EMDR

As an emotional response to a painful event, trauma can have many consequences. It’s quite common to have lingering negative feelings or physical responses long after a traumatic event is over. This is why many trauma victims seek help through therapy. Eye Movement Desensitization and Reprocessing, or EMDR, is one therapeutic method that can help some patients overcome issues such as flashbacks, panic attacks and lethargy caused by bad memories.

Understanding Trauma

Traumatic experiences are known in the behavioral health world as “big T” and “little t” traumas, according to Psychology Today. “Big T” traumas are what most people associate with the word trauma. These may be caused by horrific car accidents, sexual assault or rape, surviving a war, or natural disasters. The “little t” traumas are often overlooked by most people. These can be caused by going through a divorce as a child, a near-drowning episode, a parent who was not there for you, an overly critical boss who fired you, or a nasty fight with your spouse. All of these things create the same traumatic memories within your brain. And even though you may try to “get over them” or pretend that they are no big deal, you and your body won’t forget.

How Are My Memories Made?

When an event occurs, the brain immediately takes the image and creates a memory. It soon processes the memory and stores it in the past. Greater information is stored in more prominent memory places while lesser information (like what you ate for breakfast three days ago) is not as easy to recall. The important thing to remember with your memory is that what happens is placed within the right timeline. Your breakfast three days ago occurred in the past; it is not happening right now.

Making sure that your memories are appropriately placed in the past in your brain is very important. The brain moves normal memories during sleep. However, many researchers believe that REM (rapid eye movement) sleep helps your mind to process normal memories. EMDR therapy mimics the REM sleep process so that a person can process their memories when a person is not able to do it on their own.

How Does Trauma Affect Me?

According to the National Institute for the Clinical Application of Behavioral Medicine, when a traumatic event occurs, such as a car accident, the retina in the eye sends the information to the brain stem with lightning-fast speed. The body then immediately starts to activate the sympathetic nervous system. This system is known for providing the fight-or-flight response. This crucial response allows your heart rate to speed up, increases blood flow to your muscles, and allows you to quickly get yourself to safety. The same reaction happens at many intervals in our life whenever danger is found. Sometimes, we are able to respond by running away. However, other times we may instantly freeze and shut our body down — like when a snake is seen on a hiking trail and we need to be very still and quiet.

These responses allow us to protect our body, and they are a lifesaver in the moment of trauma. Unfortunately, some extreme experiences can lead to post-traumatic stress disorder. With this condition, the memories that are created and frozen in time are never able to be stored away properly. For example, someone who gets PTSD after a car accident may suddenly get a flashback while they are driving. They may then experience a pounding heart and vivid memories that leave them feeling afraid and fearful.

According to the Mayo Clinic, some people may not experience symptoms of PTSD until months or even years after the traumatic event. PTSD can cause symptoms such as:

  • Nightmares
  • Panic attacks
  • Recurrent memories
  • Negative thinking
  • Difficulty remembering
  • A loss of interest in daily activities
EMDR: An Explanation

Eye Movement Desensitization and Reprocessing Therapy were started in 1987 by Francis Shapiro. While she was out walking, she found herself thinking about some troubling thoughts. But then, she noticed that when her eyes would dart back and forth, the painful thoughts were not so painful anymore to her. In essence, the memories were desensitized. Surprised at this, she began studying more and more about the eye movements and eventually performed a landmark study with 22 individuals who had traumatic memories. While 11 of the individuals had the standard treatments of the time, which were “imagery and detailed descriptions,” the others received the eye movements. Those who had the EMDR therapy reported “significant decreases in ratings of subjective distress and significant increases in ratings of confidence in a positive belief.”

Before EMDR, those who were suffering from PTSD were considered very difficult to treat because the memories of the trauma kept arising. When Francis Shapiro started working on this treatment, she specifically wanted to help those who were suffering the most.

Who Can Perform EMDR?

EMDR should only be performed by trained professionals. While the eye movements can be mimicked by anyone, you should only trust your difficult, traumatic memories with someone who knows what to do. Specifically, you should look for someone who is trained and certified in EMDR. The major professional organization that trains therapists is the EMDR International Association. It sets rigorous standards and protocols to ensure that you will be taken care of appropriately.

