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What Does EMDR Actually Do?
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Hello friends! This episode features Cassandra and Garth, as they talk about what EMDR actually does, how EMDR therapy works, and the science behind why trauma memories can feel like they’re happening in the present rather than the past. They break down concepts like dual awareness, bilateral stimulation, and the leading theories researchers have about how EMDR helps people reprocess traumatic memories and reduce distress. You can learn more about Cassandra and her practice at: seentherapy.org. Get a taste for the episode below. If you enjoy your listen give us a follow, share, or five star review. Have a good one!
“EMDR allows someone that has not previously been able to do so acknowledge that a trauma occurred in the past for them and that they exist in the present.”
Hello, hello, hello friends. Welcome to the podcast where we simplify everything about mental health. Just kidding. But here's what we are gonna do. We're gonna sit down together, a licensed mental health professional, Batsman, and a regular old Joe, as my husband Garth would describe himself. We're gonna talk about the nitty-gritty of the MBR, some nervous system mapping, how couples can help each other heal, what healthy parenting actually look like, maybe a little bit of good old banter mixed in. All with the goal of making mental health a little bit simpler for you. Which no, because my lawyer says that I have to. I'm a therapist, but not your therapist, unless I am. Even if I am, this is still just a podcast, okay? Have a good listen. Hello, friends. This is Cassandra. As always, I am joined by Garth.
SPEAKER_01Hey everybody.
SPEAKER_00Thanks for being here, sir. We appreciate you.
SPEAKER_01I live here.
SPEAKER_00Playing the average Joe.
SPEAKER_01Yeah, that's me.
SPEAKER_00You refer to yourself often. Okay. What are we talking about today? We are talking about what does EMDR actually do. And in talking about what EMDR actually does, we're going to talk about how it actually works. So the really short version of what does EMDR actually do? EMDR allows an individual to hold dual awareness when they have not previously been able to. What does that mean? EMDR allows someone that has not been able to previously do so acknowledge that a trauma occurred in the past for them and they exist in the present. It allows them to integrate that information to go back as a result and desensitize the distress that they had assigned to these trauma memories because they are not as distressing if they are not a current threat. It allows them to reprocess the core beliefs that they had about themselves and the world around them as a result of these trauma memories. Bam.
SPEAKER_01Oh, so it does therapy.
SPEAKER_00Yeah. That's what EMDR does. But I think whenever people ask, what does EMDR actually do? Which is a question that we get often and a question that people are turning to Google for often. I think what they're really asking is how does it work? What what's actually happening? What's actually going on? So that's what EMDR does. EMDR allows someone to realize that a trauma has happened in the past. That's really like the core of it.
SPEAKER_01Well, and until like the the deep, deep part of their brain that that was in the past. Yes. And it's not right now.
SPEAKER_00It is not occurring right now. That doesn't mean that it was wasn't a bad experience.
SPEAKER_01For sure.
SPEAKER_00That doesn't mean that we're okay with it happening. It just means it's no longer happening. It's no longer relevant to our survival.
SPEAKER_01Then the underlying anxiety and stress that comes with feeling like it's happening right now can go away.
SPEAKER_00Yeah. Yeah. We can let that go. Yeah. Because it does not pose an immediate threat to us and need more. Cool. So that's what it does. And how what does it actually do? But how do we actually get there? So that's more of what we're going to talk about today. Okay.
SPEAKER_01Good. Good.
SPEAKER_00Before we dive into that.
SPEAKER_01Oh, I thought you'd forgotten.
SPEAKER_00What's our band?
SPEAKER_01What is your favorite woodland creature? So this must be a forested creature.
SPEAKER_00Hmm. What first came to my mind was a chipmunk, but you know, as a kid, I used to build like little front porches for squirrels.
SPEAKER_03Yeah.
SPEAKER_00This is my like little thing for like two years.
SPEAKER_01By front porches.
SPEAKER_00Yeah.
SPEAKER_01Elaborate on that for the for the audience, a smidge.
SPEAKER_00I I mean, it was I I think you're wanting me to elaborate because you think it was elaborate. They weren't like huge front porches, but they were what's the word I'm looking for? There was it was a lot of detail.
SPEAKER_01People might be wondering, but squirrels don't live in houses. How do they have front porches?
SPEAKER_00Sure. So I would find trees that I had seen squirrels frequent. And this is just like really giving you a peek into who I was as a child. So I would find trees that I had seen squirrels frequent, and particularly if there was some sort of like hole at the bottom of the tree or something that indicated that the squirrel was like burrowing into the tree. That got me really excited. I would build out a little porch.
SPEAKER_01I'm not sure that's ecologically what's do squirrels burrow into trees?
