EMDR stands for Eye Movement Desensitisation Reprocessing.
It began when its founder, Francine Shapiro was watching the swaying leaves of a tree in a park while ruminating on a particular anxiety. She noticed that the anxiety had completely disappeared – and recognised that it was somehow linked to the movement of her eyes while following the swaying leaves. This then developed in a whole approach to therapy.
When initially training in hypnotherapy, we had a day of learning EMDR which left me a bit skeptical. I found it a bit wishy-washy sounding, the idea of waving fingers in front of a person’s eyes while they hold onto a negative thought, in the hope that it diminishes. It hardly seemed like the kind of thing that would create lasting change for deep-rooted issues.
I was massively wrong about it. Looking back, I’m actually annoyed it was even attempted to be taught in a day. With breaks, practice sessions etc, that’s probably about an hour of actual training, which is absurd. It was a huge disservice to the approach to present it in such a hamfisted, reductive way.
It caught my attention again while working as a Recovery Practitioner, when it was being touted as this holy-grail therapy that’s offered to a select few via the NHS’s (UK) “Talking Therapies” (TalkWorks) scheme. The thing is though, is that TalkWorks were too nervous to work with ‘difficult’ clients with ‘complex’ needs (they preferred good-looking ‘success’ figures) and would throw them out to charity workers instead. Therefore, the people who would most benefit from EMDR are denied from accessing it.
(Also, in multi-agency meetings where the local TalkWorks EMDR practitioner would be present, he said stuff like “ugh, this situation seems too complex for EMDR” or “there’s a danger of retraumatising the person if we tried EMDR”. When challenged he’d throw out jargon to bury his cowardice).
This is part of the downside of EMDR – the sheer inaccessibility of finding a good practitioner. They’re rare, and will be expensive due to the rigorous egilibility requirements of training. It’s a tragic waste that the people who would most benefit aren’t readily able to access it.
But! It doesn’t stop us from learning about EMDR, why it works so well, and appreciating its dynamics and benefits. Like most therapies, its components are nothing unique by themselves, so it could really be called anything and still have a useful impact.
The great power of a pattern interrupt
The best personal change-work is achieved when existing automatic processes are interrupted in their tracks – allowing for new options for response.
There are various levels for how this can be achieved.
In NLP, there’s a technique called the ‘swoosh pattern’. Briefly, the person is asked to mentally picture something that triggers anxiety, and then ‘swooshes’ a new picture of something that triggers calm and confidence in its place. Again and again – old picture – swoosh! – new picture.
The person will be asked to ‘try’ and think of the old picture, to ‘try’ and access those anxious feelings, and typically report that they can’t, they just automatically go to the new picture. This is a bit iffy though – the overbearing expectations of a typical NLPer can easily trigger compliance from the client – saying what they know is expected so as to not have this swoosh business drag on any longer than it needs to.
Emotional-Freedom Technique (EFT) is an approach you might have heard of where negative thoughts and feelings are held in mind while the client taps various places of the body, may be asked to move their eyes around, and even hum a tune like happy birthday.
It all sounds a bit ridiculous but can be effective – primarily I believe because its hard to maintain the usual automatic chains of cause-and-response while being so sensorily and physically distracted.
Terrence Watts has an excellent book called BWRT – Brainworking Recursive Therapy. This approach is about visualising the scene of an event that triggers negative responses, then zooming out of it, back in from a different perspective, a few other reframes and manouvers until the responses lose their automatic potency.
In hypnosis and hypnotherapy, post-hypnotic commands can be trained to allow certain feelings or behaviours to arise following very specific cues – interferring with the old, unwanted response.
These kinds of ideas all evolve from a central tenet – if you interrupt a chain of automatic cause-trigger-response, it loses it’s ability to happen in the same way.
EMDR offers a very powerful pattern interrupt, and can be used in conjuction with hypnotherapy.
Let’s see how it works.
The workings of EMDR
EMDR is quite a complex model – Francine Shapiro’s books are generally excellent in explaining and encouraging engagement with it. “Getting Past Your Past” is an excellent, readable book for people who might be curious about using it. The main manual (EMDR) is a much heftier text-book explaining all the details for practitioners (it’s one of my all-time favourite therapy books).
The first phase of EMDR is to explore history and drill down to the core barriers.
What I love about this aspect is the purity of getting to the essence of negative beliefs.
Shapiro has distilled this down to three main ‘cognitions’. They are:
Defectiveness – personal (e.g. I’m not good enough, I don’t deserve love, I’m bad/incompetent/worthless/inadequate/shameful/ugly/unimportant) and action (e.g. I did something wrong, I should have known better)
Safety (e.g. I can’t trust anyone, I can’t protect myself, I’m in danger, I feel threatened)
Power/control (e.g. I’m not in control, I can’t get what I want, I’m helpless, I can’t be trusted, I can’t succeed, I have to be perfect)
A statement is then formed to best represent the underlying belief.
