What Does EMDR Really Do?

Maddy Liebing, Ph.D.
Clinical Director

What is EMDR? And how did we come to discover the benefits? The story is that Francine Shapiro, an American Psychologist, was walking through a park and noticed that when her eyes were going back and forth she experienced a calming of some distress she had been experiencing. She began to follow up with that with experimentation and eventually found that pairing bilateral stimulation (moving energy back and forth between the two hemispheres of the brain either by moving the eyes back and forth or by other means) with clinical components, trauma healing was enhanced and trauma memories were reprocessed and desensitized. Thus the name: EMDR: Eye Movement Desensitization and Reprocessing. This energy movement can be accomplished in a lot of ways. For the client, the therapist can simply move their fingers in front of the client’s face while the client follows them with their eyes. Or the therapist can use what is sometimes called thera-tappers.. small electronic devices that buzz and can be held in the hands of the client and alternately buzz back and forth. That way the client can close their eyes and feel the energy switching back and forth.

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But this bilateral stimulation to help with emotional regulation and calming is also part of our daily lives–even though we may not really be aware of it! Walking is bilateral stimulation. As you walk, you move the energy in your body back and forth between the two hemispheres of your brain. That is why we have the common reference when someone is upset to “Go for a walk.”  It really will calm you down. Running is another example of bilateral stimulation. So is horseback riding. All these are healthy ways to release tension and calm the chemicals in the brain. You can also do it while sitting still. You can tap your knees, alternately back and forth, or fold your arms and tap your arms alternately.  I have even seen people use it on dogs to help them calm down by having them sit and tap them softly just below their ears.

Francine’s discovery of this niche of neuroscience over 30 years ago was extremely helpful for the treatment of trauma. At the time, mental health professionals were realizing that we did not know how to treat trauma. Talk therapy, which required clients to repetitively remember their trauma, only made it worse, and we needed more ways to help folks who were suffering from being stuck in pain and horror. What Francine developed over time was a systematic way to use her discovery along with some of the core components of the trauma experience to help people heal. 

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One of the things that all trauma victims seem to share is that despite the fact that horrible things happened to them, they subconsciously, or even consciously, begin to believe that it was their fault that this terrible thing happened to them. They believe that they made a mistake or that they somehow deserved to be treated in some terrible way. As EMDR begins, and a memory is identified to be the starting place, the client is asked to not only remember the memory, but also, the negative beliefs they have about themselves because of it. Then they are asked what they would prefer to believe about themselves, the positive beliefs they would like to have about themselves. They will also rate the distress level the memory has. 

As the series of bilateral stimulation is given, either by having them follow a finger or by running the alternating electronic pulsers, they are told that whatever comes up, comes up.. there is no right or wrong in this process. They may see something, feel something, have a thought, or notice something in their body. They are in charge of their healing and their heart, soul, mind, and body knows what needs happen to help them heal. 

In my own work with EMDR, I find the things that will come up for clients in these sessions are amazing. After a series of 20 or 30 bilateral stimulations, we will stop and take a deep breath. I then ask the client what they noticed. And they say what comes up… like “my chest hurts,” or “I saw a shadow,” or “I remember what someone said,” or “I feel sad,” or “I think I can do this hard thing”.. 

I encourage clients to take notice of all of those things, and then we do another set of bilateral stimulation.

What will come up for clients with these memories changes over time, but it seems like when the process starts that the somatic components of the trauma memory come first.. pain, tightness in the throat, queasiness in the stomach. Just like Bessel Van der Kolk says in his book: The Body Keeps the Score, we hold trauma in our bodies. One of the most important things we need to do as we treat that trauma is to find ways to release those physical memories and sensations. 

What I have found with my clients is that over time the positive cognition or associations become stronger and the negative ones go away so that the overall distress of the incident (SUD Subjective Units of Distress) goes down.  In the final phase of EMDR treatment, clients do an “installation of positive thoughts of self,” which helps clients to start to associate their trauma first and foremost with the fact that they are healed, rather than with distress and painful memories. In a short term program like ours I rarely have rarely gotten that far because it can take many months or years, but my clients often go on to complete their EMDR/trauma treatment. 

How do we use EMDR in Wilderness Therapy?  The research indicates that EMDR is very effective in the short term for trauma experienced by an adult in a single incident (for example, if a person had a car accident and experienced trauma). Studies have shown that 12 sessions of EMDR is very effective. If  that is a weekly session that means the full treatment will take 12 weeks. For more complex trauma, such as childhood trauma or chronic trauma, (growing up in an alcoholic family, or even multiple sexual or physical abuse incidents), EMDR is effective as well, but it takes a lot longer.

At Legacy Treatment Center, like most Wilderness Therapy programs, we have our clients for about 13 weeks. When a client comes to a Wilderness Therapy program, it takes some time to assimilate to the wild..  going from living in a modern home or apartment with electronics and plumbing to living in a primitive, simple outdoor setting, (campfire, sleeping bag, tarp, etc.) takes time! At the same time, you wouldn’t start EMDR until you’re sure your client has a tool chest of resources to help self-regulate when they have difficult memories come up. We spend intentional time teaching and practicing breathing techniques, mindfulness, meditation, yoga, movement, and finding magic rocks to hold and keep in our pockets. We use bilateral stimulation to create a guided imagery of a safe/calm place that they create and develop themselves to go to when they need to regenerate and feel safe and secure. 

As clinicians, we have to make sure the client is ready before we start using EMDR. At Legacy, this is usually midway into their stay. Sometimes we are able to complete treatment for one traumatic memory, and they are ready to move on to another one. Or, depending on how serious the trauma is, we may only be scratching the surface when their time with us is up. In any case, most importantly, we will have determined if this trauma modality is a viable option for our client and can make recommendations about what will be beneficial for them going forward. 

For our clients, one of the most important parts of being introduced to their trauma treatment and healing is the conceptualization that:

  1. Trauma is most often the root cause of addiction, and a lot of mental health issues and must be treated. 
  2. Most often in a traumatic experience we blame ourselves consciously or subconsciously and develop a negative belief about ourselves because of it.
  3. We will live out that negative belief until we are healed from the trauma and have come to recognize the truth about ourselves. 

Healing requires seeing ourselves as we really are and filling in the empty place between what we pretend to be and what we fear we are–What Carl Gustav Jung called the Mask and the Shadow: neither are really us. What our journey of healing requires is to find the true self that lies in between, the imperfect but genuine self, as Brene Brown teaches. 

So what we do here in the wilderness is what we do anywhere else: all that we can do with our clients in the time that we have together, and then connect our clients to resources going forward that will help them continue their journey. If we find that the EMDR modality does not particularly resonate with them in working on their trauma, we try other modalities and we recommend other modalities for them in the future. Our goal is to help people heal and find purpose– to discover a healthy, productive life. We want our clients to leave Legacy healing and moving forward, having the magic of Wilderness Therapy and science of the brain.