How EMDR Therapy Works: EMDR and the Brain

As a psychotherapist who specializes in helping clients to overcome trauma, I learned to do EMDR (Eye Movement Desensitization and Reprocessing) in 2005 (see my article: What is EMDR?).  I decided to learn EMDR because the traditional therapy that I learned in postgraduate training didn't help some of the clients who came to me who had PTSD (posttraumatic stress disorder).  I've been using EMDR with many clients ever since with positive results.

EMDR Therapy For Trauma

EMDR and Advances in Brain Research
When I learned EMDR, which was developed by psychologist, Francine Shapiro, Ph.D., researchers still weren't sure exactly how it worked.  They just knew that compared to other forms of therapy and compared to medication, it was more effective.

Since that time, there has been a lot more research on EMDR and brain research, so how EMDR works is starting to become clearer.

EMDR is an integrative therapy.  It combines the best of psychodynamic, cognitive behavioral therapy (CBT), and other mind-body oriented therapies.

Many psychotherapists, myself included, now also integrate Somatic Experiencing and the use of imagination, which has powerfully enhanced EMDR.

How Emotional Trauma Affects the Brain
Before discussing EMDR any further, it's important to understand how emotional trauma affects the brain.

Emotional trauma has a powerful effect on the nervous system.

How EMDR Works: Traumatic Memories and the Brain

People often have problems processing traumatic memories in regular talk therapy because these memories are stored in the nonverbal, nonconscious, subcortical part of the brain, which includes the amygdala, thalamus, hippocampus, hypothalamus, and the brain stem.

Before traumatic memories are processed with EMDR, they're not accessible to the frontal lobes, part of the brain that is used for understanding, thinking and reasoning.

Very often, individuals who are traumatized are unable to give a coherent narrative about their traumatic past because, as previously mentioned, the traumatic memories are stored in the nonverbal part of the brain.

Advances in brain scanning have shown that often when people with a traumatic history remembered these traumatic memories, the left frontal cortex (speech and logic) actually shuts down.

At the same time, the right side of the brain, which is associated with, among things, emotional states, images, and autonomic arousal and includes the amygdala, lit up on these brain scans.

This would explain why traumatized individuals have problems providing a coherent narrative about their traumatic memories--the part of the brain that is associated with thinking and speaking is "off line" when they're asked to think about the trauma.

This is also why, for many people who have PTSD, there are flashes of images from the traumatic event, but no words.

These memories also have a sense of timelessness so that people who suffer with trauma often have a hard time distinguishing "then" from "now" (see my article:  Working Through Emotional Trauma: Learning to Separate "Then" From "Now").

These emotions and sensations are often felt with such immediacy that it feels like they're experiencing the traumatic event now, even though it might have happened many years ago.

For instance, this is a common experience for veterans traumatized in battle as well as for people with other types of emotional trauma.

The corpus callosum is a part of the brain that connects the right and left sides of the brain and it helps both sides to "communicate" with each other.   It helps to integrate the emotional and cognitive parts of the brain.

Trauma, by definition, is overwhelming.  It can cause dysregulation of the body and brain chemistry.

EMDR, the Adaptive Information Processing (AIP) Model, and Bilateral Stimulation (BLS)
Francine Shapiro, Ph.D., developed the Adaptive Information Processing (AIP) model to explain the effects of EMDR.

The AIP model says that all memory is associative, and that learning occurs through the creation of new associations.

EMDR Therapy and the Brain

For example, in order to recognize an object, your current perceptions have to link the object with your past experiences.

So, if your only experience of a stick is that sticks were used to beat you, you would have no past memories that could tell you that a stick could also be used for other things, like walking.

But if someone shows you that a stick can be used to help you walk, you can integrate this information with other similar information in your existing memory networks.

Our memory networks help us to survive in the world.  But emotional trauma causes impairment to these networks.

EMDR helps to restore the proper functioning and integration of these networks.

In order to heal from emotional trauma, to start, there needs to be an integration between the right and left hemispheres of the brain.  In EMDR this is done with "bilateral stimulation" (BLS).

Initially, when EMDR therapy was first developed, BLS only consisted of eye movements, hence the name Eye Movement, Desensitization and Reprocessing.

As advances were made in EMDR therapy, researchers and EMDR clinicians discovered that effective BLS in EMDR processing could take many forms, including alternating, rhythmic tapping, pulsing and music that alternates between the right and left ears.

Under normal non-traumatic circumstance, the brain has ways of integrating psychological disturbance.

For instance, if you have a minor disagreement with a stranger, you might feel annoyed, but it's usually not traumatic.

Part of emotional integration might involve talking to a friend or a therapist about the argument, writing about it in a journal or possibly having a dream about the incident.  These are all integrative processes for events that are non-traumatic.

But when there's a traumatic event, which overwhelms the body and the brain chemistry, talking, writing and dreaming often aren't enough to integrate the event, so it remains emotionally unintegrated.

After a while, these unintegrated memories can get triggered by other events.

