EMDR Therapy: What it is, how it works, and Who it helps, Trauma-informed sex therapy, in Scottsdale, AZ
What is EMDR?
EMDR stands for Eye Movement Desensitization Reprocessing. EMDR therapy is a very helpful way to treat people who have experienced trauma. When someone goes through something horrible, the memory of what happened can stay with them, causing pain, fear, shame, or sadness for a very long time. EMDR helps the brain process those painful memories so they hurt and bother the person less over time.
Francine Shapiro
Francine Shapiro was a psychologist who made an important discovery that has helped millions of people. She is known for creating EMDR therapy. Francine discovered EMDR by accident. One day, she was walking in a park, thinking about something that bothered her. She noticed that as she moved her eyes back and forth, her feelings of stress seemed to go away. She was curious and started researching how eye movements could help others.
Francine did lots of research to make sure EMDR really helped. She worked with people who had been through traumatic experiences, like soldiers, sexual abuse survivors, and others who had experienced great emotional pain. Her research showed that by following a therapist’s hand or other object with their eyes, people could think about their difficult experiences without feeling as much fear, sadness, or stress. Over time, she found that EMDR helped people process their difficult memories so that past experiences could stay in the past where memories belong and not cause people as much pain in the present. Francine Shapiro’s research made an amazing discovery that changed how we help people who have survived traumatic experiences.
How does EMDR work?
If you are like me, you want to know how and why things work. Our gal Francine Shapiro developed the adaptive information processing model (AIP) to explain how the brain processes memories. According to the AIP model, our brains are always trying to heal themselves, especially when it comes to difficult or upsetting experiences.
Our brain can process everyday experiences that happen to us and store the memories in a healthy way. We can think about it later without feeling too upset. But when something really hard or traumatic happens, the brain sometimes gets “stuck.” The memory doesn’t get processed correctly. It stays active in the present. In other words, the memory is too big for the brain to compute the download and put the memory in its rightful place as something that happened in the past and is currently not happening; therefore, we don’t need to stress about it anymore. This can cause a lot of emotional and physical problems, like anxiety, depression, or even chronic pain, because the brain hasn’t had the chance to heal.
Francine Shapiro’s AIP model says that EMDR therapy helps the brain finish this healing process. By using things like eye movements, EMDR uses the brain's natural healing mechanisms and helps the brain “unstick” those painful memories and store them in a way that doesn’t hurt as much. Once the brain processes the memory properly, people can think about it without feeling the same intense pain, shame, fear, anxiety, or sadness. Thanks to the AIP model, we understand how EMDR works to help people heal from their experiences and feel better about their lives.
You might be thinking, "Wow, that sounds so simple!" If all it takes is eye movements, why can’t I just do this on my own and save myself a pretty penny? The reality is that there is so much more to EMDR than just eye movements. EMDR is an eight-phase process, and it is very important that when we are processing trauma, we have a trained professional guide us through our pain and distress.
Eight phases of EMDR therapy
Phase 1: History-Taking
In this first step, the therapist talks with the person to understand their life story and the difficult things that they have been through. The therapist learns about the person’s current stressors and symptoms and what the client wants help with. Research has also shown us that we carry information from two generations back stored in our bodies–our parents and grandparents. We know this because of studies on Holocaust survivors and a science called epigenetics. Unfortunately, we do not start our lives as blank slates. The therapist will do an in-depth dive into your history and treat you as a whole person with your entire story of what makes you you, and what previous experiences, conscious or unconscious, are hurting you today.
Phase 2: Preparation
In phase 2, the therapist will also explain the EMDR therapy process and set expectations. They will address any questions or concerns the client has. The therapist will also teach you ways to stay calm and relaxed. This is important because some memories can be hard to think about and feel. Every person is different, so some clients need a lot of time in phase one or two before they are ready to move on, which is okay. You need never feel rushed in your healing process.
Phase 3: Assessment
In this step, the client picks a specific memory they want to work on, known as the target. The therapist will ask for images, beliefs, emotions, and sensations associated with the event. The therapist will use the subjective unit of distress (SUD) and validity of cognition (VOC) scales to measure progress.
Phase 4: Desensitization
This is the phase where the side-to-side movements begin, also known as bilateral stimulation (BLS). The therapist activates the target memory that the client wants to focus on. The client starts to follow the therapist's fingers or another object with their eyes. While doing this, the client notices the difficult memory. Over time, the memory starts to feel less painful or disturbing. This process is tracked by decreasing the SUD to a 0 and increasing the VOC to a 7.
