As many of you know, last year I started EMDR therapy to treat my PTSD. When my therapist introduced me to EMDR, I was very skeptical. Despite years of therapy and trying everything, I had never heard of it. Surely if something worked on complex PTSD the way that EMDR supposedly did, everyone would know about it, right?
Well, not necessarily.
EMDR absolutely transformed my life. It is the most effective form of therapy I have ever tried. And that’s coming from someone who’s tried just about everything: talk therapy, cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), mindfulness, decluttering, float therapy, and various medications, to name a few.
Which is why I wanted to do a post on it.
EMDR completely changed the game for me and my PTSD. It helped me regain control of my life in a way that I never knew I needed to. I found it interesting that no one in my close circle had ever heard of the therapy before, and from writing about it on the Bare, I realized that not many people have heard of it.
I think it’s important to know about alternative therapies available because we don’t know what we don’t know. And we can’t try something new that may help us if we don’t know that it exists. While what works for me, may not work for other people– it’s important to know what’s out there and available.
So let’s talk about one of the many therapies out there that is available.
In this post, I define EMDR, the steps involved, my experience, and how I feel now. I’ll also share a few resources and videos from mental health experts that I learn from all the time.
- What is EMDR therapy?
- Eye Movement and Processing
- Short-Term Therapy and Stages
- Important Things to Note
- The Stages of EMDR and My First EMDR Session
- 1. History Taking
- 2. Client Preparation
- 3. Assessment
- 4. Desensitization
- 5. Installation
- 6. Body Scan
- 7. Closure
- 8. Reevaluation
- Subsequent Sessions
- How I’m Doing Now
What is EMDR therapy?
DISCLAIMER: Let me start by saying, I am not a therapist. This post is about my own experiences with the therapy from the perspective of someone receiving therapy. There are lots of great resources out there written by therapist, and I link to several in this post.
Now that I’ve got that out of the way, let’s define EMDR.
According to the American Psychology Association:
Eye Movement Desensitization and Reprocessing (EMDR) Therapy
A structured therapy that encourages the patient to briefly focus on the trauma memory while simultaneously experiencing bilateral stimulation (typically eye movements), which is associated with a reduction in the vividness and emotion associated with the trauma memories.American Psychology Association
Shall we dumb that down?
EMDR is a short-term therapy that involves diving into the traumatic memories and focusing on them while also experiencing a stimulation that switches from left to right. Those stimulations can be a beeping noise or tapping sensation or even a finger that goes continually from your left to right side. This stimulation usually involves eye movement, which mimics the eye movement you experience while in REM sleep.
Eye Movement and Processing
REM sleep is an important player in EMDR. Rapid Eye Movement (REM) is the stage in your sleep where your brain is doing the most processing. Your eyes move rapidly from left to right as your brain processes things that happened in your day. While in REM state, your brain is doing is the highest level of processing that it can achieve.
EMDR comes in at second. It’s the second highest level of processing your brain can do, and what makes it so groundbreaking is that you can do it while you’re awake.
Focusing on a traumatic event while experiencing the bilateral stimulation forces your eyes to move back in forth which allows your brain to reprocess the trauma.
We want to reprocess the trauma for people dealing with PTSD because when faced with a trigger, we often deal with intense flashbacks that can manifest as panic attacks, anxiety, or other severely debilitating emotional or physical reactions.
EMDR works to rewire our connections, and stay present while experiencing the trauma. By doing this, it desensitizes ourselves to the trauma, and we can better handle triggers to regain control.
EMDR stands for Eye movement desensitization and reprocessing and was developed by Dr. Francine Shapiro. Memories associated with adverse life experiences may remain unprocessed because of the high level of disturbance experienced at the time of the event. The stored memory may be linked to emotions, negative cognitions, and physical sensations experienced during the event and the unprocessed memory can affect the way a person responds to subsequent similar adverse experiences.Haneen Ahmad, LICSW
Short-Term Therapy and Stages
Also worth mentioning, EMDR is a short-term therapy which means that likely you’ll have a set number of therapy sessions that involve EMDR. That number varies person to person, but is usually over the course of a couple of months.
