By Laurel Niep

If you’ve been to a therapist’s office in the past few years, there’s a good chance you’ve heard of eye movement desensitization and reprocessing, or EMDR, therapy.

Most commonly used for treating long-standing and acute traumas, EMDR is also being shown to help with some kinds of chronic pain.

A growing body of studies shows that EMDR can be used to effectively treat a variety of conditions, such as substance abuse, specific phobias and anxiety that occurs alongside symptoms stemming from a trauma. More studies are needed, but results so far are encouraging.

I’m a trauma therapist who was trained in EMDR in 2018. Since then, I have consistently used this approach with dozens of clients to work through trauma and deeply held negative core beliefs.

EMDR and Traditional Therapy

Eye movement desensitization and reprocessing was developed in 1987 by Dr. Francine Shapiro after she discovered that moving her eyes from her left foot to her right as she walked – in other words, tracking her feet with each step – resulted in lower levels of negative emotions connected with difficult memories, both from the more recent frustrations of the day and deeper events from her past.

Conventional treatments, such as cognitive behavioral therapy or dialectical behavioral therapy, rely on extensive verbal processing to address a client’s symptoms and struggles. Such therapy may take months or even years.

Depending on the trauma, EMDR can take months or years too – but generally, it resolves issues much more quickly and effectively. It is effective for both adults and children, and can be done remotely.

EMDR is an evidence-based therapy that can help people process trauma in ways that other forms of treatment cannot.

EMDR has the capacity to work faster by targeting negative thoughts and emotions in combination with what is called bilateral stimulation – that is, the use of eye movements, tapping, audio or tactile sensations to process the emotions.

The most common form of bilateral stimulation is when the patient holds their head steady and uses their eyes to follow the therapists’ finger movements back and forth. Patients may also wear headphones that alternate music from ear to ear, or a tone that goes back and forth. Another common technique is having the patient hold a small buzzer in each hand that alternates vibration back and forth. Sometimes, therapists alternate tapping on each of the client’s hands or knees.

Some practitioners equate it to adding conscious thought to what the brain is trying to do during rapid eye movement, or REM, sleep. During this stage of sleep, the eyes go back and forth under your closed eyelids as you’re dreaming.

How EMDR Works

Researchers are still working out exactly how and why EMDR is effective at helping patients heal from trauma.

Trauma is a physiological and psychological response to an event where one perceives a threat to their safety – or to someone close to them – that is so severe, it overwhelms their capacity to cope.

The traumatic event can give rise to various symptoms that affect daily life, such as anxiety, depression, mood swings, intrusive thoughts, hypervigilance, difficulty sleeping or changes in appetite or weight. Sometimes, the person has thoughts of self-harm or suicide.

The trauma can also leave one with various triggers – sights, smells, sounds, locations, phrases – that bring up memories of the event. This causes the person to relive the emotions or reactions they had when the trauma initially occurred, as if it’s happening again.

For example, on a stroll through a crowded mall, someone who had been assaulted months earlier might catch a whiff of the same cologne the perpetrator was wearing. As the smell of the cologne triggers them, they suddenly feel like they’re experiencing the assault again, including physical sensations and seeing images of the event.

Dislodging Trauma

Memories of traumatic events often become stuck in the brain’s limbic system, where the fight, flight and freeze response resides. This is not the place where memories are intended to be stored. Here, the memory is triggered by various experiences in daily life – a similar sound, smell, sight or sensation – that can make the client feel as if the trauma is happening again in that moment.

Targeting the traumatic memory while engaging in bilateral stimulation during EMDR allows the brain to highlight and move the memory from the limbic system – where it cannot effectively connect to other critical information or memory networks – to the prefrontal cortex and other cortical brain regions where the memory is better able to be processed and supported.

Certain places, disturbing noises or large crowds can trigger traumatic memories.

EMDR therapy is a multistep process. Together the patient and therapist first identify targets, meaning the specific traumatic memories to be addressed during the reprocessing phase.

