What is EMDR?
Eye Movement Desensitization Reprocessing (EMDR) is a type of therapy specifically designed to treat clients with Post Traumatic Stress Disorder (PTSD). The overall goal of EMDR treatment is to help clients heal, rather than have to live with trauma symptoms. EMDR scholarship asserts that traumatic memories are “trapped” in the nervous system, keeping the traumatic events active and replaying. EMDR aims to target these memories using specific techniques involving eye movement. This method allows these memories to be reprocessed. Once the memories are reprocessed, the trauma feels less active or completely inactive.
If you are considering EMDR treatment, and are wondering what it might be like, here are five key points to know about EMDR:
While the name begins with the phrase “Eye Movement,” most EMDR therapists no longer use the eyes to conduct this type of treatment. The original treatment, designed by Dr. Francine Shapiro, did in fact involve eye movement, where the therapist guided the client’s eyes by moving their hands back and fourth during the session. This is known as bilateral stimulation (BLS). As you can imagine, that gets pretty exhausting if you’re the therapist, and are expected to hold your arm up for 45 minutes straight! It is also a lot to ask a client to keep their eyes open for 45 minutes straight, especially while talking about traumatic events. So, the process quickly evolved to using tapping methods, which allows the client to close their eyes during the session. Soon, clinicians started to use a device that pulsates, so no tapping was even required. Today, the client simply holds a small device in their hands or under their legs that pulsates back and fourth from one side to the other. Before Francine passed away, she stated that if she could go back and rename the therapy she designed, she would call it “reprocessing therapy,” since less and less therapists use eye movements for this modality of treatment.
What if the client is unable to come in person to treatment? How is this type of therapy going to work if a client cannot hold a device that pulsates or have a therapist tap them? This was a dilemma that nearly every EMDR therapist experienced at the start of the COVID-19 pandemic in 2020. EMDR therapist adapted to a new way of tapping for virtual sessions where they become a guide and the client taps their own shoulder, elbow, or thighs during the virtual session. This is still used in treatment today, giving clients the option to go to therapy in-person or online for a virtual session.
During the session, the client is always in control. It the client does not want to work on EMDR treatment for that session, that is perfectly fine. This type of treatment does not have to be done every single session. If during an EMDR session, the reprocessing becomes too intense, it’s also perfectly fine for the client to stop the session.
It’s common for EMDR therapist to do some additional mindfulness work at the end of an EMDR session to make sure the client feels as calm as possible before going back to their day to day life. Common techniques include visualization, grounding techniques, meditating, and breathing techniques.
After an EMDR session it is best for the client to rest. This type of therapy can be intense and exhausting, and it is important to remember that the thoughts, imagery and emotions that come up during a session cannot hurt the client. Reliving painful memories is common element of the reprocessing treatment. It is important for clients to take it easy, relax, and allow the work they are doing to settle. Lastly, in order to give the mind time to do that settling and reprocessing, it is recommended to abstain from any substances, like alcohol, marijuana, or any other substances, on the day when receiving EMDR treatment.
EMDR is a proven and highly impactful modality and one I have seen work well in my practice.