What is EMDR?

These initials stand for Eye Movement Desensitization Reprocessing. Now, you know why it is abbreviated EMDR. EMDR is therapy that helps people who experience the effects of trauma heal. Since it was developed by Dr. Francine Shapiro, Ph.D. in 1989, EMDR has been extensively studied and has been empirically validated as an effective and efficient form of intervention for healing the effects of trauma. To read more about it, I recommend Dr. Shapiro’s book, "Getting Past Your Past."

What is trauma?

Human beings have a complex and wondrous mechanism in our brains to think, determine safety and danger and react to survive. If we see a snake and it’s rattling, we freeze, flee or get a hoe and kill it. We don’t even have to think before taking action. Trauma occurs when a person experiences life threatening events or when exposed to chronic, highly, emotionally charged stress over a prolonged period of time. Life threatening traumas such as car accidents, physical or sexual assault, war and natural disasters are very obvious forms of life threatening events. Trauma often shows up in less obvious ways such as: When a baby is born into an inconsistent or chaotic environment where basic needs are threatened; exposure to verbal, emotional, physical, sexual abuse or when abandoned by a parent, caregiver or spouse; when exposed to chronic anxiety such as difficulty in school, bullies on the playground, fear of a parent dying in a war.

When a person experiences trauma, the complex wondrous survival reactions described in the sentence about the snake can get stuck in a highly charged emotional/physical state that can paralyze, isolate, lead to violence or physical collapse. Over time, traumatic experiences that are not addressed can lead to chronic patterns of behavior that made sense when the trauma happen but have become problematic when there is no threat at all.

Serious trauma creates a perception of the world being dangerous all the time. When someone faints, argues with a boss, runs away or freezes when there is no obvious danger, observer’s think, “What’s wrong with you?” Nothing is “wrong.” The person is reacting normally when something triggers or reminds him or her of traumatic experiences in the past. The sound of a breaking glass can trigger a reaction related to a wind shield breaking in a serious accident. The smell of smoke can trigger a memory of living through a serious fire. The tone of voice of a frustrated boss can trigger memories of a fathers voice before a beating.

Why eye movements?

Dr. Shapiro observed the calming effects of guiding eyes back and forth, right to left in a consistent rhythm. Brain research demonstrates through the use of SPEC scans or Functional MRIs what the brain looks like in a state of trauma. The front of the brain which is the control center of our brain goes dark. The left brain which is where thinking and learning reside goes dark. The perception of time and space and even the ability to verbalize go off line. The back of the head, right brain is lit up like a movie Marquee. This highly charged part of the brain is focused on survival responses that don’t require thought. And, behind this movie marquee, a movie is running that has all the scary images and experiences from the past. After EMDR, the left brain and front of the head are back in balance with the right brain and back of the head. With all parts of the brain on board, the person can decide when the world is really dangerous and when it is not. The person no longer screams at the sound of breaking glass, the person no longer runs at the smell of smoke and the person no longer fights with the frustrated boss.

What is desensitization?

When we first hear a train horn up close, we might jump. Over time, we become sensitized to the sound because we know what to name the sound and know it’s a train. No need for the original startle, it is not dangerous.

When experiences are highly charged, they are stuck in the traumatic past. The person is sensitized to the sound of breaking glass, the smell of smoke or tone of voice. These sensitized reactions are stuck in “danger … have to survive!!” Desensitization reduces and neutralizes the charge by bringing the brain and physical responses into balance. EMDR targets the brain systems of the stuck place, helps the person process the reaction and engages the whole brain to understand and respond in new ways.

What is Reprocessing?

Once the trauma reactions are desensitized, the rebalanced brain and body can process what happened in a new way.

What is EMDR again?

A tried and true method for helping with depression, anxiety and traumatic reactions is Cognitive Behavioral Therapy (CBT). The idea is that we create “irrational” beliefs based on misinterpreting our environment. This belief is expressed by negative thoughts about ourselves: “I’m stupid”; I’m not enough”; I don’t matter”; No one cares about me” or the world “I am always in danger.” Thinking these negative thoughts leads to depression, sadness or feeling threatened all the time. By challenging the irrationality of these beliefs and acting as if the belief isn’t true, the emotions are expected to come around. If I know I’m not stupid, I don’t feel sad and depressed. If people do care about me, I don’t have to be anxious anymore. This approach to therapy works well. For a good part of my practice, I utilized CBT and found it effective. Clients would get better when they challenged their “irrational” thoughts and acted “as if” the positive way of thinking were true. Some would return saying, “I know I’m not stupid … that people care about me … but the feelings don’t change.”

EMDR is CBT up-side down. EMDR works from the body up instead of the head down, from the feelings to the thoughts. If traumatic experiences shut off the thinking brain, how will challenging thoughts help? Emotions or what some people call feelings are experienced by the body first and then the brain. Emotions are expressed in physical form: My heart feels like it is breaking; I feel sick to my stomach; I’m shaking; I felt like my legs were made of rubber.

EMDR links the physical sensations with the negative thoughts and feelings. When the emotions are desensitized the person automatically thinks more positively which is called reprocessing. With reprocessed thoughts there is no need for “acting as if the belief is not true.” The behavior automatically follows the balanced emotional state and new way of thinking. In addition to neutralizing the distress, EMDR can then sensitize the person to the new emotions, thoughts and view of the world.