EMDR: Therapy at Lightning Speed

Eye Movement Desensitization and Reprocessing was discovered in 1987 by a research psychologist named Francine Shapiro who was taking a walk in a park. As she walked, she was thinking about a personal matter that was bothering her. She happened to notice that her eyes were going back and forth and that, as they did, her level of disturbance went down. Intrigued by this discovery, she began the extensive research and formulation that culminated in EMDR theory and methodology.

In the beginning, it was assumed that eye movements were essential to the process. Then tapping on two sides of the body was found to be effective and, finally, alternating audio stimulation through headphones and a scanner. What is common to all these different modalities is that they all constitute bilateral stimulation - that is, stimulation on two sides of the body.

Why is bilateral stimulation effective? The bottom line is: there is no definitive, finally agreed upon explanation at this time. However, what makes sense to me is that bilateral stimulation seems to allow trauma to process through in such a way that it no longer produces a high level of disturbance for the client. What we mean by “trauma” is an experience or pattern of experiences that were overwhelming to the coping structures that were available to the client at the time of the traumatic experience. As a result, trauma of this sort gets locked away in the nervous system and cordoned off in certain areas of the brain that are only minimally connected to the rest of the brain and its circuitry.

The use of bilateral stimulation allows this traumatic experience to become connected with the bulk of experience and prior learnings that have been developed in the course of the client's life history and stored in the other parts of their brain. Consequently, the client will no longer continue to experience the recurrence of such traumatic experience(s) in their nervous system and limbic system exactly as if it were happening again. With lowered disturbance and new understanding, the bilateral processing enables them to convert compulsive behavior patterns into decisions based on choice. Since each client's learnings and life history are different, each client's processing will be different. Thus, although the fundamental principles are the same, each person’s work will be unique.

People have been asking how it is possible to resolve an issue using only one processing session - not just once (as if it were a fluke) but repeatedly.

To use an analogy, it is as if I threw down seeds in my garden and then sat back and watched them sprout and bloom right in front of my eyes, not over a period of months or weeks or even days, but in just two hours. It's impossible, isn't it? I would have said the same as a therapist about resolving clinical issues. But it is happening consistently in my practice.

Let me be very clear. I am not saying that two hours is the total time I spend with each client - as if they were to walk into my office for the first time and then walk out two hours later healed. That would be impossible. The Eight phase model for EMDR requires a psychosocial assessment, development of rapport and a therapeutic alliance, as well as an explanation of EMDR theory and practice. The EMDR model I use begins with a one and a half hour preparation session and ends with a one and a half hour follow-up session. However, the actual healing process – i.e. the processing time for each trauma - is two hours, not a series of twelve to twenty sessions as has been reported in the literature. That in itself is remarkable enough.

I was trained in EMDR in 1997 and have been using it regularly in my practice since 2003. I developed the format I will outline here in the last four years. In my results to date using this format, all of my EMDR clients have successfully resolved the issue they were working on within this time frame. Client follow up forms indicate that the results are holding. None of my EMDR clients have returned to work on the same issue again.

Unlike many other EMDR trained therapists I have talked to, I do not do twenty or thirty minutes of EMDR during a one-hour counseling session. I follow a very definite structure as to how I utilize the time. My time structure is:

1. a one and a half hour preparation session,
2. a two hour processing session,
3. a one and a half hour follow-up session.

We need to keep in mind just how remarkable it is that major changes are being realized in this time frame in order to truly appreciate the dramatic impact of this work. Normally, therapy for these issues would take months and sometimes years to resolve. And for some clients, even after spending months and years in therapy, they still may not have accomplished their goals. For example, I worked with a woman with a major depressive disorder who had spent fourteen years in therapy and was hospitalized twice for extended periods of time with no improvement. After EMDR, her depression lifted and she was able to move on with her life.

Whatever explanation finally comes to dominate our thinking about what makes bilateral stimulation effective, the fact that it is effective is self-evident to anyone who has experienced this work, either in the client or therapist role. What may look like “ordinary therapy” is actually powered by the bilateral stimulation that accompanies it. Bilateral stimulation galvanizes the work and takes it to a new level.

In the more than thirty-five years I have been a therapist, I have never experienced a methodology as fast and effective as EMDR. The inescapable conclusion is that Eye Movement Desensitization and Reprocessing allows us to find a way out of deep personal suffering at lightning speed. It is an elixir of change.