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| How Are Emotions Processed in EMDR Therapy? |
EMDR was developed by Dr. Francine Shapiro in the 1980s as an alternative to traditional talk therapy to heal psychological trauma.
EMDR is one of several types experiential therapies, including AEDP (Accelerated Experiential Dynamic Psychotherapy) IFS (Internal Family Systems) Parts Work and Somatic Experiencing, that were developed by trauma therapists help clients to overcome trauma (see my article: Why is Experiential Therapy More Effective Than Traditional Talk Therapy to Overcome Trauma).
The cornerstone of EMDR is the Adaptive Information Processing (AIP) system which is a theory about how the brain stores memories and that the brain stores regular memories and traumatic memories in a different way.
While normal memories are stored by strengthening connections between neurons, traumatic memories aren't stored in a cohesive way. Instead, traumatic memories are stored with fragmented, sensory and emotional imprints due to the hyperactivation of the amygdala and inhibition in the hippocampus in the brain.
The unprocessed nature of traumatic memories can cause flashbacks and triggers.
Prolonged trauma can lead to structural changes in the brain with a reduction in neuroplasticity, but the reduction can be repaired by EMDR therapy and other trauma therapies.
How Are Emotions Processed in EMDR Therapy?
Emotions related to traumatic memories are processed in EMDR therapy using bilateral stimulation (BLS) which can be either eye movements, bilateral tones or tapping, to stimulate the brain while the client focuses on the traumatic memory (see my article: What is Bilateral Stimulation?).
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| EMDR Therapy Using Tappers For BLS |
This technique is similar to REM (Rapid Eye Movement), which is a crucial stage of sleep associated with dreaming and increased brain activity.
Bilateral stimulation helps the brain to "metabolize" the unprocessed traumatic memories by reducing their emotional charge and replacing negative self beliefs with positive, adaptive beliefs.
Prior to processing traumatic memories with EMDR, an EMDR therapist assesses whether EMDR is the appropriate therapy for a particular client.
If so, she obtains a client's history, helps the client to develop the necessary internal resources and coping skills to do the trauma work and evaluates whether the client is ready to process the trauma.
Some clients, who have a significant history of ongoing trauma might need an extended period of resource development before they can process traumatic memories (see my article: Developing Internal Resources and Coping Skills).
What Are the Key Aspects of EMDR Therapy?
Here is a breakdown of the eight phases of EMDR therapy.
If the therapist assesses that EMDR therapy is appropriate for a client, there are eight phases to EMDR which vary in length depending upon each client's needs:
- Phase 1: History Taking and Treatment Planning: The therapist obtains the client's history, as mentioned above. She identifies the traumatic memories and creates a treatment plan in collaboration with the client. During this stage, the therapist helps the client to identify the "touchstone" memory, which is the earliest memory related to the trigger the client is experiencing. For instance, if the client seeks EMDR therapy to deal with a difficult boss who humiliates the client in staff meetings, the touchstone memory might be memories of being humiliated by a critical father. The earlier memories would each have their own eight stages for processing. The therapist tries to find a touchstone memory which will have generalizable effects meaning that working with a one or a few of these memories is healing to the other similar memories. If these earlier touchstone memories aren't processed, the client is likely to get triggered again with another current situation that has similar elements to the touchstone memory. The mechanism for identifying the touchstone memory is the Float Back technique which is also known as the Affect Bridge in hypnotherapy (also known as clinical hypnosis).
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| An EMDR Therapist Writing Down the Client's History |
- Phase 2: Preparation: The therapist explains the process, establishes safety for the client, and teaches the client coping skills (also known as internal resources) to manage emotional stress during trauma sessions and between sessions (see my article: Why is Establishing Safety So Important in Trauma Therapy?).
- Phase 3: Assessment: The therapist activates the traumatic memory that she and the client have chosen to work on by identifying specific images, the client's negative self beliefs, emotions and physical sensations related to the trauma. This is also known as setting up the EMDR protocol.
- Phase 4: Desensitization: Bilateral stimulation (eye movements, taps or tones) is used to reduce the distress associated with the memory. When clients have experienced ongoing trauma, such as developmental trauma during childhood, there can be many memories to process using the eight stages for each memory. For instance, if a client experienced extensive physical abuse as a child as well as bullying in elementary school and date rape in adolescence, each one of those experiences would need to be processed.
- Phase 5: Installation: A positive belief, which is identified by the client, is strengthened to replace the negative belief associated with a particular traumatic memory.
- Phase 6: Body Scan: The client checks for any remaining tension in the body linked to the traumatic memory. If there is tension in the body associated to the memory, the therapist uses bilateral stimulation until the tension dissipates.
- Phase 7: Closure: After each EMDR session, the therapist uses stabilization techniques, which might include debriefing/talking about the experience or a meditation, to ensure the client feels secure at the end of a session.
- Phase 8: Reevaluation: The therapist assesses the client's progress, determines the success of the treatment and plans the next step of the therapy in collaboration with the client.
What Are Emotional Blocks?
Emotional blocks are unconscious barriers to processing traumatic memories.
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| Overcoming Emotional Blocks in EMDR Therapy |
An emotional block can occur at any phase of the EMDR processing.
I have been doing EMDR therapy regularly since 2006 and, unless a client comes with an uncomplicated one-time traumatic event, there will be emotional blocks during processing.
The emotional block can take many forms. One common example is the belief, "I don't deserve to feel better".
When a therapist and client encounter an emotional block, to use a metaphor, it's like encountering a tree that has fallen across a train track. The train can't go any further until the tree, which is blocking the train track, is removed.
Similarly, EMDR processing won't go any further until the emotional block is removed.
When a client and I encounter an emotional block in EMDR processing of a memory, I find it's useful and efficient to conceptualize the block as a part of a client. It might be a very young part (or inner child) or another part the client has internalized.
Whatever the block might be, I have found that working with the part using Parts Work can help to soften or remove the block so that the part allows the processing to continue (see my article: Trauma Therapy: Combining EMDR Therapy and Parts Work to Overcome Emotional Blocks).
Another way to think about an emotional block is to think of it as a defense mechanism that was a survival strategy at one point (usually when the client was younger) but no longer is adaptive.
It's not unusual for there to be several emotional blocks along the way during EMDR processing and each one needs to be addressed before EMDR processing can continue.
Conclusion
EMDR therapy is one of several types of trauma therapies.
The trauma therapist assesses each client to determine which type of trauma therapy--whether it's EMDR, AEDP, Somatic Experiencing, Parts Work or a combination of these modalities is for a particular client.
Getting Help in Trauma Therapy
If you feel stuck with unresolved trauma, you could benefit from working with a licensed mental health professional who is a trauma therapist.
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| Getting Help in Trauma Therapy |
Freeing yourself from your trauma history can help you to live a more fulfilling life.
About Me
I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), Parts Work (IFS and Ego States Therapy), Somatic Experiencing and Certified Sex Therapist.
As a trauma therapist, I have over 25 years of experience helping 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.
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