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Answering Your EMDR Questions

Lacey Lemaster, LPC
Counselor, Insight Clinical Counseling and Wellness, LLC

What is EMDR therapy?

EMDR therapy is a type of therapy that works directly with the brain. EMDR stands for Eye-Movement Desensitization and Reprocessing. It utilizes bilateral stimulation – stimulating both
the right side and the left side of the body – to help the brain reprocess stressful experiences. Your EMDR therapist may not use eye movements, but they may also use tapping, sounds from headphones, hand buzzers, or even just moving with both sides.

What can EMDR therapy be used for?

EMDR therapy can be used for essentially anything. Typically EMDR therapy is used to work through trauma, but it can help with a multitude of things. EMDR therapy can be used for PTSD, OCD, depression, anxiety, chronic pain, stress, and many, many other things!

How does EMDR therapy work?

There are a few different theories on how it works with neurobiology, but essentially it takes a
stressful memory, thought, feeling, or body sensation you have and allows your brain to reprocess it in an environment where you are not stressed out, overwhelmed, or in fight or flight mode. This way, the brain makes a connection that this memory does not need to hold that much power over you any longer.

What should I expect during and after EMDR therapy?

At first, you and your EMDR therapist may set up “targets” for reprocessing. Targets are typically particular memories that you would like to reprocess in relation to a particular “negative cognition.” A negative cognition is something negative that you believe about yourself, such as “I am worthless.” or “I should have known better.” You will also work on different coping skills before reprocessing. This may be forming a safe place, forming a container, incorporating bilateral stimulation into your daily routine, grounding skills, or many other types of coping skills.

Once you get to the desensitization stage, your therapist will form a “flight plan” with you. This is in case you feel extremely overwhelmed during reprocessing and need to stop. Oftentimes it is just saying, “STOP!” or raising your hand. Your EMDR therapist will then “activate” the memory by asking you a series of questions related to your level of stress, your emotions, beliefs, and body sensations. Your brain will then do all the work as your EMDR therapist uses bilateral stimulation. You just let whatever comes to mind come to mind and let any body sensation that happens happen. Your EMDR therapist will periodically stop the bilateral stimulation to check in to ensure that things are not going awry.

Once at the reprocessing stage, you should not have any stress associated with the target. If you do, be sure to let your therapist know when they ask. If you do not, you can move on to
reprocessing a “positive cognition.” A positive cognition is a positive belief you would like to
have about yourself in relation to the target. Often this is the opposite of the negative cognition, but it can be anything that is adaptive and helpful to you. Your EMDR therapist will then help you “install” this positive cognition. Much like the desensitization stage, your brain will again do all the work as your EMDR therapist facilitates the bilateral stimulation and checks in with you. Once you fully believe the positive cognition in relation to that target, your EMDR therapist will ask you to scan your body to see if you feel anything out of the ordinary. Let them know if something doesn’t feel right.

Once that is all completed, you’ve successfully finished a target! Congratulations! If there is anything you need to vent to your EMDR therapist or something you had noticed, feel free to let them know. Afterwards, you may feel a little more tired than usual, and it is extremely important to practice self-care. You may also possibly experience an “abreaction” during or after reprocessing. An abreaction is essentially the body purging out an intense feeling, whether that is a body sensation or an emotion. For some, this can be crying, for others, it may be more of a body sensation, such as needing to use the restroom after reprocessing. It is important to let your EMDR therapist know if you experience such a thing.

*Please note that the EMDR therapy process can be adjusted for your needs, and your EMDR therapist may adjust the protocol accordingly to best serve you.

What do I say during the check-ins while reprocessing?

You are welcome to share anything that comes to mind, an emotion you feel in the moment, or a body sensation you are having. You do not need to go into detail, the check-in is typically expected to be a few words of description. It is designed to let your EMDR therapist know that what is being reprocessed is “moving through” and you are staying within your window of tolerance.

What is a window of tolerance? What happens if I feel like I am out of my window of tolerance?

A window of tolerance is essentially what your brain can tolerate in that moment while reprocessing. If you end up out of your window of tolerance, your brain and body will feel like it is going into fight or flight mode, meaning you may feel like you can no longer tolerate the process. If you feel you are outside of your window of tolerance, do not hesitate to let your EMDR therapist know, and you will stop reprocessing.

Does it hurt?

No, EMDR therapy should not hurt. While reprocessing, you may experience different body sensations that are relevant to what you are reprocessing. For example, if you are reprocessing a memory where your hand was smacked, you may end up feeling a sensation on your hand.

What if I don’t want to do EMDR therapy during my appointment?

If you do not want to do EMDR therapy during your appointment, do not hesitate to let your therapist know. You and your therapist can further discuss any barriers or any situations that may prevent you from engaging in EMDR therapy.

If I have other questions, what direction should I turn?

If you have other questions, definitely feel free to ask your EMDR therapist. You can also refer to EMDRIA’s website, which has many great resources, and goes further in depth. I have
provided the website link below. If you enjoy reading books, I would highly recommend Bessel van der Kolk’s book The Body Keeps the Score and Laura Parnell’s book Tapping In. If you
enjoy videos, I’ve provided a couple below as well.
● EMDRIA – https://www.emdria.org/about-emdr-therapy/
● How EMDR works video – https://www.youtube.com/watch?v=hKrfH43srg8&t=6s
● EMDR Therapy Demonstration – https://www.youtube.com/watch?v=M2ra8p4MSOk