What is EMDR therapy?
What is EMDR therapy?
Psychologist Francine Shapiro, PhD, first developed EMDR (eye movement desensibilization and reprocessing) for the treatment of post-traumatic stress disorder in 1987. Thirty-five years later, EMDR therapy has become more and more mainstream – and is used not only to treat PTSD, but also to relieve various mental disorders.
A Q&A with Luz Kyncl, LCSW
Eye movement desensitization and re-treatment is a psychotherapy modality designed to help relieve stress associated with traumatic memories and the negative beliefs associated with memory. It uses a combination of talk therapy and bilateral stimulation, like eye movements, to do that.
The neuroscience behind EMDR is still emerging, so researchers are not entirely sure what is happening in the brain. But a new theory is centered around where memories are stored in the brain.
Theoretically, it works like this: Like our body, our mind is designed to heal itself naturally. The healing mechanisms occur mostly while we sleep, especially during REM sleep (rapid eye movements), where emotional therapy and memory consolidation take place.
However, when an event is too overwhelming or traumatic for a person to process, such as repeated distress due to abuse or neglect in childhood, the treatment during sleep is not enough and the memory remains unprocessed.
Unprocessed memories are stored in the emotional memory part of the brain – the limbic system – instead of in the cortex, where the memories are stored using language. When stored in the limbic system, memories can be easily triggered, causing the person to repeatedly activate the emotional stress and negative beliefs associated with memory.
For example, if someone has an unfortunate history of childhood abuse, they may have disturbing memories of the abuse and repressed beliefs that it created, such as “I am powerless” and “I am unloving.” When they as an adult hear someone raise their voice, it can trigger an emotional reaction associated with the memories and the belief that they are powerless and unloving. And they are likely to act in a way that reflects that belief.
EMDR therapy uses eye movements, such as those during REM sleep, to help release an emotional memory from the limbic system so that it can be stored in the brain’s language center, where it can become more like a neutral memory of an event in the past. And it creates positive beliefs to associate with memory. After EMDR therapy, the memory is still present, but it is less worrying and stored as a neutral memory of an event in the past.
EMDR therapy involves a combination of talk therapy and eye movements. Whether and when EMDR is used in a session depends on the client. If a client requests EMDR, I use the therapy immediately in a session. Other times, I spend more time getting to know my client and their concerns, then I assess whether EMDR would be helpful.
EMDR therapy is performed in eight steps:
History and treatment planning: A client’s history is assessed and a treatment plan is drawn up to address the traumatic memories that need to be processed.
Preparation: The client and the therapist establish an alliance and set expectations for what is to happen in the session. After the EMDR process is thoroughly explained, the client’s concerns and questions are addressed, and coping techniques are created to help the client deal with the emotional stress that may arise during therapy.
Assessment: In this phase, the raw memory is identified and recreated using images, feelings, sensations and beliefs. To assess the effectiveness of treatment, baseline measurements of untreated memory are taken using subjective units of distress (SUD) and validity of cognition (VOC).
SUD is a scale from 0 to 10 that measures the intensity of suffering that the client is experiencing. It is used to evaluate the emotional intensity before and after treatment.
VOC is used to measure the underlying beliefs associated with memory. VOC is a scale from one to seven, where one indicates that the belief is completely incredible, and seven represents that it is completely credible.
Desensitization: The eye movement process begins at this stage, as the client focuses on the therapist’s movements back and forth (or another choice of object) while thinking about the traumatic memory. SUD is measured during this process to assess how the treatment is progressing. This process continues until the SUD drops to zero (or one when appropriate) and new thoughts, images, feelings, and sensations emerge.
Installation: A positive belief that the client chooses is attached to the targeted memory and reinforced until it feels completely true to the client.
Body scan: This phase reveals any persistent distress. While thinking about both the memory and the newly created positive faith, the client observes sensations in the body from head to toe. If any tension is felt, this indicates that more memory processing is required and the desensitization phase is repeated.
Closure: Before the end of the session, the therapist helps the client to reach a state of calm and recalibrate to the present. Reprocessing is complete when the client has neutral feelings towards the memory, which means that the SUD is zero; the newly created positive belief feels completely true to the client (or their VOC is seven); and the body is free from the distress associated with the specific memory.
Reassessment: Each additional session begins with an evaluation of the newly treated memory to determine if the need remains low and the positive beliefs associated with the memory remain strong.
EMDR has been shown to be very effective in curing trauma, and it can often yield results in significantly less time than talk therapy alone. However, a client must be open to experiencing intense emotions and disturbing thoughts that may arise during the sessions.
It has been successfully used to treat:
Anxiety and panic attacks
Chronic illness and medical problems
Depression and bipolar disorder
Pain (including phantom pain)
Feelings of worthlessness and low self-esteem
Trauma as a result of sexual assault, violence and abuse
PTSD and CPTSD
You can visit the EMDR International Association website emdria.org to find a trained EMDR therapist in your area.
Luz Kyncl, LCSW, CHC, MBCT, is a licensed psychotherapist, certified health coach and author of Free yourself: Your past is not your prison. With certifications in cognitive behavioral therapy (CBT) and eye movement desensitization gene therapy (EMDR), she integrates both mindful modalities into her practice in Los Angeles, where she specializes in depression, anxiety and childhood trauma. She is also the founder of Kyncl Family Foundation.
This article is for informational purposes only, though and whether it contains advice from physicians and physicians. This article is not, and is not intended to be, a substitute for professional medical advice, diagnosis or treatment and should never be relied upon for specific medical advice. The views expressed in this article are those of the expert and do not necessarily represent the views of goops.
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