By Lauren Thomas, MA, LPC
We all have experienced hurt and heartbreak in our pasts, to varying degrees of impact. Abuse, accidents, military service, grief due to death or divorce, rejection, or neglect from a caregiver are just some examples of trauma. Sometimes the distress from a traumatic event lingers for a long period of time, even decades after it happened. This is because the “alarm center” in our brain, the amygdala (responsible for our “fight, flight, or freeze” response), tells our body that it is in crisis when images, thoughts, or emotions related to that event are triggered.
One cool fact about our brain is that our memories exist in networks. Something that happens to you today can bring up thoughts and feelings from similar experiences years ago. For example, let’s pretend that you have a conflict with your spouse. As soon as your partner raises his/her voice, you feel a knot in your stomach and your heart rate increases. You notice it’s hard to stay present in the moment, your head is spinning, and you just “shut down,” unable to communicate how you feel or what you need. When prompted, you might observe that your thoughts immediately go to, “I am not safe” or “I am responsible for keeping the peace.” Perhaps you’re feeling scared, alone, and out of control.
If we were to do a deep dive on your past, you could probably recall other times in your life where you have had these same thoughts, emotions, and body sensations. Maybe you remember “freezing” when a parent or teacher yelled, or when in conflict with a peer at school or work. The cumulative effect of these stress responses over time impacts your ability to stay calm and regulate your nervous system in the present.
The good news is that our brain, given the right conditions, naturally moves toward healing. Amazing, right?! It is possible for you to recall a painful event in your life and no longer carry the same intensity of emotions. It is possible for your body to feel calm, instead of tense, when you remember what happened.
I want to talk about an evidence-based tool, EMDR, that safely and effectively “quiets” the alarm center so that our memories can be processed through the logical part of our brain. We can actually create new memory networks that are adaptive (positive) instead.
EMDR stands for Eye Movement Desensitization and Reprocessing. This form of therapy guides the client to focus on a traumatic memory while simultaneously experiencing dual-attention stimuli (DAS), which is a fancy way of describing engaging the left and right sides of your brain through either eye movement, tactile movements, or listening to alternating sounds in each ear.
8 Phases of EMDR
EMDR is a process that exists in eight phases. While the actual reprocessing typically moves more quickly than traditional talk therapy, your therapist will not jump right in without preparing you for what is to come.
Phase One:
We’ll start by collecting a history of your symptoms, such as panic attacks, anxiety, or depression. We’ll look at your past experiences and note any patterns of thoughts and behavior that are contributing to your symptoms.
Phase Two:
Your therapist will educate you on what EMDR is, explaining the theory and technique. We’ll answer any questions or talk through concerns you may have. Visualization exercises will be introduced, as well as other positive resources that will help you feel safe and successful while processing hard things.
Therapists will typically create a “target map” of what traumatic events you want to work through during this phase. Sometimes this is called “floatback,” as we will ask you to float back to another time where you felt or thought the same way as your presenting problem. Targets are generally reprocessed in chronological order. Because our memories exist in networks, when we desensitize one event in the target map, it will start to desensitize the subsequent targets. In other words, as the intense “fight, flight, or freeze” reaction starts to subside, it will no longer feel as strong as each target is addressed in therapy.
Phases Three and Four:
These steps always go together. Your therapist will “set up” the target you want to work on first, asking what image represents the most disturbing part of the traumatic event and what thoughts, feelings, and body sensations accompany this image. We will rate your distress level on a scale of 0 to 10. The goal of EMDR is to reduce your distress level to a 0, using the form of DAS you decided on during phase 2.
Let me mention that the purpose of EMDR is NOT to retraumatize you. We will “follow your brain” as you notice memories, thoughts, and feelings during each short set of DAS. It can be compared to watching these scenes in a movie, rather than experiencing them the way it happened initially. You will share these observations with your therapist between each set.
Phase Five:
Once your distress level, as you recall the original image, becomes a 0, we will then “install” a positive cognition (thought), what you want to believe about yourself, until you feel it strongly (a “7” on a scale of 1 to 7). For example, if the negative cognition associated with your first target was, “I am responsible for what happened to me,” the positive cognition could be, “It is not my fault,” or “I am not responsible for other people’s choices.” In this way, a new adaptive pathway is being created in your brain, in place of the former negative beliefs.
Phase Six:
Your therapist will ask you to do a body scan and notice any tension that remains. If you’re feeling calm, you’ll move on to the next phase; if you feel discomfort, you’ll do more sets of DAS until the tension dissipates.
Phase Seven:
This is the closure phase. Your therapist will remind you of the grounding exercises you learned and prompt you to put any remaining distress into your “container,” if the target needs to be completed during the next session. You’ll be encouraged to get a good night’s sleep, drink water, and eat protein, as this will strengthen the neural pathways that were created.
Phase Eight:
The final step is “re-evaluation,” where your therapist will check in with you about any thoughts, feelings, or symptoms that have come up as a result of EMDR in the last session. You’ll then determine whether to revisit the initial target with more sets of DAS or begin the next target.
Ready to Heal?
EMDR therapy is just one direction to take when dealing with trauma, but it is effective for many people. It is client-centered, does not require as many words, and clients describe relief from symptoms in fewer sessions. EMDR is offered both at our office in Ambler, PA, or through online counseling in Pennsylvania or online counseling in North Carolina. Our counselors specialize in trauma therapy, grief counseling, and addiction counseling. One blog cannot possibly cover the many facets of this form of treatment, so if you have additional questions, please schedule a free 15-minute consultation with an EMDR-trained member of our therapy team. Healing is possible, and we look forward to working with you!