W h a t i s E M D R ?
EMDR. A name that has been attracting more and more attention since the start of the pandemic. Chances are, if you haven't heard of it, you probably know someone who has, or has even gone through EMDR treatment. You might have read a newspaper article about it, or even seen Prince Harry go through an EMDR session during his interview with Oprah Winfrey.
Lets start with the name. What does EMDR even stand for?
EMDR therapy is short for Eye Movement Reprocessing and Desensitization therapy. It's a bit of a mouthful, so it's been referred to by its initials from the very beginning.
EMDR therapy is an evidence-based, clinician led psychotherapy. Developed in the 1980s by Dr. Francine Shapiro, it has been the gold standard in the treatment of post-traumatic stress disorder ever since. Since its inception, EMDR has evolved tremendously: the original protocol has expanded to include the treatment of many different symptoms, issues and disorders, excluding practically no-one from benefiting from the treatment.
EMDR therapy is an eight phase, three-pronged approach - which we will get to in a moment. EMDR’S theoretical framework is based on Shapiro’s AIP model, which posits two fundamental concepts:
1. The past lives in the present
2. Our minds, just like our bodies, have an innate ability to heal.
But what does that mean ?
The past is in the present refers to how our mind and body stores traumatic memories. The idea is that:
“when a person experiences a trauma, it becomes locked into its own memory network as it was experienced - the images, physical sensations, tastes and smells, sounds, and beliefs - as if frozen in time in the body and in the mind. (…) Ordinary daily events seem to pass through us without leaving a mark. Traumatic events, however, often get trapped and form a perpetual blockage. Like a broken record, they repeat themselves in our body-mind over and over again.” Parnell, 2007
The idea is that we are almost “stuck” in the past, and the past informs how we perceive ourselves, others and the world. The things our brain did to (very wisely) adapt to traumatic situations and circumstances are still occurring, even though the threat is no longer present, and are now considered “maladaptive” and harmful to the self.
The second part of the AIP model is that our brains have a beautiful, innate capacity to heal itself. Just like our bodies do: when we cut ourselves, our body knows how to heal the wound. However, if debris is stuck in the wound, the body will not be able to heal itself. We have to facilitate healing by cleaning out the debris - or by unblocking a traumatic memory. EMDR facilitates the natural healing process by unblocking.
*It’s important to note that EMDR will not remove anything that is useful or necessary. It will only clear what is dysfunctional, but it will not remove anything you might need for functioning. It will also not clear emotions that are deemed suitable for a given individual, time and situation. It also cannot clear anything that is true.
Now, back to the eight phases and the three-pronged approach:
The eight phases and the three-pronged approach refer to how an EMDR clinician facilitates treatment. The three-pronged approach can be described as an approach…
“(…) which targets past experience, current triggers, and future potential challenges, results in the alleviation of presenting symptoms, a decrease or elimination of distress from the disturbing memory, improved view of the self, relief from bodily disturbance, and resolution of present and future anticipated triggers.” (EMDRIA, 2019)
The eight phases, on the other hand, refers to the procedural steps used to access and process information in a way that optimizes the efficacy of EMDR. The eight phases can be interchanged depending on each person’s unique wants and needs:
Phase 1 - History & Treatment Planning
Length: typically between 1 and 2 60-90 minute sessions
Phase 2 - Preparation
Length: this can last anywhere between 1 and 10+ sessions, depending on resourcing needs.
** Phases 3 to 7 are typically done within one 60-90 minute session, although this can sometimes take a bit longer.
Phase 3 - Assessment
Phase 4 - Desensitization and Reprocessing
Phase 5 - Installation
Phase 6 - Body Scan
Phase 7 - Closure
Phase 8 - Re-evaluation
Length: 1 60-90 minute session
** You can refer to the “EMDR FAQs” page for a detailed explanation of the eight phases.
So, how does it work? What does it do?
EMDR uses bilateral stimulation through right-left-right-left rythmic tapping, eye movements, sound or through hand held buzzers. The bilateral stimulation allows us to access the trauma and helps us process it. It helps unblock the memory, event or issue that has remained stuck in our limbic system.
EMDR practitioners integrate patterned eye movements or other BLS with talk therapy techniques to clear emotional, cognitive, and physical blockages. In theory, traumas leave unprocessed memories, feelings and thoughts that can be reprocessed or “metabolized” with BLS. Similar to the way rapid eye movement (REM) or dream sleep works, the eye movements help to process this blocked information, allowing the body-mind to release it.
Dreams each night cleanse the body-mind of the day’s residues. It seems that some particularly strong dreams that are related to past events are the body-mind’s attempt to heal. The problem is that during disturbing dreams, the eye movements are often disrupted, and one wakes up, thus not allowing the REM sleep to complete its job. With EMDR, which is different from dreams, the therapist keeps the eyes moving back-and-forth and guides the client into focusing on the traumatic event. This allows the event to be fully experienced and reintegrated.
EMDR moves information from dysfunctional to functional. The end result of successful EMDR is adaptive resolution of the trauma. This means that the emotional charge is reduced or eliminated, and there is an objective view or understanding of the incident. Just like the river flows to the sea and the body heals the wound, EMDR clears the trauma and brings integration and wholeness. (…)
EMDR removes blockages caused by negative images, beliefs, and body sensations, allowing one’s natural state of well-being and emotional balance to come through. EMDR unlocks what is natural within each of us. It is our innate healing process that has been blocked and can be unblocked with EMDR. There is an inherent wisdom within each person that is already whole, it is just obscured by the traumas.” (Parnell, 2007)
Additional resources to learn more about EMDR and how it might help:
EMDR might help with trauma and anxiety. Here's what you need to know - The Washington Post
Though there are no guarantees that any type of therapy will work for you, EMDR is a well-researched therapeutic model recognized as effective by organizations such as the American Psychiatric Association, the United States Department of Veterans Affairs/Department of Defense, and the World Health Organization.