The most common example that is usually given is when a veteran with PTSD returns from combat and  s/he hears a car backfiring, s/he experiences it as if s/he is back in combat.  This could include the sights, sounds, taste and other sensory experiences from the war.

There are many other types of triggers.  For instance, if you feel belittled by your boss, this could trigger what you experienced if you were belittled as a child.

The problem is that, because these traumatic memories are stored in the nonconscious part of brain, the person who is triggered doesn't realize that much of what they're experiencing is from the past.

As I mentioned before, they often have problems distinguishing "then" from "now" when they're emotionally triggered.

Due to the lack of emotional integration, the traumatic memories are stored in isolated memory networks, which remain just below the surface and ready for reactivation.

EMDR Therapy For Trauma

EMDR was developed to help access and process these traumatic memories.

After accessing these memories, the goal of EMDR therapy is to make connections between the isolated memory networks and functional memory networks.   This is done, as previously mentioned, with BLS.

Next Article:  Part 2 of this article: How EMDR Works will give a composite example to demonstrate how EMDR therapy works.

Getting Help in Therapy
Emotional trauma that creates psychological, physical, and interpersonal problems is much more common than most people realize.

Getting Help to Overcome Trauma With EMDR Therapy

Research has shown that EMDR is one of the most effective forms of therapy to overcome emotional trauma.

If you are suffering with emotional trauma, rather than suffering alone, you could benefit from working with a licensed mental health professional who is trained as an EMDR therapist.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR, AEDP, EFT, Somatic Experiencing and Sex Therapist who works with individual adults and couples.

I have helped many clients to overcome emotional trauma so they could lead a more fulfilling life (see my article: What is a Trauma Therapist?).

To find out more about me, visit my website:  Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during. regular business hours or email me.

Keeping the Spark Alive in Your Relationship

In recent years, researchers have discovered that the initial phase of a new romantic relationship is characterized by new relationship energy (NRE).  NRE refers to that intense passion you experience at the beginning of a romantic relationship, which can be exhilarating and fun (see my article: The 5 Stages of Love From Attraction to Commitment).

Keeping the Spark Alive in Your Relationship

NRE occurs during the so-called "honeymoon phase," which typically lasts up to 2-3 years or so.  

This is the phase when you spend a lot of time thinking about and yearning for that person, and when you see each other, you can't keep your hands off each other.

The Brain and New Relationship Energy 

Dr. Nan J. Wise, cognitive neuroscientist, licensed psychotherapist and certified sex therapist, explores NRE in her book, Why Sex Matters.  

According to Dr. Wise, NRE includes high levels of dopamine flooding the brain.  

Keeping the Spark Alive in Your Relationship

Dopamine plays a major role in movement, motivation, perception of reality and the ability to experience love and pleasure. 

High levels of dopamine can make you feel giddy and euphoric when you're around your partner.  

In addition, you usually experience high levels of oxytocin, often referred to as the "cuddle hormone," and vasopressin, which makes you feel emotionally and psychologically attached to your partner.

So, it's no wonder NRE makes this phase of the relationship so intense.

Tips For Keeping the Spark Alive in a Long Term Relationship

As previously mentioned, NRE eventually diminishes.

The chemicals in the brain settle down and, if your relationship endures past this phase, your feelings for each other often mature into a deeper kind of love.

Keeping the Spark Alive in Your Relationship

While it's normal for NRE to wane after a while, many couples want to know how to keep the romantic and sexual spark alive in their relationship.

Here are some tips:

• Keep Joy Alive: The ability to experience joy together is important, especially for a long term relationship that will, inevitably, go through ups and downs.  The ability to laugh together is important to maintaining the vitality in your relationship.  In addition, finding new and novel ways to be with each other can also keep the joy alive.  This could include you and your partner being more playful with each other and exploring new fantasies.

• Engage in Open Communication: Being able to give and receive feedback openly is important to keeping the spark alive.  This means being open to hearing feedback which might not always be positive without getting defensive as well as your ability to talk openly and tactfully with your partner about how you feel about all aspects of your relationship, including sex (see my articles: How to Talk to Your Partner About Sex - Part 1 and Part 2).

• Show Your Love and Affection: Rather than holding back, nurture your relationship, show your love for your partner by being physically affectionate, allowing yourself to show you're happy to reconnect with them when you've been apart, being emotionally and sexually generous in ways that are pleasing to both of you, making loving eye contact with your partner, establishing relationship goals, being aware of your peak erotic experiences as a couple, and finding other ways that are meaningful to both of you (see my articles: What Are the 5 Love Languages? and What If You and Your Partner Have Different Love Languages?).

• Be Open to New Experiences: Whether this means exploring new interests, ideas or places or finding new and exciting ways to be sexual, being open to new experiences helps to keep the spark alive in your relationship (see my article: Being Open to New Experiences).

• Be Your Own Person: Rather than merging together, find that balance between being your own person and being part of your relationship.  Maintain your own identity and interests as well as those you share with your partner.  Learn to compromise about time together and time apart.  Not only will being your own person allow you each to grow as individuals, but you'll both have something unique to bring to your relationship.  