Next, the patient is asked to associate the event with a negative thought about themselves linked to the trauma. For example, I might say, “And when you think about the worst part of that event, what is a negative thought you have about yourself?” Often something comes up along the lines of “I’m unlovable,” “I’m worthless” or “I’m not worth protecting.” The patient is also asked to identify and locate any physical sensations they might be having in the body.

Then the therapist will ask the client to focus on all three of those things – the specific trauma memory, the negative thought about themselves and where they feel it in their body – while applying some form of bilateral stimulation.

EMDR in Practice

Although trauma therapy is a very individualized experience, research shows that 80% to 90% of clients can process – meaning resolve – a singular traumatic event with only three sessions of this therapy. In one initial study study from 1998, past experiences such as post-traumatic stress disorder from combat were resolved in 77% of participants after 12 sessions. Other research suggests that for patients who have suffered chronic trauma or abuse, more treatment time is likely needed to resolve the symptoms stemming from the trauma they survived.

In this context, resolve means that the target thought or memory has been cleared and the impact should be greatly reduced – not that the person will no longer have any negative thoughts or emotions about it.

If a patient has multiple traumas, I’ll ask them to identify the memories that stand out the most. The therapist will start with the earliest of those memories and work toward present day. One memory at a time is focused on, and once it has been completely processed – there’s no more disturbance in the body when thinking of the memory – then the therapist and patient move on to the next one.

One of my patients had struggled with devastating childhood memories of verbal, emotional and physical abuse by their parents. This consistently affected their relationships with family and peers into adulthood. After working with EMDR, the patient was able to process the haunting memories, gain insight on setting boundaries with others, and provide comfort and guidance to the young child they once were.

Another patient was a high school student, afraid to leave the house after enduring an assault on the way home from school. Concrete, visible changes began after the second session. School attendance became more consistent; grades improved. “I don’t understand what’s happening,” said the patient. “It’s like magic. I’m not so scared anymore.”

But EMDR is not magic. It is a unique strategy that allows the client to approach the trauma in a different way. The client is able to think about the events they are affected by and engage with the support of the therapist without having to verbalize each detail of their trauma.

Finding EMDR Specialists

If you’re considering trying out eye movement desensitization and reprocessing therapy, find a therapist who is trained or certified for this treatment. The EMDR International Association website has a list of them, though there are many other qualified therapists not affiliated with that organization, and you could ask about a clinician’s credentials before beginning treatment with them.

If you’re struggling daily with past trauma or deeply held negative beliefs about yourself, are willing to delve into those difficult emotions and would like to try a different type of therapy backed by research, I would strongly recommend giving EMDR a chance.

Laurel Niep, LCSW, is a Trauma Therapist and Senior Instructor with the Stress, Trauma, Adversity Research, and Treatment (START) clinic in the Department of Psychiatry at the University of Colorado School of Medicine.

This article originally appeared in The Conversation and is republished with permission.

By Cynthia Toussaint, PNN Columnist

About 20 years ago, my mother called to share what felt like a disorientating thought.

“Cynthia, of all the members of our family, you’re the together one, the capable one and the successful one,” she said.

Though flattered, my thinking was, “How can that be? I’m the daughter with all the problems. The pain, the wheelchair, the one left childless without her show-biz career.”

I’m guessing now that my mother was intuitively letting me in on a secret -- a generations-long family secret. By telling me I had the right stuff, Mom was revealing that I’d broken the trauma cycle. She potently advised that I never let my family members hold me back, to “never not succeed because of them.”

That day I realized I’d done something exceptional, but I didn’t fully understand what it was. You’d think 38 years of chronic pain would have opened my eyes, but it took a cancer crisis for me to deeply examine what my mother was shedding light on.

I come from a profoundly dysfunctional family (domestic violence, divorce, mental illness, suicide, alcoholism, etc.), one so traumatizing my doctor believes that the toll of trying to fix my family, along with the inflammation of CRPS, was what gave me cancer. To have a chance at survival, I had to walk away from the toxic members of my family, which was the hardest and best decision of my life.

Unfortunately though, walking away might not be enough. Now that I’m in remission, I’m concerned that my inability to unlock from my frequent harmful thoughts about the trauma of past assaults will bring on a swift and more aggressive cancer recurrence.

