EMDR Therapy: Can It Heal Your Trauma? (Part 1)

EMDR therapy is one of the most effective treatments for trauma, anxiety, and PTSD — and most people have never heard of it.

In this episode of RECOVERable, licensed clinical psychologist and trauma expert Dr. Jenny Hughes breaks down exactly what EMDR therapy is, how it works, and whether it's right for you.

Dr. Hughes covers:
✔ What EMDR therapy actually is — and what it isn't
✔ How trauma gets "stuck" in your brain (and how EMDR unsticks it)
✔ The difference between EMDR and traditional talk therapy
✔ All 8 phases of an EMDR session, explained step-by-step
✔ Whether EMDR works for anxiety, depression & complex PTSD
✔ Common myths about EMDR — and what the science says
✔ Why you should NEVER try to do EMDR on your own
✔ How to find a certified EMDR therapist

If you've been struggling with trauma, anxiety, or depression — and feel stuck — this conversation gives you a clear, practical understanding of one of the most powerful healing tools available.

——————————————————————
🕒 CHAPTERS
0:00 — Introduction: What Is EMDR Therapy?
1:12 — How Trauma Affects Your Brain
3:02 — Bottom-Up vs. Top-Down Therapy
3:37 — EMDR Myth vs. Fact ⚡ Lightning Round
9:47 — What EMDR Therapy Actually Is
12:05 — How to Find the Right EMDR Therapist
13:41 — EMDR vs. Brain Spotting: What's the Difference?
14:37 — What Can EMDR Treat?
15:58 — The Science & Research Behind EMDR
18:13 — What a Client Experiences During EMDR
22:33 — EMDR Session Walkthrough: All 8 Phases
36:35 — Do You Have to Relive Your Trauma?
39:33 — EMDR vs. Talk Therapy
41:09 — What If You Don't Know What to Target?
43:17 — Risks of EMDR Therapy
44:25 — Can You Do EMDR on Yourself?
45:59 — Does EMDR Work for Anxiety & Depression?
50:01 — In-Person vs. Virtual EMDR
51:20 — Where to Find Help & What's Next
——————————————————————

RECOVERable is a production of Recovery.com — the best place to find mental health and addiction treatment.

Find the right treatment for you at Recovery.com
https://recovery.com

Transcript

SPEAKER_02 0:00

You don't want to do EMDR on your own because having that therapist there to be with you and your emotions in this process is absolutely critical to the healing.

SPEAKER_01 0:11

Licensed clinical psychologist and trauma expert Dr. Jenny Hughes joins us to explore how brain spotting and EMDR help to process traumatic memories.

SPEAKER_02 0:22

EMDR is such a cool intervention because you can share as much or as little with me, the therapist, and still have really powerful and profound outcomes.

SPEAKER_01 0:31

So does EMDR make you relive the trauma? It depends. So if you ever talked a problem or a condition to death, but the feeling you have from it is still stuck in your body. Today we're joined by trauma therapist and psychologist Dr. Jenny Hughes to talk about two types of therapy that heal the parts of your brain that words alone can't reach. Today we'll be learning about eye movement desensitization and reprocessing, or EMDR. And next week we're going to drive into the lesser-known but growing practice of brain spotting. Welcome, Dr. Hughes. Thank you so much for having me. Delighted. I look forward to learning about this because it's new to me. And I assume there are going to be some viewers who also don't know a lot about it, but it has great reputation. So this is about the answering the top questions on the internet. And it was very interesting researching EMDR because there were two landscapes that dominated the searches. And one is the mechanism, how does it actually work? And the second is the experience. And the main question around that is sort of things like am I going to lose control? So Google searchers focused on the cost and clinical effectiveness. TikTok and YouTube audiences were highly concerned with the physical sensation and the hangover effect after a session. So we will get into all of that. But we now start with a lightning round of myth or fact, just so we can quickly address some of the misconceptions around different therapies. So myth or fact. EMDR is a form of hypnosis where the therapist controls your mind.

SPEAKER_02 2:10

Myth. 100%. Hypnosis therapy is actually a very well-researched and evidence-based intervention. And it there are certainly some similarities on the surface when you're looking at the two from outside. But um in EMDR, we're not trying to hypnotize anyone at all. And the therapist never wants to be in control of anyone. No therapists, that's ideally and ethically not their job. In EMDR, yes, we use bilateral simulation, which may be through eye movements, it can be through tapping, it can be through sounds, any combination of those. And especially when you see the eye movements or someone going like this or a light bar, it can certainly look like they're trying to hypnotize you with a ticking clock or something, but that is not the goal at all. And the therapist never has control over the client. The client is in the driver's seat. They are the ones that are in charge at every single step of the way.

SPEAKER_01 3:07

All right. Myth or fact, Dr. Hughes. EMDR works by mimicking the brain's natural state during REM sleep.

SPEAKER_02 3:14

Uh, myth and fact. So that was one of the early explanations of what's going on with the bilateral movement of the eyes, but we now know that there's a lot more going on than just that.

SPEAKER_01 3:25

Myth or fact. You have to talk about every painful detail of your trauma for EMDR to work.

SPEAKER_02 3:30

Absolute myth. You actually don't even have to share any details about your trauma with your EMD or therapist for it to be incredibly effective.

SPEAKER_01 3:38

That is going to be a relief to people. Myth or fact. EMDR can actually erase a bad memory so that you don't remember it ever happened.

