Originally posted April 17, 2017.
When is it a good time for you to try EMDR?
Eye Movement Desensitization and Reprocessing (EMDR) is a mindbody approach to therapy that’s effective with trauma and moving stuck emotional places. EMDR as a treatment modality, is best used with someone who is stable in his or her mental health treatment. For example, someone with untreated clinical depression needs to address the depression before beginning EMDR treatment. Or someone with bipolar disorder needs to be stable on their medication for at least six months prior to beginning EMDR treatment or a person struggling with addiction needs to be stable in recovery for at least a year before beginning EMDR treatment. Persons with complex trauma, such as persons subjected to ongoing childhood sexual abuse, should have a good understanding of their abuse before undertaking EMDR. EMDR is appropriate for persons who suffered a single incident trauma.
Why use EMDR?
EMDR is what is known as a bottom up trauma treatment. The brain is (not so sharply) divided up into the higher cognitive and the lower emotional centers. Trauma needs to be addressed on cognitive, emotional and body based levels. Cognitive behavioral therapy (CBT) is a top down therapy. CBT comes at emotional issues from a thought /belief /explain/reframe perspective, which is valid to some degree. There’s alot of extant research on CBT because it’s easy to fund. Insurance companies love it…12 sessions and you’re good to go (supposedly). EMDR comes at emotional issues from a bottom up perspective. The emotions and the body sensations are all addressed, as the trauma memories are all tied up together in a body based experience. Using non-invasive bilateral stimulation brings in body sensations and ties parts of the brain and nervous system together, along with imagery and words.
What is the first EMDR session like?
At the first EMDR session, we establish feelings of safety in the therapeutic relationship and in the treatment modality. Feelings of safety are important. We get to know each other and we discuss your history and what issues you’d like to focus on.
In the first session, I like to start out with things that bring comfort and well being before going on to the harder stuff. I like to help you find your inner resources, including a place you can return to in your imagination for comfort, and the r constructs your can call on for strengthening, such as a support circle, your inner healer and your adult self.
What happens as the treatment progresses?
In the next two or three sessions, we parse out which issues are the treatment focus. Then, we identify which memories are relevant and related to these identified issues. Together, we decide where to begin treatment. We choose which memories to work on. Maybe we choose three to six memories that seem to come up over and over again for you, and then choose one to reprocess first.
The most traumatic memory is not the one to look at first. We might work on a smaller memory first, not a central one. Once we select a target memory to work on, we access this memory in great detail. We look at the images, emotions, sensations, and beliefs that are associated with this memory. The idea is to agree beforehand to stay with this target memory, even as tangential thoughts and other memories begin to surface during the treatment. We stick to your memory’s beginning, middle and end.
As we go through the target memory as it exists for you, and keep coming back to the target memory, we look for opportunities to bring in positive coping skills and/or ways for helpers or the adult you to intercede. This helps alter the negative intensity of the memory and associates new and more positive thoughts, feelings and images with the memory as you experience it.
So that’s a lot of information packed into a few sentences. Does it make sense?
You hold the clappers in each hand and they provide mild bilateral stimulation.
What is Bilateral Stimulation (BLS)?
Now, the other part of EMDR is what is called bilateral stimulation (BLS), using what are called clappers. You hold a clapper in each hand. The clappers create a pulse, which alternates back and forth in your hands. The pulse is totally adjustable. You are in control of how fast or slow the pulse goes back and forth and how strong the pulse feels in your hands. Most people find the mild stimulation to be very soothing, helping to induce a trance-like state. The back and forth movement stimulates the left and right sides of your body, bringing in both sides of your brain, setting up optimal integration of the logical and emotional sides of the brain.
How does the session draw to a close?
Some memories are very large and carry big trauma (big “T”) with them, others carry smaller trauma (small “T”) . The larger memories are processed over several sessions. We look for ways to stop the chaining into other memories and look for appropriate areas that can be left in the office to work on at another time or put into a trunk to be opened later in the office next time. Positive thoughts and feelings are brought in and a place of safety and strength is created that you can draw upon between sessions.
Every person is an individual and every one reacts differently to EMDR. Some people really like the treatment and others don’t find it to be the best thing for them.
The goal is for you to be able to live a happier life and let the traumatic memories lose some of their negative charge as you re-process what happened and integrate your traumatic experiences into the complex definition of your self.
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