What is EMDR?

Eye Movement Desensitization and Reprocessing Therapy is an anti-deterministic form of therapy. Anti-deterministic is a fancy term that means people are capable of change throughout their lives and that growth is not linear. The research behind EMDR has proven time and time again that people are capable of great change (2). EMDR can help alleviate negative symptoms or beliefs associated with a traumatic or distressing event and reinforces positive beliefs (1). EMDR has become the authorized therapeutic technique of the Department of Veterans Affairs and has been instrumental in helping people heal from traumatic events (2). By “loosening” a memory or image frozen from the past, it puts it in the larger context of one’s full life experience. I know this from my own experience doing EMDR.

Present and Past. 

Instead of managing emotions, pushing them away, or trying to cognitively change a belief or perceived threat, EMDR allows a person to go back to that memory without being re-traumatized (2). In grad school, we talk a lot about theoretical orientation, how change happens, and how people heal. It is my belief that to help people move forward, they may need to address the wounds of the past. When a triggering situation occurs, a distressing memory becomes present again (1). *Sidenote* Socially, there are so many words we use to describe traumatic or distressing memories and experiences that I think a lot of times can be interchangeable. It might be hard for some to "label" a memory as traumatic and instead easier to call it "distressing".  EMDR can be incredibly helpful for someone who does not have PTSD or trauma. So for the sake of this blog, I will use "distressing" or "adverse" to encompass stressful, distressing, maladaptive, traumatic, Big T, little T, etc. 

Memory. 

To understand better how EMDR works, I think it is helpful to have a basic understanding of how memory works. I have found that a little psychoeducation can be very helpful. A little bit of neuroscience and neurobiology has helped me realize I am not crazy, my brain is literally wired in a way to protect me. So let's cover a very quick science lesson on the limbic system. Or just jump to "Misslabled Memory" if you don't care for a short lesson in neuroscience. Hah!

The Limbic System maps the perception of our surroundings and categorizes its emotional significance (5). There are multiple parts to the limbic system but I am going to focus on the amygdala, hypocampus, and hypothalamus. The Amygdala is also called the smoke detector, it constantly takes in information via the thamalus assessing if our environment is safe or unsafe. While the amygdala is pretty stellar at organizing information from safe to dangerous, trauma increases the probability of misinterpretation of a threat (6). As the amygdala takes in information it sends signals to the hypocampus and the hypothalamus (6). 

The first signal gets to the hypothalamus (6). The hypothalamus releases hormones and neurotransmitters; and controls the Autonomic Nervous System to maintain homeostasis. The Autonomic Nervous System controls the Parasympathetic (rest, digest) and the Sympathetic (fight, flight, freeze) Nervous Systems (6). The second signal gets to the hippocampus or the cognitive mapper which plays a key role in remembering (2). The hippocampus retrieves information from the past and assembles information from the amygdala as explicit memories, which is just a fancy term for memories that we can recall (2). Like the sound of a car backfiring.

So how do all of these parts work together? Keep in mind I am not a neuroscientist! So very simply put, the thalamus takes in information, the sound of a car backfiring. The amygdala categorizes the information for emotional significance and signals are sent to the hypothalamus and the hippocampus (6). The amygdala sends a message to the hypothalamus which then tells the Sympathetic Nervous System to release the hormones to protect you from the perceived threat, like cortisol or adrenaline preparing you to fight or flight (6). The second signal gets to the hippocampus for a more accurate interpretation of the perceived threat (6). You realize it's just a car backfiring so the hypothalamus tells the Parasympathetic Nervous System to turn on, and your heart rate settles to return back to homeostasis/rest and digest. 

Misslabled Memory. 

However in an distressing event, the limbic system becomes flooded with the fight/flight/freeze hormones, and instead of memory being accurately labeled and filled away neatly in the hippocampus as a past experience, it is essentially missfilled and the brain thinks that said distressing or traumatic incident is still happening (1). “The neural pathways in the amygdala and hippocampus store traumatic memories” and those memories become trapped, essentially causing someone to live in a constant state of fight/flight/flee (1). A present trigger can set off emotions that were programmed in the past and what might seem like a reaction to a present moment is actually, "a reliving of past emotional experience" (3). Replaying a trauma or a perceived traumatic experience wreaks havoc and reorganizes the nervous system (2). 

How It Works.

So back to EMDR. EMDR is not like talk therapy, many friends who have done EMDR will ask me if they are "doing it right". I tell them their only job is to notice what comes up. Opposed to other kinds of therapy, EMDR does not require talking in detail about a traumatic or distressing memory. It does not require homework in between sessions either. Keeping a logbook in between sessions can be helpful if new thoughts, beliefs, or experiences arise but it is not mandatory or essential. EMDR helps the brain return to its natural way of processing. By providing some kind of bilateral stimulus (either tapping someone's knees or watching the therapist's hand move from left to right) EMDR helps keep one foot in the present to address adverse experiences in the past. Having another body and nervous system to ground a person in the present moment an individual is able to address a past experience and reprocess any negative beliefs. We are then able to fit the experience into the totality of our lived experiences, instead of the nervous system acting as if it was still going on. 

EMDR can help with PTSD, chronic pain, attachment wounds, ongoing trauma, and just regular ole' life stuff. You do not have to suffer from severe trauma to be a good candidate for EMDR however, is not for everyone! It is a great therapeutic tool that I look forward to being able to use with my clients one day. If you are interested in EMDR for yourself, as your therapist, or visit the EMDR International Association. 

Be Well, 

KB

1. Neukrug, E. (2018). Counseling Theory and Practice (2nd Edition ed.). (C. Benson, B. Christian, & J. Giganti, Eds.) Cognella Academic Publishing.

2. Van Der Kolk, B. (2014). The Body Keeps Score: Brain, Mind, and Body In The Healing Of Trauma. New York, New York: Penguin Books.

3. Maté, G. (2009). In the Realm of Hungry Ghosts: Close Encounters with Addiction. Berkeley, California: North Atlantic Books.

4. Claere, A., Gadelrab, R., Juruena, M., & Young, A. (2020, December 28). Epigenetics: A missing link between earl life stress and depression. Progress in Neuropsychopharmacology & Biological Psychiatry, 109(110231), 1-10.

5. Badenoch, B. (2008). Being A Brain-Wise Therapist, a Practical Guide to Interpersonal Neurobiology. New York: W. W. Norton & Company.