SPEAKER_02 3:46

Myth. So it certainly changes our experience of a memory, can feel like it's further away, it's not as intense, but we can never erase our memories, no matter how much we wish we could.

SPEAKER_01 3:58

Myth or fact. You can feel physically exhausted or hung over after an EMDR session.

SPEAKER_02 4:04

That is true for some people sometimes. So sometimes there's a really, really intense session, and you're gonna feel that for the next 24 or 48 hours, but not every single time.

SPEAKER_01 4:15

So myth or fact, EMDR is only for veterans or survivors of big T traumas.

SPEAKER_02 4:20

Myth. It is for big T and little T traumas and anywhere in between.

SPEAKER_01 4:25

Myth or fact. You don't actually have to move your eyes during EMDR therapy.

SPEAKER_02 4:30

Fact. So you can do bilateral simulation with your eyes, you can do bilateral sounds, you can do tapping, you can do any combination thereof.

SPEAKER_01 4:38

Myth or fact. EMDR is new age therapy with very little scientific evidence.

SPEAKER_02 4:44

Myth. EMDR has been around since the 1980s and has a wealth of evidence to support it.

SPEAKER_01 4:50

Excellent. Myth or fact. Doing EMDR yourself via a YouTube video is both safe and effective.

SPEAKER_02 4:57

Myth.

SPEAKER_01 5:09

Myth or fact. EMDR is often faster at resolving PTSD or post-traumatic stress disorder than traditional talk therapy is. Fact, especially compared to traditional talk therapy. Nice job on the lightning round. So now we get to answer in a little more depth. And the most asked question about EMDR on the internet, this will not surprise you. What exactly is EMDR therapy?

SPEAKER_02 5:32

Yeah, uh that's a big question. Yeah. So we talked about in the lightning round. It's been around since the 1980s. So Francine Shapiro, she was a psychologist and she developed, she discovered EMDR and kind of discovered it on accident. Uh so she tells this origin story about how she was on a walk and she was dealing with whatever was going on in her life, some stress. And she started to notice as she was walking that her eyes were scanning back and forth. And that during and after the walk, she kind of started to feel better. And this is how a number of especially bottom-up therapies have been developed and discovered in the past decades, is kind of by accident by the developer. So she started to experiment with it. And, you know, you asked in the lightning round two about the eye movements. That's considered the gold standard bilateral simulation, is the eye movements because that's what Francine started with. But it doesn't have to be that. And also when we're talking about EMDR, it can be a hard question to answer of what is it? Because until you experience it, sometimes it's hard to describe it. So when you're doing EMDR with your therapist, there are all of these different steps that you go through. In EMDR, we talk about the eight phases and the three prongs. So we can work on past, present, and future. Those are the three prongs. And then within that, we have all these different phases in the protocol that we move through to help the client reach whatever their goal is. Only one of those phases actually involves real kind of bilateral simulation, the reprocessing, what people think of as EMDR when you're moving your eyes or you see a light bar or you've got buzzers or whatever it is. It's all EMDR, though. Everything from your intake to your assessment to teaching your resources and coping skills to doing that processing to checking in with the body, following up, um, and and really kind of diving into all of that. It's all EMDR. So it's not a simple answer of what is it?

SPEAKER_01 7:37

It also makes me think of the lightning round question about doing it yourself.

SPEAKER_02 7:40

Yeah.

SPEAKER_01 7:41

You alone wouldn't be able to step through eight different things because you can't be teaching yourself skills you don't know yet, or you'd be in a different place, perhaps.

SPEAKER_02 7:49

And also, so much of the traumas that we experience are relational. So whether that is childhood trauma or something that happens at any point in life, most traumas are experienced between humans. And you don't want to try and heal a relational trauma on your own, uh, because you need the attachment relationship with your therapist to really be able to move through that healing process.

SPEAKER_01 8:15

And you recommend finding a therapist who is certified in the therapy.

SPEAKER_02 8:20

Uh ideally. So things like EMDR, brain spotting, lots of the therapies now have certification processes, which is really good because it it means that the therapist has done more than just read a book or an article or a manual. So they've gone through the formal training, they've done formal consultation with an actual consultant, they've uh done a certain number of hours of training and consultation to say that they truly know the model and the intervention. And that is a huge benefit to the therapist and especially to the clients. And so when you're looking for a therapist, whether it's a trauma therapist or any other kind of specialty, you don't want the therapist on psychology today who has every single box checked saying that they can treat all of the things that are on that list. You want someone who actually probably only has a few boxes checked and that those things clearly overlap because that's their specialty. You want a specialist in these situations. And a certified EMDR therapist, that's going to be a really good indicator that they've done the work to uh really know how to do that intervention with you.

SPEAKER_01 9:25

That's good advice. In your answer, you brought up brain spotting, and we will be doing a deep dive into that in the next episode. But what is the difference between EMDR and brain spotting when they both involve the eyes and can be confused?

SPEAKER_02 9:36

Yeah, so uh EMDR is more about the more rapid bilateral eye movements back and forth, whereas brain spotting is more about a fixed eye position. So in brain spotting, we say where you look affects how you feel. And so we're not moving back and forth. We're actually finding one, maybe two spots, uh, but we're really holding those eye positions as we're working on whatever the target is.

SPEAKER_01 10:01

They're both under what? Eye movement therapy? Is that the umbrella?

