What is EMDR?
EMDR (eye movement desensitization and reprocessing) is a treatment technique used to reduce chronic mental health symptoms (e.g. anxiety, depression, low self-esteem, etc..) caused by traumatic events. This technique involves both talk therapy and be performing repeated eye movement exercises which stimulate a process resulting in reduction in mental and emotional disturbance. EMDR is a relatively new treatment (first developed about 30 years ago), however extensive research has targeted EMDR, determining its high degree of effectiveness around alleviating traumatic symptoms, and PTSD.
How does EMDR work?
When someone experiences a traumatic event, and possibly develops PTSD, the memory is stored in “isolated neural networks”. This prevents the memory from being adequately processed, and therefore not allowing the person to emotionally recover. The combined effect of back and forth eye movement (as done in EMDR), along with simultaneously holding specific thoughts or images in one’s mind, works to disrupt the pattern in which the brain currently experiences this memory. This “disruption” caused by the eye movement allows for new processing to take place, generally with notably fewer feelings of emotional disturbance associated with the memory.
Different Uses for EMDR
– ‘Single incident’ trauma can be described as a one-time event from the past that continues to affect how someone feels, experiences troubling memories/thoughts, and impacts one’s general well-being. Although single incident traumas can be very pervasive, this tends to be the easiest and simplest form of trauma to treat with EMDR. There is also the most clinical evidence supporting the use of EMDR for single incident trauma, compared with any other psychiatric or trauma-related condition.
– ‘Multiple traumas’. Treating multiple traumas can be similar to treating single incident trauma, but unsurprisingly is more complex, and treatment generally takes much longer. In many cases one trauma has occurred, but before this can be processed and healed from, another trauma is inflicted. In some ways this may cause detachment, or “burying”, of the initial trauma, and only complicating and/or prolonging its impact on the person.
– ‘Overt trauma’. The most clear and apparent forms of trauma are caused by such incidents as physical assault, sexual assault/abuse, child abuse (physical, sexual, and emotional), combat/war, car crashes, and other violent and threatening events. These are examples of traumatizing events which may also be treatable with EMDR.
– ‘Discrete trauma’; describes events and experiences which may seem to not have the same severe impact as the violence described above, but in fact can have similar effects and consequences on one’s mental and physical health. This may include victimization of persistent verbal abuse, general emotional mistreatment (especially in childhood), social exclusion/isolation, and/or social humiliation. These types of traumatic experiences may occur in the family context, peer contexts, or both. Although there are clear contrasts between different types of trauma, such as those containing severe violence versus only verbal hostility, the mind and body process these similarly. Therefore each of these can have similar adverse reactions when they remain unprocessed.
A key concept used in treating trauma (through EMDR or otherwise) is the “therapeutic window”, or “window of tolerance”. When a person with past trauma engages in certain behavior, or is reminded of certain thoughts, images, feelings and/or memories, the effects of their trauma can be triggered. This is an instance of striking above the therapeutic window, which often only reinforces the trauma because it is too intense for the brain and body to process. On the other hand, the (natural) response of avoidance, or emotional disconnection, dodges the thoughts and feelings related to the trauma altogether. Therefore the necessary sensations involved in trauma processing are not felt. The aim therefore is to find the path to where the traumatic sensations are strong enough to tolerably feel the discomfort, but not so strongly as to overwhelm and cause mental retreat. Initially the therapeutic window is often small, but as progress as made it starts to widen. This allows more trauma/EMDR processing to happen, and success in treatment to accelerate.