Eye Movement Desensitization and Reprocessing (EMDR) was founded by Francine Shapiro in the late 1980s as a type of psychotherapy specifically for the treatment of traumatic memories. Since then, EMDR has been expanded to treat not only singular events (such as a car accident) but also complicated trauma (such as extended exposure to war or other violence) as well as faulty core beliefs (trauma-based beliefs we hold about ourselves or the world that continually cause us trauma).
Here’s what you can expect when participating in EMDR treatment:
It’s not like traditional talk therapy. EMDR has a set protocol that guides the therapist to ask specific questions without responding in any way. This is simply information gathering. At this point, scaling is also used, and the client is asked to scale their level of disturbance with a number between zero and ten. This is a way to measure any changes that occur throughout the course of treatment.
Some sort of device will likely be used to enhance the treatment. I use EMDR pulsers: two plastic pods wired to a device that controls the pods’ vibrations (as well as the speed and intensity of those vibrations). This allows the client to experience controlled, predictable, bilateral stimulation. In its earliest form, EMDR was practiced by therapists moving their raised hands back and forth in front of clients’ faces while the client traced the back and forth movement with their eyes. Some therapists still practice this way (see this sample session for more). Some therapists use a light bar, which moves the light back and forth across a bar to be followed by the client’s eyes. Other therapists tap their clients with their own hands, sometimes on the clients’ legs or the backs of their hands. There are lots of different ways to incorporate the bilateral stimulation; it depends on the therapist’s preference and the client’s comfort. What matters most is that bilateral stimulation is used. The therapist guides the client through sets of bilateral stimulation with guidance to go with whatever comes up mentally, emotionally, and physically.
The actual experience of trauma-focused EMDR is different person-to-person. When I went through it myself, as part of my training in EMDR therapy, the trauma I was working on became very heightened at the beginning, felt even more disturbing at during the first few sets, and then started to shift. By the time my session was complete (less than hour later), my disturbance was very low, near non-existent, and my perspective on the trauma had changed dramatically. It felt like the mess was all cleaned up and everything was put in order; I could make sense of what happened and find meaning in the experience. To this day, that trauma does not disturb me the way it once did.
From both what I’ve read and what I’ve seen, my experience with EMDR is very common. Most clients I’ve worked with report feeling lighter and more peaceful after a complete EMDR session. They often say the trauma feels distant or far away, too far to see clearly. Most clients can’t get worked up about the trauma even when they try to. They often wonder aloud, “Why did that even bother me so much? It seems so inconsequential now.”
The way I imagine EMDR’s effect is by picturing a filing cabinet, its drawers all opened and the files strewn about. Papers everywhere, disorderly and messy. This is the traumatized brain, before EMDR. EMDR facilitates not the quick shoving of files back in the drawers and the hasting locking of the cabinet, but the slow, deliberate, orderly examination of each document and the clear placement of each paper in its rightful place. What’s miraculous to me is how carefully the brain can work during EMDR, which is a short-term treatment method. What takes talk therapy years to unpack and put away may take only a few sessions of EMDR to actively heal from.
In my practice, I use EMDR to support whatever work the client is doing. For those in recovery from addiction, I often use it as a tool to combat shame-based beliefs about the self. For example, a client in recovery may have developed the belief “I’m not good enough,” or, “I’m unlovable.” I use EMDR to target those faulty core beliefs and others like them to ease the disturbance they cause and lessen the power they hold over clients.
For clients working to heal from a specific traumatic experience (whether diagnosed with PTSD or not), EMDR is very effective. Targeting the memory psychosomatically helps bring the trauma up in a controlled, safe environment so it can be observed, reprocessed, and filed away where it goes. This process usually takes two-three sessions of EMDR work and the overall therapy is fairly short-term (two-three months total).
For clients with a long history of exposure to violence or abuse (such as veterans, childhood sexual trauma survivors, first responders, etc.), EMDR is one part of a multi-faceted treatment approach. Because safety is so important to the therapy process, and because EMDR is a form of exposure therapy, the early stages of therapy focus on establishing safety and trust within the therapeutic relationship. Once that’s established, I use EMDR to deactivate some of the most problematic symptoms of the trauma, then move onto treating the traumas themselves. This often takes many months and sometimes years, alongside other treatment methods (group therapy, support groups, medication, family or couples therapy, DBT work, etc.).
Lastly, here’s a list of resources for more information about EMDR: