— Whether you’re looking for an EMDR therapist or simply want to learn more about this therapy, you’ve come to the right place. Here, I’ll provide a concise overview of how trauma affects the brain, the theory behind EMDR, and key considerations before embarking on your EMDR journey. Let’s begin by understanding what trauma is.
Trauma: An Overwhelming Threat
Trauma, including prolonged neglect, is an overwhelming threat that we are not prepared to handle. To cope, it’s common to detach oneself from what is happening during traumatic experiences. If these experiences are ongoing or frequent, one may feel stuck in a fight, flight, freeze, or fawn response.
Initially, these automatic stress reactions are highly effective for survival. However, if we continue to isolate ourselves from the trauma, we cannot fully process the experience. This can impair our functioning, as “the body keeps the score” of unresolved trauma, as described by Bessel van der Kolk in his renowned book.
When we continue to distance ourselves from past traumatic experiences, it indicates that we still feel threatened. While distance can be important, the unresolved trauma often continues to exert power over us. Let’s explore how EMDR can help address this.
EMDR: Eye Movement Desensitization and Reprocessing
EMDR, or Eye Movement Desensitization and Reprocessing, is an integrative psychotherapy extensively researched and proven effective for treating trauma and related symptoms.
Developed by Francine Shapiro in 1987, EMDR is recognized as an evidence-based therapy by the American Psychiatric Association, the U.S. Department of Defense, the World Health Organization (WHO), and other international institutions.
Trauma and the Brain
Imagine accidentally downloading a corrupted file onto your computer. This file can affect the processor and ultimately impair the entire system’s functionality. Sometimes the impact is immediate, while other times, it becomes apparent later that the computer’s database has been altered. If we don’t occasionally clean the system, it may eventually freeze or shut down. Similarly, trauma can act like corrupted files in our brain.
When something traumatic happens, the brain stores it as partially unprocessed memory. Some of this unconsolidated and fragmented material remains in short-term memory, making it difficult for the brain to recognize that the danger has passed.
Symptoms like flashbacks or anxiety can persist and become chronic. Brain scans of PTSD patients show overactivity in the limbic system, even years after the actual event.
The Stress Response System
In ‘trauma mode’, part of the brain remains in a heightened state of alert. This can lead to misinterpreted cues and overestimated danger. Due to the evolutionary need to survive, the ’emotional brain’ assumes danger until safety is proven and it reacts with a specific stress response: Fight, Flight, Freeze or Fawn.
These stress responses are activated automatically—within 200 milliseconds if necessary. The ‘thinking brain’ on the other hand, lags a few seconds behind when a stress response is triggered. That’s why we sometimes make impulsive decisions instead of smart ones.
| FIGHT | FLIGHT | FAWN | FREEZE |
| • Irritability | • Avoidance | • Auto Pilot | • Disconnected |
| • Loss of Temper | • Addictions | • Over-Compliance | • Memory Loss |
| • Defensiveness | • Impulsivity | • Giving Up Easily | • Shut Down (also: Fainting) |
| Examples of symptoms during stress response activation. | |||
Unresolved Trauma Causes More Trauma
In a sense, neural pathways in the brain function similarly to muscles that are growing stronger and more efficient with repeated use. The more often the stress response system is activated, the more it develops. Therefore, experiencing complex trauma or a cascade of traumatic events often leads to an overdeveloped and overly reactive stress response system. This can result in dissatisfying social interactions, maladaptive beliefs about oneself and others, overwhelming emotions, and problematic behaviours.
In this way, unresolved trauma can lead to more trauma, affecting both ourselves and others. Unfortunately, the brain’s preference for familiar patterns can further exacerbate this cycle and lead to the chronification of maladaptive behaviours and beliefs.
Trauma Changes the Brain (and the Body)
Beyond straining interpersonal relationships, an overdeveloped stress response system can also cause physical stress. The increased release of stress hormones, such as adrenalin or cortisol, can contribute to illnesses like diabetes or heart conditions.
In some cases, trauma can lead to feelings of powerlessness, fear, or disorganization. If these emotional states are experienced repeatedly or over extended periods, they can develop into personality traits. This may manifest as personality disorders or a disorganized attachment style.
How EMDR Works
EMDR acts like a cleaning program for our nervous system, based on Francine Shapiro’s Adaptive Information Processing (AIP) model. It helps traumatic memories become unstuck and move through our system, using bilateral stimulation to desensitize and reprocess the traumatic material.
Depending on the type of trauma or symptom, the therapist can use different EMDR protocols. Most protocols require a focused re-connection with the traumatic material, while various forms of bilateral stimulation are used to distract from the upsetting material.
One exception is the Flash Technique. This technique allows for less intense sessions when a traumatic event seems too difficult to process with the standard protocol. So if you are concerned about intensity, ask your therapist if they are trained in the Flash Technique.
