Eye Movement Desensitization and Reprocessing (EMDR) is a contemporary, interactive therapeutic approach designed to address the emotional distress stemming from traumatic memories. Created by psychologist Francine Shapiro in 1990, EMDR’s objective is the reprocessing and integrating traumatic memories into the client’s existing biographical memory framework.
EMDR combines bilateral hand movements, cross-body tapping, or side-to-side eye movements with structured dialogue therapy in a controlled setting. This helps people to process the negative sensations, emotions, and distressing images tied to traumatic recollections, thereby addressing the core of the problem and alleviating trauma-related symptoms. EMDR is backed by substantial research and is recognised as a highly effective integrated psychotherapy technique for trauma treatment.
The Process of EMDR
EMDR therapy facilitates the reprocessing and transformation of traumatic memories in a way that renders them no longer psychologically disruptive. This structured approach consists of eight phases:
- Evaluation:
The assessment determines the client’s readiness for EMDR therapy and develops a treatment plan, considering past and present distressing memories.
- Preparation and Resourcing:
The therapist equips the client with coping resources for potential emotional stress during EMDR, teaching grounding techniques, relaxation, and stress management.
- Assessment and Selection:
The client chooses a specific memory linked to their target experience, identifying vivid images, negative beliefs, emotions, and sensations. A positive memory is also noted for comparison.
- Desensitisation:
Guided by the therapist, the client focuses on the negative memory while undergoing bilateral stimulation (BLS) through eye movements, auditory cues, or tapping. The therapist asks questions, and the client shares their experiences.
- Installation:
Once desensitisation is complete, the client associates a positive belief with the memory, strengthening it during faster bilateral stimulation.
- Body Scan:
After each EMDR action, the client scans for physical discomfort associated with the memory. This process repeats until all somatic distress is resolved.
- Closure:
Sessions end in a calm state. The therapist reviews the session, discusses progress, and may encourage journaling between sessions. Reprocessing concludes when the client feels neutral about the memory, fully accepts the positive belief, and experiences no somatic distress.
- Re-evaluation:
The following session involves reflecting on addressed memories and feelings, rating disturbance levels, and assessing progress.
EMDR therapy systematically reshapes traumatic memories, reducing their psychological impact and enhancing overall well-being.
Theory Behind The Therapy
The underlying theory behind EMDR therapy’s success is the Adaptive Information Processing (AIP) model. This model suggests that trauma can become lodged in the brain’s neural network, causing the recall of traumatic memories to trigger negative emotions, sensations, and responses.
EMDR aims to reprocess these memories by introducing adaptive emotions through bilateral stimulation, forming new neural pathways in the brain. This process facilitates access to and reprocessing of the stuck trauma, leading to reduced emotional distress, the establishment of new associations with traumatic memories, and the emergence of healthier adaptive behaviours.
Understanding How Trauma Affects Memory: A Brief Overview
In order to understand how EMDR therapy works, it is helpful to know how traumatic memories are stored and how they affect the brain. Traumatic memories disrupt normal brain processing, leading to fragmented recall and vivid sensory fragments. High arousal levels impede the hippocampus during a traumatic event, impairing the brain’s ability to properly store and retrieve event details.
Elevated arousal levels, coupled with emotional and somatic stress, impact the hippocampus, impairing the brain’s capacity to accurately store and retrieve event specifics, including their chronological order. Trauma memories are frequently described as being stored ‘without a timestamp, which causes people to retain only fragmented sensory details. This also causes a sense of imminent fear and danger when sensory information relating to the trauma is processed – without a ‘timestamp’ the event feels like it is happening again in the moment, as awful and intense as it was the first time.
The stress response also activates the amygdala, which causes the ‘thinking brain’ (neocortex and prefrontal cortex) to shut down and the brainstem to take over. This leaves trauma memories improperly stored, manifesting as sensory fragments, nightmares, and flashbacks long after the trauma.
EMDR’s Approach to Targeting Trauma Memories
EMDR, rooted in Shapiro’s information processing theory, aims to reprocess traumatic memories by linking them with adaptive information. Memories are connected to positive beliefs, fostering appropriate emotional storage.
In EMDR therapy, clients identify target memories and associated positive thoughts. They recall the event while undergoing bilateral stimulation (e.g., rhythmic eye movements, auditory or tactile cues), reducing anxiety. This allows for desensitised exploration and detachment from the traumatic memory. The limbic system stores new sensory data and associations, enabling clients to reframe the trauma positively and repeatedly reprocess the associated feelings. EMDR expedites information processing, facilitating adaptive resolution and reprocessing of traumatic memories.
The Promise of EMDR Therapy Research
EMDR therapy, with its standardised eight-step protocol, is designed to address various past events or memories, not limited to trauma, that contribute to a client’s present issues. This approach can also target specific emotions or reactions associated with these memories.
Research into EMDR therapy has yielded promising results, with around twenty controlled studies having validated its effectiveness in treating PTSD, while numerous other studies have demonstrated its efficacy in managing a wide range of disorders, including anxiety disorders and phobias.
EMDR’s capacity to expedite information processing empowers individuals to access positive reframing and replace distressing feelings linked to trauma. Ultimately, EMDR therapy, in the hands of a skilled therapist, provides a supportive space for individuals to navigate their traumatic experiences, fostering healing, resilience, and well-being for a brighter future.
Endnotes:
- Shapiro, F., (2002). Paradigms, Processing, and Personality Development. In F. Shapiro [Ed.]. EMDR as an Integrative Psychotherapy Approach; Experts of Diverse Orientations Explore the Paradigm Prism. Washington, D.C.: American Psychological Association Books.
- Oren, E & Solomon, R. (2012) EMDR therapy: An overview of its development and mechanisms of action. European Review of Applied Psychology, Volume 62, Issue 4. https://doi.org/10.1016/j.erap.2012.08.005