Have you wondered what EMDR therapy is? Have you been in and out of traditional talk therapy and made minimal progress? EMDR therapy might just be what you are looking for. But first, learn about what EMDR is and dispell some common EMDR myths. This is a guest blog post by EMDR Therapist Jeremy Fox of Fox EMDR. Jeremy was a guest on my podcast. Click here to listen to the full podcast episode.
I remember watching the Matrix for the first time and observing how seamlessly the characters entered and exited the Matrix itself, which was a world of perception and sensation, devoid of any reality or time orientation. Wherever a telephone was present, Morpheus, Neo or Trinity could “jack in,” attuning to the Matrix through its distinct signal. It didn’t matter the venue used to enter the Matrix, as long as the signal was acquired and maintained.
The Matrix, with its convincing falsification of reality, serves as a superb metaphor for trauma itself: a set of sensory experiences which represent a bygone era, accurate at the time of encoding, but unhelpful and even damaging to present functioning.
With this in mind, treating trauma via Eye Movement Desensitization and Reprocessing (EMDR) is similar to entering the Matrix, as only the “signal” of trauma (somatic/sensory memory) is necessary, for “locking on” and desensitizing traumatic experience. Whether a memory assumes the form of a sight, sound, smell, taste, or tactile recollection, the floatback (“think back to original memory”) or affect scan (“feel/sense back to original memory”) EMDR exercises may “lock on” to specific traumatic experiences, allowing the EMDR standard protocol to desensitize and reprocess them (Hensley, 2016, p. 204-205).
Just as a professional runner’s exit from the Matrix proved sudden and serendipitous, within the Animatrix film, Dr. Francine Shapiro’s discovery of EMDR proved similarly spontaneous. In the Animatrix (a supplemental animated movie to the core Matrix trilogy), a sprinting athlete strides with such force and speed that he strains the Matrix program, awakening in the real world. In 1987, Dr. Francine Shapiro inadvertently recognized that, as she walked in a park, thinking of emotionally distressing material, her eyes spontaneously moved in a saccadic (left and right) pattern, which significantly decreased her distress (Hensley, 2016). With that fateful event, Shapiro’s journey toward systematizing EMDR began.
Across my 4 years of experience with EMDR, first as a basic-trained clinician, and now as an EMDR-certified therapist, I have enjoyed the distinct honor of observing clients with a multitude of clinical disorders and syndromes overcome their traumatic memories and accomplish new goals once thought impossible. Next, I share 8 attributes of EMDR that I personally find inspiring and exciting, followed by 5 misconceptions.
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8 things I like about EMDR:
- It is trauma informed, allowing for specialized, specific interventions and pacing.
- EMDR is evidence based and validated as an intervention for PTSD, according to the World Health Organization (WHO)
- It is highly structured, relying upon both the strengths of the left brain (SUDs/VOC scoring) and right brain (emotional qualities of the memories; client/therapist attunement). it is a phasic approach to anxiety/trauma that applies research and methods from qualified clinicians (Hensley, 2016).
- EMDR is the ideal complement to other trauma-informed therapeutic methodologies, including polyvagal theory.
- It is a “bottom up” therapy, which quells hypervigilance. It is the therapy for clients who state, “I know that the trauma is over, but I still FEEL unsafe,” or “I know I have worth, but I just don’t FEEL it.” It operates at the physiological level. See the work of Schwartz & Maiberger (2018) for more on this attribute of EMDR.
- EMDR is not a traditional “talk” therapy; the brain is faster than the word, and EMDR honors this crucial fact. In other words, it is neurobiologically based (Hensley, 2016).
- It is a therapy which encourages reprocessing and reclamation of past events, recognizing the processing/ containment dichotomy necessary to trauma treatment.
- Reprocessing enables lasting change and development (“trait change”), as continued processing following sessions is a common occurrence (Hensley, 2016, p. 51). “New insights” may arise through conscious realizations or dreams, which might pertain to previous memories or experiences, pertinent to the EMDR target (p. 132). As Neo gained new awareness following his entrance to the “real” world, he was able to re-enter the Matrix with these powers, even ‘”rewriting” and changing the rules of the Matrix itself (flying, etc.). Similarly, the truths which clients learn in desensitization phases (“I have choices, now; the trauma wasn’t my fault”) can be brought into the desensitization of subsequent targets, rendering reprocessing even more thorough and effective.
