What is Eye Movement Desensitization and Reprocessing Therapy?
EMDR Therapy (Eye Movement Desensitization and Reprocessing) is a powerful, effective, evidence-based therapeutic approach used to treat anxiety, depression, PTSD, stress, emotional dysregulation, phobias, panic, addictive behaviors, self-esteem, and a variety of other issues. EMDR is based on the premise that negative thoughts, feelings and behaviors are caused by unprocessed memories. Clients often report that traditional talk therapy has not produced the relief they were looking for. This is because traditional talk therapies work primarily with the neocortex part of the brain (the “logical brain”). However, distressing and unprocessed memories are often stored in the limbic region of the brain (the “emotional brain”), which can’t be accessed by talk therapy. EMDR has the ability to access, process, and resolve the memories stored in the limbic region.
Eight Phases of EMDR Treatment
History - The purpose of gathering your history is to identify where you’re struggling and get all of the relevant historical information as it relates to your current problems. We’ll explore the significant relationships and positive and negative experiences throughout your life that inform your beliefs, perceptions, behaviors, and interactions with other people. Once we’ve gathered all of the pertinent information, we’ll design a customized treatment plan to address your unique needs.
Preparation - During the preparation phase, you’ll learn more about the process of EMDR. We’ll teach you stress reduction techniques, coping and calming skills, and methods to increase your tolerance for distressing emotions.
Assessment - We’ll select and activate the target memory to be reprocessed.
Desensitization - In this phase of treatment, you’ll begin to reprocess the selected target memory by incorporating eye movements.
Installation - We’ll work to install and strengthen the positive beliefs that emerge during phase 4.
Body Scan - You’ll be asked to scan your body while holding the original memory in mind to identify any residual disturbance in the form of body sensations.
Closure - At the end of your therapy session, we’ll guide you through a relaxation exercise and review relaxation and coping skills you can use throughout the week to maintain emotional balance.
Reevaluation - At the beginning of each session, we’ll reassess the previously processed target to ensure treatment gains have been maintained.
How It Works
The adaptive information processing model (AIP) provides a framework for EMDR treatment. The model posits that memory networks are the basis of psychopathology and health. It further suggests that the brain has an inherent ability to process information to a healthy, adaptive resolution when we think about it, talk about it, and dream about it.
During adverse life experiences, the information-processing system can get blocked due to high arousal states, resulting in memories being maladaptively stored attached to the emotions, negative beliefs, images, physical sensations, and sounds that were present during the distressing experience.
Think about it like this: when you cut yourself, your body works to heal the wound. If you develop an infection, the wound persists and causes pain until the infection is resolved. A similar sequence of events occurs with mental processes; the natural inclination of the brain’s processing system is to move toward a state of well being. If the system is blocked by the impact of adverse life experiences, then dysfunctional emotion, behavior, and thoughts are observed.
EMDR repairs the obstruction so your brain can process memories to an adaptive resolution.
During a traumatic experience, the information gets stored in your brain in the same disturbing form in which it was initially experienced. In essence, it becomes frozen in time and isolated in its own memory network because of the intensity of the emotion. This causes past memories to feel present, or to feel as if they will happen again at any moment. Each subsequent experience you have that reminds you of the memory is likely to trigger dysfunctional emotional reactions, behaviors, and beliefs. Although you likely have healthy memory networks with information that counterbalances the dysfunctional information, those networks can’t link up because the traumatic memory is isolated. I often hear clients say, “Logically I know it wasn’t my fault, but that doesn’t feel true.” This is because they have access to the adaptive information, but it hasn’t linked up with the isolated material.
What Do I Need to Know About Memory?
Memories are stored in the brain by association, so memories with similar information are linked to one another. Adaptive memory networks store positive beliefs, learning, and resources. Maladaptive memory networks contain traumatic memories that remain isolated from positive, adaptive networks. Maladaptive and dysfunctional memory networks are the primary cause of psychopathology, including negative behavior patterns, dysregulated emotions, body sensations, and distorted beliefs about self and others.
Explicit Memory: Memories that you can recall either by choice, or they arise by association (for example, the smell of chocolate chip cookies brings back memories of baking cookies with a grandparent in childhood). They often contain details such as who was there, what was happening, and when it happened.
Implicit Memory: Memories of adverse life experiences are often implicit, because trauma floods our brain with cortisol, the stress hormone, which shuts down the part of our brain that encodes memories and makes them explicit. Unlike an explicit memory, an implicit memory does not involve the internal experience of recalling. It’s been described as “retention without remembering”. It can be behavioral, emotional, perceptual, or somatic. Our implicit memories can be like invisible forces in our lives, causing us all kinds of trouble. Because it’s an unconscious, bodily memory, when it gets triggered in the present, it does not seem like it’s coming from the past. Instead, it feels like it’s happening now. Thus, we react as if we are back in the original situation. Ever have knee-jerk reactions that you don’t understand? Because of the nature of implicit memories, they’re often triggered subconsciously and cause reactions we don’t always understand. For example, seeing a certain paint color may unconsciously remind a person of a room in which they were abused as a child, leaving them feeling distressed without knowing why. Or, going to bed alone after a breakup can trigger a loneliness a person felt in childhood when their parents didn’t make the effort to tuck them in. A person who felt abandoned as a child may experience a much more intense feeling of abandonment after a breakup. A parent who felt terrified as a baby may become dysregulated and overwhelmed when his own baby cries. A person may react angrily to a certain expression on their partner’s face. A person whose parents ignored their distress cries in infancy may engage in frantic attempts to prevent their partner from leaving them. Often, our strongest, most intense reactions in the present come from our implicit memories, because of the intense feelings attached to these memories.
What’s Up With The Eye Movements?
Eye movements activate the brain’s information-processing system, allowing the dysfunctionally stored memories to be reprocessed and integrated into adaptive memory networks. During the reprocessing phase, the memory components (emotions, physical sensations, negative beliefs, images) transmute and become more positive as they link up with adaptive memory networks.
Why Hasn’t Traditional Talk Therapy Worked for Me?
Talk therapy was designed to activate the part of the brain that is rational (the neocortex). Distressing memories are locked inside the emotion center of the brain (the limbic system) which isn’t easily accessed through just talking. The eye movements allow both parts of the brain to communicate with each other.
What is Trauma?
Trauma is any adverse life experience, series of events, or relationship dynamics that overwhelm the brain’s ability to process them. This results in the memory becoming encoded and isolated in the limbic system of the brain in “emotional” form, rather than in the brain’s cortex where we use language to store memories.
Examples of traumatic experiences include a near-death experience or witnessing a death, car accidents, physical or sexual assault, psychological abuse, a humiliating or embarrassing event, sudden job loss, betrayal, divorce, failures, racial or ethnic discrimination, bullying, and illness.
Complex trauma is a result of repeated, chronic exposure to traumatic or stressful experiences in childhood, such as neglect, emotional instability and inconsistency from caregivers, caregivers struggling with addiction, caretaking responsibilities as a child, bullying, problems with peers, repeated physical/sexual/verbal abuse in the family home, financial instability, and isolation.