If you have a history of trauma, you may experience vivid memories of traumatic events long after they’ve stopped happening. According to PTSD United, about 20% of individuals who have experienced a traumatic event end up developing post traumatic stress disorder. Processing, or thinking about, these memories can be emotionally challenging but may help you work through your trauma and de-escalate feelings of distress attached to your memory.
EMDR — which stands for Eye Movement Desensitization and Reprocessing — is one method that specialists use to help people work through their traumas to decrease emotional intensity of traumatic memories. EMDR is a specialized psychotherapy treatment technique that facilitates the reprocessing of traumatic memories using eye movements. The eye movements (or any bilateral stimulation like tapping or auditory tones) help to process disturbing information into a more normal process of memory.
[Read: How to Prepare for Your First Therapy Session.]
What Is EMDR Therapy?
EMDR therapy is a trauma-focused intervention in which therapists guide patients to bilaterally stimulate their brain — meaning, patients focus on two things happening simultaneously on either side of their body — while thinking about a distressing memory. This process can help patients unlock and explore past traumas, eventually changing how these memories are stored in their brain. By doing this, the memory can become less intense and burdensome to the patient.
“The reason why we want to change the location of where those memories are stored in the brain is because what makes them traumatic is where they are currently being processed in the brain,” says Jillian Cruz, a licensed clinical psychotherapist at RiseWell Therapy & Consultation, who serves patients in Chicago and Mission Viejo, California. Cruz specializes in trauma therapy and sees multiple patients for EMDR.
“When you bilaterally stimulate the mind while you’re recalling these triggering memories, after a period of time, you become desensitized to those memories,” she explains.
This can have massive benefits for patients whose traumatic memories feel overpowering and hyperrealistic.
“It’s like taking a movie that is in 3D with surround sound and changing it into a movie in black and white with very little to no sound,” Cruz says. “That’s the level of intensity that changes over a period of reprocessing with the bilateral stimulation.”
[Read: What Is Cognitive Behavioral Therapy?]
How Does EMDR Therapy Work?
For EMDR therapy, a patient must first locate and think about a distressing memory, and then engage in an activity that bilaterally stimulates their brain.
When it comes to locating memories, Cruz explains that many of her patients start EMDR after working with her on other trauma interventions, such as talk therapy, during which they identify distressing memories they want to target and change the way they think about. This is not always the case, however, and some patients may initiate EMDR without first seeking out talk therapy.
EMDR Therapy Methods
When it comes to bilaterally stimulating the brain, there are three primary methods of doing this in EMDR. Per EMDR’s name, eye movement exercises are one method of bilateral stimulation — but not the only. The three methods used to bilaterally stimulate the brain during EMDR are:
— Eye movement
— Tapping
— Buzzing
Eye movement
If receiving bilateral stimulation through eye movement techniques, you will engage in an activity that causes you to look from left to right, right to left. A common way of doing this is to sit still in a chair and face an illuminated rod or beam with a light that moves from either side. You will concentrate on the light as it moves from one end to the other, following it with your eyes but keeping your body still.
Tapping
If receiving bilateral stimulation through tapping, you may sit still with your palms facing up while your therapist taps one palm then the other, again and again. You can also tap yourself — if you are uncomfortable with your therapist touching you — by holding your arms in a hug-like position and tapping one shoulder and then the other, again and again.
Buzzing
Similar to tapping your palms, buzzing works by holding a small buzzing machine in your right and left palms. When activated, the buzzers will buzz one palm and then other, over and over.
Individuals will only perform — or receive — the above stimulation tactics while actively thinking about their distressing memory. This is usually for a few seconds, but not minutes, after which their therapist will “pull them out” of the memory to ask about where their thoughts have been traveling, or to inquire about the intensity of their distress, Cruz says.
This cycle of spending a few seconds in the memory under stimulation and a few seconds out of the memory without stimulation is repeated multiple times throughout the session.
[READ: Types of Therapy: Choosing the Right One for You.]
Your Therapist’s Role in EMDR
An certified EMDR therapist can assist you in bilateral stimulation processes and coach you in and out of your memories.
“The role of the therapist during the bilateral movement processing is similar to a music conductor working with an improvisation,” says Shiva Wilson, a psychotherapist with Menlo Park Psychiatry & Sleep Medicine in Menlo Park, California. “The clinician’s ability to observe the physical cues of the client is an important skill.”
Additionally, pulling patients in and out of their memories is critical to the safety and success of EMDR, and is something that Francine Shapiro, the founder of the practice, highlighted in her teachings.
“One thing that Francine Shapiro always said is the goal of EMDR is to have the patient in reality and in the current moment but also have one foot in the past,” Cruz says. “We don’t want to totally leave them in the past — you know, I’m not going to leave you thinking about this memory for five, ten, twenty minutes — but we don’t ever want them fully in the present either. We want their mind to be activated, and we want that memory to be brought up to that frontal lobe so they can focus on it.”
Having the memory in the frontal lobe allows it to display itself most vividly, Cruz adds.
For best results, it is important to work with a therapist who is certified in EMDR — and don’t try EMDR on your own.
“Doing self-administered work puts a person at risk for retraumatization,” Wilson warns. “I don’t recommend it.”
