What is EMDR and How Does It Relate to RuGirl Alaska 5000?
EMDR is everywhere at the moment and it’s enjoying a bit of a zeitgeisty moment. Royal Princes are using it, along with the famous, the infamous and the rest of us. But what exactly is EMDR and could it be helpful for you?
EMDR (Eye Movement Desensitisation and Reprocessing) is a structured, evidence-based therapy that invites the person to focus on a trauma memory while also carrying out bilateral stimulation of the brain. This reduces the vividness of the memory and its associated emotions. Bilateral stimulation (or BLS) might involve moving the eyes left to right, the client tapping their legs or shoulders or using audio or other means.
The therapy is seemingly simple, but it works on the meaning and emotional learning we attach to a trauma memory, the way it’s stored in the nervous system itself, and the way it shows up in the body. One great description I’ve heard is that the memory we choose to work on is a portal into the brain synapses and nervous system and this is what we’re actually working with.
Many people think that EMDR is all about the eye movements. Just as Alaska said “if you’re not wearing nails, you’re not doing drag”, many clients (wrongly) believe if you’re not doing eye movements, you’re not doing EMDR. In fact, there’s a lot of other stuff that’s going on before we even get to the BLS.
EMDR and its associated processing, begins from the moment you decide to come into therapy, when we discuss what’s been happening to you now, what happened to you in the past, and how you want to be in the future.
The first thing to know about EMDR is that it is very well researched, it’s not a New Age or “alternative” therapy: it’s rooted in hardcore cognitive understandings of the brain and emerging neuropsychology knowledge.
The person who created EMDR, Clinical Psychologist, Francine Shapiro (sadly, no longer with us) admirably and impressively argued the case for EMDR within a largely hostile academic environment. Rather than throwing in the towel and operating outside of the academic institution of psychology, she decided to meticulously trial and evidence the effectiveness of EMDR. It’s this body of evidence that led to NICE (the National Institute of Clinical Excellence – the UK’s NHS treatment advisory body) recommending EMDR as a therapy option for PTSD. It takes a LOT of work to get any therapy to this stage. You can find out more about the international evidence base for EMDR here.
The theoretical model that underpins EMDR is called Adaptive Information Processing (or AIP). In a nutshell what’s going on in EMDR processing is the linking together of two sets of neural networks (or pathways) in the brain -one pathway that contains unhelpful information about the trauma and one that contains helpful information. The reason the trauma memory is so upsetting is because it hasn’t been updated; the trauma memory is stuck on replay and stuck on a loop and the brain and nervous system hasn’t realised that the event is over and the memory is in the past.
The memory is held alongside the state-specific emotion we had at the time (terrified, powerless) and keeps intruding on us now. This is what Shapiro means when she writes “the past is present until it’s processed”. However, when we show up in therapy it’s because we want to change something in the present. If we can face the past, assimilate it into the present and see it from a new adaptive perspective (the memory is in the past, the trauma event is over, we are safe now), we can then face the future in a more empowered way.
In clinical practice I see this a lot. Someone comes to therapy feeing that they are a terrible person, we explore where this came from and discover a trauma event (the past) which is feeding into the present. We process the memory and the person’s view of themselves now adapts or updates as they replace old meanings with new, more accurate and useful ones. EMDR impacts on the way we register, encode and access our memories.
The client might move from “I’m terrible”, to “I’m OK” or “I am enough” or “I am a good person” and they not only think this but feel it too in the heart, the nervous system and the body. This embodied, adaptive perspective then shapes how the client will be in the future.
EMDR uses a number of tools to help this to happen, it’s not just positive affirmations and willing yourself to be OK, which we know just doesn’t work. EMDR works on a biological and psychological level in the nervous system and in those mysterious pathways and networks of the brain which we are only just starting to discover and make sense of. It also changes how we experience the trauma memory – how we reconstruct it and call it up to awareness. People often report the memory fades, becomes less over stimulating, changes how it looks or just seems more in the background somehow.
I am relatively new to EMDR as a practitioner, and have been continually surprised and impressed by the way it works. I came to EMDR from a CBT background which emphasises direct confrontation with, and exposure to, the trauma memory by zooming in on its associated “hotspots” of distress. Successful processing in trauma focused CBT requires high levels of emotion and when it works it’s great – and it definitely works - but it takes its toll on the client (and therapist!)
EMDR on the other hand works just as quickly but seemingly in a gentler way. I suspect this is because it is engaging other areas and interactions of the brain, nervous system and body (the bottom up approach as its referred to) rather than just the front of the thinking brain (the top-down approach as it’s often called).
The stance is also different, with the client remaining in control of the therapy and the way we process. Sometimes clients want to process as quickly as possible and we go for it. More often though, my role is to put the brakes on and make sure the client is well resourced to manage the process. A phrase that’s often used to describe this is “slow is faster”.
As I’ve been practicing EMDR I’ve also discovered how integrative it is with other approaches such as ACT for Trauma, Compassion Focused Therapy, CBT, Attachment Theory, Polyvagal and Somatic approaches. If you’re interested in finding out more and you’re a bit of a EMDR geek like me, check out the podcast “Notice That” which is exploring some of the incredible innovations and updates that are going on with EMDR around the world.
I was wary of the hype around EMDR, as those of us who have been around the block a few times know that every year a new “wonder therapy” emerges which turns out to be more of the same thing with a different set of labels. However, with EMDR it really does seem like there’s something exciting, new and potentially revolutionary going on. Just to be clear though, EMDR is NOT an easy option, it’s hard work and sometimes it can take some unexpected twists and turns as we uncover layers of meaning and associated memories. EMDR is also quite magical to do and also to receive, it feels almost shamanic in nature, and I suspect rests on many indigenous practices from many, many cultures….
If you’re interested in exploring EMDR for you, we offer online EMDR here at Rhizome Practice, get in touch and we can discuss whether or not it would be suitable for you or what the other options might be.
