Written by Nicole Cains, r Psych

Interest in EMDR seems to have increased recently, due to an increasing number of people becoming aware of its potential value. I get a lot of questions about EMDR, so decided to put together a post that answers some of the more common questions I get that relate to trauma and EMDR.

What is trauma?

Trauma is the mind and body’s response to an event or experience that is deeply distressing or disturbing, too overwhelming to cope with, and often creates feelings of powerless. Trauma is not the event itself but, rather, a person’s subjective experience of the event. This is why two people can experience the same event and one may have a trauma reaction while the other does not. Trauma can result from motor vehicle accidents, assault or abuse, diagnosis of illness, the death of a loved one, or a divorce, to name a few. 

What is complex trauma?

Complex trauma is the result of repetitive harm, usually within a relationship and often with a caregiver or romantic partner, that is cumulative over time. 

What is developmental trauma?

Developmental trauma results from abuse, neglect, or abandonment early in life and disrupts neurological, cognitive, and psychological development. 

What is Post-Traumatic Stress Disorder (PTSD)?

PTSD is a psychological disorder that results from exposure to intense harm or threats to safety. Specific symptoms must be present (such as intrusive thoughts and memories about the event) to be given a diagnosis of PTSD.

What are the symptoms of trauma?

• Hyperarousal: difficulty sleeping, poor concentration, irritability, anger, agitation, emotional reactivity, pronounced startle reflex, panic, hyper-vigilance, racing thoughts, pounding heart, shallow breath
• Physical reactions: aches and pains, heart palpitations, changes in sleep, appetite or sex drive, constipation or diarrhea, susceptibility to illness, muscle tension
• Emotional reactions: fear, anxiety, panic, mood swings, helplessness, loss of control, increased need to control life, numbness 
• Cognitive reactions: worrying, ruminating, poor concentration, distractions
• Re-experiencing: flashbacks, intrusive thoughts about the event, nightmares
• Avoidance reactions: avoidance of reminders/triggers, 
• Dissociation: feeling detached, difficulty remaining present, loss of memory, 
• Relational: difficulty trusting or connecting with others
• Behavioural reactions: increased use of substances, isolation, diminished interest in activities, 

What is EMDR? How does it work?

No one knows how any form of psychotherapy works neurobiologically or in the brain. However, 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 seems to have a direct effect on the way that the brain processes information. Normal information processing is resumed, so following a successful EMDR session, a person no longer relives the images, sounds, and feelings when the event is brought to mind. You still remember what happened, but it is less upsetting. I often use the analogy of a scar replacing an open wound. 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. 

How long will I need to do EMDR?

The amount of time the complete treatment will take depends upon many factors, including the history of the client. Typically, those with complex or developmental trauma need more time. Complete treatment of the targets involves a three-pronged protocol (1-past memories, 2-present disturbance, 3-future actions), and are needed to alleviate the symptoms and address the complete clinical picture. The goal of EMDR therapy is to process completely the experiences that are causing problems, and to include new ones that are needed for full health. “Processing” does not mean talking about it. “Processing” means setting up a learning state that will allow experiences that are causing problems to be “digested” and stored appropriately in your brain. That means that what is useful to you from an experience will be learned, and stored with appropriate emotions in your brain, and be able to guide you in positive ways in the future. The inappropriate emotions, beliefs, and body sensations will be discarded. Negative emotions, feelings and behaviors are generally caused by unresolved earlier experiences that are pushing you in the wrong directions. The goal of EMDR therapy is to leave you with the emotions, understanding, and perspectives that will lead to healthy and useful behaviors and interactions.(Adapted from EMDRIA, 2019)

Is EMDR scary?

EMDR does involve revisiting distressing or frightening memories. However, there are many safeguards built into the protocol to help you manage this. For example, there is a preparation phase that involves learning skills to help you deal with the difficult material. Additionally, you are always in control of the process. EMDR is done WITH you, not TO you. You have the ability to stop at any time if you become overwhelmed (and it is wise to do so). The best thing you can do to ensure you have a good experience is to tell me what you are experiencing throughout the process so that we can adjust as necessary. Consequently, part of the preparation phase is ensuring that the therapeutic relationship has been sufficiently built to allow you to share openly. 

Will I need to talk about what happened in detail?

No. This is a good question, since most therapies focus on talking about what has happened. However, one of the unusual features of EMDR is that the person seeking treatment does not have to discuss any of his or her disturbing memories in detail. So while some individuals are comfortable, and even prefer, giving specifics, other people may present more of a general picture or outline. In some cases, I even recommend that clients not share details, as this can be re-traumatizing. 

Is EMDR proven to work?

No intervention works for every individual. However, approximately 20 controlled studies have investigated the effects of EMDR. These studies have consistently found that EMDR effectively decreases/eliminates the symptoms of post-traumatic stress for the majority of clients. Clients often report improvement in other associated symptoms such as anxiety. The current treatment guidelines of the American Psychiatric Association and the International Society for Traumatic Stress Studies designate EMDR as an effective treatment for post-traumatic stress. EMDR was also found effective by the U.S. Department of Veterans Affairs and Department of Defense, the United Kingdom Department of Health, the Israeli National Council for Mental Health, and many other international health and governmental agencies. Research has also shown that EMDR can be an efficient and rapid treatment.

What kind of problems can EMDR treat?

The majority of research has looked at the effectiveness of EMDR for PTSD and traumatic memory. However, there is both anecdotal and research support for its use in panic attacks, complicated grief, phobias, pain disorders, anxiety, addictions, body dysmorphic disorders, and eating disorders. 

Click here for more information on EMDR therapy at Monarch Psychology.