Question 1

What is EMDR therapy?

Accepted Answer

Eye Movement Desensitization and Reprocessing (EMDR) is an evidence-based therapy developed by Dr. Francine Shapiro that is backed by over 30 years of research.  EMDR helps to activate the brain’s own natural ability to heal from traumatic or highly stressful events and can eliminate emotional triggers and change deeply held negative beliefs about the self.  EMDRIA, which is the organization that oversees the training and certification of EMDR therapists, has a great introductory video on their website: https://www.emdria.org/about-emdr-therapy/

Question 2

What types of issues can EMDR therapy address?

Accepted Answer

Originally developed to treat Post-Traumatic Stress Disorder (PTSD), EMDR is now used to address many different types of issues.  In my therapy practice, I have used EMDR to help clients with:
Trauma & PTSD
Grief & Loss
Depression
Low Self-Esteem
Anxiety, Panic Attacks & Phobias
Stress Management
Improving Relationships
Navigating Life Transitions
Improving Performance & Productivity
General Personal Growth
And More!

Question 3

How can EMDR therapy help me?

Accepted Answer

EMDR therapy can help you:
Learn techniques to change your emotional state in a given moment from negative (anxiety, fear, anger, sadness, resentment, frustration, envy, etc.) to neutral (calm, relaxed, peaceful, content, etc.)
Learn techniques to temporarily contain distressing or disturbing feelings, thoughts, images and memories until they can be addressed in therapy
Have more control over unpleasant feelings, thoughts, images, impulses or memories, rather than letting them control you, feeling helpless and suffering with them
Strengthen your known resources, including happy memories, supportive relationships, spiritual beliefs, enjoyable hobbies, personal strengths, positive characteristics, self-care routines and coping skills, and also develop new ones
Identify which past events are contributing to your current problems and reprocess these memories in order to prevent your past from continuing to intrude on your present
Decrease mental health symptoms, improve your relationships, resolve problems in your life and experience positive shifts in how you feel about yourself, others and the world

Question 4

How do I know if I have memories that might need to be reprocessed with EMDR therapy?

Accepted Answer

In EMDR therapy, we believe our brains naturally process new information in a way that moves us towards greater understanding, growth and well-being.  However, when you have experiences that are highly stressful or emotionally overwhelming, the brain’s ability to appropriately process what happened may become overloaded and not work well.  The memories of these experiences are then fragmented, frozen or not fully processed.  These memories can intrude upon the present and cause a number of problems, including:
You feel “triggered” in situations that remind you in some way of a trauma, loss or other negative experience,
You feel “numb” or “shut down” in certain situations or in general
You experience panic attacks, flashbacks, nightmares or night terrors
You have difficulty sleeping or unexplained physical symptoms
You react in situations in ways that feel justified at the time but later seem to have been out of proportion or that others call “immature” or an “overreaction”
You have reactions, emotions or behaviors that you wish you could control or get rid of, feel ashamed of or embarrassed by, have mixed feelings about or do not understand
You are aware of troubling patterns that seem to reoccur in your life, for example, in relationships or in jobs
You feel like your logical brain and your emotions are in conflict with each other (for example, you logically know you are safe, capable, worthy of love, etc. but emotionally feel like you are unsafe, incapable, unworthy of love, etc.)
EMDR therapy can help you understand why these things happen and reprocess the associated memories.  EMDR memory reprocessing jump starts the brain’s innate healing ability and leads to a decrease in these types of problems.

Question 5

If I’ve never experienced a trauma or can’t remember what happened, will EMDR still work for me?

Accepted Answer

There are different ways of defining “trauma.”  In EMDR, anything highly stressful or emotionally overwhelming could be a trauma.  Something may have been traumatic on a neurobiological level, whether or not you (or others) easily recognize it as a trauma.  Any event that was not well processed by the brain at the time that it occurred may need to be reprocessed with EMDR therapy.

These events may have been big traumatic events, ongoing stressful situations or even seemingly insignificant moments.  They may have taken place a long time ago or only recently.  You may or may not already know what memories need to be processed, or you may think you know but then discover that other memories altogether need attention.  There are also EMDR techniques that allow us to reprocess an event even if you have no conscious memory of what happened.

Question 6

How is EMDR therapy different from cognitive or talk therapy?

Accepted Answer

EMDR is different than traditional talk therapy.  While of course we talk with each other in our therapy sessions, we do not just talk through a problem and try to understand it logically.  Many people come to EMDR therapy after years of trying to address a problem on a cognitive level in therapy, with limited success.

You may have lots of great insight, understand a problem logically, know where your triggers come from and have coping skills to manage your emotional reactions.  However, you may find that triggers still continue to occur and that when you are triggered you have difficulty applying the cognitive skills you have learned.  EMDR works on a neurobiological level to effect deep emotional change, with the goal of eliminating these triggers altogether.

