EMDR Explained: The Who, What, Where and How of EMDR Therapy

Dr. Amy Fuller’s EMDR ONLINE MAGAZINE

What is EMDR?

EMDR is a revolutionary therapy that has helped millions let go of painful experiences, memories, or beliefs. By utilizing the brain’s natural healing processes, EMDR therapy quickly heals many emotional problems and conditions which have been difficult and time consuming to treat in the past.

What does EMDR mean?

images-2EMDR is an acronym for Eye Movement Desensitization and reprocessing, a therapy discovered and patented by Francine Shapiro in 1989. While walking through the park, Dr. Shapiro noted a healing effect from moving her eyes back and forth while simultaneously recalling a disturbing event.  Since that time, over 50,000 therapists have trained in this highly effective treatment and it has become the chosen treatment for persons suffering from post traumatic stress disorder.

How does it work?

In spite of medical advances, some mechanisms of the brain remain a mystery. However, the amazing outcomes of EMDR treatment can be theoretically explained. Bilateral stimulation (created by eye movements or alternating tapping on the hands) activates the opposite sides of the brain allowing the brain to release and redefine emotional experiences that are “trapped” within the brain.  canstockphoto8659286

This type of stimulation resembles REM (rapid eye movement) sleep as our eyes move from one side to the other. It is during sleep that the brain naturally sorts out our experiences from the day, discarding useless information and transferring memories appropriately. However, sometimes extremely negative experiences can get “trapped” or “frozen” in the brain and they are unable to resolve naturally which may result in nightmares, depression, anger, anxiety, or emotional disturbance.

Along with this “trapped” negative experience is the negative emotion, sensory information, and childlike or initial interpretation of the experience.  Even though these negative emotions, memories or beliefs are “locked away,” they can still affect us greatly and are often triggered by various sensory input (sight, smell, touch, taste, or hearing). We may see something, pick up a certain scent, or be spoken to a particular way and that memory or feeling is triggered, often without any understanding of why. When a negative memory is triggered, the neurological response is protection and the result is a state of hyper-arousal commonly referred to as flight or fight. Stress hormones are released into the body and we find ourselves saying things without thinking, or doing things that seem out of character. Most importantly, the initial and untrue negative beliefs about oneself are reinforced.

What does EMDR do?images-8

EMDR assists to unlock these painful memories or beliefs as the eye movement or tapping stimulates the two hemispheres of the brain to communicate with each other. The bilateral stimulation simulates REM sleep, which is when the brain naturally attaches meaning to experience. While awake in EMDR treatment, the brain is assisted in resolving feelings, beliefs or experience not yet resolved though the brain’s natural process.

canstockphoto13070704By focusing on the identified targets when paired with the bilateral stimulation, the negative feelings, beliefs or experience become desensitized, meaning they simple become less bothersome. The feelings, beliefs and/or experience is then reprocessed and new meaning is attached to the experience or triggers. As the brain arrives at new conclusions, the original trauma no longer contains the negative emotional charge originally associated with it. The triggers are now neutral, the interpretation of experience is now intentional and the beliefs about oneself now present hope instead of powerlessness.

What happens during the EDMR session?

EMDR therapists follow a standard 8 step protocol as defined by Dr. Shapiro. EMDR occurs within the context of a therapeutic relationship which involves gathering history, asking basic questions, and describing a bit about EMDR. Some therapists will do a full intake or assessment session before utilizing EMDR treatment. Through discussion, the clinician and client identify a “target”. The target is usually a disturbing memory or image although sometimes it can just be an idea or feeling. Click here to read more about the specifics of what happens in an EMDR session. To read the specific 8 stages of an EMDR session click here.

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After identifying the target the therapist will use bilateral stimulation usually with either buzzers also called tappers (see image) or with hand movements.
The buzzers feel like a cell phone vibrating and create a relaxed effect. If the therapist uses hand or eye  movements, the client will be asked to follow the clinicians fingers as they move from left to right, creating the bilateral simulation of the brain and creating new pathways for healing. Watch this video to see how an EMDR session might look.

Window into an EMDR Session by Colleen West, MFT

The memory or target becomes “desensitized” as the client uses the imagination to watch a movie in the mind, then talks briefly with the clinician before watching it again. This pattern continues until the image, feeling, or movie is much less disturbing. For difficult memories, this work can be quite challenging. In this case though, the benefits far outweigh the struggle. Most people experience quite rapid relief even while imaging the difficult memory or target. The goal is to “clear” or “process” the memory so that its emotional charge becomes neutral.

The “reprocessing” part has to do with the meaning attached to the memory or to ourselves as a result of the experience. The client identifies what he or she feels or believes because of the event and what he or she would like to believe. With the assistance of the clinician and the amazing power of EMDR, the desired belief will seem true by the end of the session.  In this way, the client changes what the memory means about their life and about themselves. For example, many survivors of abuse believe they are to blame for what happened to them as a child. This process can help them feel and know that they are not to blame. Frequently the client will find ways to feel empowered instead, noticing how the difficult experience created an inner strength not previously noted.

How soon will I feel better?

Sometimes only one session of EMDR can provide immediate relief from emotional distress. However, the length of treatment depends upon multiple factors.  This statement from the EMDR Institute provides a nice summary of how many sessions it may take.

“The number of sessions depends upon the specific problem and client history. However, repeated controlled studies have shown that a single trauma can be processed within 3 sessions in 80-90% of the participants. While every disturbing event need not be processed, the amount of therapy will depend upon the complexity of the history. In a controlled study, 80% of multiple civilian trauma victims no longer had PTSD after approximately 6 hours of treatment. A study of combat veterans reported that after 12 sessions 77% no longer had post-traumatic stress disorder.” 

Who can benefit from EMDR?

EMDR has been utilized primarily in the treatment of trauma experiences such as physical or sexual abuse, car accidents, victims of crime, natural disasters, and severe loss or grief or war veterans. Positive results have also been observed with panic and anxiety disorders, sexual dysfunction, chemical dependency, peak performance and chronic pain. Extensive research has shown EMDR as the most effective and rapid method for healing PTSD (Post Traumatic Stress Disorder). In addition, EMDR can result in increased self-esteem, decreased feelings of depression, and a renewed spirituality. By interacting with one’s interpretation of previous experience in life, EMDR has the ability to alter personality and personality disorders. EMDR has been utilized all over the world and proven effective with adults, children, and adolescents.

Where do I find a EMDR professional?

EMDR is used clinically by professionals such as doctors, therapists, and psychologists.  The EMDR Network gives this advice about finding an EMDR Clinician: “EMDR should be used only by licensed clinicians specifically trained in EMDR. Take time to interview your prospective clinician. Make sure that he or she has the appropriate training in EMDR and has kept up with the latest developments. The basic course is at least 5 days of training over two weekends, or spans several months, plus supervision, consultation, and continuing education. While training is mandatory, it is not sufficient. Choose a clinician who is experienced with EMDR and has a good success rate.” EMDRIA”s “find a therapist” page is a great resource for finding a qualified EMDR clinician.

EMDR - A documentary film


Additional information about EMDR can be found at: www.emdr.com  or www.emdria.com

This information is provided by Amy Fuller, PhD, LMFT, LPC

Schedule an appointment with Dr. Amy Fuller.

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