What Is EMDR Therapy?
What Is EMDR Therapy?
Psychologist Francine Shapiro, PhD, first developed EMDR (eye movement desensitization 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 for the treatment of PTSD but also to alleviate various mental health conditions.
A Q&A with Luz Kyncl, LCSW
Eye movement desensitization and reprocessing is a psychotherapy modality designed to help relieve stress associated with traumatic memories and the negative beliefs linked with the memory. It uses a combination of talk therapy and bilateral stimulation, like eye movements, to do so.
The neuroscience behind EMDR is still emerging, so scientists aren’t quite sure what’s happening in the brain. But an emerging theory is centered around where memories are stored in the brain.
Theoretically, it works like this: Similar to our body, our mind is designed to heal itself naturally. The healing mechanisms mostly occur while we’re sleeping, particularly during REM (rapid eye movement) sleep, where emotional processing and memory consolidation occurs.
But when an event is too overwhelming or traumatic for an individual to process, like repeated distress due to childhood abuse or neglect, the processing 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 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 the negative beliefs that are associated with the memory.
For example, if someone has an unfortunate history of childhood abuse, they may have disturbing memories of the abuse and repressed beliefs it created, like “I am powerless” and “I’m unlovable.” As an adult, when they hear someone raise their voice, it can trigger an emotional response associated with the memories and beliefs that they are powerless and unlovable. And they are likely to act in a way that reflects that belief.
EMDR therapy uses eye movements, like those during REM sleep, to help release an emotional memory from the limbic system so it can be stored in the language center of the brain, where it can become more like a neutral memory of an event in the past. And it creates positive beliefs to associate with the memory. After EMDR therapy, the memory is still present, but it is less distressing and stored as neutral memory of an event in the past.
EMDR therapy involves a combination of talk therapy and eye movements. If, when, and how 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 a longer time getting to know my client and their concerns, then I evaluate whether EMDR would be helpful.
EMDR therapy is performed in eight stages:
History and treatment planning: A client’s history is assessed, and a treatment plan is developed to address the traumatic memories that need to be processed.
Preparation: The client and therapist establish an alliance and set expectations for what’s to come 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 manage emotional stress that can arise during the therapy.
Assessment: During this phase, the unprocessed memory is identified and re-created using images, feelings, sensations, and beliefs. To assess the effectiveness of the treatment, baseline measurements of the unprocessed memory are taken using subjective units of distress (SUD) and validity of cognition (VOC).
SUD is a scale of 0 to 10 that measures the intensity of distress experienced by the client. It is used to evaluate the emotional intensity before and after the treatment.
VOC is used to measure the underlying beliefs associated with the memory. VOC is a scale of one to seven, one indicating that the belief is completely unbelievable and seven representing that it is entirely believable.
Desensitization: The eye movement process begins at this phase as the client focuses on the back-and-forth movements of the therapist’s fingers (or another object of choice) while they think of the traumatic memory. SUD is measured during this process to assess how the treatment is progressing. This process continues until the SUD decreases to zero (or one when appropriate) and new thoughts, images, feelings, and sensations emerge.
Installation: A positive belief, which the client chooses, is linked with the targeted memory and reinforced until it feels completely true to the client.
Body scan: This phase reveals any lingering distress. While thinking of both the memory and the newly created positive belief, the client observes sensations in the body from head to toe. If any tension is felt, this indicates more processing of the memory needs to occur, and the desensitization phase is repeated.
Closure: Before ending the session, the therapist helps the client reach a state of calm and recalibrate to the present moment. Reprocessing is complete when the client has neutral feelings toward the memory, which means SUD is zero; the newly created positive belief feels completely true to the client (or their VOC is seven); and the body is clear of distress associated with the specific memory.
Reevaluation: Each additional session begins with an evaluation of the recently processed memory to determine whether the distress remains low and the positive belief associated with the memory is still strong.
EMDR has been proven to be very effective for healing trauma, and it can often give results in significantly less time than talk therapy alone. But a client must be open to experiencing intense feelings and disturbing thoughts that can arise during the sessions.
It’s been successfully used to treat:
Anxiety and panic attacks
Chronic illness and medical issues
Depression and bipolar disorders
Pain (including phantom limb pain)
Feelings of worthlessness and low self-esteem
Trauma resulting from sexual assault, violence, and abuse
PTSD and CPTSD
You can visit the EMDR International Association site emdria.org to find a trained EMDR therapist in your area.
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Luz Kyncl, LCSW, CHC, MBCT, is a licensed psychotherapist, a certified health coach, and the author of Liberate Yourself: Your Past Is Not Your Prison. With certifications in cognitive behavioral therapy (CBT) and eye movement desensitization reprocessing (EMDR), she integrates both mindful modalities in her practice in Los Angeles where she specializes in depression, anxiety, and childhood trauma. She is also the founder of the Kyncl Family Foundation.
This article is for informational purposes only, even if and regardless of whether it features the advice of physicians and medical practitioners. This article is not, nor is it 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 the views of the expert and do not necessarily represent the views of goop.
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