Eye Movement Desensitization and Reprocessing- or EMDR- is a powerful method of therapy developed to help resolve PTSD symptoms such as strong negative emotions or the negative beliefs we can have about ourselves after surviving scary things.
For example, someone might logically know that it’s not their fault they were abused as a kid, but something deep down feels like it’s true that ‘I should have been a better kid,’ ‘I am bad,’ there’s something wrong with me,’ etc.
It can seem like every time something goes wrong, it just confirms that ick belief.
Traumatic memories can be stored in fragmented pieces, and can lead to reiterating negative beliefs about ourselves. EMDR helps traumatic memories be stored more appropriately – it doesn’t change the past, but it changes how we think and feel about ourselves now, when we think about the past. Instead of recalling Bad Thing #24 and falling into a pit of despair and self-loathing because we’ve triggered the ‘I’m a horrible person who deserved that!’ belief, we can recall that bad thing and it can feel like an everyday memory- ‘it was a shitty thing that happened, but I’m okay now, and I’m fine the way I am.’ No pit of despair.
You can truly know on a gut level … I’m okay the way I am. I am lovable. It wasn’t my fault.
EMDR activates the parts of our brain that hold adaptive information. Scary or traumatic experiences can create or strengthen beliefs about ourselves that might have been adaptive at the time, but were likely not true then and aren’t true now, but might still be driving your decisions.
For example, when you were just a kid who had little control over their life, a negative belief like “It was my fault” might have helped you behave in a way that made it less likely to have an abusive parent’s anger pointed your way. That “it’s my fault” can carry into adulthood and influence your mood and decisions you make.
EMDR helps activate the memory networks associated with such beliefs or related emotions, and helps you shift them to more adaptive beliefs. So someone who starts EMDR with “it was my fault” comes to believe “I did the best I could, and that wasn’t my responsibility.”
How is this different from talk therapy? EMDR also targets other elements of negative experiences, such as what image, sound, emotion, or sensation goes with it. In particular, the somatic piece of EMDR- noticing where you feel those emotions in your body- is a vital piece in helping change your response to a negative memory.
Instead of just trying to talk yourself into a more adaptive and accurate belief you may already know on a logical level, EMDR bridges the gap between knowing something logically, and feeling it in your bones. It helps you feel the adaptive belief on a gut level.
You don’t just know ‘that wasn’t my fault.’ You feel… ‘that really wasn’t my fault.’ EMDR helps your brain unstick fragmented trauma memories and tap into its own natural healing ability to file memories away like everyday memories.
I’ve been using EMDR in my practice in Little Rock since 2018, and seeing a client’s energy shift, shoulders drop, spine straighten a bit as that adaptive belief starts to settle in and feel true- it never gets old!
EMDR uses what’s called bilateral stimulation to help your brain activate its adaptive information processing system. Bilateral stimulation in EMDR often consists of moving your eyes back and forth, holding tappers in each hand that vibrate back and forth, or listening to a tone that plays in one ear, then the other.
Together we decide what memory, event, or belief we want to target, then identify a few different aspects of the event such as the negative belief, and what image, emotion, and sensation go with it.
Your job as a client is then to just notice what your brain does and where it goes while your eyes move, or while you hold the tappers. You don’t have to direct the process or try to make your brain or emotions do anything- you just notice. I’ll periodically ask you to pause and give me just a few words about what you noticed. Then I say, “Go with that,” and you go back to noticing.
EMDR meets you and your brain where you’re at. You don’t need a precise timeline and specific recall of your entire life, or the right words to describe your experience.
While it was originally developed to help people with trauma & PTSD, EMDR is also evidence-based for other issues such as anxiety that doesn’t care how much logic you throw at it.
I especially like EMDR for many of my neurodivergent clients because it’s both structured and flexible. I keep up with the structure so you don’t have to. You don’t have to have every detail laid out or in a specific order to get started- you actually just get to just notice where your brain goes, and give me brief updates as I check in.
How many sessions does EMDR take?
Everyone’s (least) favorite answer: it depends! A single, one-off event like a car accident might take 4-8 sessions. Something more pervasive and complex like deeply-held negative beliefs that were often reinforced in childhood experiences, often needs months of preparation before we can get to processing the memories themselves.
Do I have to talk about my trauma in detail?
No, you don’t. I only need a bare minimum, because the actual healing happens within yourself. EMDR just helps your system “digest” a memory, so to speak, that got dysfunctionally stored. I also do not advise disclosing much trauma when you’re first getting to know me, or any therapist. It’s important that you build at least a baseline of safety with the therapist you’re working with before diving into trauma work.
Is EMDR covered by insurance?
My practice doesn’t work directly with insurance companies. My understanding is that EMDR is usually covered by insurance companies *if* the EMDR use is specifically for PTSD. I recommend getting as much information about this as you can from your insurance company.
Will I feel worse before I feel better?
It’s possible with any type of therapy to feel worse before you feel better. The same is true with EMDR. Especially with sessions that are only 50 minutes long, there’s a higher chance that a traumatic memory won’t have time to completely reprocess before time is up. Generally your therapist should wrap up reprocessing with 10-15 minutes left so that time can be used to help you reorient more fully to the present and present-moment safety. (This is another reason intensives can be helpful- we have more time and therefore a higher chance of reaching the end of a target within that session).
Is EMDR hypnosis?
No, the bulk of what EMDR is known for- phase 4 reprocessing, where you’re actually working specifically with a trauma or other target- does not put you in a state of hypnosis or trance. Some phase 2 (Preparation) work such as creating a calm place or container for stressful memories, may include hypnosis/trance states to help you feel more relaxed. However, the type of brain wave activity that happens in trance vs. EMDR reprocessing are different from each other!
Can EMDR be done by telehealth?
Yes, it can! We can use sounds to help you time your own taps on your knees, or if you’re on a desktop/laptop (larger screen than a phone), I can send you a link where a dot moves back and forth across your screen for you to use eye movement bilateral stimulation.
What if I get emotional or cry during a session?
This is very normal, and why phase 2 is so important! Big emotions can come up during the reprocessing phase, and it’s important that you feel comfortable-enough letting that happen. However, if the emotion begins to feel too big or overwhelming, you can raise your hand and look at me and say you want to stop or take a break, and that will absolutely be honored.
Is EMDR only for "big T" trauma?
No, EMDR can be helpful for a wide range of concerns, from “big T” trauma like accidents or natural disasters or assaults, to “little T” trauma like memories of feeling very embarrassed or ashamed, to worries about future events that aren’t trauma at all, but might be stressful.
Can EMDR be helpful with anxiety or OCD if I don’t have a specific trauma memory?
EMDR can be helpful for anxiety, and for other concerns that don’t involve a specific memory. While some EMDR practitioners say they treat OCD with EMDR, it’s important to note that there is currently no research that supports EMDR as an effective treatment for OCD. EMDR may be used for negative beliefs that occur with or are similar to OCD beliefs, but for clear-cut OCD, I do not use EMDR because there is no evidence base for it at this point.
How does EMDR work?
The short answer is that EMDR helps your brain and body actually feel connected to adaptive information. For a more detailed exploration, check out how EMDRIA (EMDR International Association) explains the process here.