What is Bilateral Stimulation (BLS) in EMDR Therapy?

EMDR (Eye Movement Desensitization and Reprocessing) therapy is a safe and effective therapy for processing trauma (see my article: How EMDR Therapy Works: EMDR and the Brain).

Bilateral Stimulation as Part of EMDR Therapy

EMDR has been used to treat trauma since the late 1980s when it was developed by Dr. Francine Shapiro. 

In addition to being a clinician, Dr. Shapiro was also a researcher, so she did EMDR research which demonstrated the effectiveness of EMDR to process trauma.

A key component of EMDR therapy is Bilateral Stimulation (BLS).

What is Bilateral Stimulation (BLS) in EMDR Therapy?

Let's start by defining BLS.

BLS is the use of a stimulus that activates both sides of the brain and the body which allows the processing of memories, emotions and bodily sensations which are "stuck" in the nervous system as a result of trauma.

By activating both sides of the brain and body, BLS allows more effective processing of trauma than regular talk therapy.  

Bilateral Stimulation as Part of EMDR Therapy

Clients often report feeling less distressed by traumatic memories while using BLS because BLS has an integrative function. 

In other words, instead of being "stuck," traumatic memories get integrated with other experiences so that, over time, a client's distress level decreases until these memories are no longer distressing.

In the late 1980s, when Dr. Shapiro was developing EMDR therapy, BLS only consisted of eye movements (eyes moving back and forth while following the therapist's hand).

As other EMDR therapists contributed to the development of EMDR therapy, they discovered that other types of BLS worked just as well as eye movements. 

So for instance, many EMDR therapists had clients hold a set of tappers in their hands for BLS.  The tappers buzzed back and forth from the right side to the left and back again. These therapists discovered that tappers were just as effective as using eye movements as a form of BLS.

Dr. Laurel Parnell, who developed Attachment-Focused EMDR therapy, is known for using tapping as BLS where either the therapist or the client taps alternately on their arms or knees.  

Some clients like to listen to music with headphones where the music goes from one ear to the other back and forth. 

The advantage of using BLS that doesn't involve moving the eyes back and forth is that clients can close their eyes while processing a traumatic memory so they can tune into what's happening in their body, which is an important part of EMDR therapy, a mind-body oriented therapy.

Why is BLS Used in EMDR Therapy?

EMDR research has shown that using BLS as a key component to EMDR therapy and makes it a powerful modality for processing trauma, posttraumatic stress disorder (PTSD), other forms of anxiety and depression--to name just a few mental health issues where EMDR has been found to be highly effective.

Other Forms of BLS in Everyday Life

Aside from EMDR therapy, there are other forms of BLS in our everyday life.

Common examples of bilateral stimulation in everyday life include:

• Walking or Running: When you walk or run, you move one leg and then the other so that walking becomes a bilateral experience.

• Swimming: When you swim, you alternate using your arms and legs, which is a bilateral experience.

• Biking: When you ride a bike, you alternate each leg as you pedal, which is a bilateral experience.

People often report that when they walk, run, swim or bike, they feel better.  Many people say they come up with solutions to problems even if they're not actively thinking about these problems.

People also report feeling more relaxed after engaging in one of these activities, similar to how many clients experience BLS as part of EMDR therapy.

How is BLS Related to Memory Reconsolidation?

BLS is thought to be similar to REM (rapid eye movement) sleep.  

REM is a phase of sleep where memories are reconsolidated.

Since BLS activates both sides of the brain, similar to REM, it allows for communication and integration between fragmented parts of traumatic memories which have been stored in different parts of the brain.

EMDR Processing and Memory Reconsolidation

During EMDR reprocessing of a traumatic memory, the memory is brought back into consciousness during BLS and it is restored into long term memory with less vividness and intensity.  This is how memories that are "stuck" get "unstuck."

Over time, processing traumatic memories using BLS during EMDR sessions, makes the traumatic memories less distressing. When memories are restored in long term memory with less distress, the client experiences emotional healing.

They also understand on an emotional level (not just on a cognitive level) that the trauma is from the past and they no longer feel the negative impact in the present (see my article: Reacting to the Present Based on Your Traumatic Past).

This process is not something that happens in just a few sessions, especially if the trauma is longstanding and complex.  However, EMDR therapy is usually faster and more effective than regular talk therapy.

Also, see my article: EMDR Therapy Online is Just as Effective as EMDR in Person

Getting Help in EMDR Therapy

If you have been unable to resolve traumatic experiences on your own, you could benefit from working with a Trauma Therapist who does EMDR therapy.