SPEAKER_02 10:06

So we talked earlier about kind of somatic and bottom-up approaches to trauma. Sometimes body. And so they're both more considered to be somatic or bottom-up approaches. So working with those subcortical parts of the brain as opposed to top-down and focusing on the cognitions first.

SPEAKER_01 10:21

As a trauma therapist, what is the benefit of learning about different kinds of therapies that are available to us if we have been living with a trauma?

SPEAKER_02 10:31

Well, first and foremost, everyone is different. Their needs are going to be different. The kinds of support and services that they need are gonna be different, both for their brain and body, but also for um their system and their context. And so when we think about how trauma and stress affect the brain, um, Dr. Dan Siegel teaches about the hand model of the brain. So it's a great way to kind of learn how trauma affects our brain. And so if you take my hand, my arm is gonna represent the spine. And then my palm is the brainstem. And this is the part of our brain that is controlling our breathing, our heart rate, all of those things you don't want to have to think about to stay alive, right? My thumb represents the limbic system. So this is the emotional part of our brain. Um, the amygdala lives here, which is that emotion kind of like smoke alarm center. Also the hippocampus, which is our memories. And together, the limbic system and the brain stem, that's our survival response. My fingers over top represent the cortex, which is all the squiggly stuff that you imagine when you picture a brain, right? And that is the part of our brain that allows us to think, to plan, to follow through with those plans, to be creative. And my front knuckles are the prefrontal cortex right here, which is where all that executive functioning and smart human stuff happens. And the cortex is so important, but it's super slow compared to the lower parts of our brain, those subcortical parts. And I'm telling you all of this right now. It seems like it doesn't relate, but it does. Because when we experience stress and trauma, so before I experience something scary or stressful, we're going along, all the parts of our brain are together, they're functioning, they're talking to each other. If I'm startled, say I hear a loud noise, your lid flips, your cortex goes offline so that these lower parts of the brain can be really, really quick and help me decide: is that a threat? Is it just a random noise? Did someone drop a book or do I need to go run? Um, and once I figure out, okay, that sound, it was just someone dropped a book, my cortex can come back online. I can kind of integrate all of that, realize I'm safe, that I'm here now with you, and then we can move on, right? So this answers your question because especially when people are experiencing stress and trauma over and over again, which so many of us do, our lid is constantly flipping. We don't get to always do that integration process, and our lid flips more easily. And so we're constantly in this heightened sense of stress and always looking over our shoulder and overwhelm.

SPEAKER_03 13:07

Yeah.

SPEAKER_02 13:07

And so learning about all the different kinds of therapy that's out there is important because if someone is constantly stressed and they don't have supports, they don't have the context in their life to do perhaps deep work, they're gonna need something that's more structured, probably at first to help lift them up to bring in those supports. Then, and you talked about in the beginning, that kind of heart and head connection or disconnection. Once we get some of those supports in, once that person can learn about what's happening in their brain and body as a result of stress and trauma, that's when we can oftentimes start doing more of that somatic work to help kind of connect the head and heart and to do more of the work that's going to target the subcortical parts of the brain, which is what EMDR and brain spotting do so beautifully. Wow.

SPEAKER_01 13:55

Thank you. I feel like I've just been to school. And also I've never, we've all heard the term flip your lid, but I've never heard it put in it like I'd never known why.

SPEAKER_02 14:03

Yeah. And EMDR and brain spotting are considered bottom-up um approaches, somatic approaches, somatic experiencing is another one in that, in that an IFS internal family system. So they are working more from kind of the body and these subcortical parts of the brain up towards the cortex versus top-down, which is going to be more of your cognitive processing therapy, DBT, dialectical behavioral therapy falls into this, which is more working kind of with those cognitions first.

SPEAKER_01 14:34

So, what types of issues is EMDR most effective in treating?

SPEAKER_02 14:39

Well, you know, it especially early on, it was developed to work with those big T traumas. And we talked about in the lightning run is this only for veterans or people who have experienced some huge major trauma in their life? So that was where a lot of the original research started. It's also easier to research those kinds of things as opposed to complex PTSD when we're talking about experiencing trauma consistently and chronically over the course of one's life. EMDR can work with any of those things. And even when someone comes in and they're like, I don't know, it's like everything's going fine in my life, but I just, I'm always doubting myself. I never feel like I'm good enough. And that's something that we can work on in EMDR as well.

SPEAKER_01 15:21

Well, that's good to know. Second most asked question are you hypnotized in an EMDR session?

SPEAKER_02 15:27

You're not. And so it certainly looks like it could be hypnotizing. And when we're thinking about a somatic and bottom-up intervention, it can be confusing because you actually are allowing access to the body. And with the bilateral eye movement, it can put you into almost a more relaxed or meditative state. But EMDR and hypnosis psychotherapy are different interventions. They both have their evidence bases and they are both effective for a lot of different things. But with EMDR, what we know now from the research is that the bilateral movements or stimulation is it's not hypnotizing you. It's actually kind of distracting your brain. So the technical term is it's taxing working memory. Okay. And so our working memory is the part of our memory. So we have long-term memory and short-term memory. And so working memory is that short-term memory. What can I hold in mind right now as I'm doing whatever it is I'm doing? So, like we're talking, I'm holding the question in mind that you asked me as I'm saying all of this stuff. And when it comes to working with trauma, a lot of times our brain just gets so flooded, right, by the memories, the somatic things that are coming up. And it's like it gets into this tunnel vision on whatever the trauma is. And with the bilateral stimulation, it helps to kind of break up that tunnel vision. It helps to allow for some movement of the things that are coming up and to distract the brain, to tax that working memory so that other things can start to come in. In EMDR, we talk about it's the adaptive information processing model. So it means in our brain, we have all of these synapses and they connect to anything that has happened in our life, any beliefs. And our brain knows how to heal itself. Just like when we get a cut, our body can heal the cut. Our brain knows how to do that too. And with EMDR and this adaptive information processing model, it's saying when we can open up that tunnel vision of the trauma and allow for some positive things to start coming in, that's how the healing begins. All of that's in the brain already. We just have to allow access to it. And so that bilateral simulation helps to open some of that stuff up over time.

