EMDR is short for Eye Movement Desensitization and Reprocessing. It’s not yet known exactly which components (or combination of components) are responsible for its effectiveness. But lots of research has proven its effectiveness a treatment for posttraumatic stress disorder (PTSD).
Here’s an overview of what happens in EMDR sessions:
- First of all, EMDR involves at least one ‘preparation’ session before dealing with specific memories. I will not describe those here, except to they’re no big deal and make sure that the ‘memory-processing’ sessions go well.
- The client begins the ‘exposure’ phase of sessions by focusing on the most distressing image associated with the traumatic experience, plus the emotion accompanying the image, how that emotion feels in the body, and an associated negative belief about oneself (e.g., ‘I deserved it,’ or ‘I’m unlovable.’). Unlike traditional ‘exposure treatments,’ you don’t need to describe the memory in detail, and you can even just focus on those aspects of the memory without having to say them out loud.
- Then, while holding in mind the most distressing image/emotion/body sensation/cognition, and not speaking, the client tracks the therapist’s moving finger or a moving light, as they move back and forth across the visual field, for 10 to 40 seconds. (Other, non-visual options are alternating sounds or tapping sensations.)
- The client is told, in advance, that during any set of eye movements his or her experience may or may not change, and is not ‘supposed’ to do anything. Basically, the therapist trusts your mind and brain to go where they need to go (but is always ready to help if something starts to become overwhelming).
- After each set of eye movements, the client is asked, ‘what are you noticing?’ (which is briefly reported, though the client can choose not to say anything), then directed to ‘go with that’ for another set of eye movements (while not talking), after which they are again asked, ‘what are you noticing?’ This basic, repeated sequence is the core and the majority of an EMDR session.
- If the client associates forward or backward in time, to earlier or later parts of the traumatic event, or even to completely different past events, thoughts about the future, or entirely new ideas, this is all normal and acceptable. The therapist simply checks in after each set of eye movements with ‘what are you noticing,’ without discussing what the client reports, and directs the client to ‘go with that’ into the next eye movement set. (Again, if the client starts getting overwhelmed, the therapist will intervene to prevent the experience from becoming traumatic.)
The above shows very clear differences between EMDR and traditional exposure therapy, which requires clients to narrate memories out loud and in detail, from start to finish. Obvioulsy, many people do not want to do that.
Associations and Transforming Memories
Everything about EMDR allows the client to ‘associate’ to different memories, themes, and ideas — including positive ones. In fact, anyone who has any experience at all with EMDR, as a client or therapist, is quickly impressed by just how many such associations and connections occur during EMDR sessions.
When such associations arise in EMDR sessions, clients are able to transform painful or traumatic memories into ones that are woven into new webs of associations.
Rather than the same old horrible images, feelings, and thoughts, the memory becomes much less distressing or no longer distressing at all. It becomes connected to thoughts, feelings and body states involving things like safety, comfort, and kindness toward oneself. It’s still a memory of something bad that happened, but it’s not an overwhelming memory. it’s not one you struggle to push away out of fear or shame.
That’s where any good therapy approach for dealing with memories of unwanted or traumatic experiences will take you. But EMDR has a way of doing it much more quickly and with less distress than most other approaches.
Of course, as we cover under Stages of Recovery, there’s more to healing and recovery than transforming memories, which is a focus on the second stage of recovery.
But transforming such memories can be a huge relief, and some therapists who use EMDR are good at stage-oriented treatment of men with histories of unwanted or abusive boyhood sexual experiences.
Finding Help, Learning More
To find an EMDR therapist near you, use the Find a Therapist service of the EMDR International Association. EMDRIA’s primary objective is to “establish, maintain and promote the highest standards of excellence and integrity in Eye Movement Desensitization and Reprocessing (EMDR) practice, research and education.”
If you’re interested in reading scholarly papers on EMDR, a good place to start is an article by Susan Rogers and Steven Silver, Is EMDR an exposure therapy? A review of trauma protocols. The discussion above overlaps with theirs in many ways, but they provide much more theory and references to relevant scholarly work. They also provide case examples, which give a feel for the treatment and how it can help unique individuals. The article is one of several articles in a special January 2002 issue of the Journal of Clinical Psychology on EMDR. Another excellent (and brief) article on EMDR describes why, to quote the title, “EMDR minus eye movements equals good psychotherapy.”
There are effective and relatively rapid methods for dealing with intensely distressing memories. You do not have to be tortured by them for years.
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