EMDR Explained
EMDR can seem both mysterious and intimidating. You may have heard that EMDR (Eye Movement Desensitization and Reprocessing) can help you to reduce a range of difficult daily symptoms and problems, including trauma symptoms, depression, anxiety, and relationship difficulties. EMDR does this by helping you process stuck negative experiences that continue to affect you today, even though the actual event is long in the past. But what does EMDR actually look like?
Here is a 10 step run down of the process of EMDR (1), and how it helps to get the clutter of past negative experiences out of your way so you can move forward.
1.Getting to know and trust your therapist
Before processing difficult experiences with EMDR, you need to have a positive and strong enough relationship with your therapist. It often takes at least a couple sessions for you get to know each other, and for you to decide whether this is someone you’re comfortable being vulnerable with. It is important to find a therapist you like and trust enough, so you can get what you need out of therapy.
2. Coping with your emotions
In the first few sessions, your therapist will talk with you about your ability to cope on a daily basis. Before doing any processing of negative memories, they will want to ensure that you’re able to deal with the emotions and memories that might come up.
The therapist may also help you to develop some internal resources (we call this resource tapping or resource installation), that will help you to strengthen your ability to connect to positive emotions. These resources use imagination, and could include a place that makes you feel calm and grounded, or a person or object that helps you protected, confident, or provides wisdom.
Often before EMDR processing you will create a "calm place" resource, which is a place that helps you feel relaxed and grounded.
Being able to connect to positive emotions is very important, both in day to day life and for EMDR. If coping with your emotions or feeling stable on a daily basis is a challenge for you, the therapist will work with you to increase your ability to cope and feel stable before going ahead with EMDR processing.
3. Picking your target memories
Once you’ve determined together that you’re ready for EMDR, the therapist will help you identify which issues you want to work on. There may be only one, and you may already know the root – for instance nervousness which you know is from recent car accident. Or you might have a variety of issues bothering you, and may or may not know where they come from.
If needed, the therapist will help you trace back to a memory that is connected to that issue, which we call a “target”. For instance, if you’re having panic and anxiety issues, the therapist will guide you in thinking back to the earliest time you felt that intense anxiety. You may create a list of these kinds of memories with your therapist. How extensive that list is depends on the therapist’s approach and how much therapy work you’d like to do.
4. Cueing up the target memory
Once you’re determined what issue to work on first, the therapist will help you to “cue up” the target memory. This sometimes involves bringing up the memory in detail, using descriptions from the five senses. (This can be emotionally intense, depending on the memory, which is why having good coping skills and a therapist you trust and feel safe with is important.)
The therapist will help you to identify:
what emotions and body sensations it brings up,
how upsetting it is to you on a scale of 0 to 10, and
what negative belief about yourself is attached to it
It is key that the negative memories have an effect on all three levels.
The emotions and body sensations brought up by these memories are often quite strong. That’s okay, and part of the process. EMDR adopts wisdom that comes from mindfulness; if you sit with a difficult emotion or sensation long enough, it will change and eventually pass.
5. Processing the negative experience
Hand buzzers are a common form of bilateral stimulation used in EMDR.
Once you’re all “cued up” – connected to that target memory, and the emotions and sensations that come with it – the therapist will start the “bilateral stimulation” you’ve chosen to use. These always alternate between the left and right side of your body. It may be hand buzzers, earphones, or the therapist tapping your knees or moving their finger back and forth while you follow with your eyes.
When the bilateral is going, you let your mind “go.” One of the keys of doing EMDR is that as a client, the only way to do it wrong is to try to do it right. Your brain will start moving and firing off the neural pathways associated with that memory. Your job is to go along for the ride and see what thoughts, memories, body sensations and emotions arise. Wherever your brain goes is the right place.
