EMDR or, Eye Movement Desensitization and Reprocessing is becoming more and more popular. Because research is showing how effective EMDR can be, it is getting a lot of publicity these days. EMDR as a method of treating trauma is not new. In fact, Francine Shapiro, the founder of EMDR, first introduced the concept in 1980. More than 40 years later, EMDR is one of the "go to" approaches for children through adults.
EMDR was first developed to help people who have experienced trauma. EMDR is an evidenced based approach. This simply means that research has shown it works well as a treatment for trauma. In fact, research is now showing that EMDR can be an effective treatment for other things. For example, it can help with teen depression, teen anxiety, teen panic attacks, teen phobias and more.
EMDR & Talk Therapy
EMDR is unique when compared to other counseling approaches as it is not talk therapy. Talk therapy requires the client to talk through the root causes of the problem. This would be a typical course of action each time a client attends their counseling session. Based on the therapist experience level, talk therapy can be very effective.
In talk therapy, the counselor, in general, works with the front part of the brain where reason stems from. The counselor will ask questions eliciting feedback and information from the client. The counselor then guides the session based on that information to help the client heal.
In EMDR, the counselor, in general, works with the emotional, memory, and arousal part of the brain. This part of the brain comprises the limbic system. The limbic system is the part of the brain that govern's the person's survival instinct of flight or fight. EMDR accomplishes this through other means than talk therapy outlined below.
There is far more involved in both approaches outlined above. The above provides a general sense of the differences between talk therapy and EMDR.
Trauma & the Brain
When a person experiences trauma, whether it be Big T trauma or Little t trauma (will touch on that shortly), the trauma gets 'stuck' in the limbic system and the information processing that typically takes place with every day experiences doesn't occur with the traumatic experiences. For example, remember the last time you got into a serious argument with a significant other? Do you remember the feelings you felt, the thoughts you had, the image in your mind, and the body sensations? Unless it involved a traumatic incident, arguments like these typically don't last more than a couple of days.
Often, after a good night’s rest, you wake up the next day thinking about how silly the argument was and are ready to forget about it. This occurs as the brain does not identify the argument as something 'life threatening' or 'dangerous' and so when you go to bed that night, much of the information from the day gets processed through Rapid Eye Movement, or REM sleep. In REM sleep, your eyes are rapidly moving back and forth processing information while you sleep, sorting and filtering memories, sending information through an adaptive neural network so that when you wake up the next day, the emotional charge is no longer present and you are ready to move on.
In the case of traumatic experiences that have a significant emotional charge or are overwhelming to the system, the brain retains that information and does not allow it to be processed through the adaptive neural network. The purpose for this is evolutionary. If our ancestors were chased by a saber tooth tiger and that information was processed through an adaptive neural network and the next morning they woke up bright eyed and bushy tailed and not thinking about the tiger from the previous day, they very well might not survive that next day.
The thing is, this part of our evolutionary brain (the limbic system) has not caught up with modern life. Once the limbic system is triggered with what it perceives to be overwhelming to the system, it will error on the side of caution and label that experience 'life threatening' or 'dangerous' and will act accordingly. Trauma experiences can range from the Big T to the little t and, depending on the situation, the Little t trauma experiences can carry just as much emotional charge as the Big T experiences. So, what are Big T and little t traumas? I'm glad you asked.
"Big T" Trauma
Big T trauma experiences are those events that many of us think of when we think about trauma. A veteran returning from active combat, survivors of the 9/11 attacks, children who have been physically, sexually, and/or emotionally abused or neglected are some examples of "Big T" trauma. These are most certainly traumatic experiences where the limbic system will not have any problems categorizing them correctly as life threatening or dangerous.
The problem with Big T traumas and the limbic system is that the limbic system can't analyze and evaluate when one is no longer in that environment. Eventually, the person who experienced the trauma is no longer in the environment that caused the life threatening and/or dangerous conditions. The veteran will return home and out of the war zone, the survivors of 9/11 arrived home safe with their loved ones, and children who have experienced abuse are either removed from that environment, grow big enough to fight back, and/or old enough to leave.
