EMDR Resources

What is EMDR?

Eye Movement Desensitization and Reprocessing

No one knows how any form of psychotherapy works neurobiologically or in the brain. However, we do know that when a person is very upset, their brain cannot process information as it does ordinarily. Life is full of upsets also known as traumas: big T Trauma and little t trauma. Big T traumas might be abuse, car accident, overdose, witnessed or experienced violence, etc. Little t traumas are the things that happen in our daily lives that over time take a toll. Little t traumas could include continuous negative interaction with a family member, learning differences in school that lead to the disciple problems or being singled out, messing up at work, etc. Both big T and little t traumas teach us absolute truths about ourselves that in turn shape who are and how we operate in daily life. When there is significant over emotional stimulation or under stimulation those negative thoughts, feelings, and body sensations get stuck in our daily working memory because we are unable to process them. One moment becomes “frozen in time,” and remembering a trauma may feel as bad as going through it the first time. Later on, when we encounter a similar situation (conversations with parents, perceived disrespect, etc.) our body recognizes those feelings, thoughts, and sensations and causes us to over react to the current situation. Such memories have a lasting negative effect that interferes with the way a person sees the world and the way they relate to other people.

The part of the brain that is activated during EMDR is the same part of the brain that is activated during REM sleep. It is during REM sleep each night that our brains recuperate and heal from daily activities. EMDR uses bilateral stimulation (alternating activating the left and right sides of the brain through side-to-side eye movement or buzzers in your hands) to activate those parts of your brain. EMDR is designed to aid in processing traumas and allow the client to develop new behavior patterns when faced with similar past situations. The goal of EMDR is not to merely not react when emotionally triggered but for the interaction to no longer even register and in turn feel the need to prove or convince the other person of their wrong doing. Following a successful EMDR session, a person no longer relives the images, sounds, and feelings when the event is brought to mind. You still remember what happened, but it is less upsetting (EMDRIA, 2018).

Does EMDR really work?

Approximately 20 controlled studies have investigated the effects of EMDR. These studies have consistently found that EMDR effectively decreases/eliminates the symptoms of post traumatic stress for the majority of clients. Clients often report improvement in other associated symptoms such as anxiety. The current treatment guidelines of the American Psychiatric Association and the International Society for Traumatic Stress Studies designate EMDR as an effective treatment for post traumatic stress. EMDR was also found effective by the U.S. Department of Veterans Affairs and Department of Defense, the United Kingdom Department of Health, the Israeli National Council for Mental Health, and many other international health and governmental agencies. Research has also shown that EMDR can be an efficient and rapid treatment.

Resources
EMDRIA EMDR International Association., (2018)., EMDR therapy. Retrieved from:

https://emdria.site-ym.com/page/emdr_therapy

Compassion Works., (2018)., Stress factors., Retrieved from: https://compassionworks.com

Resolving Trauma with EMDR

A traumatic event is any experience, in which a person is exposed to a threatening or harmful event, and experiences strong negative emotions, or helplessness. Examples include rape, sexual assault, domestic violence, being in or witnessing a holdup or motor vehicle accident, witnessing an unexpected or violent death, being in a natural disaster or being caught up in conflicts or war. Traumatic events can also include emotional abuse.

The emotions and bodily reactions at the time of the traumatic event are associated with chemicals in the nervous system, including adrenaline, and these cause the brain to store or encode the traumatic experience in a manner different from an everyday event which doesn’t carry a strong emotional charge.

So how does a “Traumatic Memory” differ from a normal memory?

We can think of the memory of a traumatic event as consisting of three components. We can distinguish the sensory memory, the emotional memory, and its meaning. The sensory memory is stored in the sensory cortex of the brain, where the details of sight, sound, smell, etc. are encoded. There are many different sensory elements which make up a traumatic event, and our recollection of a recent trauma often consists of sensory fragments of the event, rather than a complete and coherent memory. A traumatic memory is typically vivid and often detailed in some aspects but lacking detail in others. For example, a person in a holdup may recall the detail of the weapon, but not recall what the robber was wearing. Whereas non-traumatic memories generally fade over time, losing their vividness and detail, untreated traumatic memories are often recalled with vividness, and a sense of being present (“I remember it just like it was yesterday.”). Non-traumatic memories are recalled with a clear sense of being in the past. Traumatic memories are experienced as flashbacks, disturbing dreams, or a sudden sense of re-living the event.

EYE MOVEMENT DESENSITISATION & REPROCESSING (EMDR)

During EMDR the client is guided to deliberately bring into conscious awareness the sensory memory, their thoughts, and the accompanying emotions and bodily sensations. Clients need to be willing to experience the emotions and body sensations that accompany the recall of a distressing memory and associated thoughts.

This is quickly followed by the client following the moving fingers of the therapist. The client’s eyes move rapidly for a brief period, around 30 seconds. This produces a distinctive pattern of electrical activity in the brain, which appears to result in a change to the trauma memory. The exact mechanisms in the brain which cause the memory to change has not yet been discovered, but the regions of the brain involved with sensory storage, emotional activation and reasoning all become more active, with changed patterns of nerve cell firing.

During the eye movement the therapist rarely talks or offer suggestions. The client does not try to change any aspect of the memory, and is asked to just notice the experience, to observe their memory, emotions, bodily sensations and thoughts. At the end of each set of eye movements the client is then asked to report their present experience. It may be that the sensory memory becomes less detailed or less vivid, and clients often report that the memory has become quite distant. Commonly the emotional or bodily sensations reduce in intensity quite quickly. If other associations are observed, they are shared with the therapist. Simple traumas can be treated in a single session. Older and multiple traumas can require several sessions.

© 2014 Graham Taylor, Clinical Psychologist.

  • Pre session preparation Weekly log
  • Post session handout

What to expect in a session?

For most people the first two sessions will be about you and your history, strengths, symptoms, what you would like to work on, combined with learning some coping techniques and some education about EMDR and how it works and what to expect. We figure out together what to target first (this is generally speaking the most distressing memories but depending on your preference, we may start with more recent or more minor issues). In the third session we often start the “real” work, with focussing on the targets we have identified. Sometimes we finish a target in the one session, sometimes we don’t. If we don’t, it is good to have another session pretty soon, within the week, so as not to lose momentum. Weekly sessions are usual but it is absolutely up to you as to how often you prefer to come.

Post-session: What to expect

It is a good idea to plan to have an easy day after your EMDR sessions – have a rest, gentle exercise, meditation, bath, massage, yoga class, sit on the beach, pat the dog, do your nails, whatever you find relaxing, as your brain may need a bit of a rest! During EMDR therapy your brain begins to process stored information, moving it towards a state of resolution.  It is not uncommon for processing to continue in the hours and days following EMDR therapy.  You may experience other memories, images, dreams, thoughts or emotions in some way related to the information that was worked on during the EMDR session.  

These experiences may reflect further natural information processing in your brain.  It may be useful or necessary to work on this information at your next appointment.  If some of these experiences are upsetting, use your relaxation strategies to help you. If any experience or reaction is strongly distressing, phone me.

We may give you a log book to record any experiences related to your EMDR session.  Record the date, the event which triggered the experience, and any memory, image, thoughts, or emotions. Bring this to your next appointment as it may be useful to discuss it or use it as a point to start the next EMDR target.

In between sessions it is useful to keep an eye on where your thoughts and emotions flow – this is valuable information on what needs to be processed next – if you are bothered by particular memories then that may be what needs to be approached next. Or if it an emotion that is bothering you (anger/irritation/sadness/loss/feeling inadequate etc) then we can explore this and use this as a jumping off point to find the next target.