A Therapist’s Overview of EMDR Treatment
And how it can help
I am a therapist trained in Eye Movement, Desensitization, and Reprocessing (EMDR), and many of my clients come to me specifically for this treatment method. Even for clients who have heard of EMDR, there is a certain mystery around the technique as it is intricate, abstract, and very different from traditional talk therapy.
My typical introduction of EMDR to a client includes something like this: “EMDR has been around since the late 80's and was developed by psychologist Francine Shapiro. It has been successful in helping many clients heal from trauma. It involves using bilateral stimulation through eye movements, tapping, horseback riding, and many other methods to activate both sides of our brain to reprocess trauma that is ‘stuck.’ We do not know exactly why it works, but research has shown over and over that it is effective.”
While that introduction describes EMDR, clients still do not know what the treatment is going to look and feel like. Generally they look a bit confused at this point and I like to acknowledge that this is a normal reaction as EMDR is very different from traditional talk therapy.
At this point I demonstrate how I do bilateral stimulation, which is through eye movements. I hold up my pointer and middle finger close together and move my arm back and forth a few times. I again acknowledge that this looks strange and ask that they stay with me. I discuss the training that I completed in order to utilize this modality and after prepping them that while the process can be uncomfortable it can also be worthwhile and I encourage them to give it a shot. I tell them we can always try a different treatment, or take a break from EMDR if they feel it is not working.
In addition to the strange finger movements, there is another aspect of EMDR that is different than traditional talk therapy. It is very scripted. When I was getting trained they encouraged us to read directly from the protocol script. A therapist who is more experienced can be a lot more artful with this, but it can still feel more stilted than a typical conversation.
Before getting to the eye movements, a therapist must get background history on what trauma you have experienced and make sure that you are able to have enough calming strategies to not be completely overwhelmed in the traumatic memory. Once all of that prep work has happened, you can get into the bulk of the work.
The scripted part of EMDR comes into play the most during the desensitization and reprocessing, which is where the eye movements make their debut. Your therapist will ask a variety of questions about the trauma, how you felt, what it made you feel about yourself, and how you would like to feel differently. She will also ask you to rate a few things on a scale of 0–10 or 1–7. These scales are important because your therapist will track them each session to see if the treatment is working.
After these questions and scales have been addressed, it is time for the eye movements. This is where some clients feel some performance anxiety and worry that they aren’t doing it “right.” I tell clients there is no “right” way for them to do EMDR as everyone’s brain stores and reprocesses trauma differently.
The therapist will instruct you on what part of the trauma to visualize and then do 30 seconds to a minute of eye movements before pausing, asking what you notice, instructing you to focus on that, and then resuming the eye movements. This process continues as long as there is a change between each set of eye movements. Sometimes your therapist will instruct you to go back to the original memory, do some more ratings, or instruct you to think about how you would like to feel about the trauma. During this phase, most of the time is spent on eye movements and there isn’t a lot of conversing.
The session should always end with a debriefing; addressing any challenges or successes and reminding you to use your calming strategies if the trauma comes up between sessions. Your therapist will also ask you to notice and write down any insights that come up as well as any meaningful dreams or related memories.
One of the really interesting things about EMDR is that your brain can continue to reprocess the trauma between sessions. The EMDR website gives more detailed descriptions of each phase, though the client typically experiences them more fluidly than what is identified.
Once past trauma has been reprocessed, EMDR can be used to address current situations and prep for potential issues in the future. Because of its capacity to address the past, present, and future, EMDR is being utilized more and it’s likely that there is an EMDR trained therapist in your area. If your therapist has the appropriate training (click here to find a database of trained EMDR therapists) and suggests it could be beneficial, give it a try and see what it’s all about.
