EMDR Therapists Understand Trauma
By: Sarah Fader
Updated February 16, 2021
Medically Reviewed By: Lauren Guilbeault
What Is EMDR?
Eye movement desensitization reprocessing (EMDR) therapy is a technique that can help people recover from trauma. It's incredibly useful in treating trauma and post-traumatic stress disorder (PTSD). During EMDR therapy sessions, the therapist will help a client release traumatic experiences using eye movements. It will trigger the client in brief sessions, or “bites," as they recall their traumatic events. The therapy allows them to do so while alleviating the emotional distress they experienced before. It works because the client is distracted by the therapist using their hands to guide the patient's eyes in different directions. This method allows the patient to be exposed to traumatic memories without experiencing a strong reaction because they're distracted by their vision being drawn in different directions. As a result, it lessens the impact that the trauma has on an individual.
Eye movement desensitization was developed by American psychologist, Francine Shapiro.
Francine Shapiro has become a worldwide speaker on EMDR and has co-authored many articles and books on the subject. She’s also won many outstanding awards for her development of EMDR, which include the International Sigmund Freud Award, the American Psychological Association Trauma Division Award for Outstanding Contributions to Practice in Trauma Psychology, and the Distinguished Scientific Achievement in Psychology Award by the California Psychology Association. Francine Shapiro is still today very active in many organizations, facilitating and teaching the use of EMDR, as well as helping in further research for EMDR and treatment for PTSD.
EMDR has been researched thus far so well that it is being used as a very effective treatment for those who struggle with post traumatic stress disorder in particular. However, anyone who has had traumatic events in their life, whether or not they struggle from post traumatic stress, may benefit greatly from this form of trauma therapy.
EMDR can also be described as a form of exposure therapy. By having the client describe a traumatic event and even imagine the event during the EMDR session, the client then is face-to-face with the memories of the trauma, and they may even experience physical sensations brought on by the nervous system that are related to the trauma.
Eye movement desensitization is also considered to be reprocessing therapy. According to the International EMDR Institute, it helps the client to reprocess their thoughts around traumatic events. Afterward, the way that they frame the event may have changed, and the ways that they react to triggering stimuli may lessen.
What To Expect
EMDR sessions can last anywhere from 60-90 minutes. The therapist moves their fingers in front of a client's face, and the client follows the therapist's movements with their eyes as they recall a traumatic incident. They think about the physical feelings that go along with this trauma as they follow the fingers of their therapist. In an EMDR session, your therapist will guide you on a meditation of a certain kind. You'll start by thinking about the traumatic event, but it'll lead down to various memories. Some therapists might use tapping as a technique in EMDR, and they might also use music as an alternative. EMDR therapy exists in eight phases. The bilateral stimulation or eye movements are part of the first session, and after that first session, the clinician decides what to target next.
Francine Shapiro discovered EMDR as a Harvard researcher at the time. She was investigating rapid eye movement and sleep. They noticed that sensations and disturbing memories would occur during rapid eye movement. When EMDR works, the painful memories become less and less as the patient works through them by following the therapist's fingers with their eyes. Someone could come in for their initial session entirely frightened of being assaulted and might feel extreme guilt, shame, and fear. After treatment, they learn to accept that the event happened and don't experience as many symptoms after they've been strengthened and empowered through EMDR therapy. The wounds of trauma never heal, but they get less and less over time. Clients can work through traumatic events once the memories have less power over them. They're able to process these memories, sit with them, and move through them.
Phases Of EMDR Treatment
EMDR focuses on three different periods in time: the past, the present, and the future. The first part of treatment focuses on the past, and it helps the client to bring up their memories in treatment. In phase one, the therapist takes a patient's history and talks about their memories. They emphasize one particular memory to work on. Sometimes, an EMDR therapist will focus on a client’s childhood first and then move into adulthood, depending on the trauma that the individual experienced. In phase two of EMDR treatment, the therapist helps their client deal with handling the emotional distress that they feel during the memories. The client will experience uncomfortable imagery and will work on staying grounded as they sit with the imagery and thoughts that arise. In phases 3-6, there's a target that the client and therapist agree on, and three things happen: there's a visual image that relates to the memory, a negative image of the person's self, and the body of the image that corresponds to that belief. After that, the therapist asks a client to relay a positive feeling about themselves to override the negative thinking, but the client will first focus on the negative thoughts that they have about themselves.
As they focus on these thoughts, they also have bilateral stimulation, meaning that they're watching the therapist's fingers move back and forth. After the stimulus happens, a client tells the therapist what they saw and what came up for them during the stimulation. The therapist will then interpret the images that came up for the client and what that imagery or those memories mean. In phase seven of EMDR therapy, the therapist asks a client to keep track of what happens during their week and express how or if they're able to use exercises to calm themselves down. In phase eight, the therapist and the client examine the events that have happened in the past that causes the client distress and how the client can respond in the future. In terms of how long the treatment takes, it depends on the individual and how distressed they are by their memories when they enter treatment as well as their trajectory as they progress. Like most other forms of therapy, the overall length of treatment will vary from person to person.