What Are the 8 Steps of EMDR?
Whether you receive eye movement, tapping or buzzing variations of EMDR, your treatment will follow an eight-phase process to help you locate, process and transform your experience with your traumatic memory.
The eight phases of EMDR are:
1. History taking, including assessing the patient’s health history and getting an idea of target memories that could be processed during treatment
2. Preparing the patient for the treatment
3. Assessing the patient’s target memory
4. Desensitization, or using bilateral stimulation techniques to help the patient lower their distress level around the memory
5. Installation, or using bilateral stimulation techniques to help the patient strengthen positive beliefs
6. Body scan, to assess for lingering negative thoughts or feelings
7. Closure, to help the patient return to a calming state with their mind in the present reality
8. Evaluating treatment results
How Long Does EMDR Take to Work?
How long it takes for EMDR to work can vary based on the needs of the patient and the discernment of their therapist.
For example, some people may reap benefits from EMDR in as few as 10 to 15 sessions, Cruz says. Others may need treatment for a year or more. Often, the length of treatment can depend on the intensity — or compounded nature — of the person’s traumatic memory, she adds. For example, a person who experienced an isolated traumatic incident, such as being mugged, may feel their memory desensitize sooner than a person who experienced multiple traumatic incidents connected to each other, such as experiences of marital or childhood abuse.
Though EMDR can be a lengthy investment, Cruz says time and commitment to the practice pays off.
“I’ve never done EMDR and had someone say it didn’t help them in some way,” Cruz says. “I’ve done it dozens of times now — and with singular events and more compound trauma — and I’ve never seen it not work.”
Side Effects of EMDR
Some people who undergo EMDR may experience intense physical reactions to their treatment. That’s because it’s not just the mind that remembers traumatic events but the body too.
“Even if the brain can’t remember or can remember limited information about a particular memory, the body often will,” Cruz says.
Physical reactions to EMDR may not be painful or harmful to health, but may mimic sensations that you felt around the time of your memory. For example, Cruz says a colleague used EMDR to process a bullying episode as a child, which would occur after band practice and while his arms were sore from playing his instrument. Following his EMDR sessions, Cruz says her colleague noted that his arms were sore in a similar way.
Additionally, Cruz says she has worked with postmenopausal women who were using EMDR to process memories of miscarriage, and they started their period again or had spotting.
Because of the physical psychosomatic bodily reactions that sometimes happen, “when we’re asking what are you noticing, we’re also keeping track of what the body is doing as we’re bringing up these memories,” Cruz says.
How to Verify Your EMDR Therapist’s Qualifications
Therapists can be — but are not required to be — certified in EMDR before providing this treatment. Due to the vulnerable nature of the therapy, certifications can help ensure the treatment adheres to high standards of safety, efficacy and care. Therapists who aspire to become EMDR-certified can apply for a certification from the EMDR International Association, which is the original membership organization for EMDR therapists comprised of mental health professionals focused on maintaining excellence and integrity in EMDR.
Before applying for a certification, however, mental health professionals must undergo an EMDRIA-approved EMDR Therapy training program. And before they can receive this training, they must also meet certain professional requirements, such as being a:
— Qualifying licensed mental health professionals, which refers to properly licensed medical doctors; advanced practice registered nurses with a master’s degree or above in nursing and with a specialization in psychiatric mental health nursing; and mental health clinicians with a master’s degree in qualifying mental health fields of counseling, marriage family therapy, psychology, psychiatry or social work or a related mental health discipline. This does not include mental health workers who hold a chemical dependency or substance abuse license without the other degrees.
— Qualifying pre-licensed mental health professionals, which refers to clinicians who are actively pursuing a mental health license, working under a licensed supervisor and have a master’s degree in a qualifying mental health field or related mental health discipline. Similarly, this does not pertain to individuals who only hold a chemical dependency or substance abuse license.
— Qualifying graduate students, such as graduate students who are enrolled in a master’s or doctoral program in a mental health field or related mental health discipline, have completed their core graduate academic coursework and are in the internship portion of their graduate program. These students must also be pursuing a relevant license and working under the supervision of a licensed professional. When registering for an EMDR training, graduate students must submit certain documentation and a letter from their supervisor.
Therapists must undergo EMDR therapy themselves as part of their training.
However, Cruz says there are also people who try to conduct EMDR without proper training.
To double check if your therapist is EMDR-certified or to search for an EMDR-certified therapist in your area, you can use a search engine on the EMDRIA website.
What to Do After an EMDR Session
EMDR may improve your emotional health down the line, but you may not see results immediately.
After a session, Wilson says people can feel simultaneously relieved and also a little raw or vulnerable. “This is not an easy process, but it can be very worthwhile. I urge people to take extra care to be gentle with themselves, with respect to who and what they interact with in the hours immediately afterward.”
Cruz adds that she encourages people to think about how they can nourish themselves during this time. Practicing soothing rituals like snuggling up with a blanket or sipping a warm tea may help you create a peaceful post-therapy environment and help you reground yourself in the present moment.
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EMDR Therapy: How It Works for PTSD and Other Trauma originally appeared on usnews.com