EMDR Sessions
During an EMDR session, the process is similar to what occurs naturally during REM sleep. Accordingly, we can think of EMDR Therapy as a physiologically based therapy. Through eye movements or other forms of bilateral stimulation, the traumatic material becomes resolved.
The therapist guides the client through a very structured process, which consists of several phases. The 8-phase protocol includes a preparation phase where the therapist ensures the client can apply grounding and emotional regulation strategies.
After successful EMDR therapy, one can remember the event without reliving the intense emotions or being disturbed by unwanted images. More so, the brain builds new neural pathways supporting healthier thoughts and behaviors.
Sessions usually last between 60 and 90 minutes. It is recommended to plan some free time after the sessions, as increased fatigue can set in, especially after more intensive sessions.
In certain circumstances, clients also have the option of ‘intensives’ with 3 hours per day (with breaks in between).
The therapy can be part of standard talk-based therapy, adjunctive therapy, or a standalone treatment.
Duration of EMDR Therapy
The duration of EMDR therapy depends on various factors, including the amount of previous trauma, current life circumstances, and the type and degree of the trauma. Another factor to consider is whether the person is aiming for ‘symptom reduction’ or ‘comprehensive treatment’.
For a single traumatic event, such as a motor vehicle accident, two or three sessions can already be very helpful. Multiple traumatic events or more complex trauma will require more sessions. A tailored treatment plan will be developed in the initial sessions.
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EMDR: Beyond PTSD
While EMDR is effective for post-traumatic stress, it is also used to treat other conditions and experiences like the following:
Body Dysmorphic Disorder • Complicated Grief • Compulsions • Dissociative Disorders • Eating Disorders • Emotional Abuse • Neglect • Pain Disorders • Panic Attacks • Performance Anxiety • Personality Disorders • Phobias • Physical Abuse • Sexual Abuse • Chronic Stress
Recent research shows promising results, particularly in generalized anxiety and panic disorders, phobias, and chronic pain. This is not surprising if it can be established that these symptoms have developed following traumatic experiences or chronic neglect.
Choosing an EMDR Therapist
Only trained clinicians who understand the complexity of trauma should perform EMDR. Since EMDR is not a cognitive type of therapy, but rather addresses the trauma on an emotional level, it is important that the therapist can skillfully manage adverse reactions that may occur during processing.
Further, an EMDR therapist must
- be a licensed member of a professional body
- hold at minimum a Master’s degree related to the counselling field
- have at least 2 years of practical counselling experience
- complete Level 1 and 2 of the ‘Basic training’ (ideally approved by EMDRIA)
- complete the required amount of supervision hours
When choosing an EMDR therapist, consider asking about their experience, specific areas of expertise, and whether they are EMDR certified.
Example questions:
- How long have you been practicing EMDR?
- How many EMDR sessions do you provide per week?
- Do you have experience in the specific area I want to address?
What is an ‘EMDR Certified Therapist’?
EMDR Certified Therapists (Level 3) have gone the extra mile since their basic training. They have completed advanced training and additional supervision hours, ensuring a higher level of commitment and expertise.
Plus, in order to maintain EMDR certification, therapists must complete twelve hours of advanced EMDR training every two years. In contrast, Level 2 therapists are not required to continue their EMDR training throughout their professional career.
Self-Administered EMDR
Given the complexity of trauma, self-administered bilateral stimulation is not recommended. In fact, EMDRIA strongly advises against it. EMDR is an evidence-based therapy that works when the 8-phase protocol is followed under the guidance of a trained clinician. Applying bilateral stimulation while focusing on a traumatic event is not the same as EMDR therapy.
With self-administered bilateral stimulation, there is a risk that unconscious and/or highly disturbing material emerges and overwhelms the system, potentially leading to re-traumatization. As a result, self-destructive thoughts and behaviours may intensify.
Furthermore, such a frightening experience could lead some people to falsely believe that EMDR ‘doesn’t work’ and deprive them of an effective and safe trauma therapy, thereby prolonging their suffering.
Ready to Start?
If you’re ready to begin EMDR therapy, book an intake appointment or schedule a free consultation. As an experienced EMDR Certified Therapist, I have worked with individuals of all ages and can provide the support you need.
For more information, please visit EMDRIA or contact me directly. You can also view the official EMDRIA brochures for adults or children.
Watch a few videos on EMDR:
How does EMDR work? Watch this animation.
Overcome Trauma, Anxiety, Phobias with EMDR Therapy
Healing Trauma with EMDR
EMDR with Children, 12-18 years old
Personal Stories of Healing with EMDR
TED Talk - EMDR may be able to heal our traumas
How does EMDR work? Watch this animation.
Overcome Trauma, Anxiety, Phobias with EMDR Therapy
Healing Trauma with EMDR
EMDR with Children, 12-18 years old
Personal Stories of Healing with EMDR
TED Talk - EMDR may be able to heal our traumas