Metropolitan Counseling Associates
Trauma and EMDR
What is Trauma?
Trauma can be any experience that is overwhelming and too much for our brain and body to process in healthy ways. We can experience trauma anytime throughout our lives when we encounter something too much, not enough, or too soon for us to make sense of and manage. When trauma overloads our nervous system, our brain and body are unable to process, interpret, and store the experience into memories in healthy ways that allow us to learn, heal, and recover.
Our brain uses processing to put language into a memory and store it on an autobiographical timeline. These memories connect our past to our present while allowing us to tell the difference between the two. We remember processed memories with the perspective of who we are when remembering, not when the experience occurred. Processed memories remain stored on a timeline that enables us to learn from experience, differentiate how we felt then and now, and develop narratives that help us feel secure and connected within ourselves and with others.
When trauma overwhelms our brain and body, we are not able to process our experience and store it away in memory on a timeline with language. Since we use language to comprehend, assign meaning, and communicate our experiences, unprocessed memories remain fragments of beliefs, emotions, images, and sensations. When we remember unprocessed memories, we experience the memory without language, coherent meaning, and a time stamp. Our brain cannot tell the difference between the past and the present. Whatever we saw, felt, thought, and believed when we experienced the trauma remains the same. Therefore, the inadequacy, powerlessness, self-blame, and danger we felt then blur with what we could otherwise think, feel, and know now.
Although many people associate trauma with acute life-threatening experiences, this type of Big T trauma is only one type of trauma. Many people experience little t trauma, often called complex trauma or developmental trauma. Examples of little t traumas are childhood bullying, social isolation, growing up in a family where intense emotions were judged and ignored, and undiagnosed learning disorders that lead to harsh self-criticism and shame. Developmental trauma can occur in any situation where a child grows up in an environment that is repeatedly invalidating, neglectful, and/or overwhelming. Developmental trauma impacts people in many life-shaping ways because it interferes with the ability to learn how to recognize, understand, accept, and manage needs, feelings, and fears.
Human beings are biologically designed for survival. Children depend entirely on their primary caregivers from birth through their formative years. Therefore, any experience that threatens the security of this relationship can become traumatic. “Attachment injury” endangers a child’s sense of safety and requires the child to develop beliefs and behaviors that protect the attachment at any cost so the child can feel safe and secure. Instead of seeing a caregiver as unsafe and uncaring, a child learns to believe they themselves are bad and unlovable. Instead of realizing a caregiver neglects their needs, a child learns to think their needs are unworthy or too much. When a child is repeatedly abused or neglected, these beliefs shape their self-concept and become barriers to self-esteem and overall health and well-being.
The Impact of Trauma
When unprocessed trauma stays stuck in our nervous system, it causes long-term psychological and physical problems that can range in severity. Symptoms of trauma include mood instability, dissociation, anxiety, difficulties with intimacy and managing conflict, impaired body awareness, and a wide range of other emotional, cognitive, and physical disturbances.
Because the effects of trauma become hard-wired in our brain and body, the resulting symptoms and the associated negative beliefs and behaviors we develop resist change. Many people with unprocessed trauma have little to no awareness of how often their present-day problems with mood, thoughts, or behaviors are the result of activity in their brain and body stuck in the past.
Although many symptoms of trauma meet the criteria for psychiatric and physical disorders, treatment plans are unsuccessful when they do not involve a trauma-informed approach. Many people who receive healthcare that is not trauma-informed remain unaware that the inability to heal and change is the result of misinformed treatment. Unfortunately, patients and professionals alike misinterpret the symptoms that resist change as people and problems that resist treatment.
What is EMDR?
EMDR is an evidence-based psychotherapy that helps people recover from trauma by processing the experiences stuck in the nervous system in healthy and adaptive ways.
EMDR was developed from the proven principle that our brain and body are biologically designed to heal after injury unless blocked. Our body tries to heal when we cut our hands unless a foreign object interferes. Similarly, our brain’s information processing system naturally moves towards healing and mental health unless trauma blocks its path. Adaptive Information Processing (AIP) informs the theory and practice of EMDR. Memory networks are the basis of our perceptions, attitudes, and behaviors and set the foundation for mental well-being. Changing beliefs and behaviors resulting from trauma requires us to integrate past events into the healthy and adaptive memory networks we use to learn and grow in the present.
How EMDR works
EMDR uses an 8-step protocol to identify maladaptively stored fragments of trauma and bring present-day attention and learning to the sensations, thoughts, beliefs, and emotions from trauma that are stuck in our nervous system. Once the memory networks causing present-day problems are identified, the disturbances in emotion and sensation stuck in the brain and body are desensitized, and memory of the experience is reprocessed with present-day thoughts, cognitive abilities, and emotion regulation skills. Successful completion of EMDR treatment results in unblending the past from the present, resolving post-trauma symptoms, and developing new, true, and adaptive beliefs and behaviors.
Desensitizing and reprocessing trauma is achieved by bringing present focused attention to associations in our memory networks while activating bilateral stimulation in our brain. This dual attention allows us to discharge previous disturbances and remove past emotions that no longer belong in the present. Research has shown bilateral brain stimulation (BLS) is integral to healthy processing and memory. Bilateral stimulation of the brain is what our brains do naturally during REM sleep. The stage of sleep has proven to be instrumental in helping our brain process our experience and its emotional impact.
In EMDR, bilateral stimulation occurs through introducing eye movement, tapping, or auditory stimulation. By activating brain-based stimulation of both sides of the body and both sides of the brain, old fragmented nervous system connections become rewired with new adaptive connections that create new neural networks in the brain between areas that hold trauma and areas that think and connect in the present. These biological changes are the basis for recovery and long-term health.
EMDR uses a three-pronged approach that addresses the past, present, and future. After reprocessing past trauma, BLS is used to change reactions to present-day triggers. Once the past is no longer overwhelming and the present-day symptoms are addressed, EMDR helps patients strengthen their ability to experience the future favorably by using similar BLS to connect their present experience with the thoughts, feelings, and sensations we aspire to the future. Although it is hard to believe, rehearsing future experiences with imagination in the present while using BLS is proven to increase the likelihood of manifesting them in desirable ways!
Why EMDR
The World Health Organization endorses EMDR as an evidence-based psychological intervention for the treatment of PTSD and other trauma-related disorders. Some studies have shown that 84-90% of single trauma (Big T) survivors no longer have PTSD after EMDR treatment. Other studies show that 100% of single-trauma and 77% of multi-trauma survivors were no longer diagnosed with PTSD after EMDR. Although research on EMDR leads many people to consider EMDR as trauma treatment exclusively, EMDR has proven to help people in treatment for a wide range of psychological disorders achieve long-term health and well-being.
Unlike other trauma-informed psychotherapies, EMDR helps patients successfully resolve post-trauma symptoms without having to focus on all the disturbing details of the traumatic events of the past to change what is happening in the present. Patients in EMDR therapy have much more control over the focus of work and limit discussions that are unnecessarily triggering and distressing. EMDR therapists help patients identify the parts of their experience and associations that benefit from reprocessing and guide the work accordingly.
EMDR is also unique in its ability to help patients achieve long-term, hard-wired biological changes in the brain, body, and nervous system. This results in “trait” changes that create sustainable beliefs and behaviors that spontaneously transfer across different circumstances and situations. This kind of physical and psychological recovery is uncommon in mental healthcare, which more often involves “state” change techniques that improve emotion, thought, and behavior patterns that may not withstand change when one’s life and circumstances do.
For more information about EMDR psychotherapy and research:
https://www.emdr.com/what-is-emdr/#layperson
https://www.emdr.com/research-overview/