Trauma is an injury to the mind and brain as a result of severely distressing events and experiences. The events can be quite varied and may include the experience or witnessing of a horrific accident, a violent or sexual attack, a natural disaster, a significant loss, and even ongoing betrayal, neglect, and abuse from people close to us. When the brain is faced with what it perceives as negative, intense, unpredictable and threatening experiences, it stores the information in a raw, unprocessed form which results in the symptoms we commonly see in PTSD.
Post-Traumatic Stress Disorder (PTSD) symptoms present as intrusive and disturbing memories, nightmares and feelings which can feel intolerable and often lead to avoidance behaviors. Although avoidance makes sense, the behavior can actually strengthen the perception of threat in the brain and keep it on high alert thereby depleting energy and a sense of safety. These disruptive symptoms have the ability to negatively impact our thoughts, emotions, reactions, choices, relationships and even our physical health.
Dissociation is the brain’s most effective and primitive form of self-protection and often a direct result of trauma. In dissociation the brain instinctively limits our conscious awareness of ourselves or our environment to manage the level of disturbance. Dissociation can be helpful when we have no escape from the distress, but unhelpful once the threats no longer exist.
What is EMDR and how does it work?
EMDR, which stands for Eye Movement Desensitization and Reprocessing, provides the brain with opportunity to safely recall the disturbing memories and begin to process them adaptively so that they no longer are stored in raw form nor continue to cause distress.
The process involves 8 phases beginning with history taking and stabilization skills in order to prepare you for the reprocessing work. When you are ready, you are guided to bring to mind an aspect of the disturbing memory, to notice the negative belief and distressing emotions associated with that memory as well as how your body is responding. This process activates all regions of the brain storing the raw material so that the brain is ready to reprocess. Your therapist will then facilitate a form of bilateral stimulation which alternates focus across both sides of the body thereby stimulating both hemispheres of the brain. This mechanism is known to set in motion the brain’s natural adaptive processing system that helps repair and restore disturbances and emotional injuries.
EMDR is theorized to be effective for various reasons: activation of both hemispheres much like REM cycle which cleans and restores, taxing of working memory which degrades the strength and impact of a disruptive memory, and brief exposure for which the brain adapts naturally with time.
What does it cost, how long are the sessions, and how many do I need?
The $175 fee for service is the same regardless of treatment modality used. This ensures you will receive what you need without the burden of increased cost.
Sessions are the same 45 minute length of time as any other appointment. Some people may opt for 90 minute sessions, but this is typically not required.
The number of sessions varies significantly from person to person and in respect to the complexity and impact of traumatic events on a person’s functioning. For single event traumas where support and resources were available, it may be that only 6-10 sessions are necessary to resolve the distress. For complex traumatic events involving years of abuse or neglect from caretakers or family members and where dissociation is active, treatment may last several years and involve additional therapeutic modalities. Overall though, EMDR has been identified as more efficient with fewer sessions in comparison to other forms of talk therapy.
Why might EMDR not work for me?
If you have previously tried EMDR and found it ineffective, there may be explainable reasons why.
You may not have been adequately prepared to self-regulate. EMDR can evoke very strong sensations which is why it is important to be taught and practice self-soothing and self-regulating skills before beginning the reprocessing. This is part of the protocol and worth spending time on before addressing disturbing memories.
You may experience dissociation. If dissociation is active, EMDR may not be effective. Your therapist needs to assess for dissociation and address those symptoms before beginning reprocessing work.
You are using certain drugs or taking certain prescriptions. There are drugs and prescriptions that can numb the brain which in turn will reduce the effectiveness of reprocessing. It is important to disclose everything you are taking with your therapist. With that information, your therapist can adjust the treatment or discuss alternative options for you.
Your life is currently too chaotic. EMDR may not be appropriate to begin if daily life is unsafe or unstable.
You were not providing honest feedback. During the reprocessing phase, your therapist will ask you what you notice. Honest feedback allows your therapist to make adjustments to the treatment as necessary to ensure emotional safety, stability, and effective processing.
EMDR isn't for everyone. Each person is unique and not every treatment approach works for every person. It is between you and your therapist to explore the best treatment modalities for your individual needs.
What is the difference between an EMDR "Trained" therapist versus "Certified"?
The key difference is training and experience.
EMDR Trained therapists have the skills to facilitate the full protocol in treating single event or uncomplicated chronic traumatic experiences. They have participated in multiple hours of training and supervised experience.
EMDR Certified therapists are initially trained then undergo further training and supervision with a focus on treating more complicated traumatic experiences and dissociation. Certification requires continued training and education to maintain.