SPEAKER_01 17:50

So the EMDR is not healing the brain. The EMDR is opening the door so that the brain can heal itself. Exactly. So for somebody listening who's a skeptic, and I always have to ask these questions because I'm very skeptical, not of this, of everything, but EMDR can sound like new age nonsense. Is there solid research supporting its effectiveness?

SPEAKER_02 18:10

Absolutely. And actually, that has been um a really important part of the EMDR International Association, Endrea, and the EMDR Research Foundation. So in psychology, it it's really hard to study a lot of the stuff that we do. And things like cognitive behavioral therapy, these really structured interventions are easier to study because we can control things, we can um have very structured kind of protocols and interventions. And it's easier to say that, well, this intervention from CBT caused this outcome because look at all the things that we could control, right? When we're looking at somatic and bottom-up approaches to work, which is more common not just in trauma, but throughout a lot of different interventions in psychology, you can't control all that stuff.

SPEAKER_01 19:01

Yeah.

SPEAKER_02 19:02

Right. And so I say that because for Mdria, the EMDR International Association, having an evidence base has been incredibly important to really, you know, validate the intervention, to show that it works and to help the public and providers know that this is a safe and effective way to work with and to treat trauma. That said, it's still a tricky thing to study because it is not such a clear and structured protocol. Well, sorry, let me take that back. It is a very clear and structured protocol, and yet the actual mechanism of change, the things that are going on, are much more difficult to actually, in a concrete way, kind of say that A is causing B.

SPEAKER_01 19:48

Is that because it's internal and in a talk situation? It's like, oh, I get it now, or you can say Yeah.

SPEAKER_02 19:54

I mean, so much of it is internal. Like we said during the lightning round, you don't even have to share anything about your trauma in order for EMDR to be effective. And in things like CBT, you know, we have all these worksheets, all these things are like written down and documented. And so you can see, well, well, see, look, we restructured this cognition. So they now don't believe this negative thing about themselves and their PHQ nine, their depression score is so much improved. And so that's kind of how that research and literature is describing itself. But in EMDR, if they don't have all of that stuff documented, then the skeptics out there say that there's no research base. One thing that a lot of uh a lot of the current research is moving towards is MRI and fMRI studies to understand more about what's happening in the brain. There's some really amazing literature coming out of the Netherlands, which is how we're understanding about this taxing of the working memory stuff because they can actually see in the fMRI what's going on in the brain during an EMDR session. And so that's really exciting literature and is really helping us understand why people are getting the outcomes that they do when it comes to EMDR.

SPEAKER_01 21:05

It is fascinating because I think it sounds and probably looks and maybe even feels. I don't know what word to use there, weird. I don't think people say that. But I have never heard of a therapy that more people have said to me, Oh my God, I did it. It was amazing. And I'm not endorsing anything because I'm not in a position to, but I'm really surprised every time I hear it. Like kind of every time I hear that somebody has tried it, they have a pretty good result.

SPEAKER_02 21:29

Yeah. I mean, and look, like Miley Cyrus, right? Like we've got all of these. That's what I was talking to. Yeah, she was here last week, right? No, it's it's really cool because there also are really big names and celebrities out there that have done EMDR and have helped to make it more of a household name, which is incredible for people who have been stuck because of the things that they have experienced in their lives. And one of the biggest things that I hear from clients is just like what you said at the top. I get all the things. I understand why I feel the way that I do, but it just I can't, it doesn't change. So that head-heart connection, it feels like it's severed. And so that's why the bottom-up approaches are so important and are really the up and coming in trauma therapy because it is finally bridging that divide.

SPEAKER_01 22:22

How do you as the therapist or me as the client know what has changed as a result or if in reintegration has happened?

SPEAKER_02 22:31

Yeah. So something my clients ask me a lot is, you know, when am I going to be over my trauma? And then they get pissed off to me off at me because I tell them there's no finish line. I understand. But I say that because it there is no finish line, right? Like we're always living our lives and going through things. And even when we work on a specific trauma and it feels further away, it feels like it has less control or impact over us. Who knows? There could be some weird thing that happens tomorrow that brings it back up again. And even when there's no finish line, there are so many important milestones along the way. And so it's important to be really clear about what are your goals for doing whatever the therapy is that you're doing? What is it that you're wanting to get back in your life? A huge thing that I really focus on with the people that I serve is how can we get you back to a quality of life that is something that is serving you, that you are able to live your life again, whatever that looks like. And instead of when am I never going to be bothered by this thing compared to when can I begin living my life again?