• Be Generous: It's easy to take one another for granted, especially in a long term relationship, so it's important to show your appreciation and to be kind and emotionally generous.  Instead of keeping score, pick your battles and know when to overlook certain things that aren't important in the long run.  Know your partner's love maps and talk about your own.

Getting Help in Therapy

Everyone needs help at some point.  

If you have been unable to resolve your problems on your own, you could benefit from working with a licensed psychotherapist.

A skilled therapist can help you to develop the tools and skills you need to live a more fulfilling life.

So rather than struggling on your own, seek help from a licensed mental health professional who has the expertise and experience to help you.

About Me

I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT and Somatic Experiencing therapist.

I am a sex positive therapist who works with individual adults and couples (see my article: What is Sex Therapy?

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

What Makes So-Called "Bad Boys" So Irresistible to Many Women? Brain Chemistry Might Be Part of the Answer

Are you a woman who usually falls for men who are considered so-called "bad boys" and neither you nor your friends understand why these guys are so irresistible to you?

What Makes So-Called "Bad Boys" So Irresistible to Many Women?

It Seems Counterintuitive: Women Who Are Usually Stable and Responsible Fall for "Bad Boys" 
Often, it seems completely counterintuitive because the woman who falls for "bad boys" is often the woman who is the most stable, responsible and kind person who never gets into trouble herself, but she falls in love with guys who are edgy, constantly in trouble, emotionally unavailable and sometimes abusive, and constantly breaking her heart.

Just a note before I go on:  I'm using the phrase "bad boys" as a shorthand expression that most people understand without having to go into a lot of detail.  But, in fact, I have a lot of empathy for these men, who often have a long history of trauma, and underneath that tough exterior, there's often a lot of fear and shame.  Of course, working with them as a psychotherapist is different from being in a romantic relationship or married to them and in a lot of emotional pain. 

Why Are So Many Women Drawn to "Bad Boys"?
There can be as many reasons as there are women who fall for guys who have a reputation for being "bad."

Some psychotherapists believe that women who are drawn to "bad boys" are working through unresolved trauma from their family history, especially if they had a father who was unreliable, irresponsible, and emotionally abusive.

Other psychotherapists believe that this dynamic involves a woman's need to "rescue" the man, who is often traumatized and in need of a lot of emotional support.

Other therapists believe that women in these types of relationships are masochistic.

All of the above theories, either individually or in combination, might apply to some women sometimes, but it often doesn't explain this dynamic for many women who had loving, stable fathers and who are not masochistic or in need of rescuing people.

The Brain Reward Circuit and an Irresistible Attraction to "Bad Boys"
Another interesting theory, proposed by Richard A. Friedman, MD, in his article, "I Heart Unpredictable Love" (NY Times) is that this type of attraction involves the brain reward circuit (see link below for the article).

According to Dr. Friedman, the brain reward circuit is a primitive part of the brain that is exquisitely attuned to rewards, whether they are rewards of money, sex, or food.

When the reward is unanticipated, the circuit releases dopamine which gives the person a pleasurable and exciting feeling.

Unpredictable Love and the Brain Reward Circuit

As a result, when you're involved with someone who is unpredictable, as so-called "bad boys" tend to be, you get a sense of pleasure and excitement from the brain reward circuit.  This, in turn, fuels your attraction and obsession, from the brain reward circuit.

It can feel like an "addiction" in much the same way that people who gamble compulsively feel addicted to gambling.  The difference is that you're "gambling" with the unpredictable nature of the relationship as well as your own well-being.

Often, you're unaware of this sense of pleasure and excitement that's being generated by the brain reward circuit.  In fact, your rational mind might be telling you that this guy isn't at all good for you and you should stay away.  But when the brain reward circuit is releasing the dopamine, you might find yourself with this "bad boy" despite what you know rationally.

Does This Mean That You'll Always Be Attracted to "Bad Boys" For the Rest of Your Life?
I've worked with many women who found themselves irresistibly drawn to so-called "bad boys" and who were able to overcome this problem.

Unfortunately, for some women, it often takes a lot of emotional pain before they override their brain chemistry to make healthy choices for themselves.  But just because you feel a sense of pleasure and excitement doesn't mean that you can't make healthy decisions for yourself.  You can.

Getting Help in Therapy
Relationships with "bad boys" can take its toll on you physically, mentally, emotionally and spiritually. That's a high price to pay.  And many women discover that, after being in a few of these types of relationships, they aren't as emotionally resilient as they used to be and it gets harder to move on.

If you have tried on your own to stop getting in emotionally unhealthy relationships, but you can't do it on your own, you could benefit from getting help from a licensed mental health professional.

If you're motivated to change, you can learn how to override the impulse to get involved with men who are constantly hurting you.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR, Somatic Experiencing and Sex Therapist. 

I work with individual adults and couples.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Also, read my blog article:
The Heartbreak of the On Again-Off Again Relationship

I Heart Unpredictable Love - by Richard A. Friedman - New York Times