What is EMDR?
Eye Movement Desensitization and Reprocessing
What is EMDR?
Eye Movement Desensitization and Reprocessing, or EMDR, is a powerful method of psychotherapy that has helped an estimated two million people of all ages relieve many types of psychological distress. It has been proven effective for alleviating symptoms of traumatic stress or posttraumatic stress disorder (PTSD).
EMDR, when done properly, is never about jumping right into the trauma story. It's a process that starts with building skills to be able to experience unpleasant and unwanted sensations associated with trauma and stress without becoming overwhelmed or reactive to them. It's about feeling safe in the body again.
The majority of evidenced-based, effective trauma treatment is geared toward calming the nervous system, with the trauma story itself being a much smaller part of the process.
How Do I Know If I'm Ready for EMDR?
By Lauren Goldbach, LCSW, CCTP
Many people come to me frustrated by their symptoms, tired of feeling terrible, and wanting immediate relief. They often hope that if they begin EMDR right away and look at all the terrible things they've experienced, they will feel better quickly. This is rarely the case, as trauma can cause so much disruption to a person's life.
Most of the time, stabilization has to take place before trauma work can begin. Imagine walking up to a homeless person on the street and trying to talk to them about their childhood. Would they be able to benefit from this? Doubtful — they are more concerned with safety and survival. You would spend a lot of time getting them stable before diving into the past. This is true of any type of trauma work.
The trauma narrative — the story itself — is only a tiny piece of the puzzle when it comes to rebuilding a life and reorganizing the mind. The bulk of trauma therapy is rewiring the brain to feel safe. This is done with preparation.
The phases of treatment can take time: months, or sometimes longer, depending on how much 'homework' a client does on their own to calm the nervous system. The more a person prepares, the more likely they will experience success in treatment.
Two Things Must Happen Before Reprocessing Can Begin
I need to re-wire the nervous system to stop sounding alarms for fires that aren't actually happening.
I need to ensure that safety and stabilization are in place so that the mind does not continue to focus on survival while it's being asked to revisit the past.
Readiness Guidelines for EMDR
The following guidelines are useful in determining if you need more stabilization and preparation, or if you are ready to begin EMDR:
I have resources
A stable, safe place to live with basic needs met, the ability to come to sessions regularly, and a source of income or support.
I can regulate my emotions
I can use skills to calm myself down when very upset or triggered. I can switch from being distraught to finding a "safe" space in my head and body.
I am not severely depressed
My depression is at a level that allows me to engage meaningfully in the therapeutic process.
I have support systems
I have at least one person in my life I can rely on or talk to when I am in need.
I am stable enough to feel worse between sessions
Recalling traumatic events does not make me so upset that I need emergency sessions or cause me to relapse into unhealthy coping skills.
I attend to my daily basic needs
I am not actively engaged in substance use or abuse, self-harm, or other unsafe behaviors. I have strong support for avoiding relapse.
I am aware of my body
I can feel and notice my body most of the time. I am not reliant on pain pills or anti-anxiety medications before sessions.
I don't dissociate frequently
I can keep track of time, focus on what others are saying, and don't check out for long periods of time.
I am not a danger to myself or others
No recent suicide attempts, no recent history of assaulting others, and no active plan or intent to hurt myself or anyone else.
I am firmly planted in reality
I don't see or hear things other people don't. I do not feel paranoid or have symptoms of mania.
If you do not meet these guidelines, that does not mean there is no hope! It only means that I have to work for as long as it takes to prepare you for the final stage of trauma work: EMDR. Remember — processing the actual event or events is only a small piece of the puzzle of getting better.
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