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EMDR

Do you experience repeated disturbing memories, thoughts, or images of a stressful experience from the past?

Do you ever suddenly act or feel as if a stressful experience were happening again as if you were reliving it?

Do you experience physical reactions (e.g., heart pounding, trouble breathing, sweating), when something reminds you of a stressful experience from the past?

If any of these sound like you, you may be a good candidate for EMDR Therapy.

What is EMDR? 

Eye Movement Desensitization Reprocessing (EMDR) Therapy is a structured, evidence-based therapy designed to help individuals heal from trauma, post-traumatic stress disorder (PTSD), and Complex PTSD. 

EMDR works by:

  1. Reducing emotional distress and reactivity associated with traumatic memories
  2. Equipping clients with tools to manage emotions and reactions, both during EMDR sessions and in everyday life, especially when faced with challenging or triggering situations

During an EMDR session, clients focus on a traumatic memory while simultaneously engaging in bilateral stimulation (more on this in the following sections). This dual focus helps reduce the vividness and emotional charge of the memory, enabling clients to process it more effectively and integrate it into their lives with greater ease.

How Does EMDR Work?

EMDR is guided by the Adaptive Information Processing (AIP) Model, which views PTSD symptoms as the result of unprocessed, disturbing memories. These memories are thought to contain the original emotions, thoughts, physical sensations, and beliefs from the time of the event, remaining “stuck” in the brain and body.

When these memories are triggered—often by sights, sounds, or even emotions similar to the original event—they resurface, causing symptoms such as:

  • Flashbacks
  • Intrusive thoughts
  • Emotional distress
  • Physical reactions such as sweating or difficulty breathing

EMDR helps by targeting the memory itself, working to reprocess and reorganize it in the brain. This process doesn’t erase the memory but changes how it’s stored, so it no longer causes overwhelming distress.

What is Bilateral Stimulation (BLS)?

BLS refers to the use of stimuli that alternate between both sides of the body, engaging both sides of the brain. In EMDR, the most common form of BLS involves guided eye movements, where your therapist asks you to follow a moving object, such as your hand or a light bar, with your eyes. 

Other forms of BLS include:

  • Auditory BLS: Alternating tones played through headphones
  • Tactile BLS: Pulsations of vibrations delivered through handheld devices or gentle taps.

How does BLS work in EMDR?

When we experience trauma, our brain can become “stuck,” leaving distressing memories, emotions, and physical sensations unprocessed. These unresolved memories often resurface as intrusive thoughts, flashbacks, or emotional distress, making it feel as though the traumatic event is happening all over again. 

BLS is thought to help “unstick” these memories by engaging both hemispheres of the brain, allowing the nervous system to process and integrate the experience.

During EMDR, your therapist will guide you to focus on a distressing memory while simultaneously engaging in BLS. This process appears to create a unique state in the brain where past experiences can be processed more effectively, leading to:

  • Reduced emotional distress: Many clients report feeling significantly calmer while thinking about traumatic memories during BLS.
  • Improved cognitive clarity: The brain reprocesses the memory, allowing you to view the event from a new, more balanced perspective.
  • Healing and resolution: Once the memory is fully processed, it loses its emotional charge, meaning it no longer feels as overwhelming or intrusive.

Why is BLS effective?

Although the exact mechanisms behind BLS are still being studied, here’s what we know:

  • Activates Both Sides of the Brain: BLS engages both hemispheres, promoting better communication and integration of information.
  • Mimics REM Sleep: BLS may replicate the brain’s natural way of processing during REM sleep, a phase critical for consolidating memories and managing emotions.
  • Supports Dual Attention: By focusing on both the distressing memory and the alternating stimulus, the brain is able to reprocess the experience without becoming overwhelmed.

The 8 Phases of EMDR Therapy

EMDR follows a structured, eight-phase approach. Here’s an overview of what you can expect during treatment:

Phase 1: History-taking & treatment planning

In the first phase, your therapist will gather your full history and conduct preliminary assessments to understand your needs. Together, you will identify targets for treatment, which may include: 

  • Past memories that are distressing or unresolved
  • Current triggers that cause emotional or physical reactions
  • Future goals for healing and personal growth 

This collaborative process ensures that your treatment plan is tailored to your unique experiences and objectives.

Phase 2: Client preparation

In the preparation phases, your therapist will explain the EMDR treatment process, including how BLS, such as eye movements, will be used. To build emotional resilience, your therapist will guide you through exercises like the Safe/Calm Place exercise, equipping you with the tools necessary to manage strong emotions during and between sessions.

Phase 3: Assessing the target memory

This phase involves activating the specific memory you’ll work on during the session. Your therapist will help you identify and assess the memory’s components, including:

  • The image associated with the memory.
  • The negative cognition or belief about yourself (e.g., “I am powerless”).
  • The emotions connected to the memory.
  • Any physical sensations in your body when recalling the event.

Completion of this phase ensures the memory will be fully activated, providing a clear focus for processing.

Phases 4-7: Processing the memory to adaptive resolution

Desensitization: In this phase, you focus on the memory while engaging in BLS. After each set of BLS, you’ll report any new thoughts, feelings, or images that arise. Your therapist then uses these insights to guide the next set of BLS. This process continues until the memory no longer causes significant distress.

Installation: Once the distressing aspects of the memory are resolved, your therapist will help you strengthen a positive cognition to replace the negative belief. For example, if the initial belief was “I am powerless,” the new belief might be “I am in control of my life.”

Body Scan: In this phase, you will be asked to notice any physical sensations in your body while thinking of the memory and the positive cognition. If any tension or discomfort remains, additional BLS is used to process these sensations, ensuring complete resolution.

Closure: At the end of the session, your therapist will ensure you feel grounded and safe. If the targeted memory hasn’t been fully processed, containment techniques and self-care strategies are provided to help you manage until the next session.

Phase 8: Evaluating the results

The final phase begins at the start of your next session, where your therapist will evaluate the progress made. This includes:

  • Assessing your current psychological state.
  • Determining whether the positive changes have been maintained.
  • Identifying any new memories or triggers that may have emerged.

Your therapist will then use this information to guide the next session and ensure continued healing.

Additional Resources on EMDR and PTSD

If you’re interested in learning more about EMDR therapy, PTSD, and how treatment can help, here are some valuable resources to explore:

Understanding the EMDR Process

Case Example from the American Psychological Association (APA): This page provides an in-depth case example of a 32-year-old Iraq War Veteran who underwent EMDR therapy, offering further insight into how the process works. Read more on the APA website.

Screening Tools for PTSD

  • If you’re wondering whether EMDR might be right for you, screening tools like the PCL-5 (PTSD Checklist for DSM-5) can help identify whether you’re experiencing symptoms of PTSD.
  • PTSD Symptom Checklist for DSM-5 (PCL-5) – Civilian Version: A self-report questionnaire designed for individuals who have experienced non-combat-related trauma.
  • PTSD Symptom Checklist for DSM-5 (PCL-5) – Military Version: A version tailored for veterans and active-duty military personnel who have experienced combat or service-related trauma. Note: Higher scores on the PCL-5 suggest a greater likelihood of PTSD, but only a qualified mental health professional can provide an official diagnosis.

Learning More About PTSD

Basics of Understanding PTSD: Learn about the symptoms, causes, and effects of PTSD, including how it develops and common treatment options.

Topics Relevant to PTSD:

  • Explore specific aspects of PTSD, such as:
  • Avoidance behaviors
  • Complex PTSD (C-PTSD)
  • Trauma reminders (e.g., anniversaries, fireworks, or other triggers)
  • Managing emotional and physical responses to triggers 

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