EMDR – An Overview

“What is EMDR like?”

“I’ve heard good things about it, but how does it work?”

“I want to process my trauma, but I’m anxious about re-experiencing it.”

These are questions and comments I receive multiple times a month from people who are seeking my services and curious about EMDR. I hope providing an overview of this treatment will serve as a useful resource for those who find my website. Heads up- this is a long one. I really like talking about EMDR.

Eye-Movement Desensitization and Reprocessing (EMDR) is a therapeutic treatment for trauma in which clients engage in dual attention: focusing on a traumatic memory while also focusing on an external stimulus that crosses the midline of the body (bi-lateral stimulation, or BLS). Although the name indicates eye movements, bi-lateral stimulation can also be done through physical sensation or sound. In my office, most people use a combination of eye movements through watching a light move back and forth on a light bar, along with hand-held “tappers” that buzz in an alternating pattern. The BLS helps activate the part of the brain that is responsible for logic, reasoning, and categorization of information.

Let’s back up for a minute- why do we need to engage in BLS and activate certain parts of the brain to reprocess trauma? When someone experiences a traumatic event, parts of the brain called the amygdala and hippocampus work together to create a stress response. You may have heard of “Fight or Flight”- that’s what is happening. These parts of the brain are preparing you to Fight back or to Flee the threatening situation, in order to help you survive. In recent decades terminology identifying other responses has emerged including Freeze and Fawn, which I typically think of as sub-types of Fight and Flight. When the amygdala and hippocampus are coordinating a stress response, the prefrontal cortex and frontal lobe get quiet- there’s little room for logic and reasoning when you’re trying to survive a threat. Unfortunately, this part of the brain getting quiet means we don’t fully process the event like we do with non-threatening experiences. Bi-lateral stimulation allows the logic and reasoning parts of the brain to stay active while the stress response parts of the brain are active, which means the two parts of the brain can communicate and a traumatic memory can be processed differently. This reprocessing can happen no matter how much time has passed since a traumatic event.

What does all of this look like in session? EMDR is divided into 8 structured phases:

Phase 1: In this phase we discuss the present-day problems, history of traumatic experiences, and explore possible connections between the two. We decide together what specific present-day problems and past traumas to focus on.

Phase 2: Here we engage in what is called Resourcing. We explore your patterns of coping with stress and practice new skills for managing strong emotions. This gives you tools to use between sessions in case you experience memories, images, or other strong feelings related to the memories we are working on.

Phase 3: In this phase we focus on a specific memory and assess how distressing it is to you in the present moment. We also explore how this memory feels, and how it has impacted your core beliefs.

Phase 4: Once we have established how the memory we are going to work on is affecting you in the present, we engage in the dual attention and bi-lateral stimulation. This is the phase where you might say the magic happens. Sometimes it takes a little bit of time for your brain to acclimate to the process, which is completely normal. Your job here is to let your brain go where it goes and tell me where it’s going, and my job is to guide that process. This process does not change the memory, but rather helps you relate to the memory differently.

Phase 5: Once a memory feels full processed, we use BLS to strengthen your changed relationship with this memory.

Phase 6: After strengthening what is new, we’ll double check there’s nothing leftover that we missed, and we’ll strengthen anything else that feels empowered, relieved, calmer, settled, etc.

Phase 7: This phase is called Closure and it happens every session. The goal here is to reorient you to the here and now and check in on your experience in-session.

Phase 8: In this phase we re-assess, or check in on, anything your brain might have been up to related to previous processing sessions.

In my experience, when people are hesitant about EMDR they’re mostly worried about Phase 3 and Phase 4- the parts of the process where I walk you through re-experiencing the trauma enough that it can be re-processed. This does not involve telling the entire story- in fact I will gently stop you if you get into storytelling mode, because that shifts your brain more fully into logic and reasoning mode, and we need to keep you balanced between logic/reasoning and stress response modes in order to facilitate reprocessing. When I ask a question or give a prompt, the shortest answer is the best answer. I often explain it with these metaphors- “I don’t need you to draw me a clock, just tell me what time it is,” and “I don’t need you to read me the story, just tell me the title of the chapter.”

Even though you don’t have to tell the full stories out loud, re-experiencing these memories can be really daunting too. This is why we resource and prepare. I’m also trained to handle extreme stress responses such as panic attacks and dissociative experiences, though we do lots of resourcing work to avoid those happening in the first place. I find it is crucial to work at your pace- sometimes this means spending a lot of time in the resourcing phase, or taking breaks and having talk sessions between reprocessing sessions, or even ending reprocessing early in a session because you’re becoming overwhelmed. I also know that EMDR isn’t the right treatment for everyone, and I absolutely will not push you to continue if that becomes apparent.

Now that I’ve shared a bit about the process, I want to share a little bit about my training and experience. If you’re interested in working with me, this might help you decide if I’m the right EMDR therapist for you. For the first 12 years of my counseling career, I worked in a treatment program that had strict guidelines about how therapy was provided. Training in EMDR was not an option for me at that point, but I made it a top priority once I settled into private practice in 2020. I completed EMDR basic training in June of 2021 through Personal Transformation Institute. This EMDR training provided me with additional focus on working with attachment issues during every phase of EMDR. My basic training additionally focused on providing EMDR over telehealth. I went on to become EMDR Certified through EMDRIA, an organization that sets standards for EMDR providers. Certification is important to me because it requires me to continue engaging in advanced EMDR training, which provides me with opportunities to broaden my knowledge and learn new skills. For example, In early 2024, I attended an advanced EMDR training that focused on implementing Internal Family Systems concepts throughout Phases 1 and 2. I have also completed additional training through at-home study and workshop participation on complex trauma and CPTSD. I’ve worked with clients who have a wide variety of traumatic histories, and have helped many people experience healing. My clients have reported feeling less on-edge in their daily lives, having fewer instances of intrusive memories and nightmares, and being overall more able to experience difficult emotions without becoming destabilized. It’s an immense honor to be part of this healing experience for so many individuals.

I hope this overview of EMDR and my experience as an EMDR Certified therapist is helpful. If you want to talk with me individually about how EMDR might help you, please reach out to me using the contact form on the Get In Touch tab. I offer free 15-minute consultations for anyone who is interested in learning about my services. Thanks for reading!

Sources:

https://www.emdria.org/about-emdr-therapy/

https://www.emdria.org/about-emdr-therapy/experiencing-emdr-therapy/