Eye Movement Desensitization and Reprocessing (EMDR Therapy) is a model of psychotherapy first developed by Francine Shapiro in the late 1980s. In most EMDR sessions, a person receives gentle sensory input that activates both sides of the brain. These inputs mimic the rapid-eye-movement stage of sleep.
Shapiro noticed that side-to-side eye movements helped a person process unresolved trauma more fully. Later, therapists found other types of stimuli could work as well, such as a sound in one ear and then the other, or tapping alternate hands. It is only effective when the person is able remain stable and present while reflecting on past events.
Therapists sometimes describe EMDR therapy as “bottom up treatment.” It helps form new neural connections between the areas of the brain that govern the survival system, and the thinking parts located on top. Effective EMDR treatment enables the higher, more well-developed parts of the brain to help soothe the trauma-altered nervous system and the amygdala, “the alarm system” in the brain.
It takes the whole brain to help people process trauma.
When trauma has occurred and a person feels threatened and overwhelmed, the body’s stress response takes over. The stress response floods the body with hormones, setting off a number of automatic reactions to help escape from danger. These include tense muscles, shallow breathing, and a pounding heart.
Meanwhile, the thinking brain largely shuts down during that event. The nervous system joins the state of alarm and the sensations of the moment in a body memory. Trauma occurs and memories can form without the benefit of words to help the person remain aware of the present moment and be able to put the sense of danger in the past after it has occurred.
For people with trauma, everyday events can easily prompt the life-or-death alarm response, with little conscious control.
This kind of trauma doesn’t respond well to reason, because the nervous system continues to respond in ways that bypass the thinking brain.
EMDR allows trauma survivors to develop new neural pathways or connections in the nervous system so that the stress response can become less intense than before. Plus, it helps people learn to develop ways to stay grounded in the present moment, instead of feeling flooded by an intense memory.
Frequently Asked Questions about EMDR Therapy
1. How many EMDR sessions do people need?
For some people, EMDR can treat trauma in a few short sessions. As with all models of therapy, a lot depends on the individual, their situation and their history.
2. Is EMDR a quick fix for people with trauma?
EMDR is more than a tool for trauma-informed therapy. It’s a complete therapy model that includes eight phases of treatment.
These phases (which Shapiro describes in detail) are:
- Client History and Treatment Planning
- Body Scan
The first two phases are to develop safety and stabilization. For some clients, these initial phases may need to take place over an extended period of time before processing can occur in a safe and ethical way. This is why EMDR may work more quickly for some than others.
3. Does EMDR work all by itself?
EMDR is a comprehensive therapy model that a trauma-informed therapist can use along with/collaboratively with other therapies. Other therapies include Sensorimotor Psychotherapy, Internal Family Systems (IFS), etc. Sometimes results from EMDR are dramatic, and can help trauma survivors progress in a few sessions.
4. Is eye movement all you need for EMDR to work?
The side-to-side stimulus of EMDR alone is not a complete procedure. It’s an element of an 8 phase psychotherapy treatment model. Phase 1 (History Taking) and phase 2 (Preparation and Relationship Building) must happen first. And these work as building the foundation of relative emotional stability. The goal of Phase 1 and 2 is safety and stabilization.
A foundation of emotional stability allows a person with trauma and a therapist to work to process trauma without re-traumatizing a person with overwhelming memories.
5. What kinds of trauma respond well to EMDR?
EMDR can be effective in treating single-incident trauma, such as
- A car accident
- Robbery or crime
- A single act of violence, like rape
- Miscarriage/pregnancy loss.
It can also help those who have prolonged exposure to toxic stress, or complex trauma from experiences such as
- Witnessing domestic violence
- Living with someone’s substance abuse
- Feeling alone or isolated emotionally
- Sexual or physical abuse
- Childhood emotional neglect
- Panic attacks
- Complicated grief
- Miscarriage/pregnancy loss
A person who has survived a single incident trauma may already have a solid emotional foundation of secure attachment and therefore, safety and stabilization in their current life. They may find EMDR resolves trauma symptoms quickly.
A person with a history of complex or prolonged distress trauma may take longer to process with EMDR or any type of therapy. This is mostly because it takes longer to achieve a foundation grounded by emotional stability. It takes time to establish resources self-care, from which the patient can comfortably and safely process the trauma.
6. Is EMDR Effective for Complex, Developmental Ongoing Trauma (C-PTSD)
Complex trauma is a form of posttraumatic disorder that can occur among those who experienced prolonged, repeated trauma. They have survived chronic exposure to feeling unsafe or threatened.
For a person with C-PTSD, a long-standing sense of danger may alter the responsiveness of the brain and body enough to feel like it’s a permanent change. For people with complex trauma histories, the mind and body may remain in a chronic state of stress and hypervigilance.
EMDR can help resolve the symptoms and impact of complex trauma. In order for EMDR to work effectively, a person needs a solid, safe foundation from which to process the trauma. Their individual trauma history determines how quickly they are able to establish this foundation.
The treatment approach for those with a complex trauma history may combine other modes of therapy in addition to EMDR. EMDR can work along with other treatment approaches that also promote healing.
7. Do you provide EMDR at Brickel and Associates?
EMDR therapy requires professional training to be safe and effective.
We have several therapists trained and experienced in EMDR.
We provide EMDR as part of our inclusive model of therapeutic care.
Robyn first received training in EMDR in 2001. As an EMDRIA certified therapist, I am now an EMDRIA approved Consultant-in-Training (CIT). I am excited to be able to provide consultation for other licensed clinicians who have completed EMDRIA approved training.
Still have questions about EMDR therapy in Alexandria, Virginia?
We welcome your questions.