Eye Movement Desensitisation and Reprocessing (EMDR)

It’s helpful to know a little bit about what EMDR is before deciding whether or not it could be the right therapy for you. In order to understand what kinds of presentations/problems EMDR is most suitable for, first it’s important to discuss some of the basics about how traumatic experience gets stored and stuck, according to the theory underpinning EMDR.

In a “healthy” process, following any experience, our brain-body system must allocate where and how to store the related information in memory.

Computer filing system

Imagine your memory is like a computer filing system. After an event occurs, your brain has to decide which folder to put the associated memory into. Familiar experiences, say, of going to the shop, might go into a “shopping” file and the memories are stored there – available for retrieval if needed but otherwise, fully processed. When novel or distressing experiences occur, our brain doesn’t have an automatic place for it to go, and in the absence of an identified destination in long term memory, it stays “floating around” in working memory, waiting to be processed and organised. This is why it’s so easy for us to be triggered, or have experiences like flashbacks or nightmares: because fragments of the distressing memory are waiting, very close to conscious awareness.

Food digestion

Imagine that the process of digesting trauma is similar to the process of digesting food. Familiar and healthy foods are quickly and easily digested. Unfamiliar and toxic foods are much more of a challenge, and sometimes need intervention.

EMDR is a way aiding the natural digestive process, (or preparing the memory to be filed) so that our system can successfully breakdown those experiences and store them properly. The EMDR process simply enhances your natural healing capacities. You are in control the whole time.

How does that happen?

The mechanism we use to aid processing in EMDR therapy is called Bilateral Stimulation (BLS). A therapist might provide BLS in one of several ways: using eye movements, tactile stimulation, audio stimulation or body movements; which stimulate our brains natural healing process. During a set of BLS, you and the therapist will decide what material you would like/ need to process. This should always be a collaborate conversation, in which your therapist supports and guides you. An important part of this planning process is making sense of how your present symptoms might be connected to events from the past.

Sometimes EMDR supports a very fast and efficient way to work through difficult experiences and resolve distressing symptoms or experiences. Generally, if you have more adverse/traumatic experiences in your history, the process of therapy will take longer. While your therapist can often give rough estimates at assessment about how long they think this process may take for you, the amount of time to reprocess depends a lot on the identified memories, and how fast you process as an individual. Quite soon, you will come to know what processing is like for you and it will be more possible to predict how long it might take for you to meet your goals in therapy.

Many people report that following an EMDR session, they feel great relief and a huge sense of progress. Its also possible that you might feel tired, and even need extra sleep that night. This is really important, because rest and sleep allow your brain to fully integrate the work you have done in therapy. Its also possible that your brain may continue to process the material you have worked on. This might take the form of new thoughts, dreams, memories or insights. If this occurs, you’re encouraged to make a note, and review the new material with your therapist next session. 

A case example

(this case example is based on many clients I have worked with and is not directly representative of any one individual):

Carl (32) came to therapy with what he identified as self-sabotage in his career. He had been noticing both a strong urge and confidence to progress, and an intense fear of failing and being ridiculed in that context. He was very hard working and driven, but felt stuck in a position which was not fulfilling anymore. Even outside of work, he was able to think of examples when an opportunity to move forwards came up, his body would feel frozen, with thoughts of failure and criticism. At these times he felt worthless. Not only was this becoming a problem professionally, but Carl was finding it could cause problems in his relationships, most notably, connected to buying a home with his partner.

During his first few sessions, we traced back through Carl’s life to explore early memories of these same self-critical, worthless thoughts and feelings. He was surprised that it took us to a period of time in his mid-teens when his paternal Grandfather had moved into the family home due to physical illness. At that time, Carl had been working towards his GCSE exams but his Grandad would often comment that Carl was unintelligent, and shame him for making small mistakes. This knocked Carl’s confidence at a very delicate time and in the absence of support, he assumed his Grandad, an intellectual and powerful man, must be right. Unfortunately, Carl failed several of his GCSE exams, and quietly defaulted to a job locally rather than exploring options for further study like many of his peers.

Although Carl thought he had long moved on from this difficult period, now, particularly faced with the prospect of putting himself in direct contact with several confident, older male colleagues, he felt very vulnerable and would generally avoid them, then criticise himself.

From session 6, after a short period of “preparation”, we were able to return to some of those painful memories of Grandads criticism and reprocess them using EMDR. Carl found that after only a handful of reprocessing sessions, the feelings of worthlessness and self-criticism reduced significantly, and he was much more connected with a sense of being capable and dedicated. After only 12 sessions, he was better able to take risks and put himself in new previously uncomfortable situations, like presenting ideas or interviews, and he felt much more able to work towards promotion that he deserved.

There is now a huge body of research supporting the use of EMDR for many problems. You can ready more here: https://emdrassociation.org.uk/discover-emdr/

This blog was informed by several podcast episodes by The Beyond Healing Team, and specifically this episode of The Notice That podcast: https://emdr-podcast.com/episode-15-introduction-to-emdr-therapy/

I also always recommend Baldwin, M., & Korn PsyD, D. L. (2021). Every Memory Deserves Respect: EMDR the Proven Trauma Therapy with the Power to Heal. Workman Publishing as a helpful read prior to EMDR therapy.