Phase 5: Installation
After the painful feelings become smaller, the therapist helps the client focus on positive thoughts and beliefs about themselves. They work on building new, healthier, more adaptive beliefs, such as “I am good enough regardless of what others think of me,” “I did what I needed to do to survive,” etc.
Phase 6: Body Scan
The therapist asks the client to think about the memory again and notice how their body feels. Emotion is stored throughout the body, and the body scan helps ensure no leftover tension or stress is stored.
Phase 7: Closure
The therapist makes sure the client feels calm and safe before the session ends. The therapist will use relaxation tools learned during phase 2 if the client feels upset.
Phase 8: Reevaluation
At the next session, the therapist checks in to see how the client feels about the memory. They talk about any changes and decide if they need to work on it more or if they can move on to a different phase or a new target memory.
These 8 phases of EMDR are carefully designed to help people heal step by step in a safe and supportive way. By the end, many people report lasting changes in the traumas that no longer disrupt their lives.
How is EMDR different than talk therapy?
In EMDR, talking is not the main focus. Talk therapy can lead to what EMDR therapists call a “state change.” This means that when you come into therapy feeling stressed and anxious, after talking about it, you may feel better because you feel heard and understood. You might leave the session feeling happier or calmer than when you came in. However, this change is usually temporary. The next time something reminds you of something that happened to you in your past, your mind and body may react the same way, causing the stressful, disturbing feelings to return.
EMDR is considered a bottom-up approach, which is a way of helping people focus on the body and how it feels before dealing with thoughts. Trauma is stored in the body, so EMDR looks at the body’s physical and sensory experiences, like how you might feel tense or scared, and works on calming those feelings before talking about your thoughts or feelings. EMDR changes how our brain fires and wires data and how information is stored in our long-term memories. EMDR can help people address the roots of why they are showing up the way they are so that the next time it rains, that weed will not grow back again.
Who can benefit from EMDR?
EMDR therapy can help a lot of different people who are experiencing a lot of unique symptoms. Some examples of who might benefit are people who have been through trauma and who may or may not have developed PTSD (not everyone who has trauma will develop PTSD). This could be things like accidents, sexual abuse, physical abuse, or losing someone close to them. Research shows that EMDR is effective at treating people with depression, anxiety, and chronic pain. EMDR is also beneficial in treating individuals with low self-esteem and shame, helping them replace negative self-beliefs with more adaptive ones.
Specialized EMDR Protocols: RTEP and GTEP
The Recent Traumatic Event Protocol (RTEP) and the Group Traumatic Event Protocol (GTEP) are specialized protocols within EMDR therapy designed to address recent traumatic events effectively and safely. These are my favorite protocols I have ever been trained in to treat trauma because they help people feel better rapidly and prevent PTSD from developing because of early intervention. I wish more people were aware of this as a treatment option. These protocols are suited for clients who have experienced trauma within the past few weeks or months, although they can sometimes be applied beyond that timeframe, depending on the context.
RTEP
Is primarily for individual processing of recent traumatic events. It is done one-on-one, in a private session with a therapist. It is based on the standard 8-phase protocol of EMDR, but adapted for recent trauma.
GTEP
Is designed for groups affected by trauma, such as a school that experienced a shooting or after a family was in a car accident together. GTEP provides a structured way to help multiple people process trauma in a group setting, focusing on containment and individual perception and reflection of the trauma that has impacted them. Each participant uses a worksheet to guide them through their trauma processing in a private, self-directed manner supported by group leaders. To maintain privacy, participants do not share personal details with the group.
Can EMDR therapy work virtually?
Yes, EMDR works great online! Many therapists offer it through HIPAA-compliant software, and people still see positive results. During virtual EMDR, the therapist guides you through the process, just like in person. They use online programs that allow for the side-to-side or BLS movements that can be done on a screen. Studies show that virtual EMDR can be just as effective as in-person sessions, so it’s a good option if you can’t meet face-to-face. Many people prefer online therapy to process their traumas because they can do so in the safety of their own homes.
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Expert Resources From a Sex Therapist:
Dashorst, P., J. de Jong, P. (2019). The intergenerational consequences of the Holocaust on offspring mental health: A systemic review of associated factors and mechanisms
Shapiro, F. (2018). Eye movement desensitization and reprocessing (EMDR) therapy: Basic principles, protocols, and procedures (3rd ed.). Guilford Press.
Van der Kolk, B. A. (2015). The body keeps the score: Brain, mind, and body in the healing of trauma. Penguin Books.