Eye Movement Desensitization and Reprocessing (EMDR) is a powerful and innovative approach designed to help individuals struggling with traumatic experiences and distressing memories. EMDR was developed in the late 1980s by Francine Shapiro. As the story goes, Dr. Shapiro was walking in a park, when she noticed that her own disturbing thoughts seemed to lessen when she moved her eyes back and forth rapidly. This observation became the inspiration for EMDR therapy.
At its core, EMDR is a psychotherapy approach that aims to reprocess distressing memories and alleviate the emotional charge they hold. This is accomplished by moving through the following treatment phases:
1. Preparation: The therapist and client establish a therapeutic alliance and ensure the client is emotionally prepared to revisit traumatic memories. This involves helping clients find ways to calm their nervous system and contain distressing content. This phase can move quickly for someone who is relatively well regulated or can last much longer for someone with severe and pervasive trauma who has little to no experience with regulation or a felt sense of safety.
2. Target Identification: The client identifies specific memories or experiences that are causing emotional distress. Sometimes client have specific traumatic memories in mind when they come to treatment. Other times, they are unsure about what memories still hold distress. It can be good to know that there are many ways to find and identify targets; you do not have to know in advance what they are. Your therapist will guide you as you decide where to focus.
3. Desensitization: During this phase, the client recalls the traumatic memory including images, thoughts, emotions and body sensations while simultaneously engaging in bilateral stimulation, often through following the therapist’s finger movements with their eyes. The goal of this phase is to reduce the distress associated with the memory.
4. Installation: After the mind has sorted through and reduced the distress associated with the memory, the mind is able to identify adaptive, positive truths about themselves in relation to the trauma. The therapist and the client identify these beliefs and negative self-perceptions are replaced with more adaptive ones.
5. Body Scan: The therapist and client work together to identify any remaining emotional distress and physical tension, addressing them through bilateral stimulation.
6. Containment: Toward the end of each session, the therapist will help the client contain distress and regulate the nervous system before leaving the office. The therapist and client can also work together to ensure that adequate coping is happening between sessions. As the client gives feedback to the therapist, the therapist can adjust treatment so that progress is being made but sessions are not too intense for the client.
While the exact mechanism of EMDR is not fully understood, it is thought to facilitate the reprocessing of traumatic memories by integrating them with more adaptive information. The bilateral stimulation used during EMDR may promote communication between the brain’s hemispheres, allowing for a more comprehensive and less emotionally charged processing of the memories.
As a clinician, I have found EMDR to be a powerful and effective way to treat trauma. I appreciate its use of imagery, emotion, and body work because so much of trauma is not logical but stored in the body through pictures and body sensations. I also love that EMDR acknowledges that given the opportunity, clients have an innate ability to heal by letting go of things that are not true and replacing them with adaptive beliefs about the self that are true and helpful.
Sarah Hunter, LCSW 