SPEAKER_01 23:46

So walk me through this. What if I come to you and I say, I want to try this, I just, and what is a what is a good thing to fill in that blank of I just, is there a common scenario that people come in for? Is it should we say bullying? Sure. Okay. So so I have the the feelings I have and the the trauma I have and the memories I have of having been unsafe in my school experience. I'll say it was school bully. I come to you, what happens now? Like, what am I gonna what's gonna happen?

SPEAKER_02 24:16

Yeah, totally. So we talked about the three prongs and the eight phases.

SPEAKER_01 24:20

You did.

SPEAKER_02 24:20

Um, so the three prongs are past, present, and future. And typically we start with the past stuff because what happens in the past affects how we're feeling right now and is going to affect future things as well. And so within that, there's then the eight phases. And the eight phases starts with the intake. So that's kind of phase one is I gotta learn um about your history. And so I weren't want to learn about the bullying you experienced and also perhaps other things that may have happened that have been stressful in your life as a kid and up until I know you right now, because our experiences are a network in our brain. And so when you think about all of the things that we've gone through, um, let's just say you were bullied. So there's gonna be this kind of bullying center in your brain, and maybe there's all these different offshoots of these major memories. They might also overlap with now at work, you're having difficulty with someone and you feel like they're bullying you, but then that also connects to some other trauma, right? So this is the adaptive information processing model where it's this whole network. And so I want to understand what are the stressful and traumatic things? What are also the positive and supportive and resourcing things in your life? Because we want to be be bringing those two things together so your brain can do the healing on its own.

SPEAKER_01 25:38

Okay.

SPEAKER_02 25:39

Once I collect that information, and that might take a few sessions, then I'm gonna start in phase two to start working with you to teach you what we call resourcing. And that's really teaching you a lot of the coping skills, the different strategies and interventions that we use in EMDR to help regulate our brain, body, and nervous system. So some of these include uh like calm place, or sometimes it's called safe place, but for a lot of people, there's no safe place. So a lot we've often moved to calm place or peaceful place. This is somewhere that you can go in your mind where you feel even just a little bit more calm, neutral, or grounded. Um, it can be a visualization if your brain thinks in pictures. Some people are not able to think in pictures. And so it is whatever happens in their brain that helps them to feel calm. It could be words or other things that come up. We also have something called the container, which is a really cool intervention that can help us to contain those triggering things, those images, those sensations, those thoughts, uh, and really kind of hold those in an imaginary container so that we can work on whatever we need to be working on without all of these intrusive things getting in the way. Lots of other kinds of resources. That's also somewhere where we start to introduce some bilateral simulation. So when we're talking about bilateral simulation, again, it can be eye movements, it can be tapping, it can be sounds, it can be any combination. Oftentimes with resourcing, we're using slower bilateral simulation, but bilateral meaning both sides of our brain via our eyes? Uh, either via our eyes or via tapping or through the ears. Okay. Um, but yes, we're kind of we're accessing and we're we're stimulating both sides of the brain. And when we're resourcing, a lot of times we're doing slower bilateral. So a common tapping one is called the butterfly hug. And you put your hands like this and you tap on your chest. So when you're going slow, that's naturally kind of feel like even I just slowed down the pace of my talking, right? Um, and so a lot of times for resourcing, we're doing slower bilateral, whereas when you get into the reprocessing, we're doing quicker bilateral stimulation.

SPEAKER_03 27:52

Okay.

SPEAKER_02 27:52

Um, and so that whether that's quicker tapping or a lot of times eye movements are literally going this quickly, we're following the fingers. So phase one intake, phase two resourcing. Once we um once the therapist and the client decide, okay, we we've got enough resources on board. And that can be both through complex container, whatever, and also thinking about those contextual things. Like, is this person in a safe enough environment? If they're currently experiencing active trauma, then we're not going to be moving on to reprocessing because we need to make sure they're physically and emotionally safe.

SPEAKER_04 28:29

Right.

SPEAKER_02 28:29

Do they have the resources? Can they go and make groceries? Like, can they actually afford to feed themselves and their family? Right. Then phase three is something that we do anytime we're setting up a target. And so phase three consists of these seven magic questions. It helps to really turn on the whole neural network in our brains. And so we decide what is the target? What's the memory? What's the thing that we're working on?

SPEAKER_01 28:57

So in our example, the targeting is the bullying.

SPEAKER_02 29:00

It could be a specific bullying situation from childhood, um, whatever it might be. So we're gonna, what's the memory? What's the image that represents the worst part of it? What are negative beliefs that come up about yourself as it relates to that memory? What would you like to be able to believe about yourself? How activated, zero to 10, how distressed do you feel? And how strongly do you believe a lot of these beliefs? That's and that's a pretty quick kind of check-in before we get into phase four, which is the reprocessing.

SPEAKER_04 29:32

Okay.

