What is EMDR?
Many therapists and patients alike are curious to know, “What is EMDR?”
EMDR stands for Eye-Movement Desensitization and Reprocessing. This blog post is a guide to help everyone learn more about EMDR; specifically, how it is utilized to treat PTSD.
This blog post will answer several questions:
- What is EMDR and How Does it Work?
- What are Core Beliefs?
- How Does Someone Become an EMDR Therapist?
- How Does EMDR Help to Treat PSTD?
- What is Trauma?
- What is Desensitization and Reprocessing?
- How Do Eye-Movements and Bilateral Stimulation Work?
- Bonus: Read About How I Combine Yoga and EMDR (VIDEO INCLUDED)
How Does EMDR Work?
Eye-Movement Desensitization and Reprocessing (EMDR) is an evidence-based therapy modality. It can be utilized by Licensed Professional Therapists to treat a variety of mental disorders.
An EMDR therapist utilizes bilateral stimulation to help individuals develop coping skills, strengthen resources, and process traumatic memories.
EMDR utilizes bilateral stimulation to integrate both hemispheres of the brain. It allows individuals to safely explore traumatic or core memories. Furthermore, when the memories are explored, new insights are gained. As a result, the individual may walk away with clarity, peace, or new meaning around the traumatic event.
EMDR is successful when an individual is able to revisit traumatic or core memories with a new frame of mind. Individuals will be able to revisit traumatic memories without re-experiencing the trauma. They will have enhanced resiliency and coping skills. This includes revisiting memories with positive self-talk or positive beliefs about themselves. This is where core belief work comes into play.
What are Core Beliefs?
Core beliefs are messages that an individual interprets as true. They can be both positive and negative. Core beliefs can be either overtly stated or perceived.
For example, a common negative core belief is “I am unlovable.” Individuals with this core belief may have had parents who expressed that they did not love them. However, they also may have endured abuse or neglect that led them to perceive themselves as unlovable.
Alternatively, an individual may have a positive core belief. To reverse our earlier example, they may believe “I am lovable and capable of love.” This may be the result of parents that routinely expressed their love or affection for them.
Core beliefs are usually created in childhood and sustained throughout the lifespan. However, they can also be created later in life. For example, a child that was neglected or abused may find close relationships with friends or a loving partner later in life. As a result, they may begin to believe they are lovable, despite a childhood that suggested otherwise.
For individuals that are not so lucky, EMDR can successfully create positive core beliefs. In fact, core beliefs are an integral aspect of EMDR therapy.
The following handout is designed to help both therapists and their patients uncover core beliefs. It may assist with replacing negative core beliefs with positive ones. This handout is not meant to substitute mental health therapy.
How Does Someone Become an EMDR Therapist?
For the purposes of this blog, therapists include Social Workers, Psychologists, Counselors, and Marriage and Family Therapists.
In order for a therapist to become trained in EMDR, they must complete 40 hours of training. The Eye-Movement Desensitization and Reprocessing International Association (EMDRIA) states the 40 hours should include 20 hours of instruction, 10 hours of supervised experience, and 10 hours of consultation.
However, several more steps need to occur before an individual becomes an EMDRIA Certified EMDR Therapist.
First, they must complete their basic training. Second, they must become fully licensed in their field of study. Third, they must practice EMDR with at least 25 clients and 50 EMDR sessions. Fourth, they must have 20 hours of supervision with an EMDRIA Approved Consultant. Fifth, they should obtain a letter of recommendation from their consultant and two professionals. Finally, they will obtain 12 continuing education credits in EMDR.
Rest assured, an EMDRIA Certified EMDR Therapist has done their due diligence to provide informed, safe, and effective EMDR therapy.
How Does Trauma Occur?
Trauma occurs when memories are incorrectly stored. As a result, the memory is often “triggered.” In this example, a trigger is anything that causes a memory to resurface as if it is happening in the present moment. This is called a “flashback.” Triggers include people, sounds, sights, events, or even seasons.
