“I was skeptical, too.”
It’s the first thing I say before introducing the idea of bringing EMDR into my work with a client. I believe a healthy amount of skepticism is important whenever it comes to any new idea or so-called solution. And believe me, my clients tend to have a healthy amount of skepticism, too.
The first time EMDR was explained to me, a friend described little more than waving a finger back and forth; yet she spoke with so much enthusiasm and so little actual knowledge, I almost questioned my recent decision to go into the field. In grad school, when colleagues all started pursuing EMDR training, I also couldn’t help but worry whether or not everyone hopping on the bandwagon might just be a trend. The health and wellness world has a lot of trends, and I’m not one to put my name or reputation behind something unless I’ve thoroughly vetted it.
But, just as a healthy amount of discernment is important when exploring something new, a healthy amount of humility and openness is equally as essential to ultimately form an educated opinion. Which is why I wanted to write a more in-depth way of explaining what EMDR is, and what EMDR isn’t, for those who want a slightly more thorough understanding of exactly what happens in EMDR therapy and how we currently understand why it gets some of the results it gets.
How EMDR Works
The first thing to understand about EMDR is that one of the things that makes it so unique is that it’s an incredibly integrative therapy. Psychodynamic therapy helps clients explore and make connections with their past, cognitive behavioral therapy can help clients change their thinking and underlying beliefs, and somatic therapy often increases the efficacy trauma treatment by actually addressing the physiological components. But the fantastic thing about EMDR is that it does a little bit of it all. Similarly, while traditional talk therapy helps clients make sense of themselves predominantly through the left brain, and other modalities like art therapy or movement-based therapies help clients actually connect and heal through the right brain, once again, EMDR therapy manages to do both.
Why is this important? Have you ever found yourself in a therapy session saying something along the lines of “Intellectually I get it, but I still can’t seem to feel it?” It’s one of the refrains I personally hear the most in my work as a therapist. And while clients can, and do, make great progress in this arena through traditional talk therapy, it can sometimes be painstakingly slow. Because EMDR provides a way of working that very intentionally incorporates our latest understanding of neuroscience and more equally balances working with mind and body, right brain and left brain, and top-down and bottom-up, we often see results that are much more powerful and lasting where attempts to “think our way out” of a problem may fall short.
What To Expect in EMDR Therapy
So, what does the process actually entail? Below I’ve grouped several of the most significant parts of change in therapy I believe EMDR supports, in a way that I hope is a bit more understandable to the average person.
1. Connecting the Dots Between Past and Present
While exploring the connection between past experiences and present issues is a major component in a majority of therapies, I especially enjoy how elegantly EMDR maps problems clients bring into therapy to their root. This is often done with something called the “floatback technique,” in which, rather than simply explaining a present issue and attempting to analyze where it may have come from, a client is invited to both identify the core belief and revisit the feeling related to the present issue, and allow themselves to float back to other times they’ve felt similarly. Because memories are state-dependent, it’s amazing how quickly you can follow a train back to understand where today’s symptoms may have started (it’s a bit like stream of consciousness on steroids!)
2. Desensitizing Past Experiences
Once a client’s most significant or formative past experiences have been identified, EMDR interventions are often able to first bring down the overall charge associated with them. This usually happens when we activate the memory,* bringing it into working memory, and then add EMDR techniques such as butterfly tapping or bi-lateral eye movements (more on the theories as to why this is effective below). This is the “D” in EMDR (“desensitization”), and clients often report that previously triggering memories suddenly start to feel less intense.
*A common question I often get is about targeting experiences you may not actually be able to remember. It’s a great question, and the amazing thing about EMDR is that because we are targeting activated states associated with past experiences through the nervous system, it often doesn’t require explicit memories to be effective.
3. Reprocessing Past Experiences
Then, what we tend to find when doing EMDR is that not only do old memories feel less intense after doing EMDR, but they have the opportunity to be re-contextualized from our present-day perspective in a way that often “sticks” much more effectively than in many therapies. For example, a child who took on the belief that his parents’ divorce was his fault, may finally be able to really feel (not just “know”) that it wasn’t about him. We often find more adaptive narratives and self-talk come out of processing past experiences in this way. This is the “R” in EMDR, or the “reprocessing” component.
