An Inside Look at What Makes Trauma Therapy Work: 4 Facts from an EMDR Therapist
I deeply respect my clients who willingly attend sessions week after week with the burning question, “Can you help me?” With a sense of duty, I set out to determine what therapies work best, especially for people who have experienced trauma. Trauma can be defined as any event that has a lasting negative effect. It can involve physical harm or threaten our emotional safety. Trauma can be experienced or witnessed; it can be a one-time event or ongoing (Shapiro, 2018). I see trauma as the unfair things that happen to us in life, especially in childhood, that are out of our control. It is the moments that shape our life’s trajectory and our capacity to live freely.
EMDR is a unique treatment approach that helps people recover from the haunts of specific memories. It provides an opportunity to derive wisdom and meaning from life’s most painful moments. I hope you find Francine Shapiro’s (2018) four tenets helpful in understanding how EMDR works quickly and efficiently to help people heal from a variety of symptoms and mental health conditions.
1. Mental health conditions are linked to the way we remember earlier life experiences.
EMDR assumes mental health conditions come from scary, threatening, unpredictable, and/or disturbing life experiences. When something scary happens to a child, they have a reaction—new thoughts and feelings in response to the event, and may start acting differently. “What will I do if that happens again? Am I safe? How can I fix this? My tummy hurts. Maybe if I stay in my room everything will be okay,” are some likely reactions. The child is working to make sense of an event that is unpredictable and unsafe. Adults in the child’s life may not be able to explain what happened or why. This may result in the child’s thoughts and feelings never being fully processed, leaving them “stuck".
This reaction to an earlier life experience can begin a lifetime pattern of thoughts, feelings, and behaviors. These patterns ultimately compose a set of beliefs about the self that are negative, unhelpful, and cause suffering. For instance, maybe the child decided that this bad thing happened is their fault.
With this pattern set in place, the brain is ready to see how the “It’s my fault” belief is true over and over again. It is like a pair of sunglasses the developing child sees the world through, coloring experiences and making the world a little darker. When emerging into adulthood, a routine moment in daily life may trigger a childhood memory of the scary thing that happened. The same thoughts, feelings, and beliefs connected to the early memories take over. The day goes on, and the adult is left feeling bad, unable to come up with the right words to explain why.
2. Our brains are great at processing information most of the time and this can help us move forward after trauma.
EMDR heals mental health symptoms by stimulating the brain similarly to how the body heals a physical injury. The brain is able to process an abundant amount of information consistently and with ease throughout our lifetime. It is this capacity that lets EMDR take the “stuck” memories and store it in a new way. During the reprocessing phase of EMDR, the brain can access the bad stuff (i.e., earlier memories that are disturbing) and the good stuff (e.g., a positive world view, your ability to cope) at the same time. It can take the positive adaptive thoughts and feelings and apply that to reprocess old disturbing memories.
Let’s look at one client’s story to see this in action:
Jill’s parents had heated fights when she was a child. Her parents thought she was sleeping during their shouting matches but, instead, Jill would stand with her ear pressed against her bedroom door, listening to every word. Sometimes she would hear glass shatter against the wall. Other times, it was the front door slamming followed by a car speeding off. Jill never knew when these fights were going to happen and she would anxiously stay awake as long as she could every night, listening to make sure her parents were safe.
Jill felt scared that one of her parents was going to get hurt during these fights or leave and never come back. One night, Jill heard her name in the midst of the yelling. This was the moment when Jill finally made sense of it all. She decided it must be her fault that her parents argued like this.
There was no way for Jill to see that her parents’ fights had nothing to do with her. Her explanation (i.e., “It’s my fault”) perfectly matched her stage of child development. She was unable to process the intense thoughts, feelings, and body sensations that came with her nightly high alerts. These early memories were stored in a maladaptive way—stuck and never processed.
As an adult, Jill often felt she was responsible for the events in her life that were completely out of her control. She felt scared and anxious whenever little things reminded her of what happened, like a door slamming shut or someone raising their voice. Although Jill was no longer a child in a helpless situation, she did anything possible to avoid confrontation.
Jill was unhappy in her romantic relationship and taken advantage of by her friends. She felt like it was her fault that her partner did not show affection or express his feelings. With her friends, Jill was the one who organized gatherings, took care of people when they were sick, and listened during times of crisis. She felt good about showing up for her friends but also drained by the amount of energy she put into her friendships. At her job, Jill worked hard for two years towards a promotion. When she found out that a new hire landed the position, Jill had a meltdown at work. The next week, Jill made her first therapy appointment.
In therapy, Jill's focus was to reprocess those “stuck” childhood memories. For many people, one goal of therapy is to take the sunglasses off and to see the world without blame, shame, and guilt. Trauma therapy gave Jill the opportunity to see the world in full color by being present, connected, and free.
3. You can transform the way you see yourself after reprocessing earlier, bad memories.
After trauma, the brain puts forth an unbelievable effort to avoid experiences that may bring up those disturbing memories. It becomes a priority to avoid any thoughts or feelings about the event. So when I ask my clients to share with me what they have worked so hard to hide away, I ask because I know how powerful it is to let the memories surface. After reprocessing these memories, your life changes.
Reprocessing the disturbing information associated with earlier memories shifts thoughts, feelings, and actions. With the old beliefs gone, a new way of being emerges. In my experience, clients rediscover who they really are—their authentic selves—as there is an opportunity for the client to fully express and embrace their unique, whole self. Once the client starts feeling better, they naturally begin making decisions that are healthier and create a more fulfilling life. It is safe to care about yourself.
Let's check in on Jill to understand how she began to see herself after therapy:
Jill found EMDR therapy difficult at first because she revisited those childhood memories that she was quite good at never thinking about. But, in just one session, Jill had a better understanding of how those early memories were connected to her current problems. By the end of EMDR, Jill had empathy for the little girl who had to experience her parents fighting. She used the positive, adaptive parts of her brain to understand how her parents’ fighting was not her fault.
Jill reprocessed the bad memories and no longer held the “It’s my fault” belief. Instead, she knew "It’s not my fault, I was just a kid” to be true. This realization led to a new, deeper understanding of herself. She felt invigorated and started making decisions in her current relationships that helped them become more reciprocal and fulfilling. Jill began expressing her feelings and asking for what she needed from her partner. She set boundaries and realized when she was giving too much in her friendships. There was less pressure to deal with life's tribulations on her own and she could lean on others when she needed some support.
4. Healing takes less time than we thought!
Decades of research studying the treatment outcomes of EMDR show that healing from trauma takes less time than has been traditionally assumed, regardless of how many years have passed since the traumatic or disturbing event. Shapiro (2018) wrote, “Some controlled studies have indicated that 84-100% of single-trauma PTSD has been eliminated within 4.5 hours of treatment” (p. 18).
Jill was in therapy for one year. She finished EMDR in five months and then decided she wanted to spend time getting to know the “new Jill.” It is common for a client to want to practice their new way of being in relationships with their therapist. Therapists are the perfect people to practice new skills on, like asserting oneself or asking for help.
*Jill is not a real client. Her story is inspired by a range of client experiences.
Shapiro, F. (2018). Eye movement desensitization and reprocessing (EMDR) therapy: Basic principles, protocols, and procedures. Guilford Publications.