In the docuseries, Harry explains that every time he flies into London, he is triggered and reminded of trauma of losing her mother. EDMR, which standing for “eye movement desensitization and reprocessing,” has helped him cope and better manage these negative emotions. So what does EMDR actually mean, and how does it work? We consulted the experts—here’s everything you need to know.
What is EMDR?
EMDR is a type of therapy that combines the greatest insight of depth psychology with the latest findings of neuroscience to assist people with rapidly getting to the root of issues such as anxiety, depression, trauma and even phobias, and then shifting the concern at that deeper, root level for lasting results, explains Annalise Oatman, a Licensed Psychotherapist trained in EMDR. “It was originally created to treat trauma (and is considered the gold standard therapy for treating trauma) but has since been shown through a robust body of scientific research to be highly effective for treating an array of clinical concerns,” she explains. EMDR was developed in 1987 by psychologist Francine Shapiro. “She discovered the effects of spontaneous eye movement and then developed procedures around the effects of eye movement,” says Dr. Angela Kenzslowe, Clinical Psychologist, PTSD, Trauma and Anxiety Specialist. “In 1989 the first controlled study was published in the Journal of Traumatic Stress. By 1990, it was discovered that other forms of bilateral stimulation such as tapping and tones also has positive effects. There are several professional organizations and agencies that have classified EMDR as an effective psychotherapy for PTSD including the American Psychiatric Association, the American Psychological Association, and more.” “When a person has a single trauma, typically after 3-6 sessions there is 77-100% remission,” says Dr. Kenzslowe. “About 12 sessions are needed for multiple trauma victims, such as combat trauma.” Possible EMDR mechanisms include rapid eye movement sleep processing mechanisms and increased brain hemispheric communication. The model is the Adaptive Information Processing model. The method is bilateral stimulation such as eye movements, taps, or audio tones, Dr. Kenzslowe adds. EMDR has different protocols and procedures for various diagnoses; however, all incorporate the three-pronged approach with attention to the past, present and future.
What are the benefits of EMDR therapy?
People who have undergone a full episode of EMDR therapy can expect to feel tremendous relief when it comes to the concern that was targeted by the therapy, whether that was full-blown trauma symptoms and triggers (like hypervigilance, nightmares, etc.), or other clinical concerns like anxiety or depression, Oatman explains. Deeper insight into the origins of triggers and the client’s unique schemas related to their presenting concern can also be expected. The main benefit of EMDR is its effectiveness for treating trauma and post-traumatic stress disorder. “I prefer EMDR over many of the other trauma therapies as the person in session does not have to talk about everything that occurred during the traumatic experience,” says Dr. Kenzslowe. “When thinking of the event and implementing the bilateral stimulation, we find that recalling the incident is most often less distressing. This allows the person to process the incident without a strong psychological response.”
How does EMDR work?
There are eight phases of EMDR treatment. Jason Drake, LCSW-S, BCN, Lead Clinician and Owner of Katy Teen & Family Counseling, breaks it down. The 8 phases of EMDR are:
Phase 1: History taking
In this stage, the therapist meets with the client to gather information and history related to the client’s trauma. This is where goals and outcomes are discussed with the client. The client shares their story and the therapist is taking note of the different experiences that may have been traumatic for the client. This is also an opportunity for the client to get to know the therapist. The client must feel comfortable with their therapists for EMDR to be effective. As the client shares information with the therapist, they can gauge the therapist’s response and determine for themselves if this will be a fit for them.
Phase 2: Preparation
In this phase, the EMDR therapist reviews the steps, process, and procedures of EMDR processing. In this phase, the therapist is also teaching grounding techniques, stress reduction coping skills, and emotional regulation coping skills. The therapist will practice with the client a technique called “safe/calm” place. This is a stress reduction or emotional regulation skill that is essential prior to learning prior to beginning EMDR processing. The EMDR therapist may ask the client to complete an assessment that provides information on the client’s potential for dissociation. If the potential is high, the EMDR therapist and the client may do work around grounding skills and other work around dissociation. In safe/calm place, the client is asked to think of a real or imaginary place where they have felt safe and or calm. It’s a place that is not related to the trauma in any way. It can be a place when they were a child, an adult, or anywhere in between. Once the client is able to demonstrate that they have a safe/calm place and are able to access that soothing feeling, the next step in preparation is to create a trauma timeline. It’s standard to start at the earliest trauma that they can remember and work our way up to the current time. “I suggest to my clients that they think of it as giving me the ‘chapter title’ of the trauma and not the storyline,” says Drake. “I also ask for the approximate age when the trauma occurred. We will then rate the traumatic experience on a 0-10 scale on how much this memory disturbs them today when they think back on it. A rating of 0 would be ’not disturbed at all.’ A rating of 10 would be ‘highly disturbed.’”
