When it feels safe to move on

As a psychotherapist who regularly uses Eye Movement Desensitization and Reprocessing therapy (EMDR) to help people with anxiety, depression, relationship conflict, and trauma, people often ask me why EMDR works.

​When you attend an EMDR therapy session, eventually (after preliminary work) we will identify target memories that relate to your current difficulties. For example, from a young age you might have formed the belief that you are ‘unsafe’ or ‘unlovable’, or you might carry around an overwhelming sense of shame or abandonment.

Focusing on a target memory, we will guide your eyes laterally (left and right, rather than vertically, up and down). This process helps to quieten your amygdala (your brain’s alarm system) in relation to that target memory, and the triggering belief or emotion. 

Why do we know this works? Because research shows that when we walk or otherwise move forward, and things move past us, this causes our eyes to move laterally, and thus quietens our amygdala. So the lateral eye movements in EMDR replicates the brain’s natural ability to quieten the amygdala.

But that is not all…

When you are triggered, or experience a threat (whether that is in the present, or a distressing memory of a past event), you might fight, flee, or freeze. According to research, the part of your brain that is responsible for the fight response, or “forward confrontation”, is linked to the dopamine reward pathway (and this plays a big part in us experiencing pleasure). Faced with a threat, when we move forward in a safe way, we suppress the amygdala, and we send signals to the dopamine reward centers of our brain to reward us for forward effort.

So in the face of a threat, a sense of forward action will help, and that can be replicated through the use of the lateral eye movements in EMDR - the brain thinks you are moving forward, and this suppresses the fear/alarm system of the amygdala, and it also rewards you through the production of dopamine.
 
EMDR delivered to the comfort of your home
 
When the pandemic hit, we were all required to use an online format to deliver EMDR therapy.  I use a HIPAA compliant portal to meet you online; we still get to face each other, and use the EMDR protocol effectively, and the only difference is that we face each other on a video screen, rather than sit with each other in an office. 

The benefit is that you can benefit from therapy in the comfort of your home, and you can schedule your sessions with more ease (cutting out any travel time).  This has worked extremely well with my clients, and therapists have been using this format long before the pandemic. 

Here is some research to support the use of EMDR in a virtual setting - 

• Brown, G. O. S. (2021). Reflections on Providing Virtual Eye Movement Desensitization and Reprocessing Therapy in the Wake of COVID-19: Survival Through Adaptation. In Shared Trauma, Shared Resilience During a Pandemic (pp. 235-248). Springer, Cham
• Jones, C., Miguel-Cruz, A., Smith-MacDonald, L., Cruikshank, E., Baghoori, D., Chohan, A. K., ... & Brémault-Phillips, S. (2020). Virtual Trauma-Focused Therapy for Military Members, Veterans, and Public Safety Personnel With Posttraumatic Stress Injury: Systematic Scoping Review. JMIR mHealth and uHealth, 8(9), e22079
• Tarquinio, C., Brennstuhl, M. J., Rydberg, J. A., Bassan, F., Peter, L., Tarquinio, C. L., ... & Tarquinio, P. (2020). EMDR in telemental health counseling for healthcare workers caring for COVID-19 patients: a pilot study. Issues in Mental Health Nursing, 1-12.
• Bongaerts, et al. (2021). Safety and effectiveness of intensive treatment for complex PTSD delivered via home-based telehealth

I hope you found this as interesting as I did! If you have any questions, get in touch. 

Chris Warren-Dickins LLB MA LPC
Explore Transform LLC
Counseling and Psychotherapy in Bergen County, New Jersey
www.exploretransform.com
+1 (201) 779-6917

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