4. Building & Strengthening Internal Resources
Lastly, a major component of EMDR is building and strengthening inner tools and resources. Sometimes this includes grounding and regulation techniques that capitalize on the added power of incorporating the nervous system, and they also include the more positive and adaptive beliefs that become internalized during processing and other exercises.
Why EMDR Works
There are many theories as to why EMDR has the efficacy it does. While at this time we have no way of proving exactly what is at play, the following are just a few leading hypotheses that can help it make a lot of sense:
There is some evidence that when brought back into working memory, memories are actually malleable. Let me be clear, this does not mean that we can install false memories or do an Eternal Sunshine number on your brain. However, because memories get coded with so many associations including emotions, physical sensations, and especially beliefs (for a great illustration, go see Inside Out 2!), when we have an opportunity to work with them in a more active state, we can add new associations that also get stored when they return to long-term memory. As an example, where a memory may have once been associated with shame or the belief “I’m a failure,” after EMDR it is can become associated with compassion or the belief “I" did my best,” and no longer remain as triggering when reactivated.
It’s also theorized by some that desensitization happens because EMDR’s various interventions tax working memory when revisiting a former experience. That means when we bring an old, stored memory back into working memory, by adding distractions such as instructing a client to follow a finger or even attempt to do multiplication at the same time, it can lessen the intensity a memory gets stored with again.
Many theories also suggest that positive and negative neural networks often develop separately from one another - especially when it comes to trauma memories, as they get formed while the brain is in a very primal, survival mode. The metaphor of well-travelled paths or “grooves” in the snow are often used to illustrate the idea of neural pathways in the brain. The more frequently we travel down one, the deeper it becomes and therefore easier it is to for the brain to slide down again quickly. But we can also build and reinforce new pathways, which is what we call neuroplasticity. In this case, EMDR may be forming connections between two different pathways (positive and negative), or potentially even revising the original all together.
And lastly, the bi-lateral stimulation*. These are some of the techniques EMDR uses to alternate physically stimulating the right and left sides of the body. Initially this was done solely through eye movements, which can resemble what the eyes do during REM, (Rapid Eye Movement) sleep, and thus it may logically follow that perhaps there is something to the processing our brains naturally do during sleep that we can re-create in order to further process material when needed. Some also theorize that it’s another way we’re able to both work with and integrate parts of a problem that happen between the left (logical) and right (emotional) brain. And of course, some even consider the possibility that there is a regulating effect to the bi-lateral stimulation that allows clients to maintain a baseline sense of grounding, or even one foot in the present moment, when revisiting a difficult memory.
*While “follow my finger” has become almost synonymous with EMDR, a little known fact about EMDR’s founder Francine Shapiro is that, like a true scientist, she too was open to the idea that the model wasn’t necessarily dependent on certain specifics such as eye movements (the “EM” in EMDR). In her book, Shapiro says if she were to go back, she would have simply called the method “Desensitization and Reprocessing Therapy.” However, just like Coca-Cola (which no longer uses cocaine in it’s products), by then the name EMDR had already stuck ;)
Will EMDR Help Me?
EMDR is considered an evidence-based therapy because there is so much great research supporting clinically significant results in client improvements, and its impact has also begun to greatly expand beyond just trauma and PTSD.
As an integrative therapist, I still don’t believe EMDR is only therapy that works for clients, and much of what I’ve found works about EMDR also works in other therapeutic modalities that tap a bit more of the right brain, such as IFS (parts work), guided visualizations, and more. All clients also have vastly different needs and goals, so EMDR might not be necessary or most relevant to where they are and what they want from therapy most, which is also totally fine.
But while I can’t guarantee EMDR will “work” or be advised for absolutely everyone, if you’re asking if in my experience I’ve seen it make a real difference - in often a much shorter timeframe than otherwise - then my answer is yes.
If you’re interested in exploring EMDR therapy, feel free to reach out for a consultation and I’d be happy to chat more.
