Trauma and EMDR Therapy: How Does It Work?
To understand how EMDR works, it's crucial to understand the neurological impact of trauma. When a traumatic event occurs, the brain's natural information processing system can become overwhelmed. Instead of integrating the memory into the broader network of experiences, the traumatic memory gets "stuck" in an unprocessed state. This means the sensory, emotional, and cognitive components of the memory (sights, sounds, smells, feelings, thoughts) remain vivid and raw, as if the event is still happening.
This unprocessed state is why individuals with trauma often experience flashbacks, nightmares, intense emotional reactions to triggers, and a persistent sense of threat. The amygdala, the brain's alarm system, remains hyperactive, constantly scanning for danger, while the hippocampus, responsible for contextualizing memories, struggles to place the traumatic event in its proper context.
The prefrontal cortex, which is responsible for rational thought and emotional regulation, may also be less active, making it difficult for individuals to manage their emotions effectively. Essentially, the brain gets trapped in a loop, re-experiencing the trauma rather than moving past it.
What is EMDR Therapy?
EMDR therapy was developed in 1987 by Francine Shapiro, Ph.D. While walking in a park, she noticed that distressing thoughts diminished when her eyes rushed from side to side. This observation led her to hypothesize that eye movements could have a desensitizing effect on disturbing memories. The core mechanism of EMDR involves bilateral stimulation, most commonly through guided eye movements, but also through alternating auditory tones or tactile sensations (like tapping).
How EMDR Works: The Eight Phases
EMDR therapy is not simply about moving one's eyes; it's a structured, phased approach that carefully guides the client through the healing process.
History Taking and Treatment Planning: The therapist gathers a comprehensive history of the client's trauma and identifies specific memories to target.
Preparation: The client learns coping skills and relaxation techniques to manage any distress that may arise during the processing phases. This ensures the client feels safe and resourced.
Assessment: The client identifies the target memory, including the vivid image, negative belief about themselves (e.g., "I am helpless"), associated emotions, and body sensations. They also rate the disturbance level (Subjective Units of Disturbance - SUD) and the validity of a positive belief (Validity of Cognition - VOC).
Desensitization: This is the core processing phase. While focusing on the target memory, the client engages in bilateral stimulation. The therapist guides the client through sets of eye movements (or other stimulation), pausing periodically to ask what comes to mind. The goal is to reduce the SUD level until the memory no longer feels disturbing.
Installation: Once the SUD is low, the client focuses on the positive belief they want to associate with the memory (e.g., "I am strong now") and uses bilateral stimulation to strengthen its validity (VOC).
Body Scan: The client scans their body for any residual tension or uncomfortable sensations related to the memory. If any are found, further bilateral stimulation is used to release them.
Closure: The therapist ensures the client leaves the session feeling grounded and stable, even if the processing of a particular memory is not yet complete.
Re-evaluation: At the beginning of subsequent sessions, the therapist checks the progress on previously processed memories to ensure the gains have been maintained.
The Science Behind the Success
While the exact neurobiological mechanisms are still being researched, several theories explain EMDR's effectiveness. One prominent theory suggests that the bilateral stimulation helps to "unfreeze" the traumatic memory, allowing it to move from the limbic system (where raw emotions are processed) to the prefrontal cortex (where logical thought and integration occur).
Another theory proposes that the bilateral stimulation creates an "orienting response," which temporarily distracts the working memory. This distraction, combined with focusing on the traumatic memory, makes the memory less vivid and emotionally intense, allowing for its desensitization. Regardless of the precise mechanism, numerous studies have demonstrated EMDR's efficacy in treating PTSD and other trauma-related conditions, often with fewer sessions than traditional therapies.
Trauma can profoundly impact an individual's life, leaving them feeling trapped by past events. EMDR treatment offers a powerful and effective pathway to healing by facilitating the brain's natural information processing system. Book a consultation today to learn more about our services.