Eye Movement Desensitization & Reprocessing (EMDR) is a comprehensive form of psychotherapy that currently has more scientific research as a treatment for trauma than any other non-pharmaceutical intervention. EMDR is considered an "evidence-based" practice, meaning it is scientifically verified to be effective in the treatment of a wide variety of issues, including anxiety, panic attack, post-traumatic stress symptoms (such as intrusive thoughts, nightmares, and flashbacks), disturbing memories, complex grief, depression, phobias, and more. It has also been demonstrated to be very effective in peak performance enhancement for individuals seeking to maximize their potential in job performance, athletics, performing arts, and other forms of personal achievement.
It is important to understand that EMDR is not hypnosis, nor does it “erase” memories; rather, it allows the brain to utilize its natural memory processing methods to lower or eliminate the emotional intensity or vividness of maladaptive memories so they are no more disturbing than ordinary memories.
EMDR begins with the understanding that traumatic events or other intense experiences are sometimes improperly stored in long-term memory networks, full of overwhelming emotions or sensory experiences from the time of the disturbing event. The brain is thrown into a type of shock, and often tries repeatedly to process the overwhelming experience.
It may help to visualize a person who has taken too large a bite of food and is having difficulty swallowing. This person may begin to choke, or try time after time to clear the blockage from their throat, similar to how a traumatized person might feel "stuck" or experience repeating or intrusive thoughts, behaviors or dreams. EMDR clears the emotional blockage from associated memory networks so the person's mind no longer needs to struggle to make sense of overwhelming events.
To learn more about EMDR, follow the provided resource links, or refer to the FAQ below.
Q: What is an EMDR session like?
A: EMDR is much more than hand motions or eye movements. It is a comprehensive form of psychotherapy, applicable to a wide variety of problematic issues, including anxiety, trauma, PTSD, depression, phobias, panic attacks, and more. It is often used to treat military personnel, first responders, victims of crime (or witnesses), natural disasters, life-threatening accidents, or survivors of physical, sexual, or emotional abuse. It is also exceptionally effective for peak performance enhancement, allowing athletes, business people, artists, performers, students, or anyone else facing a challenge to perform or compete to their highest potential.
There are eight phases in the process, but the most recognizable aspect is when the clinician directs a client to focus on a target memory, then applies some form of bilateral (side-to-side) sensory stimulation to encourage the client's mind to re-organize the memory and any other associated maladaptive memory networks. This bilateral stimulation (BLS) is most often a series of eye movements directed by the therapist's fingers or perhaps a bar of lights that guide the speed and direction of the client's eyes. For those who are uncomfortable using their eyes in this way, or perhaps unable to do so, alternate forms of BLS such as alternating taps or sound tones may be used.
The clinician will administer the BLS for a short period of time, perhaps 20 or 30 seconds per set, then pause and ask the client for a report of their experience. Gradually, the client's mind will begin to achieve synthesis, or spontaneously associate elements of positive memories with negative ones, then reorganize the structure of long-term memory so the event is no longer disturbing to recall, and no longer imposes itself on daily living.
After reprocessing a negative experience, EMDR then focuses on strengthening a positive element within the client. Clients (and clinicians) often find EMDR a welcome and refreshing approach to treatment in that it focuses not just on a negative aspect of memory, but builds on the client's strengths.
Progress is monitored when the therapist occasionally asks the client to assign a score to the level of disturbance felt when recalling the target memory. As reprocessing progresses, this score typically drops lower and lower until the memory feels no more disturbing than any other ordinary memory.
A video demonstration of EMDR reprocessing can be found here:
Q: What will I experience during reprocessing? How much will I have to talk about my past?
A: The actual experience of reprocessing will differ from client to client, memory to memory, or even from one set of eye movements to the next. Sometimes clients will recall specific images from memory, which may or may not appear related to the targeted experience. Other times the client will experience different physical sensations in the body, which may be pleasant or somewhat unpleasant, such as tightness, pressure, tension, or recall sensory material such as smells or sounds from memory. Some clients report remembering previously forgotten events. Or perhaps reprocessing will simply bring about new understanding, that "ah-ha!" moment in which a person has a realization never previously considered, which may or may not make sense until the memory is fully reprocessed. And still other times the client will have no discernible sensation. "I'm just watching you move your fingers with my eyes." More often than not, this simply indicates reprocessing is still occurring "down deep", and will reveal itself with additional reprocessing.
While some memories or sensations that spontaneously arise during reprocessing are unpleasant, these sensations generally only last momentarily, and successful reprocessing often eliminates future unpleasant associations, or greatly reduces the chances the disturbance will return.
One of the advantages of EMDR therapy is that the client often doesn't have to describe disturbing events from their past in great detail to begin effective reprocessing. When working with particularly disturbing memories, it is often enough for the therapist to simply use a label or small detail to focus on. A cue phrase such as, "Focus on the time you were at the beach your senior year" or "Remember the sound of the door slamming" may be enough for the patient's mind to draw up the target memory without being forced to describe or write out a detailed account of what occurred.
Q: How quickly does EMDR work? I've heard some people say they feel relief after one session.
A: Some clients experience amazing results very rapidly, but it should be noted that reputable EMDR therapists utilize the eight phase model of treatment to achieve the deepest, most significant, longest-lasting results. Your first therapy sessions will be well spent preparing for reprocessing. The more a clinician understands his or her client, the more resources can be drawn upon during reprocessing sessions, maximizes the chances of successfully eliminating the disturbing sensations associated with traumatic memories. It can be tempting to rush into reprocessing in our eagerness to feel relief, but careful, collaborative treatment planning between therapist an client will far more often achieve satisfying results.
In general, we can say that single-incident memories tend to be reprocessed more quickly than complex or long-term traumatic experiences. For example, the victim of a one-time accident, disaster, or crime is more likely to achieve successful reprocessing quickly than a person who suffered repeated or long-term suffering. In both examples, successful reprocessing is possible, but the the more complex case may require additional sessions to uncover more wide-spread effects of the problem in associated memory networks.
This FAQ is a work in progress. Please check back soon for more Q&A! In the meanwhile, please feel free to contact me with your comments or questions.