EMDR – A Treatment approach for trauma
EMDR stands for eye movement desensitization and reprocessing and has been used for about 20 years by psychotherapists to help clients heal from the ongoing emotional and functional distress that can result from trauma. Treatment using EMDR can often facilitate positive outcomes much quicker than standard talk therapy alone.
EMDR uses a set of procedures to organize your negative and positive feelings, emotions, and thoughts, and then uses bilateral stimulation, to help effectively work through those disturbing memories. To understand how EMDR works and what the process is like let’s start by breaking down the name.
Eye Movement – the process of back-and-forth (bilateral) eye movements which gives momentary opportunity for suppression of active cognition, thus allowing the neural networks that are associated with a negative memory to come to the forefront of consciousness.
Desensitization – We tend to avoid painful, uncomfortable, and negative feelings, unconsciously thinking that the avoidance means the pain doesn’t exist. The goal of Desensitization is to bring to consciousness what has been avoided and decrease the level of distress of the memory that formed the original emotional learning.
Reprocessing – As the neural networks associated with the suppressed emotional learning comes to the surface, it is then primed to be integrated into our adaptive and meaning-making system (neocortex). The more adaptive meaning (learning) will reconsolidate with the old learning, creating a new system that is characterized by less distress, triggering, and new perspective on an old wound.
The process of EMDR consists of 8 phases.
History/Intake – The goal is to gather information, evaluate, and assess whether or not EMDR is the appropriate treatment to help you reach your goal(s).
Preparation – The goal is to create and develop skills to help manage the (very real possibility of) increased distress during the reprocessing phase.
Assessment/Target Planning – The goal is to narrow down targeted emotional learning, gather the level of distress, and identify the preferred adaptive cognition that would be integrated with the negative emotional learning.
Desensitization – The goal is to focus and pay attention to the target image, while holding the negative cognition, emotions, and sensations while engaging in a series of bilateral eye movements (or substitute activity). This will continue until desensitization is achieved or the process is stopped for other reasons (ex. emotions, images, cognitions are starting to go outside your window of tolerance). Redirection of focus may also occur in this stage.
Installation – When desensitization is achieved, the initially developed positive cognition is paired with eye movements. The important work of the Installation stage is the integration of information that has been held in a separate associate network from the negative (trauma) network.
Body Scan – The goal is to focus on the body, and noticing any discomfort or any residual sensation.
Closure – The goal is to debrief what you experienced and address any new material that may have come up in awareness.
Reevaluation – In this last stage, we will reassess the previous session’s target and decide what the next steps will be.
There are different factors that affect each person’s EMDR outcome and experience.
the presence and level of dissociation
range of distress tolerance
the size and structure of the neural networks involved in the negative emotional learning
the brain’s unconscious defenses
the brain’s ability and speed of the exchange of information from system to system.
Our brain’s neural architecture is determined by our genes and our environment. In other words, what we experience in childhood greatly impacts the architecture of our brain, which manifests in our behavior, perception, processing ability, etc.
EMDR focuses on the brain’s ability to constantly learn, taking past experiences, and updating them with present information. It utilizes the brain’s adaptive information processing to update our memory network so that emotionally-charged memories can be diffused and processed.
Kat Sciacca is an Associate Licensed Therapist who is passionate about the ability of EMDR to heal deep-rooted trauma and attachment wounds. She is a brain-based therapist who utilizes the brain (and the body’s) ability to heal itself. She is trained in both EMDR and Brainspotting and is a Certified Trauma Professional