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How Does EMDR Therapy Work? What Makes It So Effective?

There's a lot of science behind it.

Source: Pixabay

“We believe that EMDR induces a fundamental change in brain circuitry similar to what happens in REM sleep — that allows the person undergoing treatment to more effectively process and incorporate traumatic memories into general association networks in the brain. This helps the individual integrate and understand the memories within the larger context of his or her life experience.” - Robert Stickgold, Ph.D., Harvard Medical

EMDR is not a traditional talk-therapy like most other psychotherapies; it's more of a mindfulness-based therapy, but there's more. It is based on the adaptive information processing (AIP) model, which Francine Shapiro, creator of EMDR, originally developed as a working hypothesis based on clinical observation. It accounts for the speed of clinical results EMDR achieved (Shapiro, 2017). Because of Shapiro’s original behavioral orientation in her clinical training as a graduate student, EMDR was influenced by Pavlov’s notion of information processing systems known in popular psychology as “classical conditioning” and recent models of neuropsychological processing (Christman, Garvey, Propper, & Phaneuf, 2003). The eye movement refers to bilateral ocular oscillations while holding a disturbing experience in mind. Eventually, this helps desensitize the emotional charge of the memory, and reprocess how it's stored in the mind and body, ultimately from self-defeating to self-affirming.

The AIP points to the strength-based notion that our minds have a natural capacity to process what happens to us in a healthy and adaptive way. However, significantly stressful experiences can overwhelm the brain’s natural processing and healing capacity. When the information related to a particularly stressful occurrence is ineffectually processed, the initial perceptions can be stored essentially as they were originally encoded, along with any distorted thoughts, images, sensations, or perceptions experienced when it happened (Shapiro, 2007). Thus, in EMDR, the culprit fueling mental health issues is a set of unprocessed, inadequately digested memories stored in the brain and body.

The AIP is part of the body’s natural, physiologically programmed penchant for healing itself when injured. A useful metaphor is that a cut in the skin naturally heals in a week—but not if there is a splinter stuck in it. In this metaphor, the splinter can represent a dysfunctionally stored memory (often a traumatic experience, but not always), which EMDR helps remove so the mind can naturally heal by activating its AIP.

In preparation for the emotional surgery of EMDR, your therapist may use visualization and imagery to help cultivate enlightened qualities such as compassion, power, and wisdom. Think of this part (phase 2 of EMDR) as a warm-up for the big game. Throughout the process, EMDR is present-oriented, helping clients notice what they are currently experiencing and feeling as transitory events in consciousness, not fixed traits, without judgment or self-criticism.

EMDR is also rooted in mindfulness and nonjudgmental awareness that can lead to transformative healing. Both involve trusting the process as it organically unfolds, what Alan Watts (1951) called the “wisdom of insecurity.” After a successful course of EMDR therapy, trauma survivors can learn to approach situations with equanimity and flexibility, yet appropriate caution. This is consistent with activating the AIP, the integration of unhealed memories into the innate larger, life-enhancing, and adaptive memory networks that serve the person in the present and future and remove the memory's emotional disturbance from the mind and body.

Still, it is difficult to know exactly how any psychotherapy approach works because it is challenging to study the brain in action; however, EMDR considers that when a person is upset, they may often have difficulty processing information compared to when they are not upset. Normally, our brains store memories in information such as sounds, smells, images, and emotions. Sometimes when we experience significant or disturbing events, our brains store these memories in unhelpful ways that are then triggered in your daily life. Difficult memories often have negative effects that affect the way people approach relationships, experience the world, and process information.

In this sense, from an EMDR perspective, mental health issues can be referred to as “information processing disorders” (Schubert & Lee, 2009), viewing the processing of the memory and its type of storage as pathological, instead of the traumatic events fueling the disturbances themselves. EMDR works by stimulating the brain in ways that lead it to process unprocessed or unhealed memories, leading to a natural restoration and adaptive resolution, decreased emotional charge (desensitization, or the “D” of EMDR), and linkage to positive memory networks (reprocessing, or the “R” of EMDR).

In EMDR, dysfunctionally stored memories transition from being isolated and stuck in the limbic system in their raw, original, and state-specific form, to the neocortex, in the form of semantic memory. This helps them get emotionally and physiologically digested or subsumed into one’s existing memory networks and coherent personal narrative (Wesselmann & Potter, 2009). EMDR therapy has been found to soothe the reactive sympathetic nervous system associated with traumatic experiences, directly lowering physiological arousal (Marich, 2011; Parnell, 2010; Shapiro, 2012, 2017).

EMDR helps people address and work through those memories, sensations, and emotions and resume normal, adaptive, and healthy processing. An experience that may have triggered a negative response may no longer affect them the way it used to after EMDR treatment. Difficult experiences will likely become less upsetting.

EMDR appears to have similar effects of rapid eye movement (REM) sleep in which the mind and body integrate information during sleep. Much like in REM, during EMDR your brain will go wherever it needs to go to heal. EMDR uses dual stimulation to help clients process difficult memories. Using the light bar, clients track the blue lights left and right with their eyes. Clients hold hand buzzers that send gentle oscillating vibrations to the hands.

Hence, when a memory is processed to completion, it informs, but does not control you; you are able to remember it but do not experience the old sensations, emotions, and maladaptive self-concept in the present (Shapiro, 2017). As evidence, Shapiro (2017) affirmed that abuse victims began EMDR with a negative self-concept regarding the abuse and ended with an affirmative sense of self-worth, and that the opposite never happened. Activating the brain’s innate AIP is the main focus clinically in EMDR therapy.

This post is not meant to substitute for treatment with a qualified professional. If you’re looking for an EMDR therapist, I recommend checking the EMDR International Association (EMDRIA) website to ensure the therapist is certified (ideally), or minimally, was trained by an approved EMDR training provider. To find a therapist, please visit the Psychology Today Therapy Directory.

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