In 1987, psychologist Francine Shapiro, Ph.D., noticed that moving her eyes from side to side while contemplating difficult thoughts improved her mood. Intrigued, she went on to research and develop EMDR. Shapiro suggests there are approximately 10 or 20 unprocessed memories responsible for most of the pain in our lives. The efficacy of EMDR therapy in the treatment of PTSD has since been well established, as evidenced by the results of over 30 positive randomized controlled studies over the past three decades. Such findings led the World Health Organization to state in 2013 that Trauma Focused Cognitive Behavioral Therapy (TF-CBT) and EMDR are the only psychotherapy modalities recommended in the treatment of those diagnosed with PTSD.
EMDR aims to process trauma in a more detached way than simply retelling the stories, which can be too emotionally intense. It works in eight phases: history taking, client preparation, assessment, desensitization, installation, body scan, closure, and reevaluation of treatment effect. The therapist will first learn about the client’s history, while also helping them to create a sense of safety in the body. From here, key memories are identified and reprocessed. Bilateral stimulation is used at certain points in the therapy, while working through painful memories. Some of the methods are eye movement from side to side (guided by the therapist’s hand), alternating electrical pulses from a therapulse device held in both palms, headphones with alternating tones beeping from ear to ear, or glasses with flashing lights. This is based on the client’s individual preference and comfort level.
Once the memories are reprocessed in this way, your brain develops new neural pathways. According to Michael G. Quirke, an EMDR therapist in San Francisco, “a brain that can change is capable of putting to rest old feelings, learning new ways of responding, and interpreting thoughts and feelings differently. The way you think, feel, and respond as a result of trauma can be rewritten and healing can become more possible.” This process in the brain is called neuroplasticity, and ultimately it promotes the formation of new, positive associations with the original event, such as “the risk of harm has passed and I am now safe.” The brain can heal from psychological trauma, much as the body recovers from physical trauma, allowing someone to act from a place of self-awareness rather than conditioning.
O’Shea Brown and I used a therapulse while I worked through my memories, starting slowly to build up to more traumatic thoughts. Before and after EMDR she asked me to rate, from one to 10, how distressing my main negative belief was from the trauma we discussed. With each session the numbers got lower, and I felt encouraged to go further. It was like shining a flashlight into a dark closet to find that the monsters I placed there were no longer present, and therefore not threatening to me. When COVID-19 hit and in-person therapy abruptly ended, we decided to continue with virtual EMDR (vEMDR). I was soon to discover that COVID-19 presented more than a few challenges for both therapist and client.
The spread of the virus and the isolation that followed has created mental health issues nationwide. For people with complex post-traumatic stress disorder, or C-PTSD (the experience of multiple and/or prolonged traumatic events rather than a single incident event), the pandemic had the power to heighten the risk of re-traumatization and exacerbate symptoms. “The abrupt loss of social norms has the potential to activate hypervigilance in many trauma survivors, while also creating a large-scale sense of uncertainty that is characteristic of a global pandemic,” O’Shea Brown explained. I could relate: All of the major pillars of my life began to come apart at the same time. My mother got out of a rehab facility from a fractured pelvis only a few weeks before COVID-19 hit, and the last time I saw her she was in a hospital bed. Then my mother-in-law passed away. My husband retired from a 20-year career as a homicide detective the first week of March and we went for a short visit to Tennessee to be with his father. Suddenly a few days trip became a six-month quarantine, followed by a move out of New York City and to the South. My oldest sister passed away in the summer and I didn’t have a chance to see her or to say goodbye. I needed to cling to the positive aspects of my old life, so EMDR therapy felt more essential than ever.
Since its inception, EMDR has been understood by both therapists and clients as a powerful vehicle for processing traumatic experiences, but only when the client has achieved stabilization. “Changes to treatment which ordinarily would be carefully cocreated and discussed over weeks or months were hastily made as this large-scale crisis began unfolding precipitously,” O’Shea Brown reflected. “Teletherapy is one potential alternative to in-person sessions; however, teletherapy is a privilege reserved only for those who can afford a phone, stable internet connection, and/or a laptop, as well as a place of solitude where they can confidentially and safely process their emotions.” For me, finding a place of solitude became nearly impossible while quarantined in a home for two that now housed four people and two dogs. Technological difficulties made things even more frustrating. Trying to talk about traumatic events when my dogs were barking, people were talking right outside my door, and the EMDR app on my phone was glitchy only heightened my anxiety. On one occasion, I was processing a charged memory when I saw the meter man right outside my window. I felt exposed. I missed the in-person sessions I had with my therapist. It can be difficult to focus without the safe protective cocoon of the therapy office.
Achieving a stable state during such turbulent times has been difficult, if not impossible. There is a shared energy and a deep connection that can happen when you are only a few feet apart from another person. During our in-office time, I felt a sense of safety and calm that I no longer feel with virtual sessions. It was easier to let down my guard and be fully present in the moment when we were able to share space.
I’ve had to remind myself that healing is a journey, with good days and bad days. Sometimes we can proactively reprocess painful memories and sometimes I just need to respond to the current chaos of life. There are days when I cannot center myself and the “noise” in my head and body are too overwhelming, so my therapist is gentle as we cocreate an experience that feels safe. We discuss the present rather than delving deeper into the past, and she helps me to utilize some of the inner resources I’ve developed through EMDR. On good days, when I can relax and tune in, I see a light at the end of the tunnel and a future where EMDR can help me to unburden myself of past trauma and access my own innate healing wisdom.