The Process of Therapy · Trauma Therapy

EMDR in your Therapy Session

Part 1

There are many therapeutic approaches Counsellors can use when working with clients on their goals. This article is about EMDR therapy, which is an approach for treating trauma, but has tons of other applications. The letters stand for Eye Movement Desensitization and Reprocessing – which I am going to describe in more detail in this article. The second article will explain what a typical EMDR session might look like

Disclaimer: please know that no therapy is one size fits all. There are many layers to therapy, and to the complex issues people bring forth into their counselling experience. My intention in this article is to provide a simple overview of EMDR. Think of it as a brief summary, and know that there is much more to it. Kind of like the sign at the local gas station that reads ‘Car Wash’.  When you go through the carwash, your car will receive the wash, along with the added bonus of an under flush, foaming polish, clear coat sealant, and air dry. There is so much more to the car wash that that sign mentions! Similarly, there is so much more to EMDR than this summary will include. My aim is to make this informative and brief, leaving you with a solid understanding of what EMDR is, so that you can feel you understand the process prior to starting therapy.

EMDR was developed by clinician Francine Shapiro. The approach has been researched and modified for many diverse applications. In this article, I am going to be describing the variation attachment-focused EMDR, which was developed by Laurel Parnell. 

Originally developed for use with post-traumatic stress, EMDR therapy is also an effective approach for working with fears and phobias, addiction, and anxiety, It also works to strengthen feelings of calm and confidence.

The Body Holds Emotion

EMDR is a somatic approach to therapy, which means that while we do look at thoughts and emotions, we also look at how the body is holding emotion (that’s “the felt sense of emotion”). 

When a traumatic event happens, we humans tend to become flooded with emotion and our brain doesn’t process and store the memory properly. What happens is that parts of the event (thoughts, emotions, body sensations, images, and smells) stay unprocessed in the brain. What this means in daily life for folks, is that reminders in day-to-day life can activate those unprocessed memories. When this happens, it can feel as though the trauma is happening all over again. You know in your rational brain that it isn’t – but the felt sense of emotion that spikes up so fast that makes it feel as though danger is very real and present.

Using EMDR, we work with the memories that are causing the present-day distress and we “reprocess” them. This means we are working with all the elements of the present, past, and even future. 

Let’s look now at what the name EMDR stands for in more detail, and then I’ll explain what you can expect when you start up EMDR therapy. 

EMDR-2
It’s All in the Name:

As you have already learned, “EMDR” stands for Eye Movement Desensitization and Reprocessing. It’s a bit of a long and complicated name, so let’s deconstruct it. 

EMDR incorporates eye movements, which is a type of bilateral stimulation (BLS). This is a core feature of EMDR. The term ‘bilateral’ refers to two sides: eyes moving back and forth in a rhythmic side-to-side pattern. Thanks to research and new technologies, we now know that the bilateral stimulation used during EMDR can be visual (the eye movements), auditory (sound), or tactile stimulation (touch). The bilateral stimulation ensures both hemispheres of the brain have an active role in memory processing. 

Visual bilateral stimulation can be created by the therapist moving their hand back and forth, or with a light bar. A light bar looks exactly as it sounds: it is a sleek bar of lights, and a light flashes on one end of the bar and then the other, and back and forth it goes. The client follows the lights with their eyes, side to side in a rhythmic pattern, thus the term “bilateral”.  

Auditory BLS is facilitated with earbuds, with a sound being played alternating from one side to the other.  Mark Grant has developed a powerful app that utilizes EMDR with auditory BLS, called Anxiety Release.

Tactile BLS can be facilitated with tapping rhythmically from side-to-side.  I use a little hand held device with 2 parts that a client holds, one in each hand, and it facilitates bilateral stimulation (BLS) with a brief pulse, or vibration back and forth. It kind of feels the way your smart phone does with the silent mode vibration.

More about Bilateral Stimulation (BLS)

You may be wondering, why is this strange BLS thing so important in therapy??

Bilateral stimulation is a core feature because through repeatedly activating the opposite sides of the brain, it harnesses the power of the accelerated information processing model and aids in releasing emotional experiences that feel ‘stuck’. It can be said that this process mimics REM sleep. You may have heard of this before: when we are sleeping and in the REM stage of sleep, our brains have a chance to process the events of the day. In trauma, we know that memories get stuck – they don’t get processed and worked through. So by using BLS as part of the trauma processing, we help our brains to finish processing those distressing events. As the troubling images and emotions associated with the disturbing/scary/upsetting event are processed while paired with repeated alternating activation (BLS) the memory consolidates, the distressing bits feel resolved, and a more peaceful emotional state is achieved.

There is a lot of emotion packed into the trauma memories.  As you read this, you might be feeling worried that if you start working with a past trauma, the level of emotion it evokes might be too much to handle. In EMDR therapy, therapists are trained to help folks through the process. So while working through distressing memories does evoke emotion – we go slowly, and keep our focus narrow. This way emotion can feel more manageable, and the body can start to regulate.

Here are a few more neat facts about BLS:

  1. BLS can help the body relax (all those muscles that were tense without you even being aware they were tense suddenly relax a bit)
  2. It can help our unstick our thinking so that we feel a great sense of cognitive flexibility (thoughts flow and feel less stuck and rigid on the troubling topics)
  3. It can help improve our concentration 
  4. And, my favourite effect of BLS: it helps us ease into the awareness of the distance between the present moment and the upsetting event. This means that the issue or event worked on during the counselling session feels smaller and further away; more anchored in the past and not so volatily-active in the present

Desensitization means that we’re working with the intensity of emotion felt when recalling a disturbing/scary/upsetting event.  Desensitization refers to the process of becoming less and less distressed with the memory of an event that was disturbing/scary/upsetting but that is now over. In it’s most simple terms: a memory that was once a super sore sensitive spot becomes less and less sensitive during the course of EMDR. We can not undo the past or erase the memory of it, but we can learn to turn down the intensity of emotion felt when recalling it. 

Reprocessing means that some memories of the disturbing/scary/upsetting event weren’t processed at the time the event occurred. There are many brain systems that are involved during trauma, and many more that are shut down, or suppressed, during the event. This means that the traumatic moment isn’t stored in the brain the way a non-traumatic event gets stored. Through EMDR therapy, reprocessing means that we work on understanding the memory so that the memory of the disturbing/scary/upsetting event becomes useful instead of so disturbing. By reprocessing it, in a very titrated and strategic way, the memory comes to be stored as part of an integrated memory system.

Here are a couple of things to keep in mind, regardless of the therapy you choose to access in your counselling session. 

  • Going slowly is important. Building up emotional coping skills prior to working through trauma is a helpful way to ensure sessions feel more manageable 
  • Therapy is rarely one size fits all. Your therapist will work on getting to know you, your story, and your needs, in order to best help you work through your goals in counselling.

In the next article, I will go over what a typical EMDR therapy session may look like. Stay tuned for it!

–> Click here for Part 2: What EMDR Looks Like in a Therapy Session

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