What is EMDR?
Eye Movement Desensitization and Reprocessing (EMDR) is a treatment developed by Francine Shapiro for healing psychological trauma. It is currently one of the fastest and most effective therapies for post traumatic stress disorder (PTSD) with 85% of those treated no longer meeting the diagnostic criteria post-treatment.
EMDR treatment involves remembering aspects of the stressful event while brain networks are activated through eye movements, taps or sounds in repeated side-to-side sequences for short periods of time. In this way, parts of the memory are reaccessed, reprocessed by the nervous system, and released, to the effect that they are no longer bothersome when recalled.
The Effects of Trauma
According to one theory, when the nervous system is overwhelmed by a stressful event, aspects of the experience become tied to the emotions of the event. For example, features of experiencing a car accident: the body’s jolt from impact, the sound of crumpling metal, the smell of burning rubber, etc., combined with emotional shock, become locked into the memory of the event. A similar sound or smell can now trigger shock and fear. Neurons activated during the traumatic event are now wired together such that reactivation of only part of this new circuit (the scent of burning rubber) can trigger the activation of other aspects of the system (fear). This may partly account for how flashbacks and intrusive thoughts related to the memory are triggered long after the first event. The traumatized individual may suffer panic attacks, anxiety, phobias, and mysterious physical symptoms in response to a person, sound or scent present at the time of the first incident.
Because the consequence of triggering this trauma circuit is so psychologically taxing, the brain or subconscious mind attempts to cordon this circuit off from the rest of the brain. A person might avoid certain people, places, or thoughts to minimize the risk of triggering a trauma memory. Inevitably an encounter with someone with features similar to the perpetrator or a scent reminiscent of the scene triggers the circuit and the nervous system activates for “fight or flight,” or deactivates in a “freeze” response. Negative, rigid, and generalized beliefs about the self are constructed from these events such as “I can’t trust anyone” or “I am powerless.” These are just a few of many ways trauma impacts mental health.
Unfortunately, avoidance prevents healing as it limits necessary exposure to feared stimuli to recalibrate what is safe from unsafe. The brain may aid in avoidance as it may be difficult to remember aspects of parts or all of the event. In this way, new assumptions about oneself and the world develop and crystalize.
EMDR therapy also reconnects individuals to personal strengths and positive memories. After treatment, the inaccurate assumptions about oneself and the world that were consequences of the trauma are no longer felt to be relevant. Neutral events that had triggered the fight, flight, or freeze response no longer have that effect. It is theorized that EMDR facilitates the linking the traumatized network into larger networks associated with healthy self-esteem.
How Does EMDR Treatment Heal Trauma Memory Networks?
Memories of traumatic events can be thought of as being linked by association to other kinds of psychological material including other memories, images, thoughts, emotions, and physical sensations. The memory of one event can spark the memory of another seemingly unrelated event. For example, recalling a recent car accident can elicit the memory of another experience of felt powerlessness such as having been bullied in elementary school. The link between these two events includes the aspects of feeling powerless to protect oneself from danger. When the memories of the accident and bullying become linked, the fear from these events is amplified and newly connected to activities that were previously neutral, such as driving. Because of this “rewiring,” innocuous events are now perceived by the nervous system as “dangerous.” Reactions meant to enable safety-seeking behaviour, like fear and anger erupt in situations in which danger is not real. The resultant physiological stress responses contribute to numerous health and relationship problems, if the trauma is not treated.
EMDR links traumatic memories to healthy psychological material which leads to new nuanced understanding about oneself and the world. The nervous system responds to the understanding that "I am safe, it's over now." Using our earlier example, the memories of bullying and the car accident might be newly connected to memories of adroit driving and effectively asserting one's boundaries. The result is a new sense of confidence and the fight, flight, or freeze reaction diminishes in response to innocuous events that were previously triggering.
The EMDR therapist applies repeated bilateral stimulation of the brain, one hemisphere at a time while the patient remembers aspects of the traumatic event. The EMDR therapist moves an object like the hand through the visual field while the client follows with the eyes, stimulating the brain's visual networks on one hemisphere and then the next. Or a hand-held tactile stimulation device is used which subtly vibrates one hand then the next to bilaterally stimulate the brain. The patient is asked to simply notice what emerges in awareness. Since these are memories typically avoided, this can initially be quite stressful. As the bilateral stimulation is repeated, the traumatic memory gradually loses its emotional charge.
Who Can Benefit from EMDR Therapy?
EMDR was developed as a method for recovery from post-traumatic stress and has been shown to be an effective treatment for individuals who have experienced abuse or neglect, rape, natural disasters, serious illness, invasive medical procedures, combat or war, violence (as a direct victim or as a witness), victims of motor vehicle and other accidents, to name a few. EMDR has also been successfully applied to other situations in which people feel stuck in thoughts, feelings, and memories from past events. EMDR has been successfully applied to the treatment of various anxiety conditions like Generalized Anxiety Disorder (GAD), Panic Disorder, Obsessive-Compulsive Disorder (OCD), and Social Phobia (Social Anxiety Disorder). This method of processing psychological “stuck points” has helped those with anxiety and phobias of flying, public speaking, social circumstance, and more. EMDR has helped others change long-standing unhealthy behaviours like binge-eating, purging, substance abuse, and gambling.
Peter Levine, in his seminal work on trauma therapy entitled “Waking the Tiger” says, “If you are experiencing strange symptoms that no one seems to be able to explain, they could be arising from a traumatic reaction to a past event that you may not even remember. You are not alone. You are not crazy. There is a rational explanation for what is happening to you. You have not been irreversibly damaged, and it is possible to diminish or even eliminate your symptoms” (1997).
People with an Insurance Corporation of British Columbia (ICBC) claim or working with a personal injury lawyer are often referred for EMDR to resolve the psychological fallout from a motor vehicle accident. EMDR has shown itself to be a quick and effective way of healing from such an injury.
How Long Does it Take to Effectively Treat Trauma with EMDR?
This is a difficult question to answer as it depends on the number of traumatic events suffered and whether one has a history of chronic abuse or neglect. Those with a single trauma recover more quickly than those who have suffered many, as in the case of Complex Post Traumatic Stress Disorder (cPTSD). In general, we can say that it may take as few as three sessions, or as many as 12 or more. The effectiveness of EMDR comes from research summarized below:
Traumatic stress studies have shown that 83-90% of those diagnosed with PTSD no longer met the criteria for the diagnosis after 4-7 sessions of EMDR (Lee et. al, 2002; Rothbaum, 1997).
Others have found significant decrease of a variety of PTSD-related symptoms after only 3-4 sessions (Ironson et. al, 2002; Scheck et. al, 1998; Wilson et. al, 1995).
One study has shown that 77% of sufferers of multiple traumas no longer meet PTSD diagnostic criteria after 12 sessions (Carlson et. al, 1998).
People with histories of childhood abuse or neglect may require more than 12 sessions (Korn & Leeds, 2002; Mayfield & Hyder, 2002; Shapiro, 2001).
For more information check the following links:
EMDR Institute’s FAQ page
EMDR Canada's FAQ page
Book your first EMDR appointment today.