What is this thing called EMDR and how can it help?

Image of various ceramic objects on a shelf.

I work primarily with anxiety and men's sexuality issues in my practice. I love helping clients find ways to address problematic thoughts and feelings that get in the way of them feeling whole. The good news is that there are lots of treatment options that are based in research, with evidence that shows that they work. 

One of my favorite tools for creating change is EMDR.

EMDR stands for Eye Movement Desensitization and Reprocessing. That's a mouthful and it can be a little off-putting - what exactly is this and why would you want to consider it? Here are some examples from my work (these are based on a number of clients and are not real individuals):

Andy has struggled with social anxiety for most of his adult life. He's seen a lot of relief from learning how to relax his nervous system, struggle less with his thoughts, and stay present in social situations. But with all of this work he still feels anxiety symptoms and finds the struggle is hard. He traces all of this back to being a gay teenager and experiencing lots of homophobia and bullying. Even though he's a successful 35 year old, sometimes it still feels like he's 14 and still being humiliated. 

Bill is very fit and the gym is his life. He works out 2-3 hours a day, is meticulous in what he eats and gets lots of positive feedback about his appearance. And, yet, most of the time, Bill feels extremely awkward and anxious about his body and appearance. He finds himself obsessing about how he looks and what other people might be thinking about him, Bill says he's always felt this way, ever since high school.

Caleb was diagnosed with generalized anxiety disorder years ago and has done a lot of work to manage the catastrophic thoughts that used to take over. Everything was going well until about two months ago when he was riding a bike and was hit by a car. He went to the ER but was lucky to only have some minor injuries. And yet, Caleb can no longer get on a bike. In fact, he finds himself thinking the same kind of catastrophic thoughts that he used to experience years ago, worrying that a car will hit him when he's walking down the street, or that his cab driver will get in an accident. 

This are just examples of the many kinds of challenges that people come into my office with and all of them are clients who found success and relief through EMDR. 

How does EMDR work?

The examples above all point to some kind of trauma. Andy's experience of homophobia and bullying was years ago but still has an effect on him. Bill isn't sure when he started feeling obsessed about his body but he can trace it all the way back to high school. Caleb had a frightening and extreme event that has had a major impact on his daily life.

Every day our brains work hard to assess, process and resolve what we've experienced. Research has shown that this may be the role of dream sleep, also known as rapid eye movement (REM) sleep. During this sleep phase, the brain reviews the events of the day, processes them, and puts them in memory banks where they can be accessed later. So, if you had a lousy dinner at a mediocre restaurant, you may go to bed annoyed at your experience and vow never to return. When you wake up in the morning, you can recall the experience at the restaurant and definitely aren't going back but you also are no longer annoyed and you can get your day started. Overnight your brain did its job of processing your experience (that was a lousy meal and really annoying) and storing the memories that will be useful to you (don't go back to that restaurant).

Unfortunately, your brain often can't do its job when trauma happens. When an experience is painful and overwhelming, your brain also gets overwhelmed. Memories don't get processed and stored properly, instead they stay put like they just happened. Caleb's accident was weeks ago but he feels like he is still headed to the ER. Andy's memories of being bullied are still just as vivid and painful, as if he's still 14 years old. Bill realizes that he received lots of messages as a boy that there was something wrong with him and the pain and humiliation of these still resonates for him when he thinks about his physical appearance. 

What can EMDR do?

Simply put, EMDR allows your brain to do the work it would have done had it not been overwhelmed in the moment. By creating rapid eye movements (just like the ones that occur in dream sleep), the brain shifts into processing mode. Typically this is done using some kind of lights, movement, tones, and/or taps to encourage rapid eye movement. Memories that were stuck, intrusive and painful become less so. In fact, for many clients, the very memories that brought up so much anxiety for them become benign - clients can recall the experience of a bike accident or being bullied as a teenager without feeling like they are still experiencing it. 

So then what happens after EMDR?

After EMDR you don't forget the memories of what happened to you, but these memories no longer have the same effect. Andy still is sometimes challenged by social situations, but anxiety no longer takes over. Bill has a healthier relationship to his body and going to the gym is about being healthy. Caleb can move on with his life, ride a bike, and drive a car. 

Ultimately, EMDR allows real change to happen by processing memories so they are no longer so painful, difficult and intrusive. When memories no longer intrude, instead of making choices to deal with these painful experiences, you can make choices based on what really matters to you. This leads to a richer, fuller life.