How EMDR Helps The Brain Process Trauma
How Is the Brain Affected By Trauma?
The human brain is the most intricate and expansive organ in the body. Scientists, researchers, and doctors studying the brain and the elaborate interactions of its various systems. One area of intense study has been to understand how trauma affects the brain. Research has shown when a person experiences a traumatic event, their brain is flooded with chemicals which elicits a fight, flight, or freeze response. While this response may be adaptive and self-persevering, it requires an immense amount of energy, and interrupts the brain’s normal processing. The brain needs to compartmentalize the event in order to continue its normal functioning, but the associated stimuli and emotions are left unprocessed.
A good metaphor for this process can be a simple garden hose. Water flows freely when the hose is open and unobstructed. However, the flow of water stops or is inhibited when there is a kink in the hose. Our neurotransmitters follow a similar path. Information and emotions flow through the neurotransmitter into various parts of the brain. Trauma has the effect of putting a “kink” into the neurotransmitter hose causing a back-up of processing information and emotions. These kinks of unprocessed stimuli can cause severe anxiety and panic when a similar emotion or event takes place. These anxious responses are often referred to as triggers. For example, a person may have been a witness to a drive-by shooting. Now, every time they hear a loud banging noise they are instantly triggered back to the traumatic moment. Although they logically know they are not in any danger, their brain is being flooded with the fight or flight response, and their anxiety can skyrocket. It is not hard to imagine these kinks can be highly disruptive and even devastating.
How to Unkink the Hose?
In 1987, American Psychologist, Francine Shapiro, made the chance observation while she was in the middle of a panic attack that her eyes were moving quickly back and forth while she was remembering a traumatic event. She further noticed her anxiety was reduced when she voluntarily controlled her eye movements while thinking about this trauma. Dr. Shapiro went on to conduct a scientific study using subjects diagnosed with Post Traumatic Stress Disorder (PTSD) to test her observation. The results of the study were published in the Journal ofTraumatic Stress in 1989, and indicated a significant decrease in anxiety and other PTSD symptoms when participants moved their eyes back and forth while thinking of a traumatic event. She termed the intervention Eye Movement Desensitization and Reprocessing (EMDR).
Subsequently, over 30 controlled outcome studies have been done on EMDR as an intervention. Multiple studies indicated 84%-90% of single-trauma victims no longer experienced symptoms associated with PTSD after only three 90 minute sessions. Another controlled study utilized combat veterans diagnosed with PTSD. This study indicated 77% of participants were free from PTSD symptoms after twelve sessions. So much research has been done that organizations such as the American Psychiatric Association, World Health Organization, and Department of Defense have accepted EMDR as an effective form of treatment for trauma and other disturbing experiences.
Dr. Shapiro also began research into why something as simple as moving one's eyes back and forth while thinking about a traumatic event could produce such helpful results. Studies indicated the brain’s mechanism for activating the kinked neurotransmitter hose is bilateral stimulation- or stimulating the brain utilizing an external left/right pattern. Consciously moving the eyes back and forth is one way to provide this type of stimulation, but other modalities such as alternating taps to the hands or knees, or auditory tones going from one ear to the other have been proven to be clinically effective as well. Accessing the neurotransmitter is only the first step of the process. The client must purposefully and continually think of the trauma and experience the blocked-up emotions and stimuli to effectively process the event.
What are the Steps for the EMDR Processing?
Unlike traditional talk therapy, EMDR follows a specific protocol designed to cue up the brain’s natural processing functions.
History and Preparation: The therapist and client work together to identify the client’s history and trauma by completing a formal assessment. Additionally, the client identifies their “Safe Place,” and “Container,” which can be used to aid with calming down any uncomfortable feelings which may arise.
Targeting Memories: The client identifies specific traumatic memories that they would like to address. These are the memories that cause distress or negative beliefs about oneself. Oftentimes these memories are the triggers for distress and negative beliefs about self.
Bilateral Stimulation: The core of EMDR involves bilateral stimulation, which mimics the brain’s natural processing mechanism. Traditionally this was accomplished through guided eye movements. However, other forms of bilateral stimulation such as tapping or tonal sounds have also been found to be effective.
Desensitization: The client recalls the traumatic memory while also engaging in bilateral stimulation, and the brain begins to process the memory. Usually the client begins to feel a reduction in distress associated with the memory.
Cognitive Restructuring: The client reprocesses the memory and begins to integrate the insights in a healthier way. Additionally, clients begin to develop more positive beliefs about themselves as related to the trauma.
Integration: Finally, the therapist leads the client to use the insights and beliefs into their daily lives. Promoting resilience and healing.
EMDR does not fully erase the memory, but eases the pain.
A helpful metaphor for this could be a hand with a sliver in it. If the hand is wrapped up and held away from the body, it can avoid pain for the most part. However, if the hand is touched, the sliver causes immediate and intense pain. EMDR is the process to remove the sliver and allow the hand to begin to heal itself.
A victim of rape may not only have flashbacks of the event, but may also experience self-deprecating and damaging beliefs of self, “I dressed provocatively and invited the attention.” “I didn’t fight back because I am weak.” “I’m damaged and don’t deserve to be loved.” EMDR therapy does not erase the incident in a client’s mind, but effectively works to open up the kinked neurotransmitter, process the unresolved feelings, and allow the client to find resolution, self-acceptance, and ultimately, peace. “This is not my fault.” “This event does not define me.” “I am strong.” “I am a survivor.”