I started in April 2018, had to stop because I wasn’t ready for it, and then started up again in June 2018. By the beginning of September, I had recovered from the particular trauma target my therapist and I worked through.
Unlike long-term therapies, EMDR is also an eight stage process. The stages include:
- History taking
- Client preparation
- Body scan
Important Things to Note
Before I dive deep into what my first experience with EMDR therapy was, there are a few things I think are important to note.
- You MUST be comfortable with your therapist before attempting EMDR therapy. EMDR therapy makes you relive your trauma, and can result in flashbacks. Flashbacks can retraumatize someone which is why it’s important to do this type of therapy with a therapist who is not only qualified, but also makes you feel as comfortable as possible.
- EMDR is not for everyone. If you don’t have the time to do some really draining, tough, emotional shit that makes everything worse before it gets better– probably not the time for you to do it. It’s draining. And rough. But if you’re okay with dealing with that for a few months– it’s absolutely worth it.
I think that’s it for now. On to the experience, eh? Here we go.
The Stages of EMDR and My First EMDR Session
As I explain each stage, I’m going to share my experience in each stage during my very first EMDR session. I had many more sessions that were much less intense, but I’ll give a brief overview at the end of these steps.
1. History Taking
In addition to getting a full history and conducting appropriate assessment, the therapist and client work together to identify targets for treatment. Targets include past memories, current triggers and future goals.American Psychological Association
I started seeing my therapist in September 2017, but didn’t mention the traumatic experience until several months later. I thought I had recovered on my own, and at that time I didn’t consider what happened to me “trauma.”
For the most part, I didn’t want to focus on what happened to me in China. Instead, I thought I needed to find tools and tricks on how to manage what I was feeling–depressed, anxious, trapped, overwhelmed, out of control with my emotions. What I never realized is those feelings revealed symptoms of my untreated and unprocessed PTSD.
Even so, history taking started before I ever brought up the trauma. We started from the beginning, working through my childhood up to the present, and discussed how I had managed things to date.
When finally I brought up the trauma, we talked about what happened, how I handled it, why I didn’t seek out help before.
Back then, I couldn’t talk about what happened without completely disconnecting from it. My experience felt too insane to discuss out loud with people, even my therapist. When I talked about it, it felt like a story that happened to someone else.
I didn’t connect to it. And even my therapist had a hard time understanding it.
The incident, at that point in my life, did not feel real to me. I don’t know if it ever felt real to me, to be honest. Describing it felt like describing some outlandish horror movie that was too ridiculous to be believable. It was so unbelievable to me that I stopped believing it had happened to me.
But all in all, from the outside looking in I thought I handled it fine. Even from the inside I took pride in how far I had come since the experience. Ultimately, everything was fine. I was just having some troubles with anxiety and panic and emotional regulation and intimate connection and paranoia.
When my therapist told me I had PTSD, I didn’t believe her. PTSD was for veterans, and I was doing fine. I had a car and a boyfriend and a good job that promoted me yearly. I was fine.
But I figured I would try this EMDR thing she recommended. Because even though “I was fine”, I was willing to try anything to make the overwhelming anxiety I felt go away.
2. Client Preparation
The therapist offers an explanation for the treatment, and introduces the client to the procedures, practicing the eye movement and/or other BLS components. The therapist ensures that the client has adequate resources for affect management, leading the client through the Safe/Calm Place exercise.American Psychological Association
At this stage, my therapist started preparing me for the therapy which meant explaining the treatment and giving me the research and reasoning behind it.
We also dove deeper into my emotional state to determine if I was ready for the therapy.
For the most part, we both believed I was ready for it. I talked calmly about the incident, understood how it affected my current life and seemed emotionally stable. She explained the intensiveness of the therapy, and that if I felt the need to stop at any time, we could do exactly that.
