I wanted to offer up some reflections on the elements of EMDR (Eye Movement Desensitization and Reprocessing) that I have observed in sessions to be helpful. If you are a client considering EMDR but feeling confused or overwhelmed by what it might entail, I want to demystify it a little and explain what I think are some of the core mechanisms that lead to transformation for clients.
It Identifies Core Issues Quickly
One of the earliest things we do in therapy is create our treatment plan, which helps us to identify what memories we will be focusing on for processing. It starts with asking what your present day struggles are but quickly drills down into asking, “As you focus on that image (of something about your current struggle) what words go best with that picture that express a negative belief about yourself now?” This will be something like:
I am not good enough
My needs are not important
I am helpless
I cannot trust anyone
This is just to name a few examples, but I think you can see that identifying this will immediately get you into some very profound places. When we think about identifying a negative belief in therapy, I think there can often be an immediate association with cognitive behavioral therapy, which aims to track these kind of beliefs and work to challenge or modify them. Examples of this would be working to not be so hard on yourself or to not be catastrophic in your thinking. The EMDR treatment plan is much more than an effort to be more rational or positive in your day to day life (though there is value in that), it is identifying what you felt and believed in some of the most painful experiences of your life. Then we ask about other times in life when you felt this way and many clients are surprised to realize that there is a whole network of associated memories in which they felt powerless or like they were not good enough, and that this is contributing to their present day marital struggles or addictive behavior or anxieties.
Trauma is about what happened to you but it’s also about what you came to believe about yourself and life after it happened to you, and EMDR will help you get at both things.
It Slows You Down and Focuses Your Attention on Memories
In talk therapy I have had many experiences with clients where we are talking about something and they start to feel emotions around it, and we’ll usually slow down and look at those emotions. This could go in any number of directions, and all of it is generally useful. But I think the brain naturally bounces around a bit when in conversation, so I’ve noticed that clients will drop into an emotion or start discussing a memory, but it can be hard to stay there, or they won’t want to stay there for whatever reason. I think perhaps we often just need a structure and permission to simply stay in a memory or emotion, and EMDR provides that. The entire hour session is spent on a memory.
Every processing session starts with a set of questions about the memory to help you access it and focus on it, and then you are simply given the space to focus on the memory and allow whatever associations, thoughts, emotions, or bodily sensations emerge. This is done through short sets of bilateral stimulation- the eye movements, tapping, or buzzers while you pay attention to whatever is emerging. After each set we check in to see what you are noticing and then we go right back into sets. This simultaneously gives you a ton of freedom to process and have an internal experience, while providing a structure that sets the expectation of remaining focused on the memory and whatever is associated with it instead of getting sidetracked into other discussions or topics.
It’s rare that we ever slow down and pay attention to ourselves in this way, whether in or out of therapy. Many clients have said some version of, “I thought I processed this issue or event but after doing EMDR I realized I had only loosely processed it in a mostly intellectual way. I knew that it had happened and I thought I was over it because enough time had passed.” Of course, we naturally don’t want to sit in painful thoughts or experiences, but if we never do this in any kind of meaningful way, then those experiences will continue creating problems for us. It is an amazing gift to take an hour for a session to really be with a memory, to not bounce out of it due to social constraints, and to feel everything that is associated with it.
What I’m touching on here is the “desensitization” part of the title, which is about exposing yourself to memories and events in a prolonged and intentional way instead of avoiding them. This is a fundamental element of many approaches to trauma, anxiety and phobias because we understand that avoidance actually maintains symptoms and keeps us stuck. We can think we are successfully avoiding something, but it inevitably intrudes, sometimes in dramatic ways through nightmares or flashbacks, but often more subtly, through something like overreacting to your spouse’s tone or shutting down when something happens with a boss or coworker.
The Change Can be Unexpected and Profound
One of the things I like best about EMDR as a therapist is that it almost completely takes the pressure off of me to figure everything out and come up with the needed insights. I’ve always felt this was a basically impossible (and somewhat arrogant) task, to believe that I should somehow be able to dig through a lifetime of events and a complicated personal narrative and offer up an insight that would explain everything. Of course there are times that this is helpful and I can certainly give my observations or reflections, but what I’ve seen in EMDR is that you can think you are working on one thing and then something entirely different comes up.
I have had clients I’ve worked with for years and felt like I had a good grasp on their most important life experiences, but we’ll be doing EMDR and I’ll check in on what they’re experiencing and they will tell me, “I haven’t thought about this in years, but right now I’m remembering x, y or z” and it will be something we have never talked about in therapy. Or we will start targeting a memory and they’ll identify a belief “I am helpless” only to discover during processing that what they actually felt in the memory was “I am dirty and disgusting.” This is not something they even knew was in there from an intellectual perspective until we started doing the EMDR, and this was the thing that was haunting them. I never would have gotten there if we were just talking about things.
This is the “reprocessing” part of the title. We aren’t aiming to only desensitize you to past events, we want you to be able to replace the negative core belief with a positive one and to no longer have the trauma define your life and reactions in the way that it had. This makes the approach an ultimately hopeful one that is forward focused and wants to tap into your innate strengths and capacity to grow.
And perhaps the most profound growth happens in what I see with clients who have a relationship with God. For many years I have been interested in how I could move out of the way and allow God to be the one that provides healing for people, and I think EMDR creates a fantastic space for that to happen. Within this slowing down that I previously mentioned, a kind of contemplative prayer and reflection can be entered into. Sometimes I’ll prompt clients to picture Jesus entering a memory and to ask what he would say to them about it, but many times it spontaneously happens. And when they feel that God is speaking to them in the midst of their deepest pain, it changes everything. Lies about self and life are immediately dispelled by truth. Intellectual assent turns into emotional experience and seems to connect the head and the heart.
There’s a lot more that could be said here, but I’ll close by simply repeating that something profound seems to happen when we are willing to stop avoiding and escaping, and slow down in an intentional way to engage with our memories and life experiences. EMDR is not the only way to do this and is not a magic pill, but these are my reflections on what I have experienced with clients and I hope it is helpful in understanding some of what you might be signing up for if you pursue therapy along these lines.