The limbic system doesn't care. Its role is to maximize your chance of survival to perpetuate the species and will error on the side of caution. An example from the above is the veteran who returns home and hears a car backfire -- the limbic system tells him he's being shot at again and you find him/her diving for cover. The body reacts based on the fight, flight or freeze response.
Now, rationally and logically, the veteran can reason that they are not under fire, however, the emotion center of the brain shifts his/her mind into autopilot and sends signals to the mind and body telling them otherwise. EMDR will help that information that has been stuck and not processed, be 'unstuck' and processed through an adaptive neural network and just like the fight you had with your significant other, the emotional charge behind the backfire will drain away and those who have experienced Big T trauma can finally find peace.
"Little t" Trauma
"Little t" trauma are those stressful life events that happen to all of us at one time or another. Examples of "little t" traumas may include being bullied or picked on as a child, experiencing a non-life threatening injury, moving to a new town and changing schools, breaking up with a girl/boyfriend, the loss of a pet, or the loss of a loved one. Depending on the age of the experience, the resiliency of the person, and a host of other factors, little t traumas can have as serious an impact as Big T traumas.
"Little t" Traumas & Mood Disorders
The little t experiences can influence the development of anxiety, depression, panic attacks, phobias and the like. Remember, the limbic system isn't very good at analyzing the environment to determine if the person is in real danger or not. If the little t experience is emotionally charged enough or overwhelming for the person, the information can get stuck, like a sliver in the mind, and fail to process which can underlie these life struggles.
For example, often times when working with someone who experiences panic attacks, the analytical and reasoning part of the brain understands that they are not in a life threatening or dangerous situation when they are giving a speech in front of a room full of people. However, due to previous experiences in that person's life, the limbic system convinces the rest of the nervous system that that person is in imminent danger. Once this occurs, the brain takes over and sends signals, messages, and hormones throughout the nervous system and directs the mind and body to respond accordingly. The only options at this point are fight, flight, or freeze with the latter two occurring most often in panic attacks.
Working with someone who experiences panic attacks, more often than not, we can trace the initial triggering event to an experience or experiences early on in their childhood where they had an emotionally charged experience(s) and felt overwhelmed. These experiences grow roots that throughout one's life, reach up and impact the person's ability to function the way they would like in everyday life.
EMDR taps into that part of the brain where these Big T and little t life experiences are stored. Through the guidance of a trained EMDR counselor, the client it taught how to access that information and helps the client to process it to resolution.
What Can I Expect in EMDR Counseling?
EMDR is an 8 phase, therapeutic approach designed to help individuals resolve previously unprocessed traumatic experiences that are creating difficulties in their lives. If you think of a gear shift in a car, when the gear shift is stuck it causes the engine (traumatic experiences) to rev resulting in damage to the engine. EMDR helps 'shift' the experience(s) through the gears resulting in alleviation or complete resolution of the problems.
EMDR utilizes bilateral stimulation through eye movement, sound, or tapping. This is the mechanism at work in REM sleep: our eyes are moving rapidly back and forth as this helps information be processed through an adaptive neural network while we are sleeping. EMDR mirrors this mechanism through various means such as the person following a counselor's fingers moving back and forth, sound alternating from left ear to right ear, or 'tappers', which are little handheld paddles that vibrate back and forth in your hands.
For EMDR to fully process a traumatic experience through an adaptive neural network, EMDR targets three areas:
1. A vivid visual image of the memory of the incident
2. A negative belief about yourself created by the incident
3. The related emotions and body sensations related to the incident
The 8 Phases of EMDR
Phase 1: History & Treatment Planning
This is where the counselor will meet with you to explore the past incidences which have created the problem, how that problem is causing distress for you currently, and identify skills and resources that will aid you during your EMDR journey. In Phase 1, the counselor will gather information needed to inform them of the best pathway forward to meet your individualized needs.