I just needed to tell her when to stop if it became too much, and we would end the session.
I didn’t fully understand what could possibly make me want to stop therapy mid-session.
It was just therapy, so how could it be any more intense than talking to her?
Despite this stage being all about preparing me and despite my therapist doing a good job, I was not at all prepared for EMDR. Unlike my usual self, I didn’t Google it or YouTube video it. I really didn’t think much about it, and I certainly was not expecting what I ended up experiencing.
But I’ll save that for the next couple of steps.
The third phase of EMDR, assessment, activates the memory that is being targeted in the session, by identifying and assessing each of the memory components: image, cognition, affect and body sensation.American Psychological Association
In the assessment stage, my therapist had me list out all the memories I had surrounding the trauma. I rambled off all the random memories I could think of in no particular order while she wrote them down.
I remember the first time he told me he believed he was god. I laughed it off because I believed he was high or just sleep deprived. I didn’t realize it was the beginning of something much more serious.
I remember when he tried to intimidate me as we sat in the hospital, waiting for a doctor to see him. He thought he could scare me into taking him home, and I wouldn’t even though I almost did.
Next is that moment– when he screamed at me in the lobby of he school where he worked. “Obey me, wife,” he yelled from across the building. I wasn’t his wife. He wore the glasses he stole from our friend because he believed those glasses made him human.
I remember the time he dug his fingers into my arm, and gripped it so hard I had bruises from his finger tips. He told me he would “destroy” me if I wasn’t careful. He told me I’d be better off listening to him if I wanted to stay alive.
Handcuffs and Mental Hospitals
I’ll never be able to forget the image of him handcuffed to a bed and drugged out of his mind in the hallway of a rundown mental hospital. I was afraid to wake him because I wasn’t sure which version of him I’d get– the man who hated me and wanted me dead, or the man I loved.
I remember how possessed and filled with hate his eyes looked when only seconds before we laughed about how if he had just slept more, we wouldn’t be here now. But in a flash of a second, I couldn’t recognize who he’d switched to. I couldn’t keep up with mood swings and personality changes, I was too tired and defeated.
I remember the moment when I realized I would lose him. That he’d be sent back to his home country. I remember how terrified yet relieved I felt when the police finally contained him and brought him to the psych ward.
Bones and Bags
The bones in his back that poked through when he forgot to keep eating, the bags under his eyes when he decided to stop sleeping– I can see them all like their own characters in a movie.
I’ll never forget how he looked when we finally found him after searching for him for 12 hours. He asked me if he was dead and didn’t believe me when I answered “Not yet.”
I remember his explosions of rage at the strangest triggers, and how I was scared that someday I wouldn’t be able to calm him down.
Bandages and Knives
Bandages. The blood on his knuckles and the the bandages on his fingers. How he told me he was out fighting demons all day in order to get back to his angel.
I remember hiding the knives while he was out of the apartment for fear that in a fit of rage or delusion he would hurt himself. Or me. Or someone else.
The Dress & Invisibility
The dress. I remember the dress he wore when he came home. He wore my dress, no shoes and a wool sweater in the hundred degree humidity of the Wuhan summer.
I remember him telling me that he was invisible, and he could make people live or die just by thinking about it.
I remember how he cried after he believed he had accidentally killed his aunt by talking to her.
The Script from Someone Else’s Life
Sharing these things with her felt like reading a script from someone else’s life. They made me tear up because a tug in my heart reminded me that these scenes were from my own past life, but my brain created enough distance between me and the memory that it felt more numb than anything else.
After we went through the scenes, she told me to rate how uncomfortable each one was for me on a scale of 1 to 10. I ranked one scene an eleven. It was the memory of him staring at me, the one where we were sitting in the hospital lobby as our friend went to hunt down a doctor. The one where he looked at me as if he were a man possessed, and I was the person he hated most. The moment where he told me he would destroy me if I didn’t leave. The one where he gripped my arm and reminded me that he could kill me at any second if he really wanted to.