SPEAKER_02 29:32

Interestingly, Francine Shapiro later said that if she could go back, she would have actually removed all of the eye movement desensitization stuff and just called it reprocessing therapy. And at the same time, when people think about EMDR, they think it's only phase four, which is the reprocessing. Yeah. Um, but once we've turned on the neural network, then we can start to do the bilateral simulation, that reprocessing work. And a lot of that, it's like this beautiful dance where we do phase three, we turn on the neural network, and then we just say, okay, notice what's happening in your brain and body and go with that. You're just gonna follow with your eyes or you're gonna start tapping, or whatever it might be. We have buzzers, and you just sit there and notice it. And then at a certain point, there's not a hard and fast rule here. This is where some of that research criticism comes in. At a certain point, the therapist will pause, ask you to take a breath, and then just notice what's happening right now. And you can share as little or as much as you want. We don't want a ton of talking in between these sets, we call them, in between the bilateral sets, but kind of quick check-in, what are you noticing right now? Go with that. And in the standard protocol, it's a pretty open-ended process right here, where we just want to see what the neural network is bringing up, what is the brain and body starting to surface from this bottom-up approach from these subcortical parts of the brain? When it comes to more complex trauma and a lot of things that can potentially happen, there are of course adaptations here. And we can add in some more kind of containment or supports. But in general, we want to let the brain heal itself. Over time, even just in one session, doing phase four, doing the bilateral, checking in, noticing that the distress in a typical kind of standard session, it'll oftentimes go up and then it'll start to come down. And it's important to move through that beginning, middle, and end, as opposed to in life, a lot of times we'll start to go up and then we want to hit the escape button to get out. And then that just proves to our brain and body that whatever we think is dangerous actually is. And so that's where that relationship is so important too. We talked about you don't want to do EMDR on your own because having that therapist there to be with you and your emotions in this process is absolutely critical to the healing. Once that distress starts to get lower, we kind of aim for a sud-score, subjective units of distress score of like zero to one, maybe two. Then you can move on to the next phase, phase five, which is where you kind of start to check in with that positive belief that you were wanting to believe about yourself.

SPEAKER_01 32:26

Okay. And give me an example of what that might be in a situation where we're talking about bullying in school.

SPEAKER_02 32:32

Yeah. So with bullying, a lot of times it ends up in a negative cognition. We use that term in EMDR of I'm not good enough.

SPEAKER_04 32:38

Yeah.

SPEAKER_02 32:39

Uh so perhaps the positive cognition, the PC is I am good enough or I am worthy, right? And so then we start to check in. Okay, so tell me on this other scale from one to seven, how strongly do you believe that I am good enough now? When you think about that bullying thing we started with and these words, I am good enough, how strongly do you believe it? And we want to get that number, it's a one to seven scale there. We want to get it as close to seven as we can while holding in mind whatever the target is that we started with. Then, and if we need to, we can go back and forth between the phases here, right? And then once we get a strong, um, it's called the VOC score, validity of cognition for the for the positive cognition, once we get that to a six or seven, then we drop into the body as kind of the final kind of check and clearing. Okay. So this is phase six. What do you notice in your body? As you think about that thing we started with that we've kind of worked through in phase four. What do you notice in your body?

SPEAKER_01 33:40

And if before I got like wound up and maybe sweaty or my heart was beating, now I'm likely to be feeling.

SPEAKER_02 33:48

Who knows? You might be feeling whatever you're feeling. And when we start that body phase, phase six, there's no judgment. You're just feeling whatever you're noticing in your body. Okay. And so then um, in phases five and six, we're also doing bilateral simulation sets. And so let's say you're like, I don't feel quite as tense and as sweaty as when we started, but I still feel it there. I I notice it. Okay, go with that. Just notice your body, right? And so again, we're looking for a lot of this beginning, middle, and end stuff.

SPEAKER_04 34:20

Okay.

SPEAKER_02 34:20

Once we kind of get that to I feel calm and regulated in my body, then we move to phase seven, which is where we kind of wrap up the session. And then phase eight actually starts in the next session where we check in on how do you feel since the last session. Okay. So that's sort of like the picture perfect sequence of it. But it doesn't always go that way, right? Especially in a 50-minute session, it's hard to get through all of that. That's why therapy intensives are becoming so much more widely used, because if we can have three hours or even three hours over the course of a few days back to back, think about how incredible and how powerful that work is. And even when we're working within the medical model and we have a 50-minute session, um, if we don't get through all of those, you know, phases uh three through through seven or three through six, let's say you're still in phase four of that reprocessing and you're at minute like 40 or 45 of your session, it's okay to stop there to introduce some resources to say, okay, we're at the end of our session. Let's bring in our container, for example. What do you want to put in your container to really hold on to, to kind of protect so that you're not carrying it out of the session with you today? Um, and sometimes even therapists, it can be really powerful for the therapist to say, like, I can keep your container here in my office, right? And so we're helping to regulate the client as best as we can to wrap up the session so that they can walk out with their head held high. Now, then it comes to the question of the hangover. Depending on what they're working on, the brain is going to keep processing whatever you did in that session for the next 24 to 48 hours. And that's actually one of the beautiful parts of EMDR is that it's not confined to just those 50 or 90 minutes or whatever it is. Your brain keeps doing the work.

SPEAKER_04 36:09

Okay.

SPEAKER_02 36:10

And so we don't have to have homework, we don't have to have, you know, stuff like that. And part of that, especially in the next day or two, for some people after some sessions can be a bit of a hangover, but not always. A lot of people feel great or they're they're regular, they're normal after an EMDR session. And so everyone's gonna be different.

SPEAKER_01 36:31

Okay.

SPEAKER_02 36:31

Wow. Thank you for that walkthrough.

SPEAKER_01 36:33

It's a lot. It's also it's really good because I do just think of the the wizard space for. So does EMDR make you relive the trauma?

