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.

How Reading Literature Has a Positive Effect on Your Brain

I've always been a proponent of having children learn to read for pleasure early in their lives. I've always enjoyed reading from the time I was in the first grade.  My interest in reading was encouraged by my mother, who would read to me everyday when I was a young child, and who each week brought me to the library, a place that seemed magical and filled with possibilities to me.

Reading Literature Has a Positive Effect on Your Brain

I was also fortunate to have a first grade teacher who recognized my love of reading and gave me beautifully illustrated books that were a little challenging for me at the time, like "Heidi" and "Pippi Longstockings," to inspire me to continue reading.

Reading Literature Has a Positive Effect on the Brain

Without the present day distractions of video games and the Internet, my imagination came alive and took flight as I read about characters who lived in places that were so different where I lived.  This also created a curiosity in me about people, customs and places outside of my immediate surroundings.

Reading and Brain Research
We now have research from neuroscience which reveals that brain scans taken while people read a detailed description, a metaphor or an emotional conversation between two characters in a story stimulate the brain.

The Broca's area and the Wernicke's area, among other areas of the brain, are parts of the brain that are involved in interpreting narratives.

Reading Literature Has a Positive Effect on the Brain

According to Annie Murphy Paul, a journalist who writes for the NY Times, the brain doesn't make much of a distinction between reading about an experience and actually living the experience.  She says that the same parts of the brain are stimulated.

This is similar to hypnotherapy, where the unconscious mind, including imagination, are engaged in a hypnotic state and the brain doesn't distinguish between the imagined images or metaphors and actual lived experience.  This is one of the reasons why clinical hypnosis is effective.

Reading Literature Has a Positive Effect on the Brain

As most people who love literature know, reading also gives us an opportunity to enter into the experience  of the protagonist, especially if it contains rich metaphors and descriptions and lively conversations between characters.

Entering into the protagonist's world, we can have an intimate emotional experience of his or her relationships, insights, doubts, fears, joys and sorrows.

By having this intimate emotional experience, we can't help to compare the protagonist's experience with our own.

It's often easier to develop psychological insights when the experiences are outside of ourselves, like, for instance, when we see a protagonist struggle and overcome a particular emotional dilemma, than it is when we're going through it ourselves.

In doing so, we can also develop insight into our own personal experiences, notice something that we've never thought of before or see an experience in a completely new light.

Good literature has a way of transporting us into new psychological states as well as new places in a way that reading nonfiction usually doesn't.

I'll continue this theme with specific examples in a future article.

About Me
I am a licensed New York City psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who works with individual adults and couples.

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

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

Emotional Trauma Often Creates Negative Expectations About the Future

People who suffer with a history of emotional trauma often have negative expectations for the future because of their trauma.  This is a common experience that many psychotherapists see in their clients, especially among adults with early childhood trauma.

 Emotional Trauma Often Creates Negative Expectations About the Future

Negative Expectations About the Future Are Often Unconscious
These negative expectations are often unconscious so people, who experience them, often don't question them because these thoughts are outside of their conscious awareness.

However a skilled therapist, who is attuned to clients, can recognize these negative expectations, especially when these clients talk about their future in an overly pessimistic way.

If a traumatized client is in therapy where only cognitive behavioral therapy (CBT) is used, the therapist usually will point out the distortions in the way that the client is thinking and the problematic behavior that s/he is engaging in.

This is a useful first step because it makes clients' unconscious feelings conscious and they can learn to become aware of these feelings in order to change them.

By becoming aware of their pessimism, they can begin to challenge their thoughts and feelings by asking themselves if these thoughts and feelings are objectively true.  This assumes that clients can take a step back for self reflection.

If they're able to challenge their thoughts and feelings, they might be able to entertain an alternate scenario where the possibility of the future could be more realistic.

If they're not at the point where they can actually imagine a positive future for themselves, they might, at least, be able to see that there is the potential for a future that is better than their past or present experiences.

Counteractive Therapy vs Experiential Therapy
As I mentioned in a prior article, Experiential Therapy, Like EMDR, Helps to Achieve Transformational Breakthroughs, CBT works as a counteractive therapy that provides clients in therapy with an alternate scenario to their usual way of thinking and feeling.

But, for many traumatized clients, this form of counteractive therapy isn't enough.  They can see the distortions in their thinking, but they're unable to feel it in an authentic way or to change it.

Emotional Trauma Often Creates Negative Expectations About the Future

This can be very frustrating and, for some clients, it makes them feel ashamed.  They feel like they're "not doing therapy right."  For some clients, the contradiction between how they feel and what they can  see can make them feel that there's something seriously wrong with them.

These clients often leave therapy because they continue to have negative expectations for their future.  At that point, they leave therapy with the idea that "I tried therapy--it doesn't work for me."

But the problem isn't with the client.  The problem is with the type of therapy, CBT.

Experiential Therapy and Brain Research
When it works, CBT affects the logical part of the brain, but it often has no impact on the emotional part of the brain, which is the part of the brain that needs to be changed when emotional trauma is involved.

We're fortunate now to have the brain research to prove this, as cited in Unlocking the Emotional Brain: Eliminating Symptoms at Their Roots Using Memory Reconsolidation by Bruce Ecker, Robin Ticic, Laurel Hulley and Robert A. Neimeyer, and in other recent books and articles about brain research as it applies to emotional trauma.

Experiential Therapy and Brain Research

In their book, the authors discuss research that demonstrates that experiential therapies, like EMDR and other similar types of therapy, help these clients to have a transformational experience, as I mentioned in my prior article about experiential therapy.

Rather than just being a counteractive therapy that only provides an alternative on a logical level, experiential therapy affects the limbic system so that the client not only recognizes the distortion on a cognitive level--they also feel it.

With experiential therapies, like EMDR, Somatic Experiencing and clinical hypnosis, clients remember the narrative of their traumatic memories, but they experience the memories differently on an emotional level from how they did before they came to therapy.

Experiential Therapies Can Provide Transformative Experiences

Often, clients, who participate in experiential therapy, will make comments like:

• "When I think about the memories, I remember everything that happened, but I no longer feel traumatized."
• "I never thought I would be able to think about these memories without feeling upset about them."
• "I used to feel so upset by these memories, but now when I think about them, my feelings about them are neutral."

Experiential therapies also help clients to overcome feelings of foreboding (based on their trauma past) about the future.

Getting Help in Therapy

If you have a history of trauma that causes you to feel pessimistic about your future, you could benefit from getting help in therapy with a licensed psychotherapist who provides experiential therapy.

Getting Help in Therapy

Rather than feeling trapped by your emotional history, you could be free to live a fulfilling life.

About Me

I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who works with individual adults and couples.

One of my specialties is helping clients to overcome emotional trauma.

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.