The Memory We Focused On
This is the memory that we chose to focus my first EMDR session on.
I told her which scene I picked, and then she reminded me what the EMDR process was. At any point, I could ask her to stop and we would stop. She told me she had never had to stop before, but it was up to me how far I wanted to go.
During this phase, the client focuses on the memory, while engaging in eye movements or other bilateral stimulation (BLS). Then the client reports whatever new thoughts have emerged. The therapist determines the focus of each set of BLS using standardized procedures. Usually the associated material becomes the focus of the next set of brief BLS. This process continues until the client reports that the memory is no longer distressing.American Psychological Association
In this stage, my therapist told me to focus on that target image, the image of him threatening me. She placed the tappers in my hands, and told me to focus on the body sensations and the negative image while the tappers vibrated back and forth, causing my closed eyes to move back in forth in the same way eyes move during REM sleep.
She told me to focus on that image, and see where it goes. See what happens and let whatever happens take me there.
When I closed my eyes, she started the stimulation, and I sat there with the image, looking at the memory.
The memory was him.
His dark eyes, that usually I found solace, understanding and comfort in, had turned into the eyes of a man I didn’t recognize. There was so much hate and anger in the way he looked at me. I felt an overwhelming sensation of loss as I tried to move beyond the glare of his eyes that burned when I looked back.
I started to shift under the weight of the discomfort as waves of grief hit me, over and over again. The air felt as if it had been sucked out of the room and a rising panicky heat sat on my chest.
I stared at the memory and tried see what happened next, what happened after this moment? What happened after he told me he would destroy me? What happened after he believed I was a demon that was trying to take away his ability to be god?
I couldn’t move beyond that moment. All I could see was him.
Diving Deep into the Memory
My lips started to tremble and the tears came as the thoughts I thought then bombarded me.
He hates me.
The man I love hates me.
He wants to kill me.
I’ve lost him.
I did this.
How do I bring him back?
I’m sorry, I don’t know what to do.
But no matter how much I tried to move beyond the image of his face, the memory remained on his eyes.
I threw the tappers out of my hands and gasped: “STOP. I have to stop.”
And the sobs became me.
I hyperventilated as I hunched over and cried the type of cry I hadn’t cried since I lived in China. Since right after I lost him. Since right after the trauma. The type of cry where you’re not sure what’s snot and what’s tears and what’s slobber. I wanted to crumble, to find a tiny space in between the walls that I could bury myself in and disappear.
So much for not believing I was traumatized.
My cheeks burned red with embarrassment. Only moments before, I had believed that I was not actually traumatized. I even believed I was going to end up disappointing my therapist by not having any sort of reaction to the therapy at all.
And here I was having to stop it thirty seconds in.
The fifth phase of EMDR is installation, which strengthens the preferred positive cognition.American Psychological Association
As I tried to regain control, my therapist put the tappers back into my hands and we started a meditation to find my way back. I sat on the couch, hiccuping in between sobs to try and catch my breath. She started the guided meditation that went something like this:
“Picture a cloud, and give it a color, a color that is absolute calm to you.”
I pictured a lavender cloud.
“Now, I want you to breathe in that cloud. Breathe it in, and let the calm spread over you, and as you breathe out, I want you to picture another color. The feelings and the discomfort and the grief that you feel, give it a color, and as you breathe in the cloud, I want you to breathe out the distress.”
I imagined a black cloud.
“Breathe in the calm. Breathe out the anxiety. In the calm. Out the distress.”
In with the lavender, out with the black smoke.
Over and over again we did this until I calmed down, until I came out of the memory and back into reality.