The Phases of EMDR
There are many phases of EMDR therapy.
The first phase of EMDR is the phase that involves treatment planning. During the treatment planning phase, a certified EMDR therapist will request information about the client’s history. This helps the therapist to develop a treatment plan for the client and understand where to begin their focus. Trauma treatment may begin at varying levels, depending on the individual and the person’s past experiences.
The second phase is the preparation phase. This is where the client and the therapist begin their therapeutic relationship and set expectations for the treatment plan. The therapist teaches the client how to maintain stability in between and during the sessions, as well as certain signals for stopping the treatment if it gets too intense.
The third phase is the assessment phase, where the therapist and client focus on the first target memory. The client is guided to focus on the details of this memory that stand out, imagining visuals and beliefs that have become associated with it. The therapist will ask the client to envision positive things about the incident too, such as what they have learned, etc.
In the fourth phase, the target event that was brought up in the third phase is evaluated and looked at deeper. This phase is called the desensitization phase. In this phase, the trauma-related sensations and sensory experiences begin to transform, and the client may begin to experience a brighter sense of self efficacy and insight. This is the phase where the client will focus on the event and the eye movement simultaneously.
The fifth phase is the installation phase, where the therapist will bring in positive cognition, which is aimed at replacing the negative cognition. The EMDR therapist measures the progress of this phase through the VOC, which is labeled successful if it reaches 7. Until then, both experiences, the positive and negative, are paired together. The goal is to get the positive to reach a higher score.
The sixth phase is the body scan phase. During the body scan phase, the client is asked if there is any physical sensation left from the trauma, felt anywhere in the body still. If there is, the therapist will target the specific body sensation and help to calm the nervous system.
The seventh phase is closure. The closure state helps bring the person back into equilibrium, and anything that has not been reprocessed can be helped with the control techniques taught earlier on. The therapist explains to the client what to expect in between sessions and and to keep track of any disturbances that happen.
The eighth phase is reevaluation. This phase is for review and to see how the treatment plan has worked. Reevaluation also helps the therapist and client develop a further treatment plan if needed. The therapist will check back in with the client about additional targets.
When a person is in EMDR therapy, they will be visualizing traumatic events. The therapist will tell them to focus on particular traumatic events and zero in on one moment that impacted them. They will imagine those moments as the therapist takes their two fingers and move them back-and-forth. Then they will close their eyes and report to the therapist what they see. The images that they envision may not make sense to them. They may seem strange or unrelated to the trauma. But they are related because the person is articulating what is in their memory bank. They are following the traumatic events and everything related to it. Their unconscious forces at work, and that's why trauma is so sneaky. It lives inside a person's brain and makes a home for itself. So the person will talk to their therapist about what they see with their eyes closed and try to stay in the moment. No image is wrong. During the visualization process, the person may feel anxious, and their heart might race. That's when their therapist will tell them to go to a safe place in their mind. They might imagine their partner holding them, or being with one of their children. A safe place can bring a person back from feeling in a state of fight-or-flight to a state of grounding.
Internal Family Systems And EMDR
There is an exercise in internal family systems therapy that is related to EMDR. It involves the therapist telling the client to imagine themselves as a child. They envision sitting with the younger version of themselves and talking to them. The client will ask the child what they need from them. It's the client's turn to give the younger version of themselves what they need emotionally. We are all broken in some way inside and during EMDR therapy you have the chance to address the pieces of yourself that need healing. And the inner child work is a powerful way to connect with yourself and be reunited with that part. Healing does come from within, and it's important to remember that there are times during this exercise that will be painful. As you begin to address your pain, you will start to feel less sadness or anxiety due to the trauma you experienced. Eventually, you'll feel more whole and one with yourself.
How Effective Is EMDR?
Many people have said that EMDR is effective in treating PTSD. The Department of Veterans Affairs strongly encourages and recommends this form of treatment for PTSD. A recent study of 30 veterans found EMDR was 100% effective in treating PTSD. In that study, the test group’s delusions, anxiety, and depression all improved after moving through EMDR therapy. EMDR is shown to be effective long-term, and it has been looked at in numerous studies. What’s more, increasing evidence shows that it is just as effective via online therapy. As a result, it is becoming more and more accessible.
Seeking Help For Trauma In Therapy
Trauma has a way of holding people back. But you don't have to let that happen. EMDR is one of the most effective forms of therapy for trauma. Via online counseling, it is available whenever it works for you. It's time to seek the help of mental health professionals who can help you through these painful memories. Whether you're looking for EMDR specifically or another method of therapy to treat trauma, it's imperative to find help for your experiences. There are mental health providers out there that care and can help you move through your trauma. You can work with a therapist online here at BetterHelp. Read what others have to say about their experiences below.
“Tasha has been extremely helpful to me! She listens to my concerns, and has given me a variety of tools to work with to make progress. I am particularly pleased with the EMDR therapy.”
“Scott Van Camp is an amazing listener, and I mean he takes time to really understand what you are going through, and asks questions to allow you to think for yourself. His skill in EMDR therapy has transformed my life, and has led to so much inner healing. I highly recommend Scott!”
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