SPEAKER_02 36:43

It depends. It really depends on what you're working on and how your brain and body work. Okay. So for some people, and with complex trauma, it can be anywhere and all over the map. But let's just say there are some people who they don't have a lot of clear, concrete memories of the trauma they experience, but their body very much reacts. And so it may not be that there's pictures and images and thoughts that are coming up, but their body is activated. They are dissociating, which is a very common and normal thing. We all dissociate. There's nothing wrong with dissociation. And if we're dissociating really intensely and all the time and we're missing out on our life, it can be dangerous. Their body might be reliving it, but they may not have clear memories that they're working on in that session. Also, people can absolutely and they do have flashbacks when they're doing trauma work. And so it's a spectrum and it depends on what you're working on. It depends on the how resourced you are in any given moment, depends on the therapeutic relationship and how the therapist is able to be with you in that work and hold that work alongside you to not freak out or to pathologize normal reactions to abnormal experiences of trauma and stress. And so I'm not ever gonna say you're not gonna be triggered, you're not going to re-experience things. And yet, EMDR is such a cool intervention because you can share as much or as little with me, the therapist, and still have really powerful and profound outcomes. Because I know the whole story? Because your brain and body knows it. I don't have to know it.

SPEAKER_01 38:28

Okay.

SPEAKER_02 38:28

And interestingly, then, for the therapist, that's actually kind of really protective. There's some cool research out there, specifically about EMDR, about how EMDR can help protect therapists from things like vicarious trauma and secondary traumatic stress. Therapists are going to experience vicarious trauma. That just is something naturally that happens because the pathway of that is empathic engagement. And so when you're supporting someone, your brain and body is going to soak it up. Vicarious resilience is the other side of that, where you also get to soak up all the glimmers and beautiful stuff. And when we are using treatments that work, whether that be in trauma or OCD or depression, whatever it might be, when a therapist is trained, when they have the skills and the interventions that work, that protects the therapist from burning out. And so EMDR, it's cool to see literature out there that's saying this is actually helping to protect the therapist, not only because the client doesn't have to share every gory detail like they do in some interventions, and also because the therapist gets to see people get better.

SPEAKER_01 39:31

So is EMDR better than regular talk therapy?

SPEAKER_02 39:38

That's a complex question because they serve actually different purposes. So EMDR is a targeted intervention for stress and trauma. There are also now variations of it for things like OCD, lots of different stuff. But it is a targeted specialized intervention. And talk therapy is not. So it could be an EMDR therapist or an OCD specialist that's for whatever reason at the top of mind today to do some really specific work for a certain number of sessions. And so their client can see both of those therapists at the same time because they're doing very different interventions. And so the talk therapist can do that supportive weekly kind of touching base. Here's how things are going and stuff like that. Whereas the specialist can come in, has that surgeon, right, with the scalpel and actually do that focused work while then returning the client back to their talk therapist.

SPEAKER_01 41:06

Okay. So when you use the phrase targeted therapy, what if the client is not clear of the target? You know, it's not this happened when I was this old or or for a long time if it's a complex trauma, but it just uh, you know, you sort of brought up the example of I don't know what happened, but I'll tell you what it did to me. You know, I am so insecure or I am so afraid all the time or whatever it might be. Is EMDR effective in that situation too?

SPEAKER_02 41:36

It is. And for clients and also for kind of more traditional talk therapists, that can actually be a really good indicator that they want to bring in an adjunct specialist because the whatever work it is that they're doing and that they're working on, what will happen with that is it starts to feel like they're kind of stuck in these loops, right? They're doing really important work through the talk therapy, but it's like the same thing keeps happening or coming up over and over again. It seems like they're always working on the same thing. And there may not be a really clear, like this is causing this looping or this getting stuck in therapy. Yes. But the talk therapist is likely aware that there's been some kind of stress or trauma or adverse experience in this person's life. And it can just be a great time to look for a specialized trauma therapist to come in and do some work on that. And it can be as simple as, hey, my client's really stuck. We're not really sure why, but they keep having these difficulties in relationships at work. And they just they're they keep getting fired and they don't know why, and they just can't keep a job. And that can be exactly what you start out with when you begin something like EMDR or a targeted treatment of like, just keep having these problems and relationships. And what image could comes up for you about that? What negative cognition, what happens in your body, all that, go with it. Let's see what happens.

SPEAKER_01 43:01

Is there a risk to doing it? So I want, I love the idea, and it's like, oh, I would just like to what feel better about myself. And then I say, okay, I'm gonna try this. Is there a chance? I don't know what. What is the risk?

SPEAKER_02 43:15

Well, when it comes to risks, so you know, anytime you're doing trauma work, it's probably gonna be hard and emotional. Also, though, our brain, uh, when it comes to dissociation, our brain is so incredibly powerful and it's such a beautiful superpower that our brain has to disconnect from the scary and awful things that happen to us in our lives. And at the same time, when you start to do trauma work, especially if you're someone whose brain and body has really learned how to dissociate and disconnect, go with that might mean that some scary stuff starts to come up and to resurface. And so uh perhaps looking for an EMDR therapist who also is able to talk about how they understand dissociation, how they don't pathetic. Pathologize it, how maybe they're actually a specialist in dissociation. Uh, so that when those things naturally begin to come up, it doesn't have to be this flooding flashback, but can be normalized, can be supported in the therapeutic relationship, and can really be able to work with and through those things instead of having it be a re-traumatizing experience.

SPEAKER_01 44:22

Another top internet question. Can I do E, and we talked about it a little bit in the lightning round, can I do EMDR on myself at home, given that there are plenty of videos online that show me how?