SPEAKER_00I have no idea.
SPEAKER_01Yeah, but little kid you was like, they certainly do. It must be in the front door.
SPEAKER_00And so she built some pretty cool front porches.
SPEAKER_01Love it.
SPEAKER_00How about you?
SPEAKER_01Man. So I'm excluding, I don't think we've talked about favorite animals on a pant. We have okay. So mine's out there. It's an otter. I'm excluding that because an otter is not a woodland animal. Okay. It is a semi-aquatic mammal.
SPEAKER_03Okay.
SPEAKER_01So I guess my favorite woodland creature is probably an owl. I love owls.
SPEAKER_00Yeah, I think we maybe have talked about that as well. Yeah.
SPEAKER_01Mm-hmm. But gotta be an owl.
SPEAKER_00Can you give us a brief why on the owl?
SPEAKER_01Or who? No, that was bad. I just I think owls, you know, I I enjoy mythology and folklore and the surrounding things like that. And owls kind of have this duality of being a very wise creature. And also sometimes they're like a supposedly an omen of like bad fortune to come. You know, they've got this slight like association with darkness a little bit, um, because they're nocturnal, is what I say. Yeah. But I just I think they're they're just they're wise creatures, and I strive to be wise in my life.
SPEAKER_00Okay. As our four-year-old would say, it's a night animal, and nine animals are cool. That's part of it. She's not wrong. She's not wrong.
SPEAKER_01She's not wrong.
SPEAKER_00Okay. All right. Our favorite woodland creatures. There you have it, folks. All right.
SPEAKER_01You can tune out now.
SPEAKER_00All the good stuff is over.
SPEAKER_01No, we got good stuff. We got good stuff to have.
SPEAKER_00All right. EMDR, how does it actually work? So we've talked about how, or no, no, I'm sorry. Let me back up. EMDR, what does it actually do?
SPEAKER_01We talked about that. What does what does it do?
SPEAKER_00What does it do? EMDR allows us to hold dual awareness that we are presently safe and that trauma occurred in the past. Okay. If I have unilateral awareness, all things are happening at once. Well, then I'm not very safe.
SPEAKER_03Right. Right.
SPEAKER_00If I have the ability to separate those two realities that this occurred and I am now, I have now reached safety. Yeah. That makes all of the difference. It's kind of like a domino effect. That happens, then this doesn't have to be as distressing to me. Then I can start reprocessing what I believe about myself and the world around me. Okay. So that's what EMDR does. But how does it do that? And again, I think that's the real question that people are asking. How does it actually do that? All right. Here's what you need to know. EMDR is endorsed by the World Health Organization and the VA. It's used widely worldwide. We still argue about whether or not the eye movements in EMDR are actually doing anything. Does that matter?
SPEAKER_01Well, we give you something to distract yourself while you're thinking. I find that helpful. Okay.
SPEAKER_00But goodness, you derail us. It's it actually it is helpful. That's what I do. I know. Yeah. Because we're going to talk about that here in a minute. Okay, so outside of there being criticism of eye movements or bilateral stimulation through eye movements, there's also criticism on just how EMDR is working in general. Like what is the actual mechanism? And we don't completely know. That said, there are tons of things in healthcare where we don't know the exact mechanism. We have theories, right? We didn't know for years and years and years and years, like decades, how aspirin worked. And we still used it, and we still saw, you know, pain relief for patients whenever people used it, right? So, like, yeah, we don't know the exact mechanism. We do have an idea, and I want to talk here in a moment about a a front runner, like a mechanism that's kind of pulling forward of the four theorized. And at the same time, yeah, we don't know exactly what behind it is making it work. And again, that's very common in healthcare. Yeah. Like very, very common. It is there are two different, it's two different things to say we can see that there is, you know, a benefit. I'm trying to think of how to put it this in plain language. We've done tons of research that very clearly indicates that EMDR is helping people to get better. We are doing research to make it clear what mechanism is allowing that to happen.
SPEAKER_03Yeah.
SPEAKER_00We are not definitive on that. It is, however, clear that EMDR is helping people get better.
SPEAKER_01And it doesn't hurt people.
SPEAKER_00Yeah. Those two things can exist, right? Like where we know that it's helping people get better and we don't know exactly how. Yeah. So I want to address first criticism of bilateral stimulation or eye movements. And I'm just going to really quickly address this one. I'm not going to get into the research on it, though we can do that, but I'm not going to dive really deep into that. I'm just going to talk about anecdotally my experience as a therapist. Yeah. I have a lot of people who come in and they want to do developmental work, which means they want to work on their entire trauma history, right?
SPEAKER_03Yeah.
