What is EMDR?
What is EMDR?
If you notice yourself over-reacting to something, it may be that your current reaction has a logic in a past situation that you were not able to resolve at the time. Consider this example: a 33-year-old professional woman who is normally emotionally composed finds herself feeling full of rage while ordering a coffee, when the barista serves the man behind her in the cue first. She later realises that the situation reminded her of growing up with her brother, who she felt was consistently favoured by her parents, something that she never expressed at the time.
Eye Movement Desensitization and Reprocessing (EMDR) is a relatively new form of therapy that is useful for settling troubling emotions that have their origins in unresolved past experiences, like the one in this example.
EMDR was developed in the 1980s in the USA by Francine Shapiro. She noticed that when she was thinking about difficult experiences from her past, if she made broad, sweeping back-and-forth movements with her eyes, the emotional intensity of her memories decreased. This inspired her to study whether these eye movements could help to reduce unpleasant emotions from troubling memories in other people.
In the decades since she made her discovery, a great deal of research has shown that the emotional intensity of memories of past events can be reduced, and unresolved issues associated with those memories can be resolved by using EMDR therapy.
What Can EMDR be Used to Treat?
EMDR is most commonly used as a treatment for trauma and post-traumatic stress disorder. Trauma disorders are troubling precisely because of the presence of unprocessed memories that are easily activated or triggered by both internal and external stimuli. There is substantial evidence that EMDR is an effective treatment for post-traumatic stress disorder.
Other difficulties that are associated with disturbing memories that may be less severe than post-traumatic stress disorder can also be resolved using EMDR. For example, someone who ruminates a lot about challenging past events may develop low mood or depression that may respond to EMDR treatment that reprocessed the past challenges.
There are documented case reports from clinicians who use EMDR that have shown it to be effective in the treatment of:
- Panic Attacks
- Complicated Grief
- some types of Pain Disorder
- Performance Anxiety
- Body Dysmorphic Disorders
- Personality Disorders
What Happens in EMDR Therapy?
Below is a description of a common course of the 8 phases of EMDR therapy, but please note that depending on the concerns that you bring to your therapy, it may make more sense to do things in a different way.
In the early stages of therapy, your therapist will take some time to get to know you, find out what is bothering you now, and see if it has any resonance with past difficulties in your life. Your therapist will be on the lookout for patterns and themes in the difficulties and struggles you have faced, as these can sometimes have a history in unprocessed material in your past. (Phase 1)
Your therapist will assess how easy or difficult it is for you to manage high levels of emotion, and make contact with your strengths and positive qualities. If these prove difficult for you, you will take some time to develop these skills by learning self soothing skills, and building your awareness of the positive attributes you possess that will help you to recover. (Phase 2)
Once you and your therapist think that you are ready to address some of your challenging memories, you will examine your troubling memories in some detail. This will involve mapping them out to understand how the unprocessed memories have changed and distorted your sense of yourself in the present, and what you might prefer to think and feel about yourself. You will work with your therapist to decide which memory or theme from your past would be most helpful to resolve first. (Phase 3)
When you have selected a priority for reprocessing, you will spend some sessions re-engaging with the troubling memory, and reprocessing it. During reprocessing, your job is to observe what is happening in your mind and body, and keep yourself within the therapeutic window of arousal; you need to be sufficiently disturbed that the neural networks that store the memory are firing and therefore re-wiring, but not so disturbed that you re-traumatise yourself. The skills you will have learned and reinforced earlier in therapy, and the bilateral stimulation of your brain during the reprocessing will both assist you to stay in the therapeutic window. Your therapist will check in regularly with you while you are doing this to make sure that you remain in the therapeutic window. For more detail, see here. (Phase 4)
Desensitising a memory is complete when you are no longer disturbed by it. To ensure that the desensitisation is complete, your therapist will help you to consolidate a more positive belief about yourself in the face of the challenging memory. If there is more to be processed, you will become aware of it when you try to install the positive material. Your body will register some disturbance if there is more that needs to be processed, and your therapist will guide you through a body scan to check for unprocessed material. You will be instructed to notice your thoughts and feelings between your therapy sessions, and maybe even to challenge yourself by experiencing or doing things that would have been difficult or impossible when you were still holding your less helpful beliefs. If anything remains to be processed, this will usually reveal it to you. (Phases 5-6-7)
The closing phase of the treatment involves re-evaluating the treatment effects, and ensuring that the resolution of past concerns has left you feeling better about the future, and functioning well in the present. You will typically imagine some future challenges, and process any anticipated obstacles, to ensure that you move forward with confidence. For some people, this can be a substantial part of their treatment, because looking into the future without past baggage reveals how many skills and tools they were unable to acquire while they were surviving life with their unprocessed difficulties from the past. (Phase 8)
Shapiro, F (2001) Eye Movement Desensitization and Reprocessing (EMDR), Second Edition. UK: Guildford Press.