Written by Eun Kyng Seo, Ph.D., Licensed Professional Counselor
A few years ago, my professor introduced me to a new and fascinating therapy, EMDR (Eye Movement Desensitization Reprocessing), and with her strong recommendation, I ended up going to an EMDR training. I admit that I was skeptical, but I didn’t feel that way for long.
During the training, the instructor presented testimonial videos and cases about EMDR therapy. I found that the testimonials all had a similar message: that their emotional pain associated with traumas were dramatically alleviated by EMDR. As I heard about all the amazing and miraculous stories. I was still skeptical, but I received EMDR therapy by my learning partner as a part of the training. It immediately eased the distress I have felt from a traumatic incident in my childhood. I was amazed that triggers which typically automatically aroused feelings of irritation associated with the traumatic incident no longer distressed me.
What is EMDR?
EMDR, developed by American psychologist Francine Shapiro, is a type of psychotherapy guided by information processing therapy, aimed at promoting positive cognitions and decreasing emotional pain developed from adverse life experiences. By exploring the current triggers, EMDR accesses the initial cause or incident which triggers the current distressing affect (e.g., anger, anxiety, fear, etc.) and develops adaptive thinking and behaviors in the future. Dual attention is the methodology of EMDR to desensitize the distressing affect associated with adverse memories. The client focuses on disturbing experiences, including images, thoughts, feelings, and physical sensations while having external bilateral stimulation.
The brain already has the capability to heal itself, especially during REM (Rapid Eye Movement) sleep, the brain processes and heals disturbing memories by integrating all aspects of memories. However, traumatic experiences are stored as unintegrated and isolated pieces along with images, beliefs, emotions, and physical sensations in the brain. Unintegrated memories stay in the limbic system of the brain which are apt to be triggered by situations similar to the origin of the traumatic experiences. Thus, before an individual becomes consciously aware whether there is a real threat, the body reacts to the triggering situation. EMDR facilitates to integrate all aspects of unintegrated and isolated traumatic memories by replicating REM sleep.
EMDR is similar to exposure therapy in that the client faces painful images and feelings associated with traumatic experiences that he/she has avoided. However, compared to traditional exposure therapy, EMDR takes less time to deal with trauma and its impacts. Also, since it is not a talk therapy, the client does not need to verbalize his/her painful memories to the therapist, which is one of the beauties of EMDR therapy.
How does EMDR proceed?
EMDR therapy is divided into eight phases. The first two phases are quite similar to the initial period of traditional psychotherapy, including taking a history of current symptoms, developing the therapeutic relationship, case conceptualization, treatment plan, and assessment. The client will develop positive affect tolerance including learning coping skills that he/she will practice in and between sessions to handle his/her affective distress. Inexperienced EMDR therapists often skip or overlook the initial phases which may result in retraumatizing clients. From my experience, I learned that the first two phases can be the most crucial process particularly for individuals who present multiple traumas with mental complexes.
From phases three to seven, a target memory will be identified and reprocessed to desensitize the client’s distressing affect associated with traumatic experiences. During these middle phases of EMDR treatment, the clients will re-experience his/her traumatic memories by exposing vivid visual images, emotions, physical sensations, and negative self-beliefs related to the targeted memory. While the client is processing the targeted memory, the EMDR therapist will utilize bilateral stimulation. Although eye movement is the traditional bilateral stimulation where the client moves his/her eyes from side to side by following the EMDR therapist’s finger instruction, hand tapping and audio bilateral stimulation can be employed upon the client’s preference. Many of my previous clients reported having difficulty concentrating with eye movement so I often tap the client’s legs or hands from side to side.
Concerns and recommendation
When I finished the EMDR training, I was so ambitious to practice EMDR with all of my clients with traumas including PTSD (post-traumatic stress disorder), and soon after I learned that EMDR did not work that quickly for all types of traumas. From my experience, high-functioning clients with a single trauma received benefits solely from EMDR within short-term therapy. However, clients with chronic mental issues (e.g,. depression, addiction, bipolar, etc.) in addition to traumas will require a lengthy process and preparation. For individuals who presents multiple complications, EMDR therapy will effectively be employed in conjunction with other therapeutic approaches (e.g., psychodynamic therapy, Emotional Focused Therapy, Dialectical Behavioral Therapy, etc). Above all, the therapist and client’s therapeutic relationship is a crucial factor for successful treatment. A therapist’s unconditional regards and validation will promote safety and trust, which clients need to have to overcome their trauma.