SPEAKER_00Their entire history, really. And they walk me through pretty significant pieces of that. They talk about pretty significant pieces of that because they want to. And they don't have a lot of symptom relief from that, if any. And then we do EMDR and they do have significant symptom relief. Right. So the eye movements are doing something.
SPEAKER_03Yeah.
SPEAKER_00Right? Like and that like I have a lot of people. Now I have some people who come in and they're like, I don't want to speak a word of this to you. Fine. Right? Like a word of the trauma. They don't want to speak a word of the trauma to me.
SPEAKER_03Yeah.
SPEAKER_00Cool. But I have a lot of people who verbally walk me through significant portions of their trauma without any significant symptom relief. Then we do MDR and they have significant symptom relief. So explain that to me. Again, we could dive into the research on that, but I'm just telling you anecdotally, I've been doing this for a decade. There is a difference. Okay. Any questions there, average Joe?
SPEAKER_01It sounds like you gotta move your eyes, people.
SPEAKER_03Yeah.
SPEAKER_01Yeah. So I've got all sorts of like crazy theories as to why it would work, but this is not the place for those.
SPEAKER_00Okay. The crazy theories as to why EMDR works? Yeah. Yeah. We'll avoid those. Let's not.
SPEAKER_01But I can I I'll I'll share an anecdote that I have about just bilateral stimulation.
SPEAKER_02Okay.
SPEAKER_01Because it it doesn't have to be eye movements, right? It bilateral stimulation by definition means you're activating both sides of your brain.
SPEAKER_00Yeah, but there is a lot of research that eye movements are the most effective form of bilateral stimulation.
SPEAKER_01Well, I was just gonna say, like, I think a lot better when I'm walking or like when I'm doing something with my hands, like, you know, just it just my brain works better.
SPEAKER_00Bilateral stimulation is yeah.
SPEAKER_01Okay.
SPEAKER_00Doing something for you. Man, you're pulling me into the weeds tonight.
SPEAKER_01Nope. Back on track. Let's get back on track.
SPEAKER_00All right. Just real quick, since you took us there, I quick piece of research. Like, there is a lot of really valid, well-done research. Like, there's a meta-analysis with like 15 clinical trials that compared traditional EMDR, so with eye movements to EMDR without accompanying eye movements, and found that the effects I've for eye movements was significant.
SPEAKER_01So you gotta move your eyes, people.
SPEAKER_00Yeah, I mean hopefully you have the ability to do that, right? Yeah. Okay. Make love. Sometimes you really move us along, and sometimes I feel like I'm a train that you're trying to derail me into your time. Okay. It's part of my charm. Are you ready to hear about the proposed mechanisms? Oh, I'm ready. Okay.
SPEAKER_01Propose some mechanisms.
SPEAKER_00Okay. Can I tell you the one that I think is pulling ahead first?
SPEAKER_01Tell me.
SPEAKER_00Okay. Working memory taxation, I think, is the mechanism that's pulling ahead the most. Eye movements tax working memory capacity. When you're following bilateral stimulation and holding a traumatic image, working memory gets overloaded. It reduces the vividness and emotional intensity of the memory. It's like, you know, trying to rub your belly, pat your head while reciting the alphabet. Um, something's gotta give. I will explain to clients my attention is fully on you until the building's on fire. When the building is on fire, my attention is completely shifts from like conversation with you to how do I get you and I safely out of the building. I will absolutely not be distracted from that. I'm not gonna suddenly think of my grocery list as I'm trying to get us out of the burning building. So I do think there's something to when the working memory is taxed, it does indicate to the brain that we are not in crisis. Um, and second theory as to what mechanism is working, we are mimicking RIM sleep. Bilateral eye movements, similar to rapid eye movements during RIM sleep, allow us to naturally process emotional experiences. EMDR is maybe hijacking this natural process system and helps us to integrate traumatic memories. Third theory is that we are communicating through both hemispheres of the brain. It activates both hemispheres of the brain and allows stuck trauma memories in the right hemisphere to utilize. I think is probably the most appropriate word that I can think of right now, the left hemisphere, in order to help process and contextualize that memory. And then the fourth mechanism, neurobiological changes, research has found that bilateral stimulation leads to clear and persistent decrease in fear behavior and increased neuron activity in again, trying to kind of make this easy language in the most like thinking parts of our brain rather than the most like safety reactive parts of our brain. So literally kind of like calming down the fear center of the brain. Yeah. Is that language that makes sense? Okay, because I don't want to get into like what are amygdalas doing, what are you know basolateral nucleus within the amygdala is doing? That's gonna get really confusing really fast.
SPEAKER_03Yep.
