Herewith is an excellent article from my forthcoming book on healing from trauma and abuse written by Cynthia Kong, LMFT. Cynthia has many many years as a trauma therapist, as well as EMDR.
EMDR (Eye Movement Desensitization and Reprocessing)
If you are a survivor of abuse, a loved one of a survivor, or a professional treating a survivor, you already know the potentially long-lasting and devastating effects that earlier experiences can have on a person’s mind and body. Even though human beings seem to have ways to deal with disturbing experiences so that we learn what is useful from them and “discard” the rest, when experiences are traumatic they may not get processed and integrated into our memories in the usual way. They may leave us with very upsetting images, thoughts and feelings, which may be there all the time, or may get “triggered” by things that remind us of the past. On the other hand, we might not have particular images or thoughts, or even conscious memories of some of the experiences, yet be very much shaped by them in terms of our ways of being and coping in the world.
EMDR is a psychotherapy approach that helps a person to complete the “stuck” or incomplete processing of upsetting experiences, including abuse and other trauma. It does this through the use of various forms of bilateral stimulation (BLS) to facilitate the person’s own innate healing processes. The BLS might simply involve the therapist guiding the client to move her/his eyes quickly from side to side in a rhythmic motion. Or it might involve the client listening to gentle sounds alternating from one ear to the other through a set of headphones. At the same time, the client is guided to begin recalling different aspects of a disturbing memory, and noticing any images, thoughts, feelings, or body sensations that arise.
With successive sets of BLS, the client will typically start to notice changes in what comes to mind when they think of the experience. Eventually, in a successful processing session, the memory will become less and less upsetting, negative beliefs about oneself will change into more positive, realistic and useful ones, and unpleasant sensations in the body will subside and perhaps be replaced by more relaxed, expansive, or otherwise pleasant or neutral ones. Although the processing of particularly disturbing memories, such as those of sexual or ritual abuse, may take a considerable length of time to complete, the general course of the processing will tend to move in this positive direction.
EMDR is a complete therapy approach with several different phases. The earlier phases (History Taking and Preparation) include aspects that resemble other forms of therapy. The important tasks of the initial phases include getting to know the client and their history, developing a safe and trusting relationship with the therapist, and making sure the client has the internal ability as well as enough support in their present day life to handle the potential emotional intensity of the trauma reprocessing part of EMDR. For some clients, considerable time may be needed to help them develop or strengthen these abilities and resources so that they may safely process the trauma.
It is usually advisable for a well-trained EMDR therapist to be the primary therapist for the survivor so that the therapist can more easily monitor the client’s overall progress, and gauge when to proceed with the different phases of treatment. In fact many EMDR therapists will only work with a client in this way. However, if you already have a strong, long-standing relationship with a therapist who is not trained in EMDR but who is supporting or even recommending EMDR as part of your treatment, it may be possible to
find an EMDR therapist who is comfortable and skilled at working collaboratively with your primary therapist. The EMDR therapist may still need to spend some time with the beginning phases of EMDR treatment, followed by the trauma-reprocessing portion of your therapy at the appropriate time.
I stress the importance of timing because it is not advisable for survivors of severe abuse to rush into working directly with the trauma memories with EMDR before adequate preparation and stabilization are done first. This is particularly true for survivors who dissociate to a significant degree as one of their coping mechanisms. Although for many people EMDR may shorten the overall course of treatment, it should not be looked upon as a “quick fix” for abuse survivors. The trauma reprocessing aspect of EMDR can be very powerful, and should not be used by an unskilled therapist, or before a client is ready.
Another very important factor to be considered regarding EMDR with survivors of abuse is the possibility of brainwashing or hypnotic “conditioning” against revealing information about the abuse. It is common for victims of any type of abuse, particularly in childhood, to be threatened with harm to themselves or others if they “tell” on the perpetrator. In ritual abuse involving a cult, the conditioning may take on particularly heinous aspects such as the threat of the cult coming after the survivor or other people to whom they reveal any information about the cult or cult-related experiences. The victim may even have been programmed to harm him/herself if at any time, even far into the future, (s)he admits any such information, even to their own conscious awareness.
Negative reactions may occur during the course of therapy if conditioning is not taken into consideration and dealt with along the way. This is not an issue unique to EMDR, but as with any therapeutic approach that may involve deep changes in abuse survivors, the therapist should be aware of and prepared to deal with this phenomenon. On the positive side, it may be possible for EMDR to be used to help deal with the programming itself.
Many creative therapists have integrated EMDR with other therapeutic tools and methods, such as art therapy, play therapy, writing, movement and body/somatic work, verbal/emotional expressive work (such as in Gestalt Therapy, Voice Dialog, Bioenergetics), as well as more transpersonal/spiritual orientations. Your EMDR therapist might suggest homework between sessions in the form of relaxation, meditation, visualization, journal writing, physical exercise, or a number of other activities to reduce stress and to help you integrate the shifts that occur in the sessions.
To learn more about EMDR, there are a number of good books written about it, as well as some useful websites. Some books are more geared for potential clients and the general public, while others are specifically written for mental health professionals.
One of the most reliable and well-respected websites is that of the EMDR Institute in Northern California. The Institute was founded by Dr. Francine Shapiro, Ph.D., the California psychologist who is the originator of EMDR. Another is the website of EMDRIA, the professional organization in the U.S. that creates guidelines for training and for the ethical and competent practice of EMDR. (These resources are detailed in the Resource Section at the end of this book.)
To choose an EMDR therapist, I would suggest that in addition to the kinds of qualities you would want in any therapist, it is important to choose one who has at the very least completed both the “Part 1” and the “Part 2” trainings. Hopefully, you can find one in your area with sufficient experience as a therapist in general and with EMDR in particular to be able to sensitively and appropriately manage some of the unique aspects of doing EMDR with abuse survivors. This may include working with dissociation (including, but not limited to Dissociative Identity Disorder). If you are a ritual abuse survivor, your therapist would be well advised to know or learn about the unique features of ritual abuse. It is important that they can comfortably and skillfully work with the very disturbing material that may come up in your therapy sessions.
Both the EMDR Institute and EMDRIA are potential sources for finding an EMDR therapist in your area. EMDRIA has lists of “Certified EMDR Therapists” and “EMDRIA Approved Consultants” who have gone beyond the basic trainings to demonstrate greater levels of competence in EMDR. There are also “Facilitators,” and “Trainers” who are therapists involved in teaching EMDR. The EMDR Institute can help you locate some of the more experienced of these, as well as individuals who have completed their basic trainings. Being in any one of these categories does not guarantee that a particular therapist will be right for you, so it is important to talk to one or more potential therapists and use both your mind and heart to help you find a good match.
In the many years since I was originally trained in EMDR, I have found it extremely satisfying and inspiring to be able to work with trauma survivors in this way. When successful, EMDR seems to allow people to actually change how they feel and think in a deep and lasting way. Rather than having to “tell themselves” not to be afraid of something, or to not feel guilty or ashamed about things that their rational mind knows they have no reason to feel badly about, they no longer feel the inappropriate feelings. Rather than having to push away upsetting thoughts and images from the past, these memory fragments actually change in some way so that they are no longer disturbing, or don’t even come up the way they did before. I often find that as people shed the distress left over from their histories, they move from feeling trapped by fears and self-limiting beliefs, to revealing the beautiful, loving, and creative beings they truly are.