“The goal of EMDR treatment is to rapidly metabolize the dysfunctional residue from the past and transform it into something useful.”  – Francine Shapiro

Eye Movement Desensitization and Reprocessing Therapy (EMDR), developed by psychologist Francine Shapiro in 1990, is a structured psychotherapy modality that has been extensively researched and proven effective for the treatment of trauma. Shapiro states that the aim of the therapy is to reprocess memories and integrate them with the client’s standard biographical memories. 

How Trauma Affects Memory

Traumatic memories cause disruption because they aren’t properly processed in the brain when they occur. To understand how EMDR is an effective trauma treatment, it is helpful to know how trauma affects the brain.

High levels of arousal, in addition to emotional and somatic stress, affect the functioning of the hippocampus, which inhibits the brain’s ability to properly store and recall all of the details of the event and the order in which they happened. It is often explained that trauma memories are stored without a timestamp, leading people to have only fragments of sensory details.

During traumatic events, the stress response is activated from the hypothalamus, and bursts of adrenaline activate the amygdala. As the stress response is activated, the so-called thinking brain (the neocortex and prefrontal cortex) shuts down. The brainstem, which is responsible for survival functions, takes over. 

The limbic system includes:

• The thalamus, which directs sensory input to another part of the brain.
• The amygdala, which governs fear, anxiety, and violence.
• The hippocampus, which turns short-term memories into long-term memories.
• The hypothalamus, which regulates the autonomic nervous system and releases hormones such as adrenaline.

Trauma memories pass through the limbic system, often referred to as the emotional brain, but are not properly processed or stored. This is what causes isolated sensory fragments of the event – such as visual images, smells, sounds, or felt experiences – to be remembered vividly and to continue affecting us through nightmares and flashbacks long after the actual trauma is over.²

Small-T and Large-T Traumas 

Francine Shapiro posits that there are large-T traumas, such as assault, and small-t traumas, such as being teased at school, and that both can cause emotional disturbance. Shapiro’s information processing theory aims to explain and predict the treatment effects seen with EMDR therapy.² She states that, “the information processing system processes the multiple elements of our experiences and stores memories in an accessible and useful form”.¹ This means that memories are stored and linked with networks containing similar, related thoughts, sensations, visual images, and emotions. Because traumatic memories are often incomplete, as a result of the deactivation of the neocortex and prefrontal cortex, and strong negative emotions, feelings, or dissociation interferes with information processing, connections are prevented from forming with more adaptive information that is already held in other memory networks.¹

This can happen with both small-t and large-T traumas. For example, in a large-T trauma such as an assault, a person knows that the assailant is to blame for the attack; however, due to the way that the memory has been stored, the survivor may struggle to process feelings of guilt. When the memory is dysfunctionally stored without related associative connections, such as material already stored in memory that attackers are to blame, many elements are still unprocessed.

The same is true for small-t traumas. For example, if a child is teased about being bad at sports in school, the embarrassment and emotional hurt may disrupt the information processing system, causing this memory to be dysfunctionally stored. The child may struggle to make connections between this negative memory and the knowledge that they are capable of doing well and can enjoy taking part in sports.

How EMDR Targets Trauma Memories 

Based on Shapiro’s information processing theory, EMDR helps process memories by linking them with more adaptive information. When the memory is linked with a positive belief or thought about oneself, the experience is stored with appropriate emotions.

For a deeper explanation of the eight-step process of EMDR, refer to the previous section.

During EMDR therapy, once the memory that a client wishes to target has been identified, along with a positive feeling or thought, a therapist will guide the client through a process of  recalling the event while sensory information in the form of bilateral stimulation is provided. The sensory information is traditionally rhythmic eye movements – hence “eye movement” desensitization and reprocessing – but it can also be auditory or tactile, through hand tapping or electronic pulses to the hands. The repetitive movements or sensory information lessens the anxiety that the client associates with the trauma, and the memory can be addressed from a more desensitized and detached perspective. Therapists will often encourage clients to just observe what is happening and pay attention to which associated memories or thoughts are surfacing. 

Meanwhile, the limbic system is storing new sensory information and making new associations, which allows the client to access positive ways of reframing the original trauma and replace the feelings associated with the trauma by reprocessing them repeatedly. EMDR accelerates information processing, which allows for the adaptive resolution and reprocessing of traumatic memories.

In Summary 

EMDR therapy offers a compassionate and effective approach to healing from trauma. By understanding how trauma affects memory and the brain’s information processing system, we can appreciate how EMDR targets and transforms traumatic memories.

Through a guided process of recalling the targeted memory while receiving bilateral stimulation such as eye movements, tapping, or auditory cues, an individual can experience a reduction in anxiety and gain a more detached perspective. This fosters reprocessing and resolution of the trauma as new sensory information is integrated within the limbic system.

EMDR therapy’s ability to accelerate information processing empowers individuals to access positive reframes and replace the distressing feelings associated with trauma. By repeatedly reprocessing these memories, healing and adaptive resolution can take place.

In the hands of a skilled therapist, EMDR offers a warm and supportive space for individuals to navigate their traumatic experiences and find lasting healing. It is a powerful tool that brings hope and restoration to those who have endured trauma and paves the way for a brighter future filled with resilience and well-being.

Sources:

[1] Theory (2020) EMDR Institute – EYE MOVEMENT DESENSITIZATION AND REPROCESSING THERAPY. Available at: https://www.emdr.com/theory/ (Accessed: November 21, 2022).

[2] Schwartz, A. and Maiberger, B. (2018) EMDR therapy and somatic psychology: Interventions to enhance embodiment in trauma treatment. New York: W.W. Norton & Company.

[3] Shapiro, F., (2002). Paradigms, Processing, and Personality Development. In F. Shapiro [Ed.]. EMDR as an Integrative Psychotherapy Approach; Experts of Diverse Orientations Explore the Paradigm Prism. Washington, D.C.: American Psychological Association Books.