EMDR Therapy
EMDR explained in a 30 minute audio file from MightyNetworks.
EMDR (Eye Movement Desensitization and Reprocessing) is a technique used in psychotherapy. It does not require talking in detail about the distressing issue. Instead of relying on insight and understanding, EMDR helps the brain resume its natural healing process. EMDR therapy is designed to process traumatic memories in the brain, so the person is informed by the memories but not controlled by them. Part of the therapy includes alternating eye movements, sounds, or taps. We call that bilateral stimulation. EMDR therapy can be done in-person or via virtual platforms and must be done with a properly trained and licensed mental health clinician. EMDR online has been studied and is demonstrated to be as effective as in-person EMDR. The national organization that oversees EMDR therapist training is EMDRIA. I am an EMDRIA-certified EMDR therapist.
Inside EMDR:
This processing method opens up feelings. Sometimes these are just body-based physical sensations, for example, tightness in the stomach or tension in the jaw. They may make sense or not. There may be a visual or verbal description or not. These feelings often lead to related memory-feeling pathways. As things come up for processing, EMDR helps them move through and out, desensitizing you to the traumatic memory. Together, we continue to notice them and help them move with bilateral stimulation. We keep the processing going until the original problem is no longer disturbing. The troubling lessons you may have learned or believed become available for revision and updating.
This mimics the way the brain processes experiences during REM sleep, but sometimes an experience overwhelms that process and (those emotions) can get stuck, maybe for years. When that happens, these feelings stay chronically present in the background of our minds and are easily triggered. With EMDR, there is no homework, but processing may continue in the background between sessions. Getting extra sleep is helpful.
EMDR may surface other issues, and the client and therapist can decide together whether to change the plan to accommodate them or stay the course.
Whether or not to use EMDR:
When I am considering whether to do EMDR with clients, I will be asking myself four things.
I will assess whether that person is comfortable enough with emotions to stick with feeling them while still maintaining an awareness of being in therapy at the moment. We call that dual awareness. So, not someone who is easily swept away in a flashback by the emotional reality of the memory.
I also want to know that they are focused and dedicated to staying on target.
And finally, I want to know that they can stay emotionally connected to me and their feelings without spacing out or emotionally disappearing.
I also want to know that they are fairly stable, not actively suicidal, or so vulnerable to overwhelm that their ability to function in daily life is compromised.
Benefits of EMDR:
For many clients, EMDR therapy can be completed in fewer sessions than other psychotherapies. This is particularly true if the trauma happened recently.
A fun way to understand how the brain and emotions work is to watch the movie Inside Out.
Here is another very simple video of EMDR:
https://youtu.be/hKrfH43srg8?feature=shared
Here is a licensed EMDR therapist explaining doing EMDR online
Further reading about EMDR:
EMERGING TRENDS IN EMDR
CHRISTOPHER BROWN, LICSW. Peak psychotherapy.co
EMDR therapy has evolved dramatically since Francine Shapiro’s walk in the park in 1987.
What began as a technique for treating PTSD has expanded into a comprehensive therapeutic approach with applications ranging from depression to performance enhancement.
But where is EMDR headed next?
Today, I want to explore the emerging trends and innovations that will likely shape the future of EMDR practice (so you can prepare your practice for what’s coming).
Neuroscience Breakthroughs in EMDR
The neuroscience of EMDR is advancing beyond general theories to more specific understandings of how bilateral stimulation (BLS) affects the brain.
Neuroimaging studies have provided deeper insights into how EMDR facilitates healing at the neural level. Functional MRI (fMRI) scans reveal that EMDR therapy can lead to significant changes in brain regions associated with memory and emotion processing:
• Amygdala Activity Reduction: The amygdala, known for its role in fear and emotional processing, often exhibits hyperactivity in individuals with PTSD. BLS has been shown to decrease amygdala activation, which correlates with a reduction in hyperarousal and emotional reactivity.
• Hippocampal Engagement: The hippocampus plays a crucial role in contextualizing memories and distinguishing past from present experiences. Post-EMDR therapy, increased activation in the hippocampus suggests improved integration and contextualization of traumatic memories, aiding in their transformation into less distressing recollections.
• Enhanced Prefrontal Cortex Connectivity: EMDR appears to strengthen the connection between the prefrontal cortex and limbic regions, facilitating better emotional regulation and cognitive control over traumatic memories.
Understanding these neural changes underscores the importance of EMDR in promoting adaptive memory reconsolidation. By targeting specific neural circuits, EMDR not only alleviates symptoms but also fosters long-term resilience and emotional well-being.
Advancements in EMDR Tech
Remember when a therapist’s fingers or a light bar were the only options for bilateral stimulation?
After switching to telehealth-only, my light bar has been sitting in my closet for two years now.
Technology is changing how we conduct EMDR therapy (especially post-pandemic).
Bilateral stimulation websites now offer customizable visual, auditory, and tactile options that can be precisely controlled and even tracked over time. Many therapists who were initially skeptical about these tools have found them surprisingly effective (especially for remote work).
Virtual reality is perhaps the most fascinating frontier.
Imagine a client entering an immersive environment that can provide BLS through visual, audio, and tactile; or even amplifying memory activation walking through seemingly live scenes that symbolize original traumas. Some may even use tech to track biomarkers real time during VR sessions.
Remote EMDR delivery has come a long way too.
When the pandemic hit, many of us worried that EMDR wouldn’t translate to telehealth. Myself included – I had gone years in-person only, but a few years later, I’m now telehealth-only! Specialized platforms now have features designed specifically for online EMDR, and the results have been on par with what we’d expect to see in-person.
What’s particularly interesting is that some clients actually process more effectively online than in-person. The comfort of their own space seems to create safety that enhances their work.
These technologies aren’t replacing the therapeutic relationship. They’re enhancing what’s possible within it.
Expanding Applications of EMDR
EMDR started as a PTSD treatment, but it’s becoming clear that its potential reaches much further. One of my favorite developments is in treating somatic symptoms. I use this a ton with clients experiencing chronic pain on top of mental health conditions.
The success we’ve seen with chronic pain is extending to other physical conditions where emotional distress manifests in the body. EMDR’s ability to address both the emotional and physical aspects of these conditions makes it uniquely effective. It seems to help change the individual’s relationship with their own pain, making it more manageable and less distressing.
Addiction treatment is also being impacted by EMDR.
The Feeling-State Addiction (FSA) protocol and DeTUR approaches address the underlying emotional drivers of addiction rather than just managing behaviors. This gets to the heart of why people use substances or behaviors to cope.
Protocol Innovations
The standard 8-phase protocol isn’t going anywhere, but it’s being joined by specialized adaptations designed for specific clinical challenges.
The Flash Technique has been one of the most significant developments. For clients who can’t tolerate direct engagement with traumatic memories, this minimally intrusive approach offers a gateway to processing. What started as a clinical innovation now has research supporting its effectiveness.
Attachment-focused EMDR is another important development, particularly for developmental trauma. Rather than focusing solely on discrete traumatic events, these approaches address the impact of attachment disruptions and relational patterns. The therapeutic relationship itself becomes a more active part of the healing process.
Group protocols are evolving too, potentially making EMDR more accessible and cost-effective. While these won’t replace individual therapy for complex trauma, they offer options for settings where resources are limited or for specific populations that benefit from group support.
These developments suggest EMDR is diversifying rather than being replaced. The core principles remain, but the applications are becoming more nuanced and specific to client needs.