EMDR Therapy
I am a trained Eye Movement Desensitization and Reprocessing (EMDR) Therapist and a member of the EMDR International Association. I have been using EMDR Therapy for over 15 years to help adults and adolescents. EMDR is a psychotherapy approach designed for working with distressing or traumatic memories and is currently being used to treat a wide variety of behavioural health issues.
The theory behind EMDR is that many psychological difficulties are the result of distressing life experiences which have not been stored in memory properly. These traumatic memories may need some help to become processed, and EMDR is one way to do this.
Clients who have used EMDR Therapy consistently are surprised at how quickly the presenting symptoms are addressed. There is no need for you to talk about the disturbing and traumatic memories, for sessions on end, when you can gain lasting resolution in a much shorter period of time.
What is EMDR Therapy?
Eye Movement Desensitization and Reprocessing (EMDR) Therapy is a psychotherapy modality designed for working with distressing and traumatic memories. The theory behind EMDR is that many psychological difficulties are the result of distressing life experiences which have not been stored in memory properly and are said to be unprocessed or blocked. The traumatic memories may need some help to become processed and EMDR Therapy is one way to do this.
What is special about trauma memories?
Normal memories are stored by a part of the brain called the hippocampus. You can think of the hippocampus as a sort of librarian which catalogues (processes) events and stores them in the right place. However, some traumatic events (such as accidents, abuse, disasters, or violence) are so overwhelming that the hippocampus doesn’t do its job properly. When this occurs, memories are stored in their raw, unprocessed form. These traumas are easily triggered, leading them to replay and repeatedly cause distress.
What happens during EMDR Therapy?
EMDR Therapy consists of three stages.
Stage 1: Case conceptualization. In this stage we get an understanding of the presenting issue, that is, the memory or memories which are causing distress. We then develop some tools for you to have at your disposal during the next stage of ENDR Therapy. These tools include ones we will develop together, such a Secure Place and a Container. We will also revisit some tools you have sued in the past such as controlled breathing techniques, meditation, and exercise. Once your tools are in place, we then develop a Target Sequence Plan. This is the list of distressing and traumatic memories as well as the negative beliefs that you have about yourself when you think of those memories. In this stage we will also identify a more positive belief you would like to have about yourself. After we have competed the work in Stage 1, we move on to Stage 2.
Stage 2: Processing. In this stage we directly engage the distressing memories. We have you think of a picture of the worst part of the memory, notice the negative belief and the negative emotions which accompany the distressing memory and use bilateral stimulation to lower the level of the disturbance causes by the memory. We call this process desensitization. One the desensitization is completed we have you again picture the worst part of the distressing memory and think of the positive belief. We then use bilateral stimulation to connect the positive belief to the memory. This process is called installation. After the installation is completed, we then have you think of the picture the worst part of the distressing memory and the positive belief. We then have you scan your body for any discomfort. If discomfort is present, we do further bilateral stimulation on the positive belief. We continue in this manner until you experience no further physical discomfort.
Stage 3: Stage three we re-evaluate the target memory to ensure it is not causing anymore distress. We then look to the future and identify any situations in which the memory might be triggered. If any are identified we have you visualize the experiences, think of the positive belief, and envision the experience going well. We then use bilateral stimulation to process the experience.
What is EMDR Therapy used to treat?
EMDR Theory was originally developed and used to treat memories of traumatic and distressing experiences. Over the years much research has been conducted on the use of EMDR Therapy to address other issues. In addition to traumatic and distressing experiences, EMDR Therapy is currently being used to address anxiety, depression, obsessive-compulsive disorder, grief and loss, specific phobias, substance use disorders, and pain management. In my practice I use EMDR Therapy to address traumatic and distressing experiences, anxiety, OCD, specific phobias, and depression.
What is bilateral stimulation?