An individual with PTSD will relive their traumatic memory as if it is happening in real time. This can happen both in their waking lives and within their dreams. The individual will react physically, emotionally, and mentally as if they are experiencing a traumatic event.
An individual experiencing a flashback will enter their fight-flight-or-freeze response. In other words, their sympathetic nervous system is dominant. Therefore, their muscles will tense, their heart rate will increase, their breathing will be short and constricted in their chest, and their higher order thinking will go offline.
A flashback can be highly distressing for individuals with PTSD. It can lead to feelings of being unsafe, unstable, or even lead to thoughts of suicide. Individuals with PTSD may feel like they are helpless and that their condition is hopeless. However, that could not be further from the truth. PTSD is a treatable condition.
Many individuals with PTSD often practice avoidance. They will avoid any triggers that may result in reliving the traumatic memory. Therefore, people with PTSD are often socially isolated. Furthermore, they are reticent to discuss traumatic memories with a therapist. However, EMDR therapy does not require individuals to engage in therapy in the traditional sense.
How Does EMDR Help to Treat PTSD?
There is strong research to support the use of EMDR to treat Post-Traumatic Stress Disorder (PTSD). Therefore, EMDR is an evidence-based intervention for the treatment of trauma. EMDR utilizes bilateral stimulation to access deep areas of the brain where trauma is stored.
Individuals who experience PTSD literally cannot “think” themselves out of trauma. Their thinking brain is no longer readily available to them during a flashback. This is why traditional talk therapy is ineffective for individuals with PTSD.
The best thing about EMDR is that is does not require an individual to discuss their trauma. Instead, they visualize a moment in time that captures the traumatic memory with the help of their therapist. Then, utilizing bilateral stimulation, the therapist will assist them in processing the traumatic memory. This allows patients to access their trauma in a way that is safe and under the guidance of a professional.
However, this does not occur until the client has practiced several grounding and coping skills. In EMDR therapy, the client will create a “calm place” they can visualize whenever the memories become too distressing. They will also create a “container” to store any residual emotions that linger after a therapy session.
The EMDR therapist will follow a strict protocol. They will prepare their patient for every step of the journey. Safety is at the forefront of every EMDR session.
Olivia Schnur
EMDR therapy can take several weeks, months, or even years. This will vary widely based on a variety of factors. Nevertheless, all EMDR sessions should begin with a trust, safety, and a supportive connection between the therapist and their patient.
What is “Desensitization and Reprocessing”?
Imagine that individuals who have sustained trauma have a big button in the center of their brain. I like to envision the “easy button” from the Staples commercial. Because trauma is not properly stored, the button is constantly getting pushed (AKA: Triggered).
EMDR helps to shrink that “easy button” and store is somewhere that it is only accessed when the patient wants to revisit it. Furthermore, it no longer causes the individual to re-experience the event. This is the “reprocessing” part of EMDR.
The patient will re-process the trauma. However, they do not need to re-live the trauma. The EMDR therapist helps to ground the patient in the present moment, while exploring their traumatic memory.
The “desensitization” piece helps to create safety and internal resources for the patient. I like to imagine a big button called “safety” stored in the patient’s brain. The button is so big that whenever a trigger threatens to cause a flashback, the safety button is pushed, and the client is able to cope with their trigger.
However, I would like to clarify this is just an analogy. In reality, a therapist is teaching their patient coping skills, self-care, and safety planning to assist during mental health emergencies.
Desensitization means decreasing the emotional reaction to traumatic memories or triggers. It also means increasing the patient’s resilience and coping abilities.
How Do Eye-Movements and Bilateral Stimulation Work?
Bilateral stimulation (BLS) is an essential component of EMDR. An EMDR therapist will utilize a variety of methods to stimulate both sides of the body (bilateral). BLS connects both sides of the brain.