SPEAKER_02 44:33

The short answer is no. The more comprehensive answer is it depends. Uh, there's parts that you can do. So especially when you've worked with an EMDR therapist and you've worked to develop the resources that we discussed in phase two. Those are things that we absolutely want people to be using outside of session. Once you have, and and you can learn a lot of the resources from YouTube videos. That's fine. Like go and look up Complex, like EMDR Complex, and start to work with a visualization that feels calming to you. Um, or learn how to like develop an internal container. Uh, those can be really great tools to use, but they are regulation tools. They are coping skills as opposed to the reprocessing. So you do not want to, there's actually apps that you can uh download on your phone that will have a little ball that bounces back and forth on the screen to technically help you do bilateral eye movements, but doing that outside of the context of a trained therapist and without that supportive therapeutic relationship and attachment relationship can be dangerous. There are absolutely risks to that because if you get really triggered and flooded, what are you gonna do?

SPEAKER_01 45:51

Right. All right, another top question. Does EMDR work for anxiety and depression?

SPEAKER_02 45:57

Yeah, absolutely. That's a lot of the more emerging literature and research. And we have, we call it the standard protocol. So that's what I described earlier. And then there's lots of variations on that. And so, like I've mentioned OCD, there's different protocols for OCD. There are specific protocols for substance use and abuse. There are also applications for anxiety and depression. Also, oftentimes anxiety and depression are an offshoot of stress and trauma. So, you know, we all experience trauma in our lives, whether it is little T, big T, anywhere in between. There's no such thing as the trauma Olympics. All of our lives are ours and we're it's okay that we're affected by things. And at the same time, anxiety and depression are then the manifestation of how our brain and body is trying to cope with things. So depression, it feels awful, right? But it's our body trying to decrease the activation of whatever's happened. Yes, they're absolutely like serotonin and other neurotransmitter things that are going on, but it also is your brain and body trying to slow down all that activation to disconnect you perhaps from um experiences that could be re triggering. Anxiety, on the other hand, is how can I control everything so that nothing bad ever happens again? Experience both. I mean, and I'm biased because I'm a trauma therapist, but all roads lead back to stress and trauma. And it is our brain and body trying to adapt to that and trying to figure out how can I keep getting through this world in a way that uh doesn't feel so triggering and activating all the time. And then it turns into these things in the DSM that we have other words for.

SPEAKER_01 47:46

So anxiety is often described as a fear of the future. How does a therapy that's focused on reprocessing the past help someone regulate themselves in an anxiety situation?

SPEAKER_02 47:57

Well, we're trying to control the future because of what's happened to us in the past. And so EMDR absolutely is going to help reprocess that past stuff. But remember, there's the three prongs. So there's the past, present, and future. And so it can get very complicated. But those eight phases can be applied to the past, to the present, and to the future. And in kind of the perfect world of the standard protocol, that's exactly what you would do. So you start with that bullying that happened to you in middle school. Then you work on once that's been reprocessed, whatever that kind of looks like or means, because everyone is different. Once you're ready, then you can process how that's showing up at work right now because you feel like everyone is just against you and is bullying you and ganging up on you at work. And then the future stuff is really cool because there's a whole um, it's it's a script essentially, but it's called the future template. And so then you can imagine well, so next time your boss is giving you some feedback, how do you let's imagine what that's gonna be like and how you want your brain and body to respond to that, right?

SPEAKER_01 49:12

And recognize it not as bullying, exactly but as feedback. Exactly.

SPEAKER_02 49:16

And so recognize that this is your boss, and this is assuming this is a uh, you know, a nice boss, like not someone who's mean and toxic, but this is your boss trying to help you grow through this constructive feedback as opposed to bully you. And so when when it comes to anxiety, that's exactly what our brain wants, right? And then depression, a lot of times we think about that as we're kind of getting stuck in the past. And just it's like that that we're like a blob and just like a bag full of sand, just stuck in the past. And so it also then can help to be at motivating and energizing in those ways to move through some of that.

SPEAKER_01 49:54

You have any openings this afternoon?

unknown 49:56

I know.

SPEAKER_01 49:58

So if you've said the importance of finding a certified EMDR therapist, is there a difference in effectiveness between doing that in person or virtually?

SPEAKER_02 50:09

Really, no. So I don't know specifically if there is research on EMDR of in-person versus telehealth. Um, but in general, the literature, when we look at therapeutic outcomes across a number of different interventions and presenting problems, outcomes are the same for telehealth and in-person. And, you know, in a post-COVID world, we're in this interesting situation where now really it's more about personal preference. So there are going to be people who would prefer online because it's much more convenient, right? They can kind of do it anywhere, all of that, um, versus in person because for a lot of folks who want in person, they want this, right? They want to be physically in a space with someone. But that doesn't mean most of my practice is online. My clients and I have incredibly deep connections. We can feel each other through the sc through the screen. We are so connected. And so the outcomes are the same. And it's okay to have a personal preference. That's good to know.

SPEAKER_01 51:19

If you are looking for additional reliable information on EMDR, we will include a link with this episode to recovery.com's resource hub. And we've got several medically reviewed articles on eye movement therapies, as well as the opportunity to look for different treatment options for these kinds of therapies. And there are more than 4,000 treatment centers I put in, you know, EMDR, and that many came up, which is great. And we will be back next week with Dr. Jenny Hughes. This time we're gonna do an exploration of a related but different brain spotting therapy. Thank you for joining us, and please come back.