Another difference is that in EMDR therapy you do not necessarily need to talk about the past experiences in great detail in order to heal from them.  This is helpful for a lot of people since many of these memories can be painful and hard to discuss.  The therapy takes place within your own brain, not primarily in discussions between you and me.

Question 7

Is EMDR like hypnosis, or will it erase my memories?

Accepted Answer

In EMDR therapy, you might sometimes follow a finger, pointer or light back and forth with your eyes, from side to side.  This seems similar to the classic portrayal of hypnosis, in which you would follow a watch swinging back and forth.  However, EMDR is not hypnosis.  In EMDR therapy, you remain fully aware and in control of yourself at all times.
 
EMDR also does not erase memories.  Some people report that traumatic memories feel further away after EMDR reprocessing or that it seems more difficult to bring a disturbing image to mind or that it seems fuzzy.  However, you still remember that the event took place and what happened.  The memory is still there, but it no longer feels as upsetting or disturbing.

Question 8

If I am involved in a court case related to my trauma, is it okay to do EMDR therapy?

Accepted Answer

This should be discussed on a case-by-case basis.  It is often advisable to wait until after the trial before reprocessing the memory of the trauma.  EMDR memory reprocessing decreases the level of distress you feel related to a memory, and opposing lawyers may point to your lack of distress to suggest that you were not really traumatized.  There may also be a concern that your memories have been “tampered with” and that you are therefore no longer a reliable witness.
 
However, you may still be able to do a lot of helpful EMDR work before your trial.  We can use resourcing (see below) to help you have better control over your trauma triggers, and we can use memory processing to work on other memories, without touching the memory of the traumatic event that is the focus of your trial.  Both of these can help you feel better overall and improve functioning in your daily life, and neither of these should affect your trial.  Once the trial is over, then we could work on reprocessing the memory of the event that was the focus of the trial.
 
In some cases, you may feel that the level of distress you are experiencing is so high that you want to go ahead and process the memory of the traumatic event itself, even before the trial.  We would talk about this together, and I would also advise you to discuss it with your lawyer.  Ultimately, whether or not to do the memory processing will be your decision, as long as you understand the risks of how it might affect your trial.

Question 9

Can EMDR therapy be done effectively via telemental health?

Accepted Answer

Yes, EMDR therapy can be done effectively via telemental health.  It seems to work just as well as in-person EMDR therapy for most clients.  There are some clients for whom telemental health may not be appropriate in general, but that is true whether using EMDR or another type of therapy.

Question 10

What are the phases of EMDR therapy?

Accepted Answer

EMDR therapy has eight phases, beginning with history taking and preparation and then moving into the EMDR memory reprocessing itself.  These phases create a structure to ensure the best possibility of success.  EMDR also uses a three-pronged approach, targeting past memories, present difficulties and imagined future scenarios, all related to the same issue that you want to address.

The eight phases are not always completely linear.  For example, I often start phase two before I have fully completed phase one and then continue them both concurrently.  It is also common to return to phases one and two later in therapy if necessary to gather more information, provide more education and/or develop additional resources.

During the memory reprocessing phases of EMDR therapy, we use a scale called Subjective Units of Distress (SUD).  This scale uses numbers from 0 to 10 to measure how much distress a memory or other target is causing you in the present.  I will periodically ask you for this number to gauge how things are going.  The ultimate goal is for the SUD to go down to zero, although this does not always happen in a smooth, linear way.  You should not be surprised if the SUD seems “stuck” for a while or if it goes down but then goes back up again.  These ups and downs are a normal part of the process.

You can learn more about the eight phases on EMDRIA’s website: https://www.emdria.org/about-emdr-therapy/experiencing-emdr-therapy/

Question 11

What is EMDR resourcing?

Accepted Answer

Resourcing (also called resource development and installation or resource tapping) is a set of techniques to strengthen existing resources and develop new ones.  Existing resources can be anything positive, for example, happy memories, supportive relationships, self-care routines, enjoyable hobbies, spiritual beliefs, personal strengths or positive characteristics and healthy coping skills.  Resourcing strengthens these things in your brain.  This helps you to be more aware of your resources and more likely to use them when you need them, and it can also help you feel better about yourself and more in control of your emotions in general.  I will also help you develop new resources.  You might create resources in your imagination, draw pictures or use things from books or movies that you like.  There are many creative ways to help you build the resources that you need.

Your resources then become the foundation that allows us to do the EMDR memory reprocessing successfully.  They provide you with ways to cope and stay in control if the processing is difficult and help you to feel calm again at the end of a session.  In some cases, we can also use them to add something to the memory that was needed but missing at the time of the original event.

Question 12

How can EMDR help me change negative beliefs about myself?

Accepted Answer

Trauma memories are associated with negative core beliefs.  A negative core belief is a negative belief you have about yourself that shows up in different situations.  Negative core beliefs usually develop in childhood, and everyone has them.  They are emotional, not rational.  We often know logically that they are not true, even though they feel true.  I will help you identify the negative core beliefs that are causing problems for you and then something positive that you would rather believe instead.

