Mindfulness

Mindfulness and EMDR Therapy

Both are powerful therapies that can work in tandem to transform your suffering.

Posted Jun 02, 2019

Although I work with couples using emotionally focused therapy, and of course mindfulness, I am primarily an EMDR therapist.

EMDR stands for Eye Movement Desensitization and Reprocessing. It began as a trauma treatment meant to reduce symptoms such as hyper-vigilance, intrusive memories, and related disturbances for returning soldiers from the Vietnam war and women who had been raped. It achieved timely results in its original clinical trials in the late 1980s that withstood six-month follow-ups (Shapiro, 1989). It was originally called eye movement desensitization (EMD) until 1990, when the “R,” which stands for reprocessing, was added to convert EMD into EMDR, the comprehensive psychotherapy treatment approach it has become. 

Francine Shapiro, creator of EMDR, transformed EMD from its initial conceptualization as a basic trauma symptom desensitization to a more integrative information processing paradigm now known as EMDR. EMDR is now used regularly by myriad clinicians to evoke positive affect and profound shifts in core-beliefs and related behaviors, as opposed to merely symptom alleviation.

Now, after 30+ years of research progress and clinical development, EMDR therapists treat a variety of mental health issues and adverse life experiences (Shapiro, 2012). Shapiro (2017) also asserted that EMDR can work on issues many clinicians have come to view as intractable, such as personality disorders, by reprocessing the memories underlying the present dysfunction.

EMDR therapy is based on the adaptive information processing (AIP) model, which Shapiro 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 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).

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.

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. 

In this sense, from an EMDR perspective, PTSD can be referred to as an “information processing disorder” (Schubert & Lee, 2009), viewing the processing of the memory and its type of storage as pathological, instead of the traumatic event itself. 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).

Hence, when a memory is processed to completion, it informs, but does not control the person; they 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. 

Here's how they connect. Renowned EMDR trainer Dr. Laurel Parnell has been interested in mindfulness since 1972; the analogy of looking into your own mind and using the mind as a lab to discover your own truths attracted her to mindfulness training and retreats. She has completed a number of silent mindfulness meditation retreats with pioneers Jack Kornfield and Joseph Goldstein.

Similar to EMDR, many Tibetan monks use visualization and imagery to help cultivate enlightened qualities suck as compassion, power, and wisdom. Jean Klein taught yoga in his retreats that emphasized body sensing on a deep, microscopic level. Mindfulness practice helps us experience what’s coming up for us as merely information, rather than something to be judged or discarded.

In my therapeutic practice with my clients, I regularly integrate mindfulness and EMDR. In fact, EMDR fundamentally is a mindfulness therapy; they go hand in hand. If you’ve read any of my previous posts, you’ll know that mindfulness is broadly defined as non-judgmental awareness of whatever comes up, ideally with curiosity, openness, non-judgment, compassion, and acceptance (an acronym I use often when discussing mindfulness is CONCA). EMDR therapists hold a mindful posture to all traumatic and related material clients report; it all arises as phenomena to be witnessed, which depersonalizes the traumatic events targeted for processing.

Likewise, both EMDR and mindfulness-based therapies are 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. Both can be briefly summarized into essentially present-time, 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.” As EMDR trainers Jaime Marich and Stephen Dansiger point out, they naturally complement each other.

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Generally, both EMDR therapists and their clients are treating what clients share during EMDR as movements toward healing (activation of the AIP), as long as they weren't distracted or stuck in a hyper- or hypo-aroused traumatized state (over-activating or under-activating nervous systems). The only difference is that EMDR is overtly goal-oriented, helping the client toward an adaptive resolution of stressful memories, whereas mindfulness purposely is not (but, ironically, can become a little goal-oriented by default; consider why you're practicing in the first place).    

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. 

References

Shapiro, F. (2007). EMDR, adaptive information processing, and case conceptualization. Journal of EMDR Practice and Research, 1(2), 68-87.

Shapiro, F. (2017). Eye movement desensitization and reprocessing (EMDR): Basic principles, protocols, and procedures. (3rded.). Guilford Press.

Shapiro, F. (2002). EMDR as an integrative psychotherapy approach: Experts of diverse  orientations explore the paradigm prism, 289-318. American Psychological Association. 

Shapiro, F. (1989). Efficacy of the eye movement desensitization procedure in the treatment of traumatic memories. Journal of traumatic stress, 2(2), 199-223.

Schubert, S., & Lee, C. W. (2009). Adult PTSD and its treatment with EMDR: A review of controversies, evidence, and theoretical knowledge. Journal of EMDR Practice and Research, 3(3), 117-132.

Parnell, L. (2013). Attachment-focused EMDR: Healing Relational Trauma. WW Norton & Company.

Christman, S. D., Garvey, K. J., Propper, R. E., & Phaneuf, K. A. (2003). Bilateral eye movements enhance the retrieval of episodic memories. Neuropsychology, 17, 221–229.