SPEAKER_00Okay, so calms down the fear center of the brain, increases activity in the thinking part of the brain. Okay, so those are the four theories of the four mechanisms. Now, here's another proposal. I think research for memory taxation is pulling ahead, right? Dual attention is an is other terminology that you might hear there if you're a clinician and you're looking through research. So memory taxation, dual attention. What if it's a piece of all four?
SPEAKER_01Well, that's what I was gonna say is or it's all of them to some degree, and maybe it varies by from person to person, what's actually going to be.
SPEAKER_00I don't know about varying significantly person to person. I don't think that that's probably it though.
SPEAKER_01I have no training or no idea what I'm talking about. Disclaimer.
SPEAKER_00But I do wonder if the domino effect that we talked about at the beginning, like uh especially like the last one, neurobiological changes, right?
SPEAKER_03Like, yeah.
SPEAKER_00Well, first of all, we know from really long-term studies that we've done that there are actually like neurobiological changes when you've done EMDR. But is that happening because one, two, three of these other mechanisms are working really well, right? Like, I I do think that probably all of these are at play to some degree. It's just who's the main player. I don't know. I wish there was a fifth one, because then we could say, like, what are the not that any position on, I'm bringing basketball into this now, not that any position on the court is necessarily more important, but we would maybe say that working memory taxation is like the point guard, right? Yeah, like their call on the plays, they're so then where is everybody else on the court? I don't know. And again, I will go back to we don't have to know. Now, I think we will know soon. Like, I think five years from now, I'm gonna be able to sit down and talk to clients about this in a really clear, assured way because there's gonna be research that supports it. Yeah, and we wanna know because we're gonna be able to optimize and innovate from there, like once we understand the exact mechanisms that are at play here. And before we know that, we know this is working. We know this is effective. Yeah, it's been around since the 80s. We have lots of research to back up how effective it is. And I can tell you anecdotally, it's effective, right? So do I want to know exactly what's going on? Yes, I think in the next five years we're going to, we're going to be able to, like I said, optimize and innovate from there. Yeah. For right now, I'm happy with what we know. So what does EMDR actually do? I'm gonna summarize really quick because we're already heading into a long episode as we typically do. What does EMDR actually do? EMDR allows someone to hold dual awareness that I am currently safe and that this thing happened in the past and it was a threat to me.
SPEAKER_03Yeah.
SPEAKER_00In allowing people to do that, it allows them to desensitize the memories that they've had that they now can recognize, not just think are in the past, but know and feel are in the past. And when I say no, I mean like deeply know in their body that this is in the past. They're allowed they're able to desensitize, which means they aren't reactive as reactive to those memories. And then they're able to reprocess core beliefs about themselves or the world because again, that happened in the past. It's no longer relevant in the way that it was. So that's what EMDR does. But how does it actually do that? Again, we're not a hundred percent sure. A little controversial that we're not a hundred percent sure. Yeah, but is it really that controversial? Because my aspirin example, we went decades and decades without knowing how aspirin worked. It still worked and it worked very effectively. And EMDR still works, it works very effectively. We're working on pinning down exactly how it works, but we have a darn good idea.
SPEAKER_01Sweet.
SPEAKER_00That's it. Okay, I think we did fairly decent on time. I haven't checked our time yet. I think we're on war. We're not doing great on time. Yeah, we're not doing great. But it's okay. I felt like I was moving and grooving the whole time. Like there was a lot of information. So anytime we pack it full of information, and I don't go over 35 minutes, I don't think I did. I remember I feel pretty good about that. Okay. Any questions before we completely wrap up?
SPEAKER_01Oh, I don't think so. I mean, uh I so you mentioned something about oh you you mentioned when you were recapping something about people wondering how it works or why it works. And I think that I was trying to think of an analogy, but I think your analogy of the basketball players, like a basketball team who knows which one of these is leading. Yeah. I think that's a really good one. It's not, I'm not, I don't really have a question, I guess just an observation. Right. It it's if you've played basketball, it's a point guard's job to get the team moving. So whichever one of these is the point guard, I think maybe they're all working in conjunction somehow. I mean, your your whole body works in conjunction. So of course, all these are probably you know playing off of each other a little bit. But yeah, which one's the point guard? I just like that. So observation. Yeah, not question.
SPEAKER_00Yeah, we don't know.
SPEAKER_01Yeah.
SPEAKER_00Mm-hmm. All right. As always, thank you for having a listen. We appreciate you, and we'll talk to you soon. Bye, everybody. Bye-bye. Well, that's all, folks. Please see our show notes for ways to connect with us or go give us a follow on Instagram. You can find us at Simply Mental. If this episode resonated with you, send it over to a friend. Give us a five star rating, subscribe, download all the things the cool kids are doing these days. Thanks for having me listen.