Introduction to EMDR
EMDR (Eye Movement Desensitization and Reprocessing) has had more clinical studies than any other form of therapy. Francine Shapiro, the scientist who discovered this technique in the 1980’s, immediately tested it through controlled studies of Vietnam veterans suffering from post-traumatic stress disorder. Only a controlled study—with a “treatment group” and a “control group”—allows one to determine whether a particular treatment is genuinely efficacious. The results have made EMDR the treatment of choice for trauma (and this applies to “small T” trauma as well as “capital T trauma”). As a consequence, EMDR has proved to be useful in dealing with anxiety, panic attacks, grief, disturbing memories, sexual and/or physical abuse, phobias, eating disorders, performance anxiety, and stress reduction.
So how does EMDR work? The brain, like the body, is designed to heal itself. If you get a cut on your arm, assuming it does not becoming infected it will heal itself, and after a month you will not even be able to see the area of injury. The brain works the same way. Suppose that your boss humiliates you in front of all your colleagues. You will become upset and may stay upset for a couple of days. Then you will talk with friends, colleagues, perhaps your partner. You may think of different ways to interact with the boss, or you may seek a transfer to a different section, or you may even look for a different job. In any event, when you look back at the incident a year later, you will likely regard it as an unpleasant experience, but not one that brings you down when you think about it.
That’s the way the brain is supposed to work. We take things in stride. “Just deal with it,” as people say. But sometimes you have an experience that overwhelms your capacity to deal with it. When that happens, instead of processing the experience, the brain wraps it up in a package—including all the associated images, thoughts, body sensations, and emotions—and files it away, along with negative beliefs such as “I am insignificant,” or “I am powerless,” or “It’s not okay to show my emotions,” or “I cannot trust anyone.” You can imagine that such self-beliefs make it very difficult for you to sustain a healthy sense of self-esteem or to form and maintain intimate relationships. Brain scans show these unprocessed memories to be unconnected with the neural network. They just sit there in the brain, along with poisonous self-beliefs whose influence may extend across many decades.
We call those overwhelming, unprocessed experiences “trauma.” Most people when they hear that word think of soldiers returning from military combat, or survivors of an earthquake or tsunami, or victims of sexual abuse. I would describe those situations as “capital T traumas.” Unresolved, they cause problems indefinitely. For a soldier, for example, the sound of car backfiring may immediately transport him or her back to the battleground, with images of flares overheard and sounds of injured comrades nearby and the sensation of a rapidly beating heart as the body goes into protective stress mode.
Not everyone experiences “capital T trauma,” but nearly everybody experiences what I call “small t traumas” such as witnessing a violent dispute between parents, being teased or bullied or humiliated, or suffering a grievous loss. We can understand that children are particularly susceptible to “small t traumas” because they don’t have an adult’s same capacity to process potentially overwhelming experiences. For this reason, a list of one’s ten worst memories may include a number of incidents from childhood.
EMDR is a method of bringing these unprocessed memories in touch with the part of the brain that does the processing. Essentially, EMDR facilitates the natural healing powers of the brain. The client holds in mind the image that represents the worst part of the experience while the therapist alternately stimulates the left and right hemispheres of your brain. This does not require implanting electrodes! The stimulation takes the form of fingers moving in front of your eyes while you track them; or tapping your knees, left right left right; or sounding a clicker by your ears, left right left right.
This stimulation initiates what may be described as a kind of train ride, in which your brain lays down the track. Neither you nor the therapist knows the destination, but the brain goes where it needs to go in order to heal the unprocessed memory. You can think of the therapist as your blind companion in the train coach. After each set the therapist will ask, “What did you notice?” You may say, “I’m scared” or “He is being mean to me” and the therapist will write that down. But the important thing in processing trauma—whether capital T or small T—using EMDR is that you will not be re-traumatized. You are never going to disappear back into the experience and have to experience it again. You will always remain aware of being in a room with a therapist’s fingers moving in front of your eyes.
Clients report a variety of experiences during the process of bilateral stimulation (usually following the therapist’s fingers with their eyes):
- Images. This does not mean hallucinations! If asked to form a mental image of your kitchen, you would have no difficulty picturing the relative positions of the stove, the refrigerator and the kitchen window. If you suddenly had an image of your third-grade classroom, on the other hand, with the students on either side of you and the teacher in the front of the room, you might say, “I haven’t thought about that for a while,” but it would still be just a mental image.
- Words. Thoughts may run through your mind such as “That wasn’t fair” or “I wish they’d asked me,” or “I wish I’d done something different.” EMDR differs from talk therapy: you will not discuss or amplify these thoughts with the therapist, but simply observe them and move on.
- Body sensations. You may experience a tingling feeling in your fingers or a hollow feeling in your stomach or some other sensations in your body. (The ability to identify and distinguish body sensations, to recognize stress or tension in your body, is an essential prerequisite to beginning EMDR therapy.)
- Emotions. You may feel emotions such as feeling frustrated or feeling. Again, you will not dwell on or discuss these feelings, but simply notice them and move on.
EMDR does not involve “erasing” memories, but EMDR does remove the ability of a memory to distress you. If you had a pet as a child, the pet probably died at some point, and this experience may have made you cry. But you no longer wake up in the morning grieving over the loss of your pet. The loss was sad at the time but it no longer distresses you. The same thing goes for a memory that you process with EMDR. You’ll always be able to recall the experience, even after processing, but the recollection will no longer bring you down. Moreover, negative beliefs such as the ones that we mentioned earlier will be replaced by positive beliefs: “I am significant,” or “I am strong,” or “I can safely show my emotions,” or “I can choose whom to trust.”
The client’s job is not to analyze, not to criticize, not to try to hold on to the passing scenes, but simply to observe. Some clients, particularly those of a strongly analytical nature, find this difficult. They want to know why they’re seeing a particular image, or they may want to try to fit their experience into a neat analytical framework. EMDR differs in this regard form traditional talk therapy. Returning to the analogy of a cut on the arm, the physical process of healing is too gradual to be observed. You notice certain stages in the healing process, but you cannot actually see it taking place. Only time-lapse photography would permit you to see what happens when the body heals itself. EMDR, by contrast, allows you to see your brain healing in real time.
EMDR represents an extremely efficient, powerful technique for processing troubling experiences. One may think of unprocessed negative memories as large boulders in the stream of one’s life. If there are enough boulders, the flow of the stream may be reduced to a mere trickle. One may think of EMDR as a large crane lifting these boulders out of the stream. Once several boulders have been removed, one is likely to experience a marked change, and eventually EMDR therapy can help produce the kind of free-flowing stream that one associates with a life of good mental health. We generally begin with early memories because each experience in our life colors those which follow it. If you think of a row of dominos, for example, a small effort will knock over the last tile in the row, but the same amount of effort, applied to the first domino, will knock over several more. This doesn’t mean that simply processing your earliest memory will solve all your problems, but it does mean that processing early memories reduces the disturbance level of later memories, sometimes to the point that they need not even be formally addressed.
EMDR also offers a powerful tool for rapidly changing those stubborn core beliefs, stemming from early childhood neglect or abuse, that are so difficult to uproot in traditional psychotherapy
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