Musings on Eye Movement Desensitization and Reprocessing (EMDR) Therapy

I first learned about Eye Movement Desensitization and Reprocessing (EMDR) Therapy when I was in a course on substance use disorders in graduate school. My professor, the amazing Susan Lisker, is the long-time director of the New York State rehabilitation facility called Stutzman Addiction Treatment Center. Susan described EMDR as “voodoo magic,” a term that still cracks me up. For a long time, as an evidence-based thinker, I was very dubious of EMDR’s eye movements. When I went into private practice, the woman whose group I joined was an EMDRIA trainer and offered a free EMDR training. How could I pass that up? We did “real plays” in the training, as we therapists often do, which involve practicing a therapy on a partner using real issues, but lower-grade ones. I served as the “patient” in one real play and instantly realized EMDR’s amazing potential.

I’m still not convinced the eye movements matter (and there are studies that contradict each other about this), but the thing I find so helpful about EMDR is the structure it imposes on sessions. It helps me get out of your way so that you can sit in your feelings and thoughts, sort through them, and ultimately move past them. Sometimes I will intervene if necessary (using a technique we call a “cognitive interweave”), but in general EMDR is very empowering because you solve your own problems, which boosts your confidence.

A patient once returned to treatment after a year or so, having worked with me for a couple years before that, and said EMDR had been the most helpful thing we’d done – not because it helped her overcome a specific trauma, but it helped her learn how to express strong emotions in the presence of another person, something she’d never been able to do with her husband which had hindered their emotional intimacy, frustrating both of them. EMDR helps you learn how feelings work, that they can be intense but that “this too shall pass.” We say, “emotions are like tunnels, the only way out of them is through them.” I connect this to the Buddhist concept that emotions can’t be stopped, only allowed to run their course (acting on them, however, is optional).

When people hear the word trauma, they often think of war combat or house fires, events that can make the evening news. We call this "big T trauma,” and it’s distinct from “little t trauma,” which isn’t newsworthy, though it can be just as problematic. Little t traumas can include being told growing up that you’re too sensitive all the time, having a parent who leans on you for emotional support (parenting is supposed to be a one-way street in this regard), or having a parent who’s depressed and checked out. Sometimes little t trauma is hard to identify, which doesn’t make it easier to treat. Attachment trauma frequently takes this form. EMDR isn’t just for combat veterans and shooting victims, it can be applied for a wide variety of concerns with significant benefits.