Our understanding of trauma has grown significantly over the past 50 years. Initially limited to discussions about Vietnam veterans in the VA, it is now a common topic in relationships, therapy, and society. As awareness of trauma and its impact has expanded, so has the search for evidence-based treatments.
Among these treatments, EMDR has emerged as a leading approach, recognized for its effectiveness in helping survivors heal and improve their quality of life. In this article, we will explore what trauma is, who it affects, and delve into the concept of EMDR as a powerful treatment method for healing and reclaiming one’s life.
What is Trauma?
Trauma, clinically known as Post-Traumatic Stress Disorder (PTSD), encompasses difficult experiences with lasting effects. According to the National Institute for Mental Health, around 3.5% of adults have a PTSD diagnosis, with more women affected than men. However, this figure may underestimate the true prevalence as many individuals go undiagnosed or do not seek help.
Trauma extends beyond textbook cases like combat veterans, sexual assault survivors, or disaster survivors. It can stem from various sources, such as witnessing domestic abuse, experiencing multiple miscarriages, enduring narcissistic abuse, or losing a loved one suddenly. Essentially, trauma refers to any life experience that overwhelms our coping abilities and prevents proper healing. Recognizing the broad scope of trauma is crucial for understanding its impact and validating survivors’ experiences.
Symptoms of Trauma
PTSD is characterized by several key symptoms:
Intrusion: This involves intrusive thoughts, flashbacks, and nightmares that occur involuntarily, often triggered by reminders of the trauma. These experiences can make individuals feel as if they are reliving the traumatic event, leading to heightened anxiety or fear.
Avoidance: Individuals with PTSD often try to avoid people, places, activities, and even emotions that remind them of the trauma. Substance abuse may also serve as a form of avoidance. Seeking therapy can be challenging for survivors due to the fear of discussing their trauma with a stranger.
Alterations in cognition and mood: Trauma affects how survivors perceive themselves and others, leading to negative beliefs like self-blame, mistrust, or feelings of worthlessness. Shame is a common emotion among survivors. They may also experience a diminished capacity for pleasure, detachment from loved ones, and increased levels of fear, anxiety, and worry.
Alterations in arousal and reactivity: Symptoms include concentration difficulties, sleep disturbances, emotional dysregulation (such as intense anger or irritability), impulsivity, self-destructive behavior, and paranoia. Survivors may fluctuate between feeling overwhelmed and feeling emotionally numb or disconnected.
PTSD takes a significant toll on survivors, affecting them physically, mentally, and emotionally. Sleep and appetite suffer, relationships deteriorate, substance abuse may arise, and self-perception becomes deeply negative.
Survivors may experience a loss of control, feeling as though their own brain has been hijacked, and even contemplate self-harm or suicide. It is clear that PTSD severely impairs a survivor’s overall well-being. Consequently, efforts have been made since the 1970s to better understand and treat PTSD, aiming to improve survivors’ lives and achieve symptom-free recovery.
EMDR: An Accidental Discovery
EMDR, or Eye Movement Desensitization Reprocessing, was discovered by chance when Dr. Francine Shapiro found relief from her own distressing thoughts and feelings by moving her eyes back and forth while walking in a park.
She then tested this method on friends and family, who also experienced improvement and relief. Dr. Shapiro developed a standardized approach using eye movements, scripts, and later other forms of bilateral stimulation like tapping or sound. EMDR is now a globally used therapy for healing from trauma, as well as addressing issues such as anxiety, addiction, phobias, OCD, and eating disorders.
EMDR targets the image of the traumatic event, associated emotions and thoughts, and desired beliefs about oneself. Bilateral stimulation, initially through eye movements but also through tapping or sound, is a crucial element of EMDR.
This stimulation aids in reprocessing traumatic events, and while the exact mechanisms are not fully understood, extensive research has consistently demonstrated the effectiveness of this therapeutic approach.
What EMDR looks like for a client
So, let’s say you’re interested in EMDR. As a client, it is important for you to have a clear understanding of what you’re getting yourself into not only for your empowerment but also, as a survivor, your ability to choose was at one point taken from you. The standard way of utilizing EMDR occurs in 8 phases.
Phase 1: Building a relationship with the therapist and history taking. Your therapist will have you complete the DES-II (a screening tool for dissociation) and will help you identify the events you want to reprocess. This may be through an activity like Top 10 Events or a trauma timeline. You should be an active participant in this part of the process.
Phase 2: Preparation. Multiple things occur in this phase and may vary. We focus on strengthening your ability to tolerate the reprocessing phases of EMDR. So, the discussion may first focus on your current coping strategies and emotion regulation tools before working to strengthen your window of tolerance, mindfulness skills, and distress tolerance skills.
You will also complete two exercises specific to EMDR: calm/safe space and container exercise. These are required to move forward with EMDR, but depending on your specific journey, you may learn various other skills in this phase.
Phase 3: Assessment. This is where we start to set up the traumatic memory/experience we have agreed to work on. In EMDR language, we typically refer to these as targets. Your therapist will ask you about the incident, an image of the worst part, beliefs about yourself, emotions, body sensations, what you’d like to believe about yourself instead as well as how distressing the target is to you right now.
Phase 4-5: Desensitization & Installation. These are the phases most people refer to as EMDR. This is the meat and potatoes of what EMDR is – the actual reprocessing of the target. This is where you will be working through the selected target and working to desensitize the event.
Phase 6: Body Scan. Once we have completed phase 5, we move on to body scan where we check in with what you are feeling physically. This is to ensure the body has processed what it needs to in order to fully move forward from the target.
Phase 7: Closure. This is a formal way to bring closure to the session. Your therapist will remind you that your brain may continue to reprocess information up to 48 hours after the session. You will be encouraged to write anything down that may be significant to your experience.
Phase 8: Re-evaluation. This phase is actually completed at the beginning of the next session. This is a way to check in about the target in between sessions and to discuss any new feelings, thoughts, or insights since the last session. This is done at the beginning of every EMDR session.
Some things to note:
- For multiple targets, the process will be repeated for each one, but there may be exceptions based on neuroscience considerations and time frames.
- Longer sessions or more frequent sessions may be suggested to resolve and heal efficiently.
- It’s normal to end sessions as “incomplete” if you don’t complete phase 5. Phase 2 skills will be used to close these sessions.
- Complex trauma or multiple incidents may require more time in preparation, and the overall time frame for completing EMDR may be longer.
- Trusting your therapist is crucial for a healing experience in EMDR.
- EMDR for issues other than trauma will follow a similar structure.
- Your journey is important, and you can express uncertainty or request pauses during reprocessing if needed.
EMDR helps you shift from ongoing panic and anxiety to feeling regulated and in control of your emotions. EMDR helps you shift from “It was my fault” or “I’m not good enough” to “I did nothing wrong” and “I am good enough.” And I don’t mean this in some surface-level, positive affirmation manner – there is a deeply held, felt-sense shift that occurs when we finally, safely, reprocess the things that have negatively affected our self-concept and perception of the world. EMDR is transformative – it will give you your life back.
If you are interested in beginning EMDR – you’re in luck, I am EMDR Trained. I can see clients in person at our office in the Greater Heights and throughout the state of Texas virtually because yes, EMDR can be done virtually.
EMDR is something I am truly passionate about as a therapist and would love to chat with you about how we can start your path towards healing. You can set up a free 15-minute consult with me to better understand how EMDR can help you as well as ask me any questions that you have about starting this type of therapy.
For more information, visit oakscounselingassociates.
This blog post was written by Cady Parliman, MSW, LCSW, EMDR Trained.
