EMDR

What is EMDR?

EMDR (Eye Movement Desensitisation and Reprocessing) is a structured therapy that helps people process and heal from traumatic experiences, aversive events or distressing memories.

By focusing on these memories while undergoing bilateral stimulation (including guided eye movements, butterfly tapping, and/or tactile buzzing), EMDR helps the brain reprocess the memory and reduce its emotional charge, making it easier to think about without distress. This in turn, leads to a reduction of symptoms related to unresolved and distressing memories such as flashbacks, nightmares, anxiety, irritability, emotional reactivity, avoidance, difficulties in relationships and negative attitudes that manifested due to experiencing these aversive or traumatic incidents.

Is EMDR effective?

Yes, EMDR is an evidence-based therapy that has been proven effective in treating conditions that have a traumatic or aversive memory at the core of the issue such as PTSD (Post-Traumatic Stress Disorder) and Complex PTSD. Evidence-based means that there have been multiple, high quality, peer reviewed, scientific research papers published demonstrating that people show significant reductions in their symptoms after being treated. Numerous clinical studies have shown that EMDR can lead to a significant reduction in mental health symptoms, often much more quickly than traditional talk therapy.

What does EMDR do?

To understand how EMDR works, you first need to understand what happens in the brain when a traumatic or aversive experience occurs. Your body naturally processes new information and experiences without your conscious awareness. Processing can mean making sense of what happened, learning from the experience, then storing it neatly into the library of long-term memory.

However, when you encounter an extraordinary event that overwhelms you (something horrific or terrifying like an assault or a situation in which you thought you were going to die) or you face ongoing distress (such as childhood neglect or psychological abuse), your natural processing mechanisms may become overwhelmed. Your brain does now know how to make sense of what happened and cannot file it away neatly in the long-term memory library.

Instead, the disturbing experiences can become ‘frozen’ or ‘unprocessed’ in your brain. These unprocessed memories and emotions are stored in the limbic system in a raw, emotional state rather than as a verbal ‘story’. This system keeps traumatic memories in a separate network associated with emotions and physical sensations, disconnected from the brain’s cortex, where memories are processed and made sense of with language. Memory fragments and the emotions associated with the trauma are often sitting just under the surface of awareness and can be easily triggered by reminders of or associations with the original trauma, even if the memory itself is forgotten. When trauma or aversive memories are triggered (consciously or not), you can re-experience the traumatic event as if it is happening again now (flashbacks) or you can be overwhelmed with a strong and painful emotion such as fear, shame, dread or rage (emotional flashbacks).

‘Triggered’, in the true sense of the word, is when a traumatic memory is activated, causing you to have a flashback or to become so engulfed with distress that is difficult to understand or control and makes it hard function as you normally would. Your body automatically reacts as if the danger is happening again in the present and your nervous system involuntarily goes into a threat state (typically fight, flight, freeze or fawn) to try to survive. Sometimes, people spend the majority of their time living in a threat state. This leaves them unable to feel safe even when there is no present danger; they cannot relax, sleep or concentrate. They often become highly reactive, numb, or unable to feel any positive emotions. They often struggle to connect or feel safe in relationships with others, and they often find themselves turning towards alcohol or other unhealthy behaviours to settle their nervous systems.

Sometimes the details of the trauma memories are unclear and jumbled, sometimes it feels like the traumatic incident is not related to what is happening in the present as it has been somewhat blocked from awareness. Sometimes trauma memories can play on repeat, like a movie that keeps playing the worst part over and over again. EMDR kickstarts the natural healing process of the brain that has become stuck due to the traumatic or aversive experience being too much for it to process on its own. EMDR helps the brain re-process and desensitise the memory. Re-processing means helping your brain make sense of what happened, helping you see it from a different and more helpful perspective and to file it away in long-term memory so that it no longer sits just under the surface ready to emerge at any time. Desensitising means helping the memory become less emotionally charged so when you think of it, you no longer become overwhelmed or experience other trauma symptoms such as flashbacks and hyperarousal. EMDR can help people regain a sense of safety, to be able to relax, build healthier relationships, develop a sense of self-worth and function better in their day to day lives.

What are the 8 Phases of EMDR?

1. History Taking and Treatment Planning: In this phase, the therapist gathers a detailed history and creates a formulation of your current experiences. The therapist will also assess whether EMDR is a suitable treatment for your particular problems.
2. Preparation: The therapist assesses readiness for EMDR. Based on your individual needs and circumstances, the therapist will make a plan to help you get ready. It is then your job to make the practical life changes and to implement the emotional regulation methods consistently so you are safe and prepared to engage in the processing phase of treatment. This phase can take between 2 to 5 sessions depending on individual circumstances.
3. Assessment: The therapist identifies and assesses the specific memory or target for EMDR processing. This involves identifying the negative belief associated with the memory, the positive belief you would like to embrace, and the emotional and physical responses connected to the memory.
4. Processing: The therapist guides you through a structured protocol that can encompass sets of eye movements, holding hand buzzers, or tapping while you focus on the traumatic memory. At Sunyata Psychology the clinicians have found that integrating other modalities of therapy, such as Schema and Internal Family Systems (IFS) therapy can make EMDR even more effective.
5. Installation: During this phase, the therapist helps you strengthen a more helpful positive belief to replace the negative belief associated with the traumatic memory. This involves integrating the positive belief with the memory.
6. Body Scan: You will be asked to focus on the memory and the positive belief while mentally scanning the body for any residual tension or discomfort. The therapist addresses any lingering physical sensations related to the trauma.
7. Closure: At the end of each session, the therapist ensures that you feel stable and safe. If the traumatic memory hasn’t been fully processed, the therapist helps you return to a state of equilibrium using the coping strategies you learned during the preparation phase.
8. Re-evaluation: In this final phase, at the beginning of subsequent sessions, the therapist reviews your progress, reassesses the targeted memory, and determines if further processing is needed. This phase also involves evaluating any new memories or issues that may have emerged.

