Trauma doesn’t always stay in the past. If you’ve lived through a traumatic event, large or small, the fear and pain can reappear seemingly out of nowhere: triggered by a sound, a smell, a random thought or seemingly nothing at all.
You could begin to sweat, feel your heart beat faster or get a stomachache or headache. You might have trouble sleeping at night or concentrating during the day. You may find yourself getting easily upset, feeling irritable and nervous, or withdrawing from people and things you love.
Help is available, no matter the trauma or your response to it. For some, a psychotherapy technique known as eye movement desensitization and reprocessing therapy, or EMDR, can help.
“EMDR is intense work because you have to come face-to-face with the traumatic event or events, but the results can allow for healing,” says Claudia Driver, a UNC therapist experienced in providing EMDR.
EMDR may be considered alongside one-on-one talk therapy, support groups or medications to help with specific symptoms.
We spoke to Driver to learn more.
How does EMDR work?
Despite the name, EMDR doesn’t always involve eye movement. An EMDR therapist can use any stimulation that moves your attention from the left to the right side of your body, over and over again, which is called bilateral stimulation. Sometimes that’s a series of eye movements; you may follow your therapist’s finger or a light from side-to-side. It can be auditory, with beeps or sounds alternating from the left and right side of your head, or it can be physical, with you or your therapist applying taps to either side of your body, one after the other.
“Bilateral stimulation can help the brain process a memory, desensitize your response and adapt to a new perspective about it,” Driver says. “The event triggers decrease in intensity, and you can experience release from the traumatic event, allowing for adaptations and healthier ways to cope.”
Neuroscientists know memory can be processed during sleep, especially during a stage of deep sleep known as rapid eye movement (REM). Moving the eyes side-to-side while awake or engaging in any activity that moves your attention from one side of the body to the other is meant to help mimic that brain state, making your brain more able to process a memory that is causing you stress or anxiety.
“With EMDR, the REM process is simulated to allow access to parts of the brain that store memory,” Driver says. “You can get into the deep parts of the brain, connect to where you are now and get the memory to adapt.”
What is it like to undergo EMDR therapy?
During a session, your therapist will guide you to visualize a specific memory related to the traumatic event, pairing it with the negative thoughts or emotions associated with it. In between sets of bilateral stimulation, the therapist may ask what you notice and then provide another prompt to consider during the next set.
Thinking about a traumatic event can cause a physical reaction—your pulse might start racing or you might even feel physical pain. This therapy also aims to desensitize that physical response, so that you don’t find yourself short of breath or feeling ill every time you’re reminded of the traumatic event.
“A lot of research has been done showing that the body stores memory of events that are encountered throughout life,” Driver says. “Even if a person cannot consciously recall what occurred, the body may hold pain or tension in certain spots because of the way our neurological system stores information. EMDR can be used to target specific body sensations to help with clearing them out.”
If you undergo EMDR therapy, know that you won’t jump right into visualization or bilateral stimulation. First, your therapist will explain the therapy, work to understand your goals or specific issues you’re hoping to address, and provide you with resources that can help during and in between EMDR sessions, Driver says.
It’s important to prepare the person for the hard work of repeatedly thinking about a memory related to trauma, Driver says. In addition to flashbacks or fear during sessions, one of the risks is being reminded of the trauma outside of a session. Part of the preparation will include a therapist teaching “grounding skills,” such as breathing or visualization that you can use during and in between EMDR sessions.
“It can be really frightening and distressing for the patient, because there can be a lot of layers and complexities with trauma,” Driver says. “The therapist should be an anchor to the present while providing space to process the memory safely. If something happens outside of a session, we have to make sure the patient has the ability to get out of the memory, come back to the present, and use skills like breathing and visualization to not become overwhelmed.”
Once sessions with bilateral stimulation start, the therapist will ask whether the negative emotional or physical response to memories associated with the trauma are decreasing. Each patient will likely need a different number of sessions, depending on their response to the trauma, but the goal is to reprocess the memories associated with this trauma to dramatically weaken the emotional or physical stress they cause.
Who is a good candidate for EMDR therapy?
EMDR is effective for people who have experienced any form of trauma, post-traumatic stress disorder, anxiety disorders, depression disorders, phobias, obsessive compulsive disorder and acute stress events. It is not suitable for anyone still in the midst of a crisis or someone who is not in a safe or stable situation. People who are mentally unstable, actively psychotic, suicidal, or who can’t practice the grounding skills necessary to get out of a past memory should not attempt EMDR.
“The best candidates will have knowledge of what their trauma is and a specific goal,” Driver says. “Maybe they want to be relieved of a recurring nightmare, are exhausted from living in a state of fear, or are feeling stuck on a past event or situation. EMDR can help make a person feel better about that situation when they can define that intention.”
Driver says that people confuse EMDR for hypnosis or as a method for discovering repressed memories. Memory loss after trauma can occur—it’s thought to be a protective mechanism of the brain—so during EMDR, people may access details or memories they’d forgotten as they repeatedly visualize a traumatic event, but the therapy would not be used to try to specifically find repressed memories.
How can I find a therapist to do EMDR therapy?
Because of the risk of finding a repressed memory and the potential distress of repeatedly revisiting a traumatic memory, Driver says it’s important to find a therapist you can trust who has training provided or endorsed by the EMDR International Association and demonstrated experience with EMDR.
“Some people have had terrible experiences, because they may have had a poor facilitator who wasn’t trained or aware of what to look for,” Driver says. “A therapist has to know what’s too much for a patient.”
In recent years, EMDR sessions have been depicted in movies and television and talked about by celebrities, leading to an increased interest from patients.
“People are curious, but I don’t think this is something that just anyone should try to do or jump right into,” Driver says. “This is a complex psychotherapy that should have some intention. It is effective and evidence-based, but it takes a lot of work with a good therapist who knows how to keep you safe and guide you.”
If you’re struggling after a traumatic event, talk to your doctor. If you need a doctor, find one near you.