Phase 3: Assessment
In this phase, the EMDR therapist and the client identify the trauma target that the client would like to process first. The EMDR therapist will ask for an image of the trauma target, a negative cognition, and a positive cognition. The client rates the positive cognition on a one to seven scale on how true the positive cognition feels to them. A rating of 1 would equate to completely false. A rating of 7 would equate to completely true. The EMDR therapist asks the client to think back on the image of the traumatic event and identify what feelings it brings up for them today. The client is asked to rate how disturbing those emotions are for them today when they think back on the image of the trauma target. The client will rate on the same 1-10 scale with 1 equating not disturbing and 10 equating very disturbing.
Phase 4: Desensitization
In this phase, the EMDR therapist will start processing with the client utilizing bilateral stimulation (BLS). This is where the work in resolving traumatic experiences begins. The therapist will use one of the mechanisms for BLS (like finger movement, hand tappers, light bar, etc.) and have the client hold in their mind three things:
The image of the trauma targetThe negative cognitionAnd where they feel the negative emotions in their body
The therapist will then begin the BLS for a short time then stop the BLS. The EMDR therapist will ask the client something along the lines of, “What did you notice?” or “What did you get?”. The client then talks about the images, thoughts, memories, sensations, and feelings that came to mind. EMDR provides an opportunity for the unconscious to start processing the “stuck” trauma. Once the client relays what came to mind, the EMDR therapist will direct them to continue and start the BLS again. This is not talk therapy and the therapist does not discuss with the client the information relayed from the client. This is an opportunity for the brain and the unconscious to be free to process the trauma that has become stuck. “There are times where a client may get stuck in a loop on the same material without effective processing,” says Drake. “At this stage, the EMDR therapist can do what is called a “cognitive interweave”. The therapist may suggest something to think about based on the information relayed to the EMDR therapist by the client. The goal in cognitive interweave is to help the client start processing information again.”
Phase 5: Installation
This phase occurs once the client reports that the trauma target has been fully resolved. At this stage, the client usually reports that they no longer feel the intense emotions or disturbances around the trauma incident. Once this occurs, the EMDR therapist spends time strengthening the positive cognition that was identified in the beginning. The EMDR therapist asks the client to rate the positive cognition on the same 1-7 scale. If the client rates the positive cognition as a 7, the therapist will ask if they believe it could be a stronger 7. If so, the EMDR therapist will utilize BLS to help strengthen the positive cognition. Likewise, if the client initially reports a lower number than 7, the EMDR therapist will utilize BLS to help increase the strength of the positive cognition to a 7 and as strong a 7 as can be possible.
Phase 6: Body scan
In this phase, the EDMR therapist will ask the client to simply scan their body. They are asked to notice any tension in their body. If the client reports experiencing tension in their body, the EMDR therapist will utilize BLS until the tension is no longer present.
Phase 7: Closure
A final check will be done by the EDMR therapist with the client and ask the client to rate their current emotional state on the 1-10 scale. If the emotional state is elevated, the EMDR therapist will help the client through a safe/calm place exercise to decrease the emotional disturbance. Once the client is at a very manageable emotional state, the client is reminded that their mind will continue to process this information throughout the week. It’s not unusual to have intense emotions, thoughts, memories, and even dreams related to EMDR. The client is reminded to take note of these experiences and practice safe/calm place or other emotional regulation skills taught. The client is also encouraged to reach out to the EMDR therapist if needed.
Phase 8: Reevaluation
In this phase, the therapist checks in at the beginning of the following session. The EMDR therapist will have the client bring up the image, the negative cognition, and where they feel the negative emotions in their body. The therapist may explore other targets the client would like to address or if therapy has come to its conclusion, the therapist will end with the client. The therapist may explore other targets the client would like to address or if therapy has come to its conclusion, the therapist will end with the client.
Is EMDR safe?
EMDR is very safe. “If the EMDR therapist is using the full EMDR protocol, they should be asking in the early preparation phase about potential medical concerns, such as pregnancy, neurological issues—like seizure disorders—and any ocular issues or eye pain,” Oatman explains. “They should also rule out a dissociative disorder, unless they are specially trained to provide EMDR to people with dissociative disorders.” If this has been done before memory mapping and reprocessing begin, there is no reason why EMDR should be physically, psychologically or emotionally unsafe for the client in any way. The only side effect of EMDR therapy is a reduction in symptoms and a drastic mitigation of emotional reactions to triggers. “There are some possible effects such as potential changes in memory and emotion related to EMDR and court involvement,” Dr. Kenslowe states. “A high level of emotion or unexpected memories may occur while processing.“w Next, read about what Prince Harry meant when he said he “inherited genetic pain.”
Sources
Annalise Oatman, Licensed Psychotherapist trained in EMDR, Author, and Transformational Life CoachAngela Kenzslowe, Clinical Psychologist, PTSD, Trauma and Anxiety SpecialistJason Drake, LCSW-S, BCN, Lead Clinician and Owner of Katy Teen & Family Counseling