Phase 2: Preparation
For most, this phase can take anywhere from 1-4 sessions. During this phase, the counselor will explain what EMDR is, the theory behind EMDR, and what you can expect during EMDR counseling. The counselor will also discuss self-care practices you utilize and explore other self-care techniques to practice in between sessions. The counselor will talk with you about your own innate coping skills, help you build and develop additional coping skills, and teach you specific techniques to manage any strong emotions that may arise during EMDR. Part of this process is the development of a safe/calm place which can be a solid resource for you to use during and in between sessions.
Phase 3; Assessment
In this phase, you will identify a target that you wish to process. A good starting place in selecting a target can be the first incident, the worst incident, or the most recent incident. The counselor will help you navigate which incident to start with by collaborating with you on where you would like to start. Once a target is selected, the counselor will help you select a key moment of that incident as an image which will serve as the target image for processing.
Negative Core Beliefs
Next, the counselor will help you identify the negative core belief associated with the incident. Some examples of negative core beliefs are "I am unworthy of love" or "I am inadequate". The negative core beliefs are typically phrased in an "I am . . ." statement.
Often, our intellectual, reasoning part of our brain can see that the negative core belief is untrue and will have evidence to back that claim. In EMDR, we are we are directly accessing the emotional, memory, and reactive part of the brain that doesn't intellectualize or reason.
It is common that part of the 'stuckness' one experiences with traumatic incidences are the negative beliefs one felt at the age that the traumatic incidences took place. Though through age, maturity, and experience we may be able to look back with perspective and reason why the negative belief was untrue at the age we experienced the incident, the feeling part of the brain still retains that belief. This can run as a script in the background of our operating system subtly, and sometimes not so subtly, affecting our present day life experiences.
Positive Core Beliefs
After identifying the core, negative belief, the counselor will help you to identify the positive belief you would like to have replace the negative belief. Often times, it can simply be the opposite of the negative belief, for example a statement like "I am worthy of love" or "I am good enough as I am". For both the negative and positive beliefs, it is important to work with the counselor to dig down deep and identify the most accurate core beliefs that resonate with you.
How True Does it Feel
At this point, the counselor will ask you to think back on the incident in vivid detail and will ask you to rate how true the positive belief feels to you in that moment. The rating is on a 1-7 sale where 1 is completely false and 7 is completely true. Remember, the counselor is not asking how true do you rationally and logically THINK it is in that moment but how true do you FEEL it is in that moment. This is a key differentiation that is important to understand in providing this rating. We are targeting the feeling part of the brain that doesn't think.
Identifying & Rating the Emotions
Next, the counselor will ask you to think back on the past incident and identify what emotions you are feeling in the present moment. If you were thinking back on an incident of being bullied when you were 10 years old, feelings of anger, hurt, embarrassment or others may rise to the surface. Once the feelings are identified, the counselor will ask you to rate how disturbed you are by those feelings while thinking back on the incident. You'll rate your disturbance on a 0-10 scale where 0 is not disturbed at all and 10 is the highest disturbance.
The counselor will then ask you where in your body you feel the emotions. For example, often times, anxiety is reported to be felt as a tightening in the core, a sinking feeling in the pit of the stomach, tension in the shoulders, etc. As EMDR focuses on helping you resolve the incident fully, clearly identifying the image, the negative thoughts, the emotions and body sensations are key elements for full resolution. The goal of EMDR therapy is to get you to a point where the negative belief is at a 0 (zero) and the positive belief is at a 7 (or stronger!).
Phase 4: Desensitization
This phase focuses on the image or incident, the negative belief, the negative emotions this evokes, and the body sensations related to your experiences. While you are focusing on these components, the counselor leads the you through a series of bilateral eye movements, sounds, or taps. In between sets, the counselor will stop and simply ask, "What did you notice?" or "What did you get?". The idea is to share with your counselor any thoughts, images, feelings, or body sensations that came up for you during the eye movements. The counselor may identify a key part and ask you to think of that and facilitate another round of eye movements.
Your brain is largely doing the work in this process, bringing to the surface thoughts, memories, emotions, body sensations as the eye movements help you to process the previously stuck information through that adaptive neural network.
The counselor will continue the process during your counseling sessions until you can confidently report that you no longer feel or have marked improvement in the negative emotions that used to be associated with the incident, can rate yourself as strongly believing the positive belief, and no longer feel the body sensations that accompanied the beliefs and emotions.
