So What Is EMDR Therapy?
I wanted to become more effective in working with trauma for two reasons.
1. I really want to be helpful to military spouses, and PTSD has become part of family life for many in military culture.
2. I believe that trauma impacts us more than we think it does. Many of the things we don’t like about the ways we react to life are actually ways we have tried to cope with trauma.
EMDR kept popping up in my search for furthering my trauma skills, but it felt nebulous to me until I took the training. Then it felt amazing to me! To explain EMDR, I first need to explain what trauma actually is (because it is more nuanced than what we usually think it is), then I will explain how EMDR therapy plays out in sessions and say a few things about what EMDR is not.
What is trauma?
Merriam Webster (1) defines trauma as:
“a: an injury (such as a wound) to living tissue caused by an extrinsic agent
b : a disordered psychic or behavioral state resulting from severe mental or emotional stress or physical injury
c : an emotional upset”
Duros and Crowley (2) defined trauma in terms of something that overwhelms your system. This could be something you had to deal with before you were ready to deal with it, something that was just too big for you to deal with, or trying to cope with a situation long-term without having adequate coping skills.
In the field of counseling, we look at trauma as "Big T Trauma" and "little t trauma."
Big T Trauma is the stuff that pretty much anyone would agree is traumatic, devastating accidents, natural disasters, sexual or physical abuse, sudden tragedies, etc. But we deal with more subtle things, things that are common experiences that often go unnoticed by others, that our brains interpret as traumatic. That's "little t trauma" and there is nothing little about it. In fact it can be harder to work with because we dismiss it as not important (and then beat ourselves up for having trouble getting past it).
When we go through something that overwhelms our capacity to handle it, our brains capture all of the information associated with that trauma spanning all five senses. This information does not get stored in "long term storage" where your brain can classify it as over and rest knowing that you are safe. Instead, your brain stores it just under the surface and connects it to other experiences that it associates with the same sensory information. When you encounter a situation that is somehow similar to the traumatic event, this memory network will trigger and cause you to react the same way you reacted to that first event.
Sensory information gets stored for positive memories, too. For example, have you ever noticed how smells can trigger memories? The smell of fresh-cut grass brings me right back to childhood, playing outside while my dad was mowing the lawn. It brings up carefree happy feelings and thoughts that all is well in my world. Likewise, a simple smell can send your brain off in a negative direction if that scent was present at a time of trauma for you.
Situations, feelings, sensations in your body, sounds, and sights can all trigger your memory network. When negative memories get triggered, you tend to react to the initial trauma, and this reaction may not be appropriate to what you are actually facing.
This reaction can look like:
Angry outbursts
Assuming someone thinks the worst of you
Feeling flushed
Silencing yourself
Overfunctioning
Feeling a pit in your stomach
People-pleasing
Giving someone the silent treatment
Overeating
Feeling tension somewhere in your body
Avoiding situations
Being hypervigilant
Talking yourself through all the worst case scenarios
Assuming others know what they are doing and you don't
Taking on too much responsibility for things
Trying to control everything
Negative thoughts about yourself
Striving to be perfect
Feeling jittery
Trouble sleeping
These are just a few possible trauma reactions. You can imagine how these types of things get in the way of living a satisfying life!
Enter EMDR therapy.
This approach to therapy helps you identify the memories your brain has connected and gets them moving through your brain to long-term storage. It uses something called bilateral stimulation to activate that memory network. This is why “eye movement” is part of the acronym EMDR. When Francine Shapiro figured out that moving her eyes back and forth seemed to help her resolve discomforting issues, she started researching eye movements and developed this type of therapy (3). The most research has been done with the use of eye movements, but bilateral stimulation can be in the form of tapping alternate sides of the body, holding buzzers that vibrate alternatively, or wearing headphones that give alternate tones in your ear. The therapist helps you target a memory and guides you through bilateral stimulation while monitoring that the memory is moving and that you are able to stay present with the memory and present in the current moment so it doesn’t become overwhelming.
How this actually plays out in therapy with me
I will spend some time getting a good idea of what you want to work on and take a complete history. EMDR is not recommended for everyone, so it is important for me to ask some questions aimed at making sure it is a good fit for you. I will also spend some time exploring your current supports and coping strategies. We will enhance those coping strategies to make sure you are ready for trauma processing. Trauma processing (using EMDR or other approaches) can stir up memories that are sometimes hard to remember, so we want to make sure you know how to handle that if it happens.
