How EMDR works

Written by: Jeanette Belew

​Eye Movement Desensitization and Reprocessing (EMDR) is an evidence-based approach to treating singular and chronic traumatic events. While the underlying neuroscientific mechanism as to exactly how EMDR works remains unknown, we do know that when a person is very upset, their brain cannot process information as it does ordinarily. One moment becomes "frozen in time," and remembering a trauma may feel as bad as going through it the first time because the images, sounds, smells, and feelings haven’t changed. Such memories have a lasting negative effect that interferes with the way a person sees the world and the way they relate to other people. 

​EMDR appears to have a direct effect on the way that the brain processes information. Clients often report that normal information processing, which was previously inhibited, resumes. So, following a successful EMDR session, a person no longer relives the images, sounds, and feelings when the event is brought to mind. They still remember what happened, but it is less upsetting. Many types of therapy have similar goals. However, EMDR appears to be similar to what occurs naturally during dreaming or REM (rapid eye movement) sleep. Therefore, EMDR can be thought of as a physiologically based therapy that helps a person see disturbing material in a new and less distressing way. 

In an EMDR session, the clinician and client together determine which memory to target first. The client is asked to hold different aspects of that event or thought in mind and while undergoing bilateral stimulation, alternating left-right stimulation of the body’s sensory system. Some methods of bilateral stimulation are left-right eye tracking following the therapist’s hand and or a light bar, headphones that play an auditory noise that alternates between the left and right ear, or tappers held in the client’s hands that alternately vibrate between the left and right side. The client’s preference determines the method of bilateral stimulation used. 

While processing the target memory using bilateral stimulation, internal associations to arise and the client can begin to process the memory and disturbing feelings. It is postulated that the sensory system stimulation triggers body’s procedural memory, aka, the memory of doing, which is much more accurate and detailed than just recalling. While, at the same time, the bilateral (left right) component encourages the brain to integrate the experience by forcing both sides of the brain to work together to process the feelings. It is believed that this allows for more rapid and lasting results. 

In successful EMDR therapy, the meaning of painful events is transformed on an emotional level. For instance, a rape victim shifts from feeling horror and self-disgust to holding the firm belief that, “I survived it and I am strong.” Unlike talk therapy, the insights clients gain in EMDR therapy result not so much from clinician interpretation, but from the client’s own accelerated intellectual and emotional processes. The net effect is that clients conclude EMDR therapy feeling empowered by the very experiences that once debased them. Their wounds have not just closed, they have transformed. As a natural outcome of the EMDR therapeutic process, the clients’ thoughts, feelings and behavior are all robust indicators of emotional health and resolution—all without speaking in detail or doing homework used in other therapies. 

There you have it, in a nut shell: bilateral stimulation used to target a negative belief system with the goal of desensitizing it and creating a new more positive belief system all done by your brain, not the therapist. Crazy right? Sounds too good to be true? Wrong, there are years’ worth of empirical research to support the process. Now that you know how EMDR basically works, the next blog will review what a typical EMDR session looks like.