Trauma Release

Enter EMDR (Eye Movement Desensitization & Repossessing). For the uninitiated, EMDR is a psychotherapy treatment designed to alleviate the distress associated with traumatic memories. For years studies have shown that people with serious adult-onset illnesses – including high-impact pain and cancer – experienced many adverse childhood events (ACE’s), as I did.

I’ve long considered doing EMDR for trauma release, but feared stirring up the debilitating depression that my family often sparks. I won’t lie to you. My EMDR plunge has been god-awful, as it’s brought on a ton of expected grieving and even rage. That being said, I’m sticking with it - and astonished by EMDR’s effectiveness and the insight it evokes.

My phenomenal practitioner, Kathy, has pointed out two major, life changing themes. The first, that family trauma is handed down over many generations, adversely changing our gene expression through what’s termed epigenetics. Sadly, I was born into the thick of this ever-rolling harm.

When I was seven, my dad jumped off a bridge due to severe mental illness. Much dysfunction led to his suicide, but this was the tipping point that my family of origin never recovered from.

After sharing what limited knowledge I had of my dad’s past, Kathy quickly assessed that, like me, he had a traumatic childhood. I was stunned to learn that his parent’s alcoholism, affairs and abandonments, along with all of the denial and covering-up, deeply wounded him. That insight gifted me great empathy for the person who shattered my world.

Mom’s side of the family was equally trauma-inducing. After her parent’s ugly divorce and Grandma having my loving grandfather committed to an institution, she had my mother kidnapped. Legend has it that this broke my aunt Grace’s heart, as her agonizing death from leukemia at age 20 soon followed.

To this day, even with advanced dementia, my mother describes her own grandmother as “a witch, the most evil person I ever met.” It goes on and on.

Healing My Inner Child

I finally understand that I have a family tree evergreen with trauma, the root of all my physical and psychological illness.

The second theme Kathy put forth is that to release my trauma we have to heal my “inner child.” I now understand that even as a fetus I took in the negative chemicals and vibe of my mother’s nightmarish situation – and it’s my inner child who’s carrying the greatest injury. The work is tricky because to reach her, we must maneuver around the many protective, life-preserving mechanisms she’s used for 60 years.

With Kathy’s guidance via Zoom, I’m slowly making friends with my inner child. While I want to protect her from the knowledge of a tragic future, ultimately I have to be vulnerable enough to let her spill the repressed memories of violence and dysfunction that host the lion’s share of our trauma.

My hope is that by healing my inner child I can end the cycle of excruciating harm I endure when I think about my family’s countless trespasses. If I can get to a strong landing point of understanding and release, my depression will turn to just sadness – and from there I can move on with better wellness.

I want to be free.

No matter the outcome, Mom was on to something. Thankfully, I’ve cracked the family code by asking why and doing the hard work. As Kathy reminds me, I choose “to think, not drink” - and because I don’t maintain the dysfunctional status quo, I’ve “jumped out of a sinking ship.”

All this time I thought my life had been upended by pain, but I now realize it was family trauma that caused every ounce of my misfortunate.

This insight lovingly brings me to my aunt Grace who, by breaking the family trauma cycle, saved my mother. While I never met her, I see Grace as an angel and forever feel a deep connection, so much so I named my work for her goodness.

We’ve always been compared, and I now see that our similarity extends beyond looks and personality. A quote I continue to hear in my research about generational trauma is “The first born daughter often carries what remains unresolved in the mother.”

Grace and I were the eldest daughters and gave everything to save our broken families, an impossible task.

It cost my dear aunt her life – and I think she’s proud watching me fight for mine.

Cynthia Toussaint is the founder and spokesperson at For Grace, a non-profit dedicated to bettering the lives of women in pain. She has lived with Complex Regional Pain Syndrome (CRPS) and 15 co-morbidities for nearly four decades, and became a cancer survivor in 2020. Cynthia is the author of “Battle for Grace: A Memoir of Pain, Redemption and Impossible Love.”

Latest Stories

A New Therapy Can Help Relieve Painful Emotional Trauma