Once you are ready to start reprocessing, we do some work to identify target memories and decide where to begin. It is considered best practice to plan weekly 90-minute sessions for reprocessing (3), but there are modifications to keep it to the standard 50-minute session if that works best for you. Once we pick a memory to start with, I’ll ask some questions that will help you bring up that memory, and then guide you through whatever form of bilateral stimulation that we decide to use. We’ll do about 30 seconds of bilateral stimulation and then I’ll ask you what you notice. Your job is just to be honest about whatever you notice. It could be a feeling, some visual element of the memory, a body sensation, a thought, a metaphor, a Bible verse. What you notice is highly unique to your brain. You don’t have to tell me much about it, just enough for me to get an idea of what is going on in your brain. This is often comforting to people who feel a lot of shame around their memories.
I’ll have you focus on whatever you notice and do more bilateral stimulation. This will go on until I can tell the memory has moved to an adaptive place. We will then focus on how you want to think about the memory and let that thought strengthen by using a similar process of bilateral stimulation. We will check for any lingering sensations in your body that could indicate you are still hanging onto something in a traumatic way. If not, we consider that memory “clear.”
I will be monitoring you to make sure you are handling this process okay. It can feel like you are experiencing some of these traumatic things all over again, although the bilateral stimulation serves to keep you slightly removed from it.
It’s like being on a train and watching images go by… you are safe on the train while seeing the images.
You always have the option to stop if it becomes too much. We also have options in the way we work on the memory that can lessen the discomfort of processing.
We go through this process with the past target memories, although we may not have to go through all of them. Often the learning from early target memories will generalize to later ones.
I will check in with you in every session to see what you’re noticing in your life between sessions. Sometimes you’ll have an insight that is relevant, or you might be experiencing yourself acting differently in your life.
Once we feel confident the relevant past memories are clear, we move on to reprocessing present situations that tend to trigger that reaction. We go through the same process, but then we add an element of imagining future situations that would typically bring up a similar reaction. It’s like we are laying down roads in your brain, so when you get into that situation you know exactly how you want to travel through that scenario.
6 Things EMDR is not:
1.Something to try without a trained therapist – there is much more to it than I can explain in this article, and it can bring up some powerful stuff. You want to know you’ve got the support of someone who knows how to handle whatever comes up.
2. Hypnosis – you are in complete awareness and control of yourself the entire time
3. A way to bring up repressed memories – Memory is such a subjective thing. It is impossible to go back and be certain that the way you remember something exactly how it actually happened. Our brains filter our memories through our perception. New content that emerges may be symbolic or factual and this process does not definitively distinguish between the two.
4. A memory-eraser- This process does not erase your memories, but helps you see them in less disturbing ways. You might notice different details of the memory or see yourself bigger than “the bully”. You may have insights about someone who hurt you, like recognizing they were reacting from their own dysfunction. You might start seeing the memory as far away, or less vivid than before. The memory might stay the same, but you now have an overwhelming sense of peace because you know it’s over; you’re safe now.
5. Always fast – there are rumors that say EMDR can reduce time in therapy. It is true that with some issues, it can be a straightforward way to feel better quickly, but you don’t know what your brain has associated with what you are working on until you start the work, so this is not always the case.
6. A fad – this has been around for over 30 years and has a robust research base supporting its effectiveness (4). It has been getting a lot more attention in recent years (especially after Prince Harry went public with his experience with it (5).
If reading about EMDR resonates with you, please reach out! You can book a phone consultation to get started, send me a secure email, or call me at 717-219-4339. I look forward to helping you live a life free from your trauma reactions!
References:
1. https://www.merriam-webster.com/dictionary/trauma
2. Duros, P., Crowley, D. The Body Comes to Therapy Too. Clin Soc Work J 42, 237–246 (2014). https://doi.org/10.1007/s10615-014-0486-1
3. Shapiro, F. Eye Movement Desensitization and Reprocessing, 3rd ed. (2018), Guilford Press, NY
4. https://www.emdr.com/research-overview/
Jennie Sheffe is a National Certified Counselor ™ who helps women find freedom from anxiety and peace in their chaos. She sees clients virtually in the state of Pennsylvania, or in her downtown Carlisle, PA office. She offers Christian counseling and EMDR Therapy.