What happens during an EMDR processing session?

1.Target memory activation.The troubling memory that is being targeted that day is activated. This means that you are asked to recall the traumatic event in detail, including the emotions, physical sensations, and negative beliefs associated with it. You are encouraged to keep ‘one foot in the past and one foot in the therapy room’ while you ‘sink into the memory’ and the feelings to produces.

2. Bilateral Stimulation. While focusing on the memory, the therapist engages your brain in bilateral stimulation which typically involves following the therapist’s finger movements across your field of vision with your eyes, listening to alternating sounds, holding hand buzzers or tapping. In between each eye set the therapist will ask you what you notice now. This could be more of the memory, another memory, a feeling, insight, realisation or a sensation. Not much talking happens during processing. You will only use a few words to convey what is capturing your attention in between sets.

3. Desensitisation. As the mind is guided back to the target memory between every few bilateral stimulation sets, the therapist will ask you what level of distress the target memory brings now. Typically, the level of distress goes down as processing progresses.

4. Insight development. Along with emotional desensitisation, you will also begin to develop new and more helpful ways of thinking about the event. This is the processing part of EMDR. You will often begin to see what happened from a different perspective or develop new attitudes towards yourself. For example, you can have the realisation that it is over, the bad thing ended and you are safe now. This sounds strange because of course you know it is over, but it is usually only the newly evolved thinking part of your brain (the cortex) that knows that, the older part that stores the sense of danger has not fully realised that yet, which is why traumatised people feel like they are in danger much of the time. Other realisations that often occur include ‘It was not my fault’, ‘I can handle my emotions’, ‘I deserve good things’ and “I am good enough’.

What are some benefits and outcomes of EMDR?

• Reduction of trauma symptoms. EMDR is particularly effective in reducing trauma symptoms such as flashbacks, intrusive thoughts, nightmares, hyperarousal, hypervigilance, sleep problems, concentration difficulties and intrusive thoughts.
• Treatment of PTSD and Complex PTSD. EMDR is particularly effective in treating PTSD and Complex PTSD. However, due to the severe and lasting impacts of Complex PTSD, the treatment will often need to be extended in duration and include other modalities of therapy.
• Reduction in symptoms of other psychological disorders. If traumatic experiences are part of the reason for their development, other psychological disorders that can be treated with EMDR. These can include anxiety, OCD, depression, panic disorder, borderline personality disorder, phobias, complicated grief, chronic pain, eating disorders, dissociative disorders and relational difficulties.
• Improved emotion management. EMDR can help people be less reactionary and feel more in control of their emotions. EMDR can help people stop being numb to all emotions and it can help people resume the ability to experience positive emotions.
• Improve self-worth. EMDR can help shift negative attitudes towards the self so people can begin to develop healthier levels of self-worth, self-respect and love for themselves.
• Develop a sense of safety. Often when people have been traumatised they lose the ability to feel safe in their own bodies, relationships and environments, even when there is no actual danger present. EMDR can help regain a sense of safety in one’s self. It can stop people from being in a threat state all of the time.

How much does EMDR cost?

At Sunyata Psychology EMDR therapy costs between $200 and $390 per session, depending on whether you are working with a Generally Registered Psychologist or a Clinical Psychologist, and, depending on whether you are doing EMDR for 50 minute or 80 minute sessions. Most of our clinicians do EMDR processing in 50 minute sessions to save you money; however, there may be times when an 80 minute session is suggested for your first session if you have a complicated presentation. Your clinician will always discuss this with you during the preparation stage. If you have a Mental Health Care Plan, you can obtain a rebate from Medicare for a portion of the session cost. Mental Health Care Plans allow you to receive up to 10 rebated sessions per year.

Is EMDR scary?

During EMDR therapy, you must be prepared to willingly endure some discomfort and tolerate some distress. While revisiting painful memories can be challenging, staying with the uncomfortable emotions related to the memories enables the brain to do the reprocessing part of the treatment effectively. The treatment will not work if you decline to feel your emotions. That said, your therapist will never force you to do something you are not yet ready to do. There are many ways that your therapist can help you become ready to feel the uncomfortable emotions. Even the people who are most anxious about reconnecting with a traumatic memory typically leave their first processing session expressing how it was not nearly as scary as they anticipated. In fact, people often leave their first session feeling lighter or changed in some other positive way.