Getting Help in EMDR Therapy

See my article: EMDR Therapy - When Talk Therapy Isn't Enough)

Working through unresolved trauma can help you to lead a more meaningful life.

About Me

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

I work with individual adults and couples.

I have helped many clients overcome unresolved trauma using EMDR therapy and other forms of trauma therapy (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 business hours or email me.

How is Emotional Avoidance Related to Unresolved Trauma?

Emotional avoidance is the tendency to avoid or control the experiencing or expression of distressing emotions.  Although emotional avoidance might provide temporary relief, it's damaging in the long term (see my article: Changing Maladaptive Coping Strategies: Avoidance).

Emotional Avoidance and Unresolved Trauma

Examples of Emotional Avoidance

Emotional avoidance can take many forms:

• workaholism
  
• Alcohol or drug abuse
• Out of control sexual behavior
• Compulsive gambling
  
• Overspending or so-called "retail therapy"
• Spending a lot of time watch TV as a distraction from painful emotions
• Spending a lot of time online to avoid painful emotions
• Engaging in infidelity
• Other forms of distraction and other maladaptive behavior

Emotional Avoidance as an Intra-Personal and Interpersonal Problem

Emotional avoidance can happen both intra-personally (on your own/within yourself) when you avoid feeling your emotions or interpersonally (with others) when you avoid experiencing or expressing yourself to your significant other, friends, family and others.

Why Do People With Unresolved Trauma Engage in Emotional Avoidance?

People with unresolved trauma often haven't developed the capacity to tolerate distressing emotions.  They find it emotionally overwhelming, so it's understandable why they try to avoid experiencing or expressing these emotions, but there are consequences to this avoidance (see below).

The Problem With Avoiding Distressing Emotions Related to Trauma

Although people can avoid distressing emotions temporarily, over time these emotions can intensify and become increasingly difficult to avoid.  

This could mean that they engage in more maladaptive behavior to avoid experiencing disturbing emotions. So, for instance, if they are drinking excessively, they might drink even more to suppress these emotions.

Since the mind and the body are connected, people who continue to avoid emotions can develop stress-related physical symptoms, including headaches and other body aches, high blood pressure, etc--as well as other mental health problems like depression and anxiety.

In addition, avoidant behavior prevents people with unresolved trauma from working through their trauma, so they are continually triggered emotionally.

Developing Better Coping Mechanisms in Therapy

One of initial strategies in trauma therapy is to help clients develop better coping mechanisms (see my article: Developing Coping Strategies Before Working on Trauma).

A skilled trauma therapist can help clients to develop a greater capacity to tolerate uncomfortable emotions by teaching them coping strategies (see my article: What is a Trauma Therapist?).

Depending upon the client and their trauma, this can take many forms. For instance, trauma therapist might teach them breathing exercises or meditation techniques to help alleviate their discomfort (see my articles: Square Breathing, Grounding Techniques, Trauma Therapy and Grounding Techniques and Safe Place Meditation).

For clients who are especially avoidant, they might start with a less distressing aspect of their unresolved problem.  For instance, if there is a situation that a client categorizes as a 4 (on a scale of 0-10 with the higher scores related to more disturbance), a trauma therapist might help the client to learn to cope with that situation before moving on to more distressing situations that evoke a more avoidant response, like situations the client categorizes as a 7, 8, 9 or 10.

As the client develops the capacity to deal with the situations on the lower end of the scale, they can progress to situations higher up on the scale because they now have more of tolerance for difficult emotions (see my article: Expanding Your Window of Tolerance).

A skilled trauma therapist will help clients to develop the necessary internal resources before they work on reprocessing trauma (see my article: Developing Internal Resources and Coping Skills).

Reprocessing Unresolved Trauma

After the client has gone through the preparation phase of trauma therapy and they have the necessary internal resources, they will reprocess the trauma with a therapy that is specifically developed for trauma reprocessing, like EMDR therapy (see my article: EMDR Therapy Helps to Achieve Emotional Breakthroughs).

After the trauma has been successfully reprocessed, there is no longer a need to avoid emotions because they are no longer disturbing.

Getting Help in Therapy

Emotional avoidance provides temporary relief from disturbing emotions, but this usually causes even bigger problems for the individual and their relationships.

If you tend to avoid uncomfortable emotions, get help from a licensed mental health professional who specializes in trauma.

Once you have worked through unresolved trauma, you can live a more authentic and meaningful life that is free from your traumatic history.

About Me

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

I work with individual adults and couples, and I specialize in helping clients to overcome unresolved 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.