Bilateral stimulation is a core element of EMDR Therapy. It can be accomplished using side to side eye movements, alternating sound for one ear to the other, or by alternately tapping the body on one side and then the other. The procedure was developed in 1987 by the founder of EMDR Therapy, Francine Shapiro. Much research has been done on bilateral stimulation and there is still much to learn about this process. What we do know is it help the client relax during EMDR Therapy. It also helps thoughts to become easier to process. Additionally, bilateral stimulation helps to distance the target memory such that it is less distressful.
How long does treatment take?
EMDR Therapy sessions are generally weekly for 60-minutes. I also provide weekly 90-minutes sessions in which we will cover more therapeutic ground than in a traditional 60-minute session. In addition to 60-minute and 90-minute session, I provide intensive sessions which can run from 2 to 4 hours. In these intensive sessions we will process several distressing memories in one session. Most of my clients prefer the weekly 60-minute sessions. If you are interested in 90-minute or intensive session, contact me so that we can talk further.
(Courtesy of EMDR International Association: https://www.emdria.org.)
I am an EMDRIA Certified EMDR Therapist, which means I have done:
Foundational EMDR Training
A Supervised Practicum
A year of Consultation
In addition to the work required to be certified, I have taken additional training in the following:
Healing Spiritual Abuse with EMDR Therapy
EMDR for Borderline Personality Disorder
DeTUR: Addiction and Urge Reduction Protocol
EMDR for Obsessive Compulsive Disorder
EMDR with Couples and Families
EMDR Intensives
FLASH Technique for Intense, Traumatic and Disturbing Memories
Four Blinks Flash Technique
DeprEnd Protocol for treatment of Depression
FAQ’s
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EMDR can help people with a wide range of mental health conditions. Children, Adolescents, Teenagers and Adults of all ages can benefit from this treatment.
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First, let’s look at how some parts of the brain work:
The Limbic System includes parts of the brain that control things like memory, emotions and automatic reactions and responses –including the flight-flight-freeze responses.
The Frontal Lobe areas control things like intentional thinking, planning, organizing, problem-solving, regulating emotions and impulses.
Our limbic system can ‘store’ memories in a way that allows it to know how react if it encounters the same situation again. Sometimes memories of distressing events can get stored in a way that causes the limbic brain to react with a flight-flight-freeze response without allowing the frontal lobe enough time to think things through.
When that happens, the limbic system can take over and cause the frontal lobe to have a difficult time in controlling and regulating emotions and impulses. We are then left reacting and responding in ways that may not be logical and we have a difficult time controlling it.
EMDR relies on the Adaptive Information Processing (AIP) model, a theory about how your brain stores memories. This theory, developed by Francine Shapiro, PhD, recognizes that your brain stores normal and traumatic or distressing events differently.
AIP explains that, during normal events, your brain stores memories in a smooth manner and connects them on a network to other things that you remember. During upsetting events, particularly if the fight-flight-freeze response was triggered, the memories may not be stored in a helpful way.
Often, your brain stores those memories in a way that doesn’t allow for them to be moved into long-term memory so that they can be recalled without all the feelings and emotions. Because they didn’t store properly, your brain didn’t receive the message that the danger or distress is over.
Newer experiences can link up to earlier upsetting or distressing experiences and reinforce the negative experience. Then your mind has a higher level of sensitivity to things you saw, heard, smelled or felt during the related events.
When something reminds your limbic brain of one of those distressing memories (which can happen without you even being aware!), it causes the brain to react and respond in a way that you may not want it to. You may experience some form of flight-flight-freeze or you may find yourself reverting back to behaviors that you showed during those past events.
If you find yourself thinking, “Why did I say that? Why did I act that way? Why can’t I just keep my cool? Why do I get so angry?” then you might be having limbic brain responses.
EMDR Processing: when you do EMDR therapy, you will access memories of distressing events in a very controlled manner and those memories will be reprocessed which allows the limbic part of the brain to store them in a different, more adaptive way. This will help the limbic brain be less reactive to triggers.
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The most common are:
• Relationship triggers: reacting and responding to people around us in ways that we don’t want to. –this includes intense feelings of rejection and abandonment.
