Jennifer Beall, LCPC, LCADC
EMDR (Eye Movement Desensitization and Reprocessing) is an evidence-based therapy that has been shown to be effective in treating PTSD, depression, anxiety, addictions, OCD, and chronic pain. It has been officially recognized by the U.S. Department of Veterans Affairs, the American Psychological Association (APA), and the World Health Organization (WHO).[i]
But how does it work? There are still many mysteries about the brain, so it’s not terribly surprising that researchers have yet to determine exactly how EMDR helps people to heal.
I remember, years ago when I was newly trained in EMDR, going to a session at a conference of the EMDR International Association (EMDRIA) where a neuropsychologist explained the latest research on the brain mechanisms of EMDR. I’m an intelligent person, but I’m not a neuropsychologist, and I felt like one of the kids in a Peanuts cartoon listening to an adult talk: “Wah wah wah, wah wah wah…”
Needless to say, I didn’t come away from that session with a thorough understanding of the brain science behind EMDR.
When I became an EMDR therapist, one of the prevailing theories about the workings of EMDR was that it triggered something akin to the process of REM (rapid eye movement) sleep. This made sense, because EMDR and REM sleep have similar goals—processing memories and filing them away where they belong.
In the original version of EMDR, which is still commonly used, the therapist moves two fingers back and forth while the client follows the movement with their eyes. The eye movements associated with this form of bilateral stimulus (BLS) seem to mimic the eye movements associated with REM sleep.
Interestingly, though, even when the BLS is achieved by using pulsators (“paddles” held in clients’ hands that vibrate alternately), clients’ eyes often move back and forth on their own.
A more recent theory of the mechanism of EMDR, by Ad de Jongh and Suzy Matthijssen[ii], has to do with working memory. The idea is that we only have so much working memory capacity, and it’s hard to do two things at the same time. The therapist asks the client to do something that taxes the working memory while also holding in their minds the trauma they’re working on. Because of the limits of working memory, the client’s brain is unable to hold on to the feelings associated with the trauma, and those feelings are released.
When I explain EMDR to clients, I don’t attempt to recreate that neuropsychologist’s lecture from years ago. I tell them that the brain effects of EMDR are still being studied. I share the REM sleep theory and the working memory theory. And then I tell them some version of what David Grand, the developer of Brainspotting therapy (which I often describe as “EMDR-adjacent,” because the two therapies work similarly) said about the subject. He said (of Brainspotting), “You don’t have to know what it is, to know that it is.”
My clients have had various reactions to the unusual nature of EMDR therapy. Some clients, after having experienced its profound healing benefits, are annoyed that something that doesn’t make sense to them is nevertheless so effective. Others, including people who make a living from understanding how things work, are able to appreciate EMDR’s transformative effects even if they’re not fully explained.
In the end, how much does it matter how EMDR works? Each person has to make their own decision about that. No matter where you stand on the question, though, I would love to help you to experience EMDR’s amazing healing effects. If you’re interested in learning what EMDR can do for you, please fill out a contact form, book a consultation, or call or text me at 410-888-0590.
[i] https://www.emdria.org/about-emdr-therapy/
[ii] https://www.enhancingtraumatreatment.com