This phase is typically short and can last from anywhere from 3-8 sessions compared to traditional talk therapy, which is highly effective, but tends to take longer. For more complex incidences or those which have endured over time, EMDR can typically take up to 8-12 sessions or more. Once the incident, or target, has been fully processed and is no longer disturbing, we move on to Phase 5.
Phase 5: Installation
The purpose of this phase is to have you focus on the positive belief and the counselor will lead you through sets of eye movements, sounds, or tapping to help strengthen this positive belief. The goal is to strengthen the positive belief and install this belief as strongly as possible in that feeling part of the brain. For example, if the positive belief is, "I am worthy of love", the counselor will work with the client until that belief is a 7 on the rating scale or stronger if possible.
Phase 6: Body Scan
Once the positive belief has been strengthened as much as possible, the counselor will ask you to think back on the original incident and notice any tension in your body. If there is tension that remains in the body, the counselor will continue to lead you through eye movements, sounds, or tapping until the tension is no longer present.
Trauma can be stored in the body and it is an important step in EMDR to ensure that the negative feelings, beliefs, and the tension in the body are no longer present. When this occurs, it's an indication that the incident has been fully processed through an adaptive neural network where you will no longer experience the difficulties due to the past incident. The PTSD, depression, anxiety, phobias, panic attacks and the symptoms related to these difficult life struggles can been alleviated and in many cases are no longer present.
Phase 7: Closure
At the end of each counseling session, whether the incident has been fully resolved or not, the counselor will work to help you to leave feeling better than when you did at the start of the session. The counselor can lead you through a guided meditation, progressive muscle relaxation, or deep breathing exercises to help you find a sense of peace or calm upon ending the counseling session.
The counselor will also help educate you on what you can expect in between counseling sessions. The work tends to continue after you leave the counseling session as your brain will continue to process in the background as you go about your daily life. The counselor will be available in between sessions should you need to touch base and get a bit of support.
Phase 8: Reevaluation
Once you process a target through an adaptive neural network and it no longer presents an issue for you, it is important for the counselor to check in with you periodically over time. You can feel a great sense of relief in the session where the incident has been resolved and this change is likely permanent. While this may the case, the counselor acts as a safeguard to ensure that the changes last over time.
Often times, there is more than one incident, or target, that leads to your discomfort. Once a target is resolved, the counselor will work with you to identify and address the other targets that may be contributing to the discomfort. At this point, the counselor would start at Phase 4 and begin the process anew until each target that feeds the discomfort has been processed fully and you have found significant relief from or elimination of the symptoms related to the past incidences.
EMDR is a highly effective counseling approach for a variety of life struggles. The relief and freedom that individuals find when they can significantly reduce or eliminate the life struggles that they have been battling with for years can be life changing.
If you or someone you know has experienced in trauma in their life, are struggling with teen depression, teen anxiety, teen panic attacks, school phobias, or other struggles, EMDR may be just what they need. At Katy Teen & Family Counseling, we would be happy to discuss your needs and whether you would be a good fit for EMDR counseling.
There is a pathway forward and answers to your struggles. You have courageously fought so hard for so long to try to beat this thing on your own. You have imagined what life could look like without the burden of those struggles. It is possible to achieve -- we see it on a regular basis.
You have an incredible resource in the experience and expertise at Katy Teen & Family Counseling. Take advantage of that resource and let us help you navigate this complex journey to a happy and successful destination. If you are waiting for just the right time to start, that time is now. If you would like to get started with EMDR in helping to resolve struggles related to trauma or PTSD, you can follow these simple steps:
Contact Katy Teen & Family Counseling
Meet with your EMDR therapist
Start the EMDR journey in healing trauma or PTSD
In addition to providing EMDR for trauma therapy and PTSD treatment, EMDR can help with depression, anxiety, panic attacks, and more. Katy Teen & Family Counseling also provides the following therapeutic and counseling services in addition to EMDR therapy:
Neurofeedback Therapy for Teen ADHD