What Happens in EMDR?

The EMDR process is not a quick fix. However, it can be a faster treatment method than spending months or years in therapy. The process occurs in eight phases, but not every phase will happen in each session, and some phases are repeated multiple times within a session.

Phase 1

is an introductory phase. This usually occurs when a client first meets an EMDR-trained therapist. During the session, the client’s history is taken. It is not necessary to delve too deeply into the memories as this can be very difficult for you to do. It is enough to simply highlight what happened in one or two sentences.

Phase 2

is a safeguarding phase. This phase is to ensure that you are safe while your memories are being talked about. The therapist may teach the client stress-reduction techniques and take them through some simple guided imagery sessions to ensure that they are calm and feel grounded. Oftentimes, the image of a vault is introduced here. Before the end of the meeting, the therapist can guide you through a guided imagery of placing those painful memories into a vault for safekeeping until the next session.

Phase 3

is the assessment phase. This may happen at the first appointment, but not in most cases. It can be a bit too much for you to meet a new therapist and begin treatment all at one time. It is best to take baby steps not to overstimulate your brain and the painful memories. Phase 3 is where the therapist starts to focus on a specific memory and the negative belief associated with it. The painful memory is typically easy to identify, but the negative belief is more difficult for most people to verbalize. An example of a negative belief would be: I am powerless, I am not loved, I am a failure, or I should have done something. The therapist will also ask you where you’re feeling the sensations in your body. For many people, this will be a heavy sensation or sick feeling in the stomach. Others may feel a tightness in the shoulders, a squeezing of their throat, or a tightening of the fist.

Phase 4

is the desensitization phase. This begins the EMDR process in which you are following the therapist’s fingers as well as thinking (or looking) at the traumatic memory. As your eyes make the movements, the targeted memory is being processed and (when successful) the emotions and sensations in the body begin to lessen or be desensitized. The eye movements take 30-45 seconds each round and often are done five to six times.

Phase 5

is called the installation phase. The therapist has the client re-look at the negative thought and then concentrate on a positive belief to override the negative belief. These positive beliefs are not just positive mantras, but things that the client knows to be true right now. These can include: I am strong, I don’t have to fear that situation anymore because I am at home where I am safe. I am not powerless, I can make decisions.

Phase 6

is the body scan phase. It is here where you will focus on the body sensations associated with the traumas. The therapist will help you to identify precisely what you are feeling by asking a series of probing questions. This will help turn abstract feelings into concrete terms that can be measured to see if they change. Phases 4-6 can happen in a pretty quick format, and they may be repeated a few times within the session. Don’t worry if you aren’t sure which phase the therapist is using, it is only your job to focus on what the therapist is saying.

Phase 7

is a day-closure phase. This helps you and the therapist to come back mentally to the present. The goal is to make sure you feel safe before you leave. The therapist may summarize what was talked about, utilize the vault guided imagery, or allow you to verbalize how you are feeling in the present moment. Even though phases 3-6 may bring up many painful memories, it’s important to know that you are safe at the end of the day.

Phase 8

is the re-evaluation phase that happens at the beginning of your next appointment. This is a check-in process that evaluates what happened at the last meeting, how you felt then, how you are feeling now, and if new body sensations have come up. It’s also a great time to ask questions. Some clients feel great after phase 7 while others can feel angry or upset. There are even some who have no reaction at all. All of these feelings are normal, and they should be told to your therapist. As the EMDR process continues, your therapist will repeat phases 4-7 on multiple appointments, and many clients report feeling much better as early as 3 appointments. In fact, most clients typically need 3-7 for general trauma, and 6 months for significant traumas.

Conclusion

The Eye Movement Desensitization and Reprocessing therapy were founded by Francis Shapiro to help victims of PTSD. In the 30 years since she began this work, thousands of people have been helped with processing traumatic memories. Though the phases of EMDR may seem lengthy, they can help people in just a few sessions start to see some dramatic and positive results. It is essential to only do EMDR therapy sessions with a trained provider. If you are struggling to process a “big T” or even a “little t” trauma, make sure you speak to your therapist about EMDR therapy.

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