I get a lot of call these days from folks who have heard from a friend that a few sessions of EMDR helped them get over a trauma. Then they go on to outline long histories of repeated traumas and ask how long therapy will last.
So, is it a miracle cure? My authentic short answer would be yes, no and sometimes. I’ve had many clients with single incident trauma (car accident, sexual assault, etc.) who had a couple of sessions and felt immeasurably better, no longer plagued by the unwanted memory and free to move on with their lives. In the 20 years that I’ve been using EMDR I’ve also had a few clients it wasn’t helpful to at all.
As a clinician I bought into it really quickly way back in 1996 when I took my first training. I was practicing it with another therapist and in a single session, the story that had informed his whole life radically changed and took on an entirely different, positive meaning. I was a believer.
Of course, EMDR isn’t about belief. It has a deep history of clinical trials to back up its efficacy and has been rated by the Department of Veterans Affairs in the highest category of treatment and recommends it for all trauma populations at all times.
WHAT EMDR DOES
What EMDR does is pretty amazing.
It literally creates new neural pathways in our brain. This is also called neuroplasticity, the ability of our brains to change and heal. We’ve all had upsetting experiences that come up, and when they do they play out like a video that we can’t stop. EMDR helps to stop that instant replay and switch the channel.
It also changes how we store memories. In the daily flow of events, we have experiences that are stored in our short-term memory and over time move to our long-term memory. So we remember what happened today better than last week and way better than last year.
But with traumatic memories, they get stored in our short-term memory and don’t move to our long-term. So when the memory pops up, it comes with a piercing urgency and strong emotional and physical responses.
Our goal is to move those memories to long-term storage, so when they come up, the reality of what happened may be awful, but it now feels like it happened a long time ago and we have integrated it into our psyche.
• Specifically, EMDR changes the visual image, often fuzzing it out so that the details are less clear, or the color washes out and it looks like an old photo, or we are more removed from the scene. If there was the squeal of brakes or people yelling, those sounds are muted or silent.
• It changes our emotional reactivity, so we are no longer hit with a jolt of fear or overwhelming sadness, debilitating shame or rage.
• It changes our physiological reactivity, so our stomach unclenches, that lump in our throat softens and dissolves, the weight on our heart lessens, and our hunched shoulders drop.
• And lastly it changes our negative belief sabout ourselves in relationship to this incident t0 positive ones. Our belief might go from “I should have done something” to “I did the best I could”, from “I’m in danger” to “It’s over. I’m safe now”, from “I am shameful” to “I am worthy.”
When the work is complete, the memory comes up less often, interests us less and has a different quality. Often, we can feel ourselves start to go down that habitual, well-worn path of reactivity, and then we just don’t.
USING BOTH EMDR & SOMATICS
EMDR was developed as a therapy for single incident trauma but here at Cutting Edge Counseling we also use it for developmental trauma. It won’t do the whole job; for that we need to add in body-based therapies like Somatic Experiencing and Mindfulness with Self-Compassion.
We use EMDR to soften the single incident traumas embedded in the developmental trauma. It’s a bit like the game of Pick-Up Sticks in which the outlying sticks are more easily moved away, then we carefully begin to remove sticks from the pile: the more easily moved sticks being the single incident traumas; the pile being the complex trauma. Many times aspects of the developmental trauma are so triggering that EMDR can help us divide and conquer the overwhelm.
EMDR is also a good way to map the trauma history because its relaxed, stream of consciousness approach helps to easily connect what might be holding a trauma in place. As the AA slogan goes: What’s hysterical is historical. What this means is that if we are having an outsized reaction to something fairly benign in the present, it’s probably being fueled by some unresolved trauma from the past.
We often use EMDR, Somatic Experiencing and Mindfulness therapies together, moving back and forth among them. We have blended somatic principles into our EMDR work, slowing things down, being invitational, and allowing the nervous system time to regulate.
That’s some of the creativity and art of this work, integrating all our knowledge and training and tailoring our approach to each individual’s needs.