6. Body Scan
The sixth phase of EMDR is the body scan, in which clients are asked to observe their physical response while thinking of the incident and the positive cognition, and identify any residual somatic distress. If the client reports any disturbance, standardized procedures involving the BLS are used to process it.American Psychological Association
As my breathing steadied and we closed out the meditation, we did a body scan. I checked in with how I felt from top to bottom, focusing on bringing myself back into the present.
In all honesty, I don’t remember much about how I felt during the body scan, but I remember how I felt afterward– like a zombie. Like I had plugged into my past and it had drained all my energy stores.
There was a certain type of calm to it though. All my anxiety that is there even when things are going good, was gone. It was as if all the noise in the back of my brain had been muted due to sheer exhaustion.
I was tired. And numb.
Closure is used to end the session. If the targeted memory was not fully processed in the session, specific instructions and techniques are used to provide containment and ensure safety until the next session.American Psychological Association
In closure of that session, my therapist told me to drink lots of water and start meditating using Headspace. She prescribed me 15 minutes a day, and told me to start journaling as these feelings came up.
Due to my intense reaction to the treatment, she told me that we would need to take a break before trying to do any EMDR sessions again. She hadn’t had anyone who needed to take stop a session before, so we agreed that perhaps it would be a good idea for me to keep processing with talk therapy before we tried EMDR again.
She warned me not to have anything big planned for immediately following an EMDR session, but I had a big work event to go to that night and left for a week long work trip to New York the next day. I was pretty useless emotionally and mentally for the next twenty four hours, but for the first time I felt a shift. I felt hopeful that this could actually work and that this might actually help me get through this.
The next session starts with phase eight, re-evaluation, during which the therapist evaluates the client’s current psychological state, whether treatment effects have maintained, what memories may have emerged since the last session, and works with the client to identify targets for the current session.American Psychological Association
In my next therapy session, we discussed how I was doing since the EMDR session. I told her that after the first 24 hours, I felt unusually good, hopeful like we had finally stumbled on to something that would make a difference.
We discussed what my reaction meant and how we’d proceed. Due to my intense reaction to the treatment, she told me that we would need to take a break before trying to do any EMDR sessions again. She wanted us to take a step back so that we could process in talk therapy further and then eventually get back into it.
We went back to talk therapy for a few more months, and by June we decided to dive back into EMDR sessions. By then we had done enough processing that I didn’t have to end a session thirty seconds in. I was scared to try it again, but I was also excited to give it another shot because of the hope that I had felt after the first session.
In my first session back to EMDR, we focused on the same image that had sent me to an upheaval. And you know what?
It was okay. I was okay. We went through all the steps, and I was alright. On the days when I went to an EMDR session, I was drained. It’s impossible to prepare yourself for diving back into trauma. It’s hard to willingly go to the moments that hurt you most. But reprocessing it helped me to unlock those brain blockages and deal with them head on so that I could finally get past it.
And I did.
How I’m Doing Now
By the end of August/beginning of September, I was over the targeted trauma. It got much, much worse before it got better, but now that I am over the hump, we’ve been using a combination of EMDR and talk therapy to manage my anxiety over certain things like dating, and purpose, and general existentialism.
Before EMDR, I would think about what happened in China at least once a week, and while in the trauma therapy, I lived and breathed it again. It was there all the time, in a song that reminded me of him or a taste that triggered me or a deja vu moment that reminded me of the past life that feels so far away. Reliving it was hard. It was hard being reminded both in my waking moments and in my dreams of what I had and how horribly I lost it.
But I’m doing really fucking good now.
I’ve started setting boundaries with people in all areas of my life.
I’m learning what’s best for me and acting on it.
I recognize the red flags before I become attached.
I’m owning my own shit and dealing with it head on.
I’ve opened myself up to understand how some of my false beliefs about myself might be limiting.
I’m managing my depression and my anxiety, and it’s getting easier all the friggin time.
I’m doing well, and I’m really thankful that I ended up with a therapist that focuses on trauma and is certified to do EMDR.
Have you ever tried EMDR therapy before? What was your experience with it? Share in the comments below.
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