EMDR—Eye Movement, Desensitization, and Reprocessing Therapy—was first introduced into the literature in 1989 by Francine Shapiro as a treatment for trauma.  EMDR is an eight-phase integrative therapy based on an adaptive information-processing model. In health, the body/brain/mind naturally integrates perceptions, emotions, and experience into associated memory networks.

 

Trauma overwhelms adaptive processing and shatters the self. When trauma causes disturbing memories to become “frozen in time,” the emotions and embodied self-states of traumatic experience are often relived in the present. In the desensitization/reprocessing phase of EMDR, which is the best-known phase of this treatment, the patient links these disturbing, frozen memories with new associations that arise spontaneously while the patient holds a dual focus of attention—on past memories being processed internally and on the present, external, bilateral stimulation (visual, auditory, and/or tactile). This reprocessing, titrated in short sets, continues over one or more sessions until certain criteria are met, including a significant reduction in the subjective disturbance and emotional charge of these memories. The memory is not forgotten, but it is adaptively returned, so to speak, to its historical context or brought to an adaptive resolution. When it is, the patient may be much less reactive to past and current triggers and less likely to be driven by fight, flight, freeze, attach, and submit responses.

 

EMDR can easily be mistaken for a series of protocols, the most familiar of which involves bilateral stimulation. But reprocessing is only one of eight phases of this therapy, and the treatment of PTSD is only one of its many applications.

 

EMDR can also be used to challenge the seemingly education-resistant beliefs the devalued self holds when it is burdened by the legacy of relational trauma. Shame-based, this self is shaped through the distortions of trauma logic. For example, a patient who feels unrecognized in his family of origin as a person in his own right may believe himself to be fundamentally unworthy of recognition. When he is later excluded from a social group, he will think he is undeserving. Or when disappointed in love, he knows that something is wrong with him. If his girlfriend lies to him, he takes himself to be the fool. Trauma logic dictates that the fault is always his. He may even have trouble accepting compliments, which he hears but can't take in.

 

How do we help patients like these revise this relationally based sense of themselves as unworthy, bad, defective, or invisible? How are these distortions undone? In Arnold Modell’s (2003) terms, we would say that the patients’ thoughts, feelings, and somatic states associated with the memories that generated them are “recontextualized” through the bilateral stimulation of EMDR therapy.  If all goes well, the distortions of trauma logic are exposed, negative emotions fade into the past, and a more complex, resilient,  and nuanced sense of self emerges.

 

One patient whose parents where sometimes neglectful and abusive said in the course of processing her memories, “I don’t feel as sad as I thought I would. . . . I just think about it and get pissed. . . . I don’t feel as upset. It’s more in the past.” And then she said of her unhappy childhood, “I see it at a distance, removed.” This is typical of the kind of distancing that can occur in EMDR therapy.

 

My patients’ experiences with EMDR are often moving testimonies to the spontaneous gestures of the emerging self and the psyche/soma’s impulse to move toward healing. Some EMDR sessions have the feel of time-lapse photography. In others, the embodied changes are more minute and incremental.

 

 

References and Suggested Reading

           

Modell, A. (2003). Imagination and the meaningful brain. Cambridge, MA: MIT Press.

       

Scarf, M. (2004). Secrets, lies, betrayals: How the body holds the secrets of a life, and how to unlock them. New York: Random House.

 

Shapiro, F. (2012). Getting past your past: Take control of your life with self-help techniques from EMDR therapy. New York: Rodale Press.

 

van der Kolk, B. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. New York: Viking/Penguin Group.