Walking
It sounds technical but really, BLS is anything that accesses both sides of the body. For example, walking is bilateral. BLS helps us to process heavy emotional material. That is why taking a walk so often helps us to clear our mind. The faster we go, the faster we process. Therefore, if you have a really hard day, you might find a run or-fast paced walk helps to clear your mind.
Eye-Movements
BLS is often achieved with eye movements. The EMDR therapist will ask their patient to follow their fingers. Typically, they will hold up two fingers, at the patient’s eye level, and move them back and forth.
This is the traditional form of EMDR therapy as designed by Francine Shapiro. That is where eye-movements come into play, and how EMDR got it’s namesake.
Technology
Alternatively, an EMDR therapist may also utilize technology. For example, a patient can hold two buzzers, one in each hand. The therapist can adjust the buzzers to varying speeds and intensities. There is NO electric shock associated with the device. Instead, it may feel like a slight pulsing sensation in the patient’s hands.
There are also computer programs that assist with bilateral stimulation. For example, a patient may watch a light stream flash from one side of the screen to another. This has the same effect as the finger movements, as the patient’s eyes move back and forth.
Sound
Sound can also be a form of BLS. An EMDR therapist may utilize music with bilateral beats. This technique as the added advantage of allowing patients to close their eyes. This is a great method for patients that are sensitive to eye-movements, have limited vision, or difficulties concentrating.
Butterfly Hugs
Furthermore, an EMDR therapist may employ a “butterfly hug.” In this technique, the patient crosses their hands in front of their chest. They will utilize their own hands to alternately tap each shoulder. Typically, the therapist will tap along with the patient to set the pace.
BLS with Children
Therapists that work with children may use toys for BLS. For example, the therapist may utilize a soft brush to tap the patient’s shoulders, hands, knees, or elsewhere. EMDR therapists may also utilize finger puppets along with finger movements. Another popular tool for kids is Anna Gomez’s “The Thoughts Kits For Kids.”
Tapping
Lastly, if the patient is comfortable, an EMDR therapist may tap the patient’s body for them. For example, the therapist may tap the patient’s knees. Furthermore, an EMDR therapist working with families may ask a parent to tap their child’s shoulders, knees, feet, or hands.
EMDR and Yoga
Breathing is an integral component of EMDR therapy. After every “set” of BLS, an EMDR therapist will instruct clients to take a breath before they check in.
I integrate Yoga and EMDR as a Certified Yoga Teacher and EMDRIA Certified EMDR Therapist. Early on, I teach my clients alternate-nostril breath. Alternate-nostril breath can be utilized as a coping skill, grounding technique, and an introduction to bilateral stimulation.
Alternate-Nostril Breath
Please utilize the following video as a guide to practicing alternate-nostril breath:
Caveats
EMDR therapy is a highly skilled treatment modality. This is not a comprehensive guide to EMDR therapy. Furthermore, there is a huge body of research around EMDR and PTSD that is not within the scope of this blog post. This post is simply a guide to assist patients in making informed decisions about their treatment, as well as assisting therapists to decide if EMDR is something they would like to add to their skillset.
About The Author
Olivia Lynn Schnur is a Licensed Mental Health Counselor (LMHC) and an EMDRIA Certified EMDR Therapist. She is also a 200-Hour Certified Yoga Teacher. She writes to educate, uplift, and inspire readers.
Disclaimer:
This blog post and additional information posted on oliviaschnur.com represent Olivia Schnur’s personal views and should not be treated as professional guidance. The views in this blog post do not represent clinical treatment guidelines or recommendations and should not be treated as medical or mental health guidance. Furthermore, the views expressed on this blog and website do not reflect the views of any professional companies by which Olivia Schnur is employed.
Note to current and former mental health clients: Any contact made via oliviaschnur.com is not considered a confidential means of communication. Furthermore, as a result of ethical and legal requirements, Olivia is unable to respond to current and former clients who attempt to make contact via social media, personal email, or website. Posting comments on blog posts or other web pages can compromise your confidentiality. It is recommended that former or current mental health clients avoid interacting with, commenting on, or making contact via this blog or website.