An opposite, positive cognition is then formed to counteract it – what would be installed in place of the negative belief (e.g. “I can’t trust anyone” would be “I can choose whom to trust”).
After some explanations and preparation, a later session will then address the negative cognition. A mental picture is arrived at to represent the negative condition – perhaps a moment frozen in time that comes to mind. This is given a value in terms of how triggering of the emotion it is.
It’s then held in mind while the EMDR takes place.
This is a short series of eye movements, side to side and/or up and down, typically by tracking the practitioners finger tips in a waving moment.
It’s largely a mystery as to why eye movements are so disruptive to mental activity. But next time you watch someone talking, be aware of how the eyes have a tendency to dart all over the place (another technique from NLP is the idea of eye-accessing cues – noticing the patterns of how someone uses their eyes while thinking and talking). We tend to look down for example while accessing feelings – it’s difficult to feel quite the same way if expressing something while looking up.
During this period of eye movements, prompts will be given like “That’s it, good, it’s just old stuff. Just notice it”. There’s a suggestive power to this moment, where the unconscious mind is quite open to stimulation. Any random thoughts or memories that emerge are encouraged to be shared afterwards with prompts like “what do you get now?” or “What are you noticing now?”
This combination of desensitisation and free-association is repeated until the value of emotional response to the trigger has sufficiently reduced.
The process is then repeated, but this time the original sensitising event is held in mind at the same time as the positive cognition. Again, prompts, encouragements and free-association occur until the positive cognition feels true and is accepted.
Once this is complete, a ‘body scan’ will take place to assess for any residual emotions held physically in the body, as well as a debriefing to summarise what’s happened.
Future events might be discussed with mental movies encouraged to ‘test’ for how a new response might automatically take place (which is very NLP).
The whole process could be repeated for however many negative cognitions can be found and appropriately worked with, until the client feels satisfied that any traumatic memories no longer trigger the usual response.
The results can be highly effective, which is why EMDR is often used for situations of PTSD or trauma in general.
EMDR and Hypnotherapy
It’s easy to recognise the structure of EMDR as a hypnotic process – despite being carried out in a highly process-driven, clinical routine. Francine Shapiro admits of the crossover herself.
The structure is highly efficient and elegant in terms of:
- working to recognise the underlying unconscious barrier
- creating a pattern interrupt to lead to openness and responsiveness to suggestion
- installing the replacement solution as a suggestion to be accepted by the unconscious mind
- checking for any new memories or barriers to be worked on to ‘clean up’
- future-pacing (an NLP term) events to visualise new responses, to check the work
Written like this, the process is not at all dissimilar to what might occur in a journey of hypnotherapy. It’s just a slightly different route to achieve the same results.
While I greatly admire the precise structure of EMDR (there are further details, ifs and buts I’ve skipped over in the brief summary above), there are pros and cons when comparing it to hypnotherapy.
Hypnosis has the added benefit of providing a wholly positive experience for the client – immense mental relaxation, the rapport, trust and safety of which can enhance awareness and disclosure of important details. This can also aid in regression work to highlight relevant moments.
Hypnosis also gives the client the experience of happenings, which in itself is both liberating and hugely suggestive of the automaticity of mind, encouraging the installation of new responses. There is far more potential there to enhance the responsiveness to suggestion, and ensure that the positive cognition ‘lands’.
The few EMDR practitioners I’ve met, due to the rigorous requirements for training, have typically come from the stuffier, clinical side of psychology and psychiatry. Far from the warm, wise, safe-feeling environment that the client surely craves (remember polyvagal trauma theory, where neutral faces can be seen as fearful, leading to cognitive shut-down), there’s surely a risk of forgetting such basic person-centered humanity while ensuring that the various phases, steps, procedures and scores are properly adhered to.
I’m not surprised that the guy from TalkWorks seemed so unmotivated to take on clients for EMDR – the vibe was that it’s more a burdensome process to shove clients through, rather than an opportunity for some excellent change-work.
Learn more about EMDR
If any of this sounds interesting, and like something that you think could be useful, then I highly recommend reading Francine Shapiro’s book “Getting Past Your Past”. It’s very human and very readable.
As a footnote, Francine regretted coining the name “EMDR”, as the eye-movement aspect isn’t as much of a central feature as how it seems from the name. The real ‘juice’ is in the recognition and use of the positive and negative cognitions. There are variations for the eye-movements, including tactile tapping techniques, or using binaural audio. I seem to remember reading somewhere that she wished it was called BDR instead – Bilateral Desensitisation Reprogramming, which seems more accurate.
Where next? We’ve covered a few areas of life-barriers and approaches to therapy.
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