Scenes that can arise in EMDR can be as amazing as dreams. (Photo of artwork by Supria Karmakar http://www.supriakarmakar.com/)
Since EMDR is alternately stimulating the left and right side of the brain, it seems to facilitate information processing in a way that is similar to REM sleep. Like dreaming, what comes up during EMDR can be amazing. Sometimes you may see strong imaginary scenes, be walking through a familiar place and experience everything in perfect detail, or imagine the event play out as you needed it to happen, rather than how it did. By letting your mind make creative connections, and by not judging or trying to control your thoughts, you allow your brain to digest that negative experience in a way it was unable to the first time.
While the bilateral stimulation is going, some people like to close their eyes. Some people are quiet, while others like to talk aloud about what’s happening for them, whatever is comfortable for you. Generally after anywhere between 20 seconds and 2 minutes, the therapist will ask you to take a deep breath and will turn off or stop the bilateral stimulation. Then they will ask you to share what came up for you.
6. Sharing with your therapist
Sharing what was happening with your therapist is helpful, although not essential to EMDR. Sharing your thoughts and feelings is helpful to healing in general because it lets you connect with another person and reduces the shame that secrets often carry. If you’re a more private person, you can just give a brief description so your therapist knows you’re moving along and not stuck. After you’re done reporting, the therapist might talk with you and use some of their other therapy skills to help you along. Then they will turn on the bilateral stimulation again, and your processing will continue.
7. Reducing your distress to zero
EMDR processing will continue until the distress around the issue reduces to a 0/10. How many sessions this takes depends on the person and the memory. It’s quite common to see an issue that starts at 10/10 upsetting go down to a 0/10 in only a couple sessions. Other times it may take longer, but as long as you do the EMDR processing for the time it takes, you will get to a 0.
8. Creating a positive belief
Some examples of positive beliefs that people develop about themselves through EMDR.
Once the upset is down to a 0, the therapist will ask you what you believe about yourself now related to the original issue. These could include beliefs such as “I am strong,” “I am normal,” or “I am a good person.” Then the therapist will do some sets of bilateral stimulation with you until that belief feels as strong as it can, at a 7/7. Sometimes this positive belief grows from something like “I am loveable” to “I am really loveable. I have so much to contribute and I have great people in my life who show me that every day.” Where there used to be upset and a negative belief, now there will be a positive belief about you and your abilities.
9. Scanning for any remaining tension
Once the positive belief is as strong as it can be, the therapist will ask you to check your body for any remaining tension. Sometimes your body can continue to hold onto negativity after your mind has let it go. The therapist will do sets of bilateral stimulation with you until your body feels clear of tension - often in fact your body will feel really calm and relaxed after you’re done processing.
10. And repeat, or not
After you’ve completed this process, that memory should no longer be distressing to you anymore. You may find that symptoms you didn’t realize were connected to it subside – such as biting your nails, or nagging self-doubt.
EMDR results generalize, which means that once you’ve processed one upsetting memory, other related memories often become less upsetting as well, or even no longer upsetting at all. So for instance if you process a memory related to your parents being neglectful, other separate occasions when you’ve felt neglected may not bother you anymore.
One of the great things about EMDR is it sticks. You shouldn’t have to re-process that memory again and the related symptoms will subside. If you’ve had a lot of difficult experiences, you may decide to do more than one target, other times one is all you will need to do. Either way, the mental and emotional clutter from that stuck memory will be gone, and you’ll be able to focus your energy on your life today.
1. Many EMDR therapists use the Basic EMDR Protocol and this article is based on a slightly modified version of that protocol. As other many EMDR protocols exist, there will be variation in how EMDR is used by different therapists. However most EMDR protocols are based on the model depicted in this article.
ABOUT THE AUTHOR
Linzy Bonham is a Psychotherapist in Guelph, Ontario who received her Masters of Social Work from Wilfrid Laurier University. She works one-on-one with people to help them feel more stable, connected, and able to focus on enjoying their lives in the present. For more information see http://linzybonham.com/
Linzy Bonham, Psychotherapist