More on Attachment-focused EMDR
Overview: EMDR Unlocks Trauma and Deconditions the Limbic System
EMDR does not create but only enhances an elegant mind/body healing process that the brain is already designed to do. Trauma is the brain's, and entire system's, response to experience. The trauma response is rooted in neurobiology. The limbic system is the complex of nerves, networks, and structures in the brain primarily responsible for emotions, mood, instinct, and memory formation. The limbic system is conditioned by our experiences, and repeated stimuli over time strengthen those responses. The limbic system can make the past feel like the present, so that we continue to respond to current life as if we are back in the past (recent or distant). The limbic system is part of the old brain, geared toward perceiving threat and surviving.To resolve the trauma response, the limbic system needs to be deconditioned from the way it has wired over time.
Robin Shapiro was walking in the park in 1987 and noticed involuntary back and forth eye movements while she was having disturbing thoughts, after which she felt better. She then deliberately experimented with eye movements and hypothesized that they were desensitizing, that they decreased her level of distress. Research ensued and the model was developed out of clinical experience over the next decade. EMDR deconditions the limbic system using bi-lateral (right-left) stimulation, which "lights up" and the neural circuitry to access memory channels and helps unlock and reprocess memories and traumas that are frozen in time on the right side of the brain. It is really important to understand that Shapiro did not make up EMDR; she initially hypothesized that we have an innate mechanism that helps us heal from distressing situations. Sometimes this mechanism get blocked, so the steps the therapist carries a client through are designed to facilitate the process.
Through the reprocessing, negative beliefs, emotions, body sensations, and images that were a part of the traumatic experience recede. Neutral and positive beliefs can now arise out of our essential, unharmed state of being. Some hypotheses of the many mechanisms at work during BLS follow.
It kick-starts a form of REM sleep.
It creates womb-like stimulation (sounds and sensations of heartbeat, etc.).
It activates both sides of the nervous system: the sympathetic (“fight or flight”) and the parasympathetic (“rest and digest”) to allow the body to process and complete the frozen trauma response and return to homeostasis.
Bi-lateral Stimulation and the Protocol
Bi-lateral stimulation is no longer just eye movements: tapping a place on the body (usually sides of the legs), holding hand buzzers, listening to a beeping sound with headphones, eyes following a light or the therapist’s fingers, or some combination of these, are now standard. EMDR follows established procedural steps, “the protocol,” that you will become familiar with over time.
If the bi-lateral stimulation feels awkward or distracts you, you may just need a little time to get used to it. Many people find the stimulation soothing. Some people say it feels like being slightly hypnotized, but they feel in control. If you have a strong reaction to the stimulation, even on very low settings, something about it could relate to the trauma itself, or your nervous system is not ready to reprocess. Other modalities may suit you better for the time-being.
The Therapist’s Role and Useful Metaphors
With EMDR, nothing is being done to you or taken away from you. You, and your brain, are in charge to reprocess what could not be adequately processed in the past. The therapist facilitates by first helping you decide what traumas and memories need attention. The therapist also tracks closely, witnesses, offers compassionate guidance, and oversees the steps.
I will do everything that I can to ensure it feels safe enough to go back and return. During a reprocessing, try to remember the “M” for “movement” in EMDR. Something that connotes movement, such as sitting by a river or watching a train going by, is a good metaphor of what we are here to do: move through and away from the trauma. Another metaphor is having “one foot in the present, one foot in the past,” so that there is a shuttling or moving back and forth—a dual awareness—between past and present. You won’t be left back there or alone with it when you are in the room with me, and you will feel different when it is over.
The Benefits of EMDR
For one, EMDR as described above kick starts and/or stimulates different mechanisms and accelerates information processing. It also facilitates a kind of adaptive information processing that
moves the narrative from fragmented to intact
clears emotional charge
shifts memory from psychological to objective (“that happened”)
achieves objective forgiveness (not forced or sentimental)
achieves a felt sense of truth inside
”repairs” the memory networks through differentiation (disentanglement) or integration (linking up)
brings to surface neutral or positive memories or perspectives
accesses a deeper spiritual connection to self and others, for some
History Taking and Assessment
Ideally, you have multiple supports in your life, are committed to safety and to the treatment, can tolerate strong emotions, and feel a rapport with me. We can build toward these. Before beginning EMDR, I will take a full history that may last several sessions. The preparation period for complex trauma may take place over months, and will begin with resourcing. Together we will develop a history or memory map from which we will choose what to reprocess.
EMDR does not cause “false memories.” Memory is subjective; the brain works to store information that it thinks will be useful. Sometimes memories are a symbol, or a blend of several events. We don’t need to have clear visual memories to use EMDR. We work with the memory channels and any corresponding images, beliefs, body sensations, and emotions. We stay on track of what we began the session on until the charge or distress is lowered. We take notes of other related memories that surface, and we can come back to those a different time.
If you have migraines, eye movements are not suggested. We will not do EMDR if you are in your first trimester of pregnancy or if you have seizures. Cannabis affects memory; abstaining for several days before and after is needed. Alcohol and other drugs, opioids and benzos, also must be abstained. Self-harming behaviors will mean we proceed slowly. If you are bi-polar, you must be on your medication. My scope of experience does not include Dissociative Identity Disorder.
Attachment Figures and Resources
The Parnell Institute EMDR is attachment-focused. It modifies the steps in the original protocol and also adds resourcing, mainly by bringing into mind real or imaginary attachment or supportive figures that are nurturing, protective, and wise. The importance of having resources is that you feel accompanied and can access positive associations while accessing the traumatic memory channels.
Reevaluation and Resourcing Between Sessions
After a full EMDR session, more may surface that still needs reprocessing. You may want to journal or keep a log of dreams, insights, triggers, behavioral shifts, new memories, symptoms, and changes in your context or relationships. If you are feeling a “charge” after the session, check your SUDs from 0-10 (the Severity of Distress) and write it down. Between sessions, develop a practice of scanning your body, use mindfulness, and find stress reduction or grounding practices that work for you. Talk to friends, family, sponsors, mentors, or spiritual guides who you know will listen well. Do art or write letters. Take a walk in nature. Listen to music. Just be or sit quietly. Read or watch something that strengthens or balances you. Abstain from alcohol and drugs. Go to your peaceful place internally and bring in your real or imaginary resource figures. Develop or find your inner advisor (or higher power), and allow them to communicate with you naturally.
*Information on EMDR compiled and summarized from Parnell Institute materials, trainer: Constance Kaplan. My own thoughts and explanations are added throughout.