EMDR Therapy Online and in San Francisco

Eye Movement Desensitization and Reprocessing (EMDR) can be an effective trauma therapy that uses the brain’s natural ability to heal in order to process – and no longer be distressed by – trauma.

When someone experiences a trauma, that traumatic memory (or set of memories) is generally stuck in short term memory storage, where it can be more easily remembered (triggered). A trigger can be anything from a smell to a situation similar to one in which the trauma occurred.

Our brains do this as a protective measure, to prepare us for further danger. Unfortunately, this usually backfires after the danger has passed, and, instead, can cause flashbacks, nightmares, and other physical reactions.

EMDR therapy uses bilateral stimulation (BLS), which can involve eye movements, sounds played in alternating ears, or gentle vibrations in each hand. Imagine BLS like a mental bridge, connecting the present moment with past memories (we call this “dual attention”). The goal is that you stay grounded in the present while revisiting the memories. This can allow you to process the trauma without feeling overwhelmed (clinically referred to as “taxing the working memory.”)

Current theory posits that by focusing on the BLS and the memory at the same time, you might have less mental capacity to hold onto the intense emotions and details of the memory, which can result in integrating traumatic memories into long term storage, where they can no longer cause disturbance. This means we may be able to consciously remember the trauma but feel that the danger is over. More info is available here.

As with all therapy, EMDR looks different for every individual. In general, before beginning EMDR, we begin with a thorough assessment to make sure the treatment is a good fit for your needs, taking into account the nature of the trauma, the timeline (past, present, or both), your symptoms, and your goals. In addition, EMDR can involve a significant amount of preparation work to ensure it works effectively without overwhelming you emotionally. If we decide not to proceed with EMDR, there are other options for our work together.

In an EMDR session we’ll target specific traumatic memories (as well as the negative beliefs you have about yourself because of them) and use BLS to eliminate the disturbance caused by each memory. Once we start with a memory, I will move my hand back and forth in front of you for your eyes to follow for a short period of time. This movement is the bilateral stimulation (BLS) that activates both sides of the brain. (For virtual EMDR, we’ll use a website that prompts you to follow a dot that moves back and forth across your screen. We may also use other forms of BLS.)

The BLS lasts for a short period of time, after which I will check in with you. We will check in between each set of BLS movements, until the memory no longer causes a disturbance, or we determine that EMDR isn’t a fit right now. At that point, we’ll use BLS to reinforce a positive belief you’d like to have about yourself in relation to the trauma that will help you reduce shame and move forward.

More in depth information is available from the EMDR International Association (EMDRIA) here

For those who prefer less reading, check out this graphic representation, also from EMDRIA.

EMDR was created to address trauma, but it can also be used to address a variety of challenges. It’s also important to note that trauma is a nuanced concept, and experiences do not need to meet specific criteria in order to “count” as trauma. If you feel strongly impacted by an event in a distressing way – no matter what the event was – then we will approach it as trauma.

EMDR can be used for:

• Trauma/PTSD (all types of trauma)

• Anxiety and Panic Attacks

• Depression

• Phobias (Fear of flying is a common one!)

• Performance Anxiety

Yes, but we’ll likely incorporate parts work and probably do more preparation and resourcing to prevent emotional flooding. We will not proceed until you have the skills to stay regulated, which is where other neurobiologically-informed therapies, like IFS, come in. In addition, if you have a history of complex trauma, it’s imperative to work with an EMDR provider who has specifically trained in the use of EMDR with cPTSD. Luckily, our EMDR provider, Laura, has done just that. Schedule a consultation here.

It can be! Nightmares often accompany PTSD, and EMDR is designed to help alleviate them and other symptoms. There are a few ways to do this, including explicitly targeting the nightmare, or a memory it evokes. Sometimes targeting traumatic memories will alleviate nightmares.

You deserve peaceful sleep, and we’d love to help: schedule a consultation with our EMDR providers, Laura here.

Other common trauma therapies, such as Prolonged Exposure (PE), emphasize changing your thoughts, emotions, and behaviors by reliving and discussing the trauma in detail to desensitize yourself to it. It also requires weekly homework, can take a long time to provide relief, and has a high dropout rate.

EMDR, on the other hand, goes right to the source – to the trauma itself. And instead of working around the trauma with ongoing exposure, EMDR uses your brain’s natural capacity to heal. It does not require talking about the trauma in detail, and it can work fairly quickly compared to some other modalities.

Yes! EMDR and IFS are both wonderful models of trauma healing, and they’re even better together. In fact, we would argue that parts work is necessary in using EMDR, especially for treating cPTSD and attachment trauma. Feel free to ask us about this in a consultation call.

Yes! Laura works out of Presidio Heights in San Francisco on Thursdays and would be happy to talk to you about whether EMDR is right for you. (She also offers EMDR virtually.) Schedule a consultation here.

Yes! EMDR has been extensively researched, and is endorsed by the U.S. Department of Veterans Affairs, the World Health Organization, the American Psychiatric Association, the International Society for Traumatic Stress Studies, the National Alliance on Mental Illness, and other national and international organizations.