Eye Movement Desensitization and Reprocessing
EMDR was originally developed for the treatment of Post Traumatic Stress Disorder (PTSD). It is very well known in the therapeutic community and is practiced all over the world.
EMDR was developed by a psychologist by the name of Francine Shapiro. Dr. Shapiro had previously had something traumatic happen to her. One day she was taking a walk in the park, and noticed that as she was thinking of her disturbing memories, her eyes were moving back and forth rapidly like they do when we dream (REM sleep). When it stopped, she noticed that when she brought those same thoughts to mind, they were less disturbing. Intrigued, she decided to look into it further. She looked into dream research (because of the rapid eye movements) and discovered that dream researchers believe that the purpose of dreaming or REM sleep is to help process the experiences that happen to us on a daily basis.
To explain how this relates to EMDR and PTSD I like to use the metaphor of a desk. So, let’s imagine for a moment that your brain has a desk. As you go through your day, you cannot possibly process everything that happens to you completely (otherwise you would likely spend large portions of the day staring off into space). So let’s imagine that the experiences stack up on the desk of your brain like file folders. At night when you go to sleep, your brain (through REM sleep and dreaming) seems to take the file folders and file them away into filing cabinetsin order to deal with, or make sense of or organize your experiences. We have likely all had dreams that seem to be a mix of issues we are concerned about, things that have happened to us, or that we fear etc. Imagine this is like your brain cleaning off the desk.
Now let’s imagine for a moment, that you have had something awful happen to you. Let’s say that you were in the Vietnam or the Iraq War, and took part in a battle that was horrific. Your brain comes to that experience (which looks more like a 4 inch ring binder rather than a flimsy file folder sitting on the desk of your brain) and says, “hmmm what am I going to do with this? I do not have a category to file this one under. I have never experienced a horrific event like this.” So your brain leaves the experience on its desk.
And since it is a large experience (filled with intense emotions), it tends to get in the way. Now let’s say you come home from Vietnam or Iraq and you are walking down the street and a car backfires. It is an experience that reminds you of your traumatic experience and so it bumps into it (the binder) on the desk and activates it. Since the battle memory/experience is sitting on the desk of your brain in its original form, you re-experience all the emotions and bodily sensations of the original event. That is essentially what happens with PTSD. A trigger from the present, reactivates a traumatic memory and the person re-experiences the event with the intensity (or near original intensity) of the traumatic experience.
So Dr. Shapiro began working with Vietnam War veterans, due to their high incidence of PTSD. What she found is, despite adequate REM sleep (Vietnam war vets often had more rather than less REM sleep- it seems their brains were working over time trying to process the traumatic material) something was interfering with the processing of their traumatic memories. Dr Shapiro also quickly discovered that most people can not produce REM on their own, in a wakeful state. So she literally waved her hand in front of her patients faces and had them track her hand in order to facilitate the rapid eye movement. Dr. Shapiro found that the Vietnam vets too, seemed to benefit from the REM while accessing their traumatic memories. Dr. Shapiro developed a very specific protocol to use along with the REM that incorporates a visual image, cognitions and body sensations.
So the question is, why do rapid eye movements seem to help us process things? What we think is going on is this: Because the brain is contra-lateral (the left side of your brain controls and receives sensory information from the right side of your body and vice versa) by definition any stimulation that crosses the midline of your body (or is bilateral) stimulates both sides of the brain. The left side of your brain tends to be the more logical, analytical side of the brain, the right side of your brain tends to be more emotional. Have you ever had the experience where you are so upset you can’t speak as fluently as you usually do? For example, let’s say you are having an argument with someone and you are so upset you cannot say exactly what you want to say. Ten minutes later, after you have calmed down, you can verbalize it perfectly…but in that moment it was nearly impossible. During times like that, your right brain is likely more active and becomes dominant and your left brain seems to just be waiting for the chance to get back involved.
It just so happens that the language centers are largely in the left side of the brain, so it makes sense that when we are emotionally over-stimulated and our right brain becomes dominant, we cannot speak as fluently as we can when we are calm and our left brain is dominant. So it seems that when something traumatic happens, it is almost as if it gets stuck in the right side of the brain. If I ask you to access those memories and I simultaneously stimulate both sides of your brain, it seems to open up a natural line of communication between the sides of the brain and allows the left side of the brain a chance to help make sense of, or help process the emotional material.
One of the psychologists who trained me in EMDR, (Dr. Puk) told a story of a Vietnam war vet whom he treated. This gentleman had a recurring nightmare of a horrible battle in which he took part. Let’s think of his nightmare/memory like a videotape which started at point A and ended at point Z. Every night he would start reliving the memory in the form of a nightmare and when he got to the scariest part of the memory (say point T) he would become so upset and afraid that it would wake him up and disrupt the processing of the memory. At that point he was too upset to go back to sleep and so every night his brain would start over at point A, get to point T and wake up. A to T was getting processed. T to Z was not processed. It seemed that in having the recurring nightmare his brain kept trying to process the whole memory, but it was not successful.
So Dr. Puk asked his patient to go through the entire memory sequence in a wakeful state and process the memory using EMDR. When the entire memory had been processed, the veteran’s recurring nightmare went away, he got a haircut and a job and became a fully functioning member of society for the first time since returning from Vietnam. Since EMDR’s initial development, it has been applied to many problems. Not all of us have had “big T’ traumas, but all of us have had ‘little T” traumas (e.g. someone sat on your lunch in 2nd grade and it was upsetting). Sometimes we are affected as adults by little things that we misinterpreted during our childhoods. For example, let’s say that you needed your mother’s attention for something when you were 4 years old and she couldn’t give it to you at that moment. Your 4 year old brain comes up with an explanation: “I’m not important.” Let’s say this same scenario happens a few months or years later with another caretaker or a teacher. Your little brain says, “See, I’m not important.” This negative thought is like a little seed that gets planted and subsequently gets watered and fertilized throughout the years by little incidents that seem to confirm its accuracy. Suddenly the seed has become a large tree that overshadows your adult decisions, attitude and confidence. EMDR takes that tree down branch by branch by allowing your adult left brain access to the hurt feelings from the upsetting incidents that allowed the tree to grow in the first place. Suddenly you can connect the knowledge that your mother was busy with her dying father, a bankruptcy and trying to finish school with the hurt feelings and realize on an emotional level that her not having time for you was not because you were not important. Once you make those connections and process the emotions associated with them, they tend to lose their power over you.
I often meet with people who have had enough therapy that they say they understand why they do certain things, but they can’t stop doing them. To me this is often a right brain left brain issue. I know why I do this, but I still feel x so I keep doing it. EMDR seems to help people past that stuck point. We have also discovered that EMDR does not only work with rapid eye movement.
Because of the contra-lateral nature of the brain, any bilateral stimulation seems to produce the same effect. When I do EMDR, I will give you headphones that play tones that oscillate back and forth in each ear and pulsers that vibrate in each hand. I will ask you some questions about your memory and then I will turn on the bilateral stimulation for a brief period. Then I check in with you and we continue on until your memory is no longer disturbing.
It is important to remember that your brain leads this process and as long as you are not trying to consciously control where your brain is going, you really can’t do EMDR wrong. I find it to be a helpful tool to have available to use during the course of therapy. I have been practicing EMDR since 2000 and I find it to be both fascinating and very helpful.
There is a website with an extensive bibliography (www.emdr.com). I am a certified EMDR therapist and you should be able to find my name listed on the EMDR International website (www.emdria.org). If you have any questions, please let me know.