These beliefs are incorporated into the EMDR processing in a way that helps the negative belief shift and evolve into the desired positive belief.  We use a scale called Validity of Cognition (VoC) to monitor this change.  The VoC scale uses numbers 1 to 7 to measure how true the desired positive belief feels to you in a given moment.  The ultimate goal is for the VoC to go all the way up to 7, which shows that the positive belief has become stronger.

Question 13

What is the Triune Brain, and how does it relate to EMDR therapy?

Accepted Answer

The structures in the brain can be grouped in three general categories, called the Triune Brain.  These parts are each known by different names, but here is a basic guide.  The lowest part of the brain is the survival brain.  The middle part is the emotional brain.  The upper part is the logical brain.  These parts of your brain all work together at times, but they also function somewhat separately.

When you experience a highly stressful or emotionally overwhelming event, the logical brain mostly goes offline, and the emotional and survival parts take over.  This has advantages if you are in real danger.  You don’t want to stop and think too much if you have to get away from a lion; you just need to survive.  However, the brain responds to perceived danger, imagined danger and reminders of danger in the same way that it does to actual danger.  As a result, the logical brain can go offline and let the emotional and survival brains take over even when you are not really in danger.  This is what people often refer to as feeling “triggered.”

If you have experienced a trauma, a part of your emotional brain may be stuck at the age you were when the trauma occurred.  This can cause you to have emotional reactions that feel younger than your chronological age.  It can also cause a sort of tug-of-war between your logical (mature, rational) brain and your emotional (stuck, traumatized) brain.  You might know that something is logically untrue, but yet you still feel like it is true.  For example, you may feel like you’re still in danger even when you logically know that you’re safe.  EMDR helps to resolve these issues by getting the information you already have in your logical brain connected to your emotional brain.  This helps the emotional brain get unstuck and calm down.  The logical brain is then less likely to get knocked offline, and you are less likely to feel “triggered.”

Question 14

What is bilateral stimulation?

Accepted Answer

Bilateral stimulation (BLS) is a gentle, painless and non-invasive way of stimulating the right and left hemispheres of the brain in an alternating rhythm.  BLS can be used to build and strengthen coping skills and other resources and to reprocess old memories.  We are still learning about how and why BLS works.  One theory is that BLS helps the logical brain and emotional brain communicate better with each other.  The logical brain can then update the emotional brain with information that has been acquired since the time when the emotional brain got stuck, which in turn helps it to get unstuck.

There are many different methods of BLS delivery.  You might follow a finger or pointer with your eyes as it moves back and forth in front of your face or follow a light or a ball moving from side to side on a screen.  Alternatively, you might listen to tones or clicks going from ear to ear, tap on the left and right sides of your own body or hold small buzzers in your hands that gently vibrate one at a time.  We will work together to identify which type of BLS is best for you.

Another theory about why BLS works is that it helps to keep you grounded in the present while you revisit memories from the past.  When you experience a traumatic or extremely stressful event, some part of your brain does not seem to recognize that the event is over and in the past.  This is why you might feel like you are reexperiencing the event over and over again.  Using BLS seems to help the brain fully understand that event is over and in the past because it helps you keep one foot in the present at all times.

Question 15

How is EMDR related to REM sleep?

Accepted Answer

In the REM phase of the sleep cycle, your eyes move quickly from side to side, which is a form of bilateral stimulation (BLS).  One theory is that this may be connected to the processing and consolidation of memories.  By using BLS while you are awake, we can therefore reprocess memories that were not fully processed before.

We think memory processing occurs in a part of the brain called the hippocampus.  During REM sleep, other parts of the brain feed information to the hippocampus for the formation of the memory, including sensory information, emotional information and logical information.  The logical information, which comes from a part of the brain called the neocortex, supports making meaning out of what happened and understanding that it is in the past.

After an event that is highly stressful or emotionally overwhelming, the neocortex is quiet during REM sleep.  The logical and meaning making information and the understanding that the event is over and in the past do not get incorporated into the new memory.  You may then be aware of this information in your logical brain, but it is not connected to the memory in your emotional brain, which explains the sense that your logical and emotional brains are having a "tug-of-war."  By using EMDR therapy to reprocess the memory while you are awake, we integrate these important missing pieces into the memory.

Question 16

What is Flash Technique?

Accepted Answer

Flash Technique (FT) is an EMDR technique developed by Dr. Philip Manfield.  FT helps to decrease the emotional distress associated with a memory without having to think about the memory itself.  This can be helpful if a memory is too upsetting for you to think about even a little bit or if thinking about a memory at all causes you to have a panic attack, feel unsafe or experience other types of severe emotional reactions.  We might use FT first to decrease the emotional distress associated with the memory so that you will not feel as triggered when we do the EMDR memory reprocessing.  You can learn more about FT at https://flashtechnique.com.

In a mental health crisis, call or text 988 or go to the nearest emergency room. For other emergencies, call 911.

Heather Baron, MEd, MSS, LCSW

About EMDR