Eye Movement Desensitization and Reprocessing can be effective, non-traditional trauma treatment
By Frankie Hart, March 26 2019 —
My eyes follow the back-and-forth movement of my therapist’s hand, focusing on her ring. In my periphery, the room is a streaky blur. Her hand comes to a stop and she instructs me to take a deep breath. She asks me, for what feels like the 20th time, what comes up in my memory. I take a long pause and honestly reply, “Nothing.”
She smiles at me. “That’s great.”
Eye Movement Desensitization and Reprocessing (EMDR) is a therapy used primarily to treat trauma. The concept is that recalling the trauma while experiencing stimuli such as eye movement or hand tapping can help the brain reprocess those memories and the emotions associated with them.
Mental health care isn’t financially accessible to a lot of people. If you aren’t privileged enough to have good insurance or money to go to traditional talk therapy, you may be wary of trying a lesser-known treatment such as EMDR. Hopefully, more visible and accessible information about personal experiences can help people make confident, informed choices.
My first appointment was mostly an assessment of my trauma to gauge what the sessions would look like and how many there would be. My therapist said that since I experienced an emotionally abusive relationship that lasted a year, reprocessing could take as few as two sessions. She informed me that for some, their traumatic experiences were life-long or happened at different times of their lives spanning years and could be more complicated to address. I hadn’t had any contact after the relationship ended, so the time frame affected was concise and contained.
I was surprised. A year is a long time, and so were the four years following the relationship when the handful of other mental health professionals I saw only addressed my symptoms, not the issue. The last one I’d seen recommended EMDR so I could finally work with someone who specializes in trauma, once we’d realized that was needed. I’ve been experiencing chronic dissociation for four years and was hoping that if the trauma had caused it, then focusing on the trauma could reduce it. I didn’t expect that this sort of process could be done in just two 60-minute sessions.
My therapist told me that for those who feel themselves start to dissociate, or dissociate more than usual, tapping on the knees or hand buzzers can be more helpful than eye movement. Then, we got started.
After the assessment, I had to establish some safety nets. These can help during the EMDR process because it is common for unpleasant memories or feelings to come back up in-between sessions. In preparation, my therapist ran me through two visualization exercises.
The first was creating a ‘container.’ I had to imagine some sort of container that was sturdy and capable of being securely locked. A vault, for example. It helps for it to be a container in some sort of context that I can visualize vividly. I chose a treasure chest on a pirate ship since it has plenty of sensory cues, such as salty air and wavy movement. If memories, thoughts or feelings come up when I feel unprepared to handle them, I can secure them in my container. However, I have to keep in mind that this is temporary storage. It has to be worked through at some point, but it’s helpful to be able to put something away if it comes up at a bad time.
The second was establishing a ‘calm place.’ I had to think up a place where I would feel the most calm. In this exercise, it was important to thoroughly establish sensory inputs. My calm place is the windowsill of a house, where I can feel the sunlight on my skin. I’m wrapped in a soft blanket which smells like dryer sheets and I hear the white noise of my family going about their business. These details were established while my therapist waved her hand in front of my face, every now and then pausing for a deep breath. After, she asked me to stay in my calm place and tap on my knees for a while. Now, if I need it, I can close my eyes and tap on my knees and return to the calm place.
For my first actual session, I chose the guiding statement, “I feel trapped” to embody the main negative feelings associated with the relationship. Then, I had to focus on my first memory in the relationship where I had felt this way. I would follow my therapist’s waving hand with my eyes and would stop to take deep breaths. Then she would ask me “What comes up?” We would follow my path of memories and reprocess and occasionally she would ask me to focus on thoughts and feelings associated with certain memories, especially if any feelings manifested strongly in my body. Then, I was to return to the original memory and give it a positive statement, to replace the feeling of being trapped. I was confused. Wasn’t the whole point of me seeing her that these memories were so bad that they negatively affected my life? She elaborated that I was to assign a statement to the memory that recontextualized how I felt about it. I thought back to who I was in the memory, what I had gone through and what I had yet to go through. My new statement was, “I am resilient.”
At the beginning of the session, I was to rate the guiding statement and target memory numbers according to how they upset me. Closing out the session, I was to rate them again, as well as rate how true I thought my new statement was. Depending on how the numbers were going, we might continue to reprocess or move on.
I was scared of going into the second session. I was informed that the first session would be the first memory and the second would be the worst one. Despite waiting so many years for improvement, I felt anxious. EMDR requires a certain amount of confronting memories that you don’t want to do. Overdoing it could risk retraumatizing yourself but underdoing it means no progress. I was mostly afraid about what my therapist had said about dreams being affected. In the week between my first and second session, I had a minor flashback. It was a childhood memory completely unrelated to what we had reprocessed, but it was something I’d never experienced before. If I reprocess some of my worst memories, maybe it won’t be so innocuous next time.
Nonetheless, I went to the session. This time it was much harder. Sometimes when I was asked what came up I only told my therapist part of it. Half of going over the memories was thinking about it, but I realized how much harder it is to have to say out loud. She never pressed for further details when I gave vague answers, which I appreciated. Eventually, she asked what came up and it felt like my brain had already been emptied. We went over the original memory and I realized that I remembered everything the same, but it wasn’t as lucid as before. Did I just Eternal Sunshine of the Spotless Mind my abuser? I attributed a new statement to the memory and realized that my ranking of the original statement had dropped to zero. I felt so relieved and so… tired. I asked my therapist if that was it. She said unless anything comes up, I seemed to be done. I was still worried about something from the worst memories coming back, so I scheduled a follow-up just in case. But nothing did.
In the follow-up, I asked my therapist about my dissociation. I had come to EMDR to try to alleviate it by targeting the trauma, and it didn’t get worse during reprocessing but it didn’t get better either. After talking more about it, she said it seems that it had likely been set off by the trauma but otherwise is independent of it. I couldn’t help but be a bit disappointed. As much as I’ve tried to accept my dissociation as a part of how I function, I still hoped that maybe there was something I hadn’t tried or heard of yet that would finally snap me back. My therapist suggested that I might have a fear of dissociating that feeds my dissociation. Looks like I’m going to have to see someone else about unpacking that self-fulfilling prophecy.
Although EMDR didn’t meet my high hopes, it still did a lot for me. There have been times where memories of that relationship would suddenly flood back to me and I would go over things that I had just realized were manipulative and coercive, and it was really helpful to finally give them the work they needed. Despite it not affecting my dissociation, knowing now that they’re not tied to it is still valuable information.
It isn’t acknowledged enough that taking care of your mental health is complicated. Not all treatments work for everybody and not all mental health professionals are helpful. I was on medication for two years that turned out to be higher than the recommended maximum dose and did pretty much nothing for me except give me insomnia, which I had to take another medication for. The first counsellor I ever went to told me that there’s a lot of common symptoms between depression and dehydration. I understand the hesitation that comes with trying to figure out treatment, which is why I hope putting my experience out there is beneficial.