5 Myths about EMDR
- “It’s hypnosis!” There is no “trance” involved, though EMDR borrows much from the hypnotic tradition, including a focus upon memory. The difference between hypnosis and EMDR is that the former induces a trance state which entails hypnotic suggestibility, unconsciousness, and which may last anywhere from 15 to 45 minutes (Hensley, 2016). EMDR actually increases emotional arousal and alertness, with each set of eye movements characteristically lasting no more than 30 seconds. Furthermore, while memory retrieval may occur during a desensitization session, this is not the clinical purpose of EMDR. While EMDR and hypnosis may be combined, they are certainly not synonymous.
- “EMDR is only the eye movements.” EMDR is a comprehensive treatment modality that begins with history taking and ends at reassessment. This means that even resource development/positive visualizations (offered during the preparation phase) count toward EMDR. The 8 phases of EMDR are as follows:
Client History/Treatment Planning
Preparation
Assessment
Desensitization
Installation
Body Scan
Closure
Reevaluation
EMDR also progresses over 3 distinct stages, as past, present, and future manifestations of the presenting target issue are all targeted for desensitization and reprocessing.
- “EMDR requires you to immediately jump into your trauma.” Again, EMDR is a comprehensive modality that refers to the entirely of treatment, from planning through reassessment (Hensley, 2016). EMDR is not just the desensitization phase; many improvements in quality of life can result from the preparation phase, and the positive, strengthening visualizations practiced (containment and calm place). To stress that only the desensitization phase “is EMDR” may mount pressure on clients, resulting in anxiety, as they may feel prematurely rushed into trauma work, before they are ready. EMDR is an orientation robust in its preparation phase, as it asserts that clients guide the process, while we therapists simply facilitate as fellow travelers on the “train.”
- “We don’t know how EMDR works.” This is a particularly pernicious myth, because no one would want to receive a treatment that is unsupported by research. While multiple hypotheses have been forwarded, regarding the effectiveness of EMDR, two in particular have received noteworthy support through empirical research. The first, referred to as the “working memory” hypothesis, suggests that administering saccadic (left and right) eye movements during traumatic recall decreases emotional vividness by taxing working memory (Hensley, 2016, p. 35). The other leading explanation for EMDR’s efficacy contends that the “repetitive redirection of attention” initiated by saccadic eye movements activates a neurobiological state similar to REM sleep (Hensley, 2016, p. 36). This is fitting, considering that REM refers to “rapid eye movement.” Both of the above hypotheses have received ample research attention and interested readers should consult the EMDRIA website for further studies: emdria.org. An EMDR Therapy Primer (2nd Ed.) also compiles relevant scholarly literature which supports EMDR’s effectiveness.
- “EMDR always has to focus on the past event first.” Several clinical adaptations to the EMDR 3-pronged protocol exist, such as the “inverted protocol,” which allows clients with complex PTSD to venture into trauma reprocessing in a titrated, limited fashion (Hensley, 2016, p. 202). The inverted protocol desensitizes fears of the future, then present triggers, saving the most traumatic memory for reprocessing until which point clients are confident in EMDR and resourced in their coping skills. If the stressor occurred in the past 6 months, the “Recent Traumatic Events Protocol” (R-TEP) may be used. Pioneered by Elan Shapiro and Brurit Laub, the R-TEP specifically addresses concerns unique to present triggers. Organized and implemented by Andrew Leeds, Symptom Informed Treatment Planning allows for the address of target issues that result in the most serious, troublesome symptoms influencing present functioning (panic attacks, obsessions/compulsions, etc.). Using this approach, the first memory contributing to the worst symptoms is targeted for desensitization and reprocessing.
Thank you for reading my thoughts on EMDR as a viable and effective treatment modality. You can follow me on Twitter at @foxemdr and reach me by email at foxemdrtherapy@gmail.com. I am excited to offer consultation for fellow EMDR professionals, as I am currently pursuing consultantship status within EMDRIA!
Jeremy Fox, MA
Fox EMDR
References:
Hensley, B.J. (2016). An EMDR therapy primer: from Practicum to practice. New York, NY: Spring Publishing Company, LLC.
Schwartz, A. & Maiberger, B. (2018). EMDR therapy and somatic psychology: Interventions to enhance embodiment in trauma treatment. New York, NY: W.W. Norton & Company, Inc.