Eye Movement Desensitisation and Reprocessing therapy

What is EMDR Therapy?

EMDR (Eye Movement Desensitization and Reprocessing) Therapy is a psychological treatment highly effective in the treatment of post-traumatic stress disorder (PTSD), as well as other psychological conditions. EMDR Therapy is based on the idea that negative thoughts, feelings and behaviours stem from unprocessed memories from stressful or traumatic experiences.

EMDR Therapy is a structured treatment that involves focusing simultaneously on a) an upsetting issue or traumatic memory and its associated thoughts, feelings and sensations, and b) bilateral stimulation that is most commonly in the form of repeated eye movements. This is believed to mimic the natural memory processing characteristics of REM sleep and disrupt working memory, thus facilitating the brain to successfully process a memory or issue. Once traumatic memories have been desensitized and reprocessed, they no longer have the same negative impact. Memories typically become less vivid and upsetting, intrusive symptoms such as nightmares and flashbacks reduce or cease, and more adaptive beliefs emerge.

How effective is EMDR Therapy?

EMDR Therapy is one of the most well researched trauma treatment models and has been shown to be effective in over 25 scientific studies and numerous independent reviews. It is endorsed by:

• The World Health Organisation (2013)

• The Australian Psychological Society (2010)

• The International Society for Traumatic Stress Studies (2009)

• American Psychiatric Association (2004).

What happens during an EMDR Therapy session?

Once adequate preparation has taken place, memory processing becomes the focus of EMDR treatment. During EMDR you are guided by your therapist to bring the unprocessed memory as well as your thoughts, beliefs and the accompanying emotions and bodily sensations about it, into conscious awareness. This is quickly followed by engaging in the “eye movements”, which usually occur by following your therapists’ fingers as they move from left to right. 

This bilateral stimulation (the eyes moving from left to right), moves the memory from the emotional part of the brain where it is ‘stuck’ (the mammalian brain) and into the part of the brain that allows cognitive processing (the human brain), which then allows you to experience distance from the event, and to be more anchored in the present moment. 

At the end of each set of eye movements you are then asked to report what you notice. It may be that the sensory memory becomes less detailed or vivid, or perhaps that it has changed in nature or feels quite distant or vague. Commonly, the emotional or bodily sensations can also reduce in intensity quite quickly. Simple memories can be treated in a single session, where as older and multiple memories can require several sessions to produce a similar effect. 

The EMDR Therapist will allow time to debrief the session, and often the session will conclude with some form of grounding or relaxation exercise. The client is fully awake, alert and in control at all times during an EMDR session.

EMDR is an 8-phase model of treatment that involves assessment and preparation prior to the commencement of trauma processing. This means that each person’s first EMDR admission will be different, as the EMDR Therapist will tailor the early stages of therapy to suit the individual client. The pace of treatment depends on the complexity of the client’s trauma history, their existing resources and emotional regulation skills, and their broader life circumstances. Some clients may only require a single EMDR admission. However, it is not unusual for clients to require 2-3 admissions to the EMDR program, with breaks of a number of months in between. For some clients, memory processing using eye movements will commence in the second or third EMDR session, while for others it may not commence until their second or third admission. Once EMDR sessions have commenced, emotions may be raw, thoughts of the issues are more present and dreams can be more vivid. This is a normal response as the brain continues to process memories in between sessions.

The EMDR Treatment Process

• Identification and mapping of significant life events and traumatic experiences

• Development of resources, coping strategies, and grounding techniques

• Exploration of different aspects of your personality (parts of self)

• Processing of traumatic memories using bilateral stimulation (typically eye movements).

How does a traumatic memory differ from a normal memory? 

When we experience a traumatic situation, our brains code this memory into three components:

1. The sensory memory (what we see, smell, hear etc.)

2. The emotional memory (what we felt)

3. The meaning or valence we attribute to the situation

These memories are stored in the part of our brain called the limbic system, which we can think of as the oldest and most mammalian-like part of our brains. Back when we were hunting lions and gazelles on the African Savanna, the limbic system elevated chemicals in our body that signalled us to be hyper-alert and ready to chase down our next meal (the fight part, of the fight-or-flight response), or merely survive and run as fast as we can in the other direction (the flight part, of the fight-or-flight response). Memories stored in the limbic system are more readily and easily retrieved due to how important and salient we attribute them to be at the time. 

When we recall a traumatic memory stored in the limbic system from decades ago, it may feel as though it happened as recently as yesterday. Our animal brain kicks in and we feel an impending sense of fear, anticipation or heightened alertness. Our body is protecting us, by registering that something dangerous may be present and that we should potentially fight, flight or freeze in response to it. However, by doing this it hijacks the part of our brain that makes us the most human; our pre-frontal cortex, which allows us to regulate our thoughts and feelings, and problem solve appropriately. This automatic response will render us unable to make the connection that this memory is a past experience and that in the present moment we are okay. 

Let’s call the memories stored in the limbic system our unprocessed traumatic memories. These memories are often recalled with great vividness and emotional attachment and can be experienced as though they are occurring in the here and now. They might also consist of sensory fragments of the event, rather than a complete and full reconstruction of the memory. 

Memories that are processed and integrated are recalled with a clear sense of what is remembered in the past. These memories generally fade over time and lose their vividness and detail and therefore feel like a more distant, understood, and put to rest memory. 

Who could benefit from EMDR Therapy?

While EMDR Therapy was originally developed for PTSD, research is continuing to support its application to a range of other psychological issues, including, (but not limited to):

• Anxiety

• Panic attacks

• Phobias

• Depression

• Personality disorders

• Complicated grief

• Chronic pain

• Eating disorders.