• Anxiety disorders: Generalized anxiety disorder, panic disorder, phobias and social anxiety/phobia.
• Obsessive-compulsive disorders: Obsessive-compulsive disorder (OCD), body dysmorphic disorder and hoarding disorder.
• Personality disorders: Borderline personality disorder, avoidant personality disorder.
• Trauma: Acute stress disorder, PTSD and adjustment disorder.
—and more -
Every situation is different. Most people do EMDR therapy for several weeks to a few months.
Much of this depends on what kind of distressing experiences we are processing. A one-time event, like a car accident that causes panic, may be able to be reprocessed in a few sessions. Childhood trauma or repeated distressing events over a life-time can take many months.
Potential Course of Treatment:
I get a lot of questions about what EMDR therapy looks like in practice. The following is a very general overview of how things can go.
Please note, this is a very general idea and does apply to every situation. Some things that can make this look different include: multiple traumas, childhood trauma, negative self-view, lack of support, anxiety, depression and use of substances. It’s important to be aware that many people do EMDR therapy for several weeks but there are also many people who do EMDR therapy for a year or more. I am putting this information here to highlight how EMDR is different than traditional talk-therapy. It is very structured and, after the first two phases, there is not a lot of talk-therapy style conversation happening in the sessions.
Initial Consultation: this can be scheduled online. It usually takes about half an hour. During this meeting we will assess if your situation is one that I can help with and you can decide if I seem like someone you would want to work with. (I dont get offended if the answer is no!) We will also discuss scheduling to see if I have a time slot that can work with your schedule.
Paperwork: I will get your name and information entered in my Electronic Health Records system and the insurance billing system. You will get consent forms, these forms must be filled out and signed, and a credit card on file, prior to the first session.
Sessions Begin:
Phase 1: History/Target Sequence Planning: Duration: 2-3 sessions
During this phase we will complete your intake interview and identify the disturbing/traumatic memories that need to be processed. We will create a Target Sequence Plan that will direct our sessions.
Homework: you will be asked to fill out the EMDR Workbook online. This needs to be complete before the second session.
Phase 2: Preparation/Stabilization Duration: 2-3 sessions
During this phase we will help you develop your ability to manage problematic symptoms. You will develop an imagined Secure Place and a Container to be used during EMDR processing, you will receive psychoeducation on your diagnoses, you will be taught coping skills to help with managing the symptoms you experience. During this phase we will also explore which type of bilateral stimulation works best for you.
Homework: you will be asked to practice taking your mind to the Secure Place each day for a short time. This is a critical piece of the process -please set a reminder in your phone to practice it each day.
Phases 3 – 7: Assessment, Desensitization, Instillation, Body scan, Closure Duration: 3-6 sessions
During these phases, we will be processing the disturbing/traumatic memories that you identified in phase 1. This is the phase that is most commonly thought of when thinking of EMDR. You will be doing the eye movements or other bilateral stimulation or using the FLASH technique during these sessions.
Homework:
You will be asked to continue taking your mind to the Secure Place each day.
You will be asked to fill out a worksheet that tracks and identifies triggers. (this will be emailed to you each week, you can add to the form as the week goes on and need to submit it by 8am the morning of your next session).
You will be asked to fill out an online form by 8am the morning of your session to report how things were between sessions. (This will be emailed to you the day before your session).
Phase 8: Reevaluation Duration: 1 session
During this phase we will reassess the memories you processed in phases 3 – 7 to ensure they are no longer problematic.
This entire process may be repeated if there are multiple traumas or memories that are not resolved with the initial treatment. This is why it is hard to predict how long treatment might take.
Again, please note: this is a very general idea of how things go. There are many factors that can make this take a longer amount of time -sometimes it’s shorter. My goal is to get you to the point where you don’t feel like you need therapy and I utilize as many tools as I can to get you there as quickly as possible. But each person’s past experiences are different, their nervous system and brains are different, and their response to treatment is different.