About EMDR

Eye Movement Desensitization and Reprocessing (EMDR) is an evidence-based therapy developed by Dr. Francine Shapiro that is backed by over 35 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/Originally developed to treat Post-Traumatic Stress Disorder (PTSD), EMDR is now used to address many different types of issues. In my practice, I use EMDR to help clients with:Trauma, including PTSD, complex trauma (or cPTSD), attachment trauma, developmental trauma, physical or sexual abuse or assault, emotional abuse, neglect, unmet needs, relationship ruptures, adverse life circumstances, preverbal or in utero trauma and transgenerational traumaComplicated bereavement or traumatic lossAnxiety, including generalized anxiety, social anxiety, fears or phobias, fear of abandonment or separation distress, persistent or irrational worries and panic attacksRelationship issuesStress managementPersonal growth

Our brains naturally process new information in a way that moves us towards greater understanding and well-being.  However, the brain has difficulty fully processing experiences that are highly stressful or emotionally overwhelming.  You can then develop a range of problems related to these memories. EMDR can help you understand why these things happen and reprocess the associated memories to activate the brain’s innate healing ability and decrease these types of problems. You might be able to benefit from EMDR if: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 generalYou experience panic attacks, flashbacks, nightmares or night terrorsYou have difficulty sleeping or unexplained physical symptomsYou 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 understandYou are aware of troubling patterns that seem to reoccur in your life, for example, in relationships or in jobsYou 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:Learn techniques to shift your emotional state in a given moment from negative (anxiety, fear, anger, sadness, resentment, frustration, envy, etc.) to positive or 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 therapyHave more control over unpleasant feelings, thoughts, images, impulses or memories, rather than letting them control you, feeling helpless and suffering with themStrengthen 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 onesIdentify 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 presentDecrease 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

EMDR can be a short-term or long-term therapy, depending on the situation, and it involves several components besides just the memory reprocessing.  These include talking through your history, understanding how your current day issues relate to past experiences, strengthening and enhancing positive things in your life (for example, happy memories, supportive relationships, self-care routines, enjoyable hobbies, spiritual beliefs, personal strengths or positive characteristics and healthy coping skills) and developing new skills and resources.  Doing these things first helps the brain to be able to reprocess the memories in a healthy way. EMDR memory reprocessing can be different for different people.  You may or may not experience intense emotions (sadness, anxiety, anger, shame, etc.) or uncomfortable body sensations.  You may or may not have distressing memories or images come up in your mind.  Some people also see colors or smell odors.  As you continue to process, the distressing aspects of this start to subside, and your brain brings in more positive understandings and connections.  As this happens, the memories become less distressing, your nervous system becomes less easily triggered and negative thoughts and feelings you have about yourself start to change.  This sometimes happens quickly or can sometimes take several sessions. EMDR therapy has eight phases, although they’re not always completed in a linear way.  We also try to do at least some work in each of three “prongs,” which include past memories, present triggers and future triggers.  I’ll explain everything as we go along, but if you want to learn more in the meantime, you can visit EMDRIA’s website: https://www.emdria.org/about-emdr-therapy/experiencing-emdr-therapy/

We have over 35 years of research showing that EMDR works, but we don’t fully understand how or why.  There are several theories.  Here are just a few… In the REM phase of sleep, your eyes move back and forth very quickly, even though you’re not consciously aware of it.  We also think that REM sleep is when the brain processes events of the day and consolidates memories for long-term storage.  One theory is that the eye movements somehow help the brain process, and this is replicated by the eye movements in EMDR therapy.  Since you’re awake and consciously aware, you can include more helpful information in your processing than what might randomly come up while you’re sleeping.  We’ve also found that other things mimic eye movements, including tapping your shoulders or your knees, listening to audio tones and holding gentle buzzers.  We call these back and forth activities “bilateral stimulation” or BLS. BLS might also help in other ways.  We believe it keeps you grounded in the present while processing a distressing memory, which helps the brain recognize that the traumatic event is over and in the past.  We also believe it somehow helps the logical part of the brain communicate information to the emotional part of the brain that otherwise was being kept separate, though we don’t fully understand how. The other main theory is that EMDR taxes working memory.  Working memory is a network in the brain that temporarily holds the information that you need to access in any given moment.  Any time something is brought into working memory, it can be changed before it is put away again in long term storage.  Working memory can only hold a limited amount of information at one time, so it’s possible that asking the brain to hold the traumatic memory in working memory and also do other tasks at the same time, like following BLS, overloads (or “taxes”) working memory.  This changes the memory before it goes back to long term storage so that it is no longer distressing.  It’s almost as if the brain says, “Well, if I can think about this memory and do these other things at the same time then it must not be such a problem anymore.” We’ve also found that many other things can tax working memory besides BLS, and we might use some of these other techniques in our work together.

Many people come to EMDR therapy after years of trying to address a problem in cognitive or talk therapy, with limited success. You may have developed a lot of insight, logical understanding about why you get triggered and great coping skills, but when you are triggered you might still feel overwhelmed or have difficulty using those skills. EMDR goes deeper than just talking and works on a neurobiological level with the ultimate goal of eliminating the triggers altogether.In EMDR therapy, you also 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 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.

Something may have been traumatic on a neurobiological level, whether or not you (or others) easily recognize it as a trauma. Any events that the brain did not process well at the time that they occurred might benefit from being reprocessed with EMDR. They may have been big traumas, ongoing stressful situations or even seemingly insignificant moments. They may have taken place a long time ago or only recently, and you may or may not already know which memories need to be processed. There are also EMDR techniques that allow us to reprocess an event even if you have no conscious memory of what happened.

In EMDR, you might sometimes follow something 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 swinging watch. However, EMDR is not hypnosis, and you remain fully aware and in control of yourself at all times. EMDR also does not erase memories. After doing EMDR, some people report that traumatic memories feel further away, more difficult to picture or fuzzy, but you will still remember what happened. The memory is still there, but it no longer feels as upsetting or disturbing.

It is often advisable to wait until after the trial before reprocessing the memory of the trauma. EMDR decreases the distress you feel related to a memory, and lawyers may suggest this means you were not really traumatized or claim your memories have been “tampered with.” You may be able to do other EMDR work before your trial, however, including learning techniques to feel more in control of your triggers and reprocessing memories that are not the focus of your trial. Then after the trial is over, we could reprocess the memory of that event. Or, your distress may be so high that you want to process the memory of the event before the trial. That would be your decision as long as you understand how it might affect your trial.

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