the phases of EMDR can be found on www.emdr.org and www.emdr-europe.org and in the book “Getting Past Your Past” by Francine Shapiro.
by Janie Montiel, AMFT