My name is Kammy Yorgason and I am a licensed clinical mental health counselor (CMCH). I have worked extensively with trauma, depression, anxiety, panic, personality disorders, bipolar, LGBTQIA+ related issues, and other mental health concerns that can take the joy out of everyday living. I use a multifaceted approach tailored to meet the needs of each client. One therapeutic approach about which I am passionate is using EMDR to heal trauma so it no longer has such a stronghold on an individual’s life.
Because EMDR is relatively new (1987), there are a lot of misconceptions about the process. Hopefully, this information will give you a basic understanding of what to expect. EMDR stands for Eye Movement Desensitization and Reprocessing. It has become a leading treatment approach for those with trauma, post traumatic stress disorder (PTSD), and is successfully used to treat a wide variety of mental diagnoses including common issues such as depression and anxiety.
Is EMDR done in the first session?
No. In order for you to have the best possible results, there is some preparation and education that needs to take place before getting started with the actual reprocessing. Your therapist will want to make certain EMDR is appropriate for your specific situation and will work with you on making certain you have the internal resources needed to stabilize as different stressors arise.
How does it work?
EMDR uses bilateral stimulation (stimulating both the right and left side of the body) to reduce distress and strengthen adaptive thoughts and beliefs. Simply put, EMDR uses eye movement, touch, or sound to reprocess how old memories are stored and how those memories are linked in the memory network. Dual attention between the past and present allows us to reprocess distressing memories that seem to be locked in the brain. It is important to know, you are always in control and it is your own brain doing the work.
Why would old memories need to be reprocessed?
Past experiences shape our understanding of the present, how we think, feel, and respond to circumstances in our daily lives. Sometimes those responses are appropriate and sometimes a person may overreact. If an overreaction is a common response, it may be due to a “trigger.” Memories that are inadequately processed and maladaptively stored can lead to triggers in certain situations.
What is a trigger?
A “trigger” is a stimulus that evokes a reaction. Situations in the present may remind us of a similar situation from the past, consciously or unconsciously, and we react based on the information learned and stored in our memories. Most everyone has heard the term “Trigger Warning.” A trigger warning simply means the information is likely to contain material that could be upsetting to those who have had similar experiences and are in place to give people an opportunity to avoid the material.
When preparing for EMDR, you and the therapist will discuss what triggers you may have and traumas that may trigger a negative emotional response. Triggers can be obvious or subtle. Most people are familiar with stories of soldiers being triggered by loud noises such as fireworks or the backfire of a car. More subtle triggers may be sounds, odors, pictures, tastes, people, places, things, or behaviors. Perhaps you enter a house and the smell of baking bread floods your nostrils. It may remind you of visiting your grandmother when you were a child and you have a strong recollection of how safe you felt. The odor of the bread triggered a memory. This isn’t a problem if the memory is pleasant. Let’s look at another example. Perhaps your parents would scream at one another prior to their divorce. Now, when someone yells, you are filled with dread. In this case, a negative memory is triggered and causes distress. Sometimes we understand the original source of our triggers, but this isn’t always the case. Reprocessing disturbing memories helps neutralize triggers and their negative effects on our present lives. EMDR can still be effective even if the source of the original trauma is unknown or if there are other factors that prevent the recollection of details.
What if I don’t want to talk about my trauma?
EMDR is different from traditional talk-therapy. Rather than being asked to recount details of a trauma, you will be asked to think about a target memory, a negative belief about yourself resulting from the trauma, and where you feel it in your body as bilateral stimulation is applied.
The response to reprocessing a memory is different for each person. For some, different parts of the trauma will come up automatically. For others, the target memory will feed into other memories that may not seem related to the identified trauma. The key is to notice what comes up for you, without judgment. Whatever does come up during the session, is briefly identified but generally not discussed in great detail.
How much trauma am I going to re-experience by doing EMDR?
You are in control at all times and have the option to take a break or stop, if or when needed. The most important factor is that you have already been through the trauma and survived. In general, what you experience while going through EMDR is not any worse than pulling up the memory, since that is what we do during the process, and you will likely notice a decrease in distress after the first few sessions.
How long does EMDR take?
EMDR has eight phases: History, Preparation, Assessment, Desensitization, Installation, Body Scan, Closure, and Reevaluation. Depending on the nature of the distress, each phase may take only one session or it may require multiple sessions. A recent trauma that only occurred one time may be completed within a few weeks; whereas, complex trauma will take more time. Your therapist will discuss your specific situation with you and let you know what to expect.
What does a typical EMDR session look like?
Once you have established the groundwork, you will decide on the memory to address. Your therapist will ask you to think of the memory, an image, your current beliefs about yourself as it relates to the situation, what you would prefer to believe about yourself, your emotions, and where you feel it in your body. You will be reminded that you are in charge and can stop or take a break at any point. You will then do a series of bilateral stimulations (eye-movement, tapping, or sound based on your preference) until instructed to stop. You will take a breath and the therapist will ask what you notice. You will continue to go through those steps until the memory is adequately reprocessed and no longer causing distress.
Once a memory has been processed, you may continue to process the information outside of the session. This processing may lead to new understanding, insights, other memories, and often, vivid dreams. You will be asked to keep track of triggers, images that occur, thoughts that arise, emotions, and other sensations that you notice between sessions.
How does EMDR feel?
Most people report EMDR feels exhausting the day of their session. People occasionally report dizziness during the bilateral stimulation, feelings of distress when thinking about their trauma, and sometimes feeling dysregulated between sessions. Many notice a reduction in triggers or distressing thoughts. Epiphanies frequently are discovered between sessions that lead to new ways of thinking about the experience or about themselves in relation to the trauma.
Summary
EMDR is an exceptional therapeutic approach that provides evidenced-based treatment for a variety of experiences. These include abuse (verbal, emotional, physical, sexual, spiritual), assault, domestic violence, accidents, natural disasters, grief, PTSD/complex PTSD, and other incidents that result in the formation of trauma. If you want more information about therapy, please schedule an appointment today.