What is Eye Movement Desensitization Reprocessing (EMDR)?

EMDR is an integrative form of psychotherapy that focuses on relieving distressing symptoms caused by trauma or stressful experiences.  There is a lot of misconception out there that EMDR is just used for people who have Post Traumatic Stress Disorder (PTSD) and that is true, it is rated the most effective, evidence-based treatment for PTSD.  However, it has expanded to treat many more symptoms and issues.  Today the therapy has evolved to work with people who suffer from Panic Disorders, Phobias, Attachment Disorders, Eating Disorders, Addictions, and Compulsive Behaviors to name a few. 

As always, EMDR is only as good as the clinician administering the therapy so make sure you are working with someone who is EMDRIA approved and getting proper training and supervision before you decide to engage with this person.   EMDRIA is the EMDR credentialing body that takes time to research, study, and develop standards of care and will only allow the most effective methods into their organization for clinicians to use and practice. 

You can be assured that every EMDR clinician has to follow a standard model for treatment and stay current in the field. Being Certified, I am required to obtain 12 continuing education credits every two years in order to understand the advances with the therapy and new scientific evidence that is found.  

So how does it work? 

EMDR is guided on the premise of Shapiro’s Adaptive Information Processing (AIP) model (1995, 2001, and 2006) which posits that trauma is stored and stuck in a neural network of the brain.  These stuck memories become inadequately processed or “maladaptive” creating many distressing symptoms in current life.   A particularly distressing incident that someone experiences may become “frozen in time” in its state-specific form, unable to get resolved by the brain’s normal methods of coping.   In a sense, it doesn’t get “filed” away in the brain the same way as short or long-term memory does.   This is why people often experience nightmares, triggers, or intense emotional reactions that they cannot explain and control.  Due the inability for the traumatic memory to connect with non-traumatic memory or “adaptive information” it continues to repeat and resurface throughout life until it gets resolved.  Clients will often use words like: “I know in my head that I’m not in danger when I walk into the grocery store, but I feel like I am and I cannot control it.”  This is a sign that the logical part of their brain (the Pre-Frontal cortex) is on line, but the Limbic System (our emotional, survival-based part of our brain) is activated and driving our thoughts and feelings.

EMDR uses Bi-Lateral Stimulation (BLS) to activate the Pre-Frontal Cortex and the Limbic System at the same time so you have access to your “rational brain” when thinking about the trauma (to put it simply). BLS can include eye movements that replicate Rapid Eye Movement (REM) sleep, tactile tapping using touch or a handheld tool, or sound signals through headphones the client wears while processing a memory.  You and the clinician decide the most effective form of BLS to use based on your own personal history and response to stimuli.  

IF decided to engage in EMDR, what should I expect? 

Once you and clinician decide that this is the right form of therapy to help alleviate distressing symptoms you will go through an eight-phase model to prepare you for trauma processing.  

Phase 1:  Includes gathering history and assessing for memories that caused the distressing problems in the present day.  A treatment plan and goals will also be developed during this phase. 

Phase 2: Involves preparing the client for memory processing and teaching self-control techniques.  This will help the client be well equipped to handle distressing material or intense emotions that may arise during processing.  

Phase 3: This is the assessment phase that focuses on a specific memory.  Here, the clinician will help you identify the image, negative beliefs, feelings, and where you feel them in your body to activate the neuro network where the memory is maladaptively stored.  

Phase 4: This is the desensitization phase where the clinician uses eye movements or other forms of Bi-Lateral Stimulation to help process the memory.  EMDR works with the body’s natural or innate ability to heal.  Here, the clinician intervenes as least as possible to allow the mind and body to process the material effectively.  Often clients will begin to experience new thoughts, emotions, and beliefs about the memory that they did not have access to prior to EMDR.  For example, a client who has been raped will start to believe that it was not her fault and understand that she was truly helpless instead of weak. When the client can think of the memory without any emotional disturbance and obtains new “adaptive” thoughts, feelings, and beliefs the next phase can begin.   

Phase 5: Involves installing the new positive belief that the client wants to believe when thinking of the memory.  For example, a client that believed “it was my fault,” may now believe, “it wasn’t my fault, I was just a kid” etc. 

Phase 6: “The body keeps the score” ~ Bessel van der Kolk, M.D.   This is the body scan phase where the clinician will have the client bring up the memory that was processed and new positive belief to see if the body holds onto any distressing feelings about the new material that was accessed during processing.  If the body is clear, the memory is resolved.  If the body has any negative feelings, more BLS will be used until it is cleared out.    

Phase 7: This is the closure phase where the client is brought back to equilibrium by debriefing the session and what was learned.  The client is reminded about the self-control techniques that were learned at the beginning of therapy to use outside of session if needed.  Often clients will not complete a full memory in the first session so it is “closed” down using these techniques until it can be revisited with the clinician the next visit. 

Phase 8:  This is the re-evaluation phase where the client will revisit the memory to evaluate if it is fully resolved or if it still needs more time to process using eye movements or other form of BLS. 

**Material on this page has been adapted from the EMDR Europian Website: https://emdr-europe.org/about/what-is-emdr