Yep, another therapy acronym! EMDR -- eye movement desensitization and reprocessing therapy -- is a very different approach than traditional talk therapy, and is sometimes referred to as a "brain-based" therapy. When I first learned about it, I was pretty skeptical about this woo-woo way of working with trauma -- seriously, how is moving our eyes side to side going to make us *feel* differently? And then I decided to give it a try, and, well, experiencing EMDR convinced me that it can be a powerful and transformative tool. Because it's so different to talk therapy, I like clients to have a good sense of what it is they're getting into, so, this is how I explain EMDR to clients who are interested in trying it out.
I often recommend EMDR to clients when they have experienced something they recognize as traumatic (frequently birth trauma), or when they are holding onto an unhelpful and irrational belief about themselves. They find that it does not matter how much we talk about it, they still believe it in their gut, even though, they logically know that the belief is not true. Somewhere in their life, they had an experience, or many experiences, that taught or reinforced this negative belief, which often sounds like, "I am not safe," "I am broken," or "I am not good enough."
Francine Shapiro, beginning with a chance discovery in 1987, developed EMDR as a treatment approach to desensitize anxiety due to traumatic experiences. Many clinical studies have proven it to be an effective, evidence-based treatment for trauma, and its application has extended beyond single-incident trauma to more insidious developmental or relational traumas.
But, seriously, how does it work? Okay, I'm no neuroscientist, so you're going to get my understanding, based on my own training, study, and clinical experience, of how and why EMDR works (and it's accepted that there is more than one reason that it's effective). First, and maybe foremost, it is a form of exposure therapy. As we are exploring what it is that we will target with EMDR, we are talking about the experience(s) and putting it in a wider context of our whole life; and beginning to make sense of the impact that it has had on our sense of self in the world. As we move into the reprocessing phase of EMDR, clients are facing that memory again, without trying to analyze or interpret it, allowing their brains to make sense of the experience in a new way.
Secondly, the whole "eye movement thing" comes from the theoretical understanding that our REM phase of sleep is part of our brain's "adaptive information processing system," when we process all of the experiences of the day, take what is useful, and then file them away in our memory bank. When we have experienced trauma, this adaptive processing system breaks down, because when we are scared, anxious, or flooded with stress hormones, our brain is not functioning as normal. The memories often stick around in the working memory, where it takes just a small sensory stimuli (a scent, a colour, a tone of voice) to "trigger" a flashback - the feeling of not remembering, but reliving the moment. By replicating the REM eye movements, we're giving the brain a chance to have a "do-over," when the brain is not stressed and the adaptive information processing system is functioning, another chance to reprocess the experience and file it away properly.
Thirdly, this left - right - left - right eye movement is referred to as "bilateral stimulation," (BLS) or "dual attention stimulus." EMDR can use eye movements, audio, "tappers" (little buzzing balls that you hold in your hands), or self-tapping to create this BLS. BLS helps to integrate the left/rational side of the brain with the right/experiencing or feeling side of the brain. Dr. Jamie Marich describes BLS as turning the congested single lane bridge between the two hemispheres (the corpus callosum) into a wide superhighway, allowing us to integrate the gut feeling with the rational knowing. You can check out her brief video here.
Finally, the action of BLS both overloads our working memory (allowing us to go deeper and make new connections), and helps to keep us grounded here in the present moment. Trauma therapy is not therapeutic if we are just re-experiencing our trauma, so we always want to maintain the awareness of safety in the therapy space as we look back into the memory. Building this capacity for dual attention helps our nervous system learn not to be overwhelmed by past experiences.
While EMDR is not the answer for everyone, it can create meaningful and lasting change - often quickly - with a new, more adaptive sense of our self, and our experiences in the world.
If you'd like to learn more about EMDR, check out these resources:
A brief overview (2 mins):
A more in depth explanation (11 mins):
FAQs from EMDR Canada:
And a (very abbreviated) demo of an EMDR session (7 mins):
Information on using EMDR in the perinatal period:
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