EMDR: A Deep Dive
Eye Movement Desensitization and Reprocessing (EMDR) therapy has become a widely recognized and effective treatment for trauma and other distressing experiences. But what exactly is it, and how does it work?
The Origin Story of EMDR
EMDR was developed in 1987 by Dr. Francine Shapiro. The story goes that Dr. Shapiro was walking in a park, contemplating some distressing personal news. As she observed a tennis match, she noticed that her disturbing thoughts seemed to lessen as her eyes moved back and forth. This personal observation sparked her curiosity and led her to research this phenomenon further, eventually culminating in the development of EMDR therapy.
If you're looking for a more basic overview of EMDR and other trauma modalities, you can find it in my previous blog post here.
Adaptive Information Processing (AIP): The Core of EMDR
The foundational principle of EMDR is the Adaptive Information Processing (AIP) model. This model suggests that when we experience trauma, the memories can become "stuck" or maladaptively stored in our brains. This "stuckness" can create obstacles to our brain's natural ability to process information rationally, leading to ongoing symptoms like irrational thinking, unhelpful behaviors, and limiting beliefs.
Essentially, there is a disconnect between the part of your brain that holds the traumatic memory and the part that handles logical thought and processing. EMDR, through bilateral stimulation (BLS)—often involving eye movements—is believed to help remove these obstacles, allowing the brain to fully process the memory and reduce trauma symptoms.
How EMDR Works: A Past, Present, and Future Approach
With the AIP model in mind, EMDR therapy uses BLS alongside a structured past-present-future approach to help alleviate the impact of emotional wounds.
Past Targets
In EMDR, we start by identifying past targets—those charged events that have created emotional wounds and contribute to current difficulties in your life. I often describe these to clients as events that have "hit you hard"—moments that made you feel incredibly sad, angry, scared, or hurt, and still have a "sharpness" or "claws" in you.
Once identified, these targets are "opened up" and processed. This involves using the brain's natural ability to integrate adaptive information, essentially creating new, healthier associations through a process called neuroplasticity. For preverbal traumas or those without clear images, imaginal work is often used.
Present Challenges
After tempering past targets, the focus shifts to present current challenge areas or current triggers. These are processed in a similar way, allowing for the integration of adaptive information and the development or reinforcement of new associations. This helps you manage the impact of triggers on your current life situation more effectively.
Future Targets
Finally, EMDR addresses future targets. This involves anticipating future challenges and processing them as you would past or present targets. Since these situations haven't happened yet, imagination plays a more significant role. This future-oriented processing reinforces adaptive ways of handling situations and helps foster the skills needed for healthier functioning moving forward.
What Can EMDR Help With?
EMDR initially gained recognition as the "gold standard" for treating Post-Traumatic Stress Disorder (PTSD). Early studies with veteran populations and humanitarian efforts in areas like Croatia and Bosnia quickly established its effectiveness. Soon after, EMDR was no longer considered "experimental" and became an accepted treatment for PTSD in the general population.
This means EMDR can be incredibly helpful for single-incident traumas like:
Car accidents
Sexual assault
Neglect
Bullying
Emotional abuse
Physical abuse
The death of loved ones (including pets)
Workplace challenges
It's effective for both "Big T" and "Little T" traumas (you can learn more about these here).
Beyond PTSD, EMDR is also beneficial for conditions like depression and anxiety, as these are often rooted in challenging past events. In these cases, targets might include the earliest, worst, or most recent times you experienced depression or anxiety.
Additionally, EMDR can address negative beliefs such as "I'm not good enough," "I don't matter," "I'm powerless," or "I'm bad/broken/damaged." Using techniques like a "floatback" visualization, we can trace these beliefs back to their origins and work through the chain of events that created them. Some clients also find it helpful to create a collage or montage of several related "charged" events to process.
Case Example
Let's imagine a 30-year-old client seeking therapy for anxiety, low self-esteem, and a lack of self-worth. They've heard about EMDR and want to explore if it's the right fit. After a few initial sessions, EMDR is deemed an appropriate course of treatment.
As part of the process, the therapist guides the client to identify a trigger situation and notice where in their body they experience symptoms, then encourages them to amplify these sensations. Once the intensity is at its peak, the therapist instructs the client, "Let your mind float back, maybe a long way back, to where you first learned to feel this way."
During this visualization, the client identifies experiences of bullying in elementary school, religious trauma throughout childhood, and instances of homophobia and gender identity shaming in junior high and high school.
In subsequent sessions, as these targets are opened up and processed, the client is able to come to terms with these multiple events. With guidance from their therapist, they integrate adaptive information: finding empathy, connection, and solace from friends and even beloved fictional characters (in this case, they were a big Star Wars fan!).
As sessions continue and targets are worked through, the client gains increasing perspective. They are able to orient the past to the past, experiencing a significant reduction in their presenting symptoms as they progress on their healing journey.
If you're struggling with the lingering effects of past experiences, EMDR may offer a path toward healing and resolution. Don't hesitate to reach out ♥
Refs:
https://www.emdr.com/what-is-emdr-therapy-layperson/