The strange part about EMDR is the bilateral (left and right) stimulation. Despite the claims of critics, the bilateral part of EMDR appears to be an essential part of traumatic memory reprocessing using this method. Clients are usually able to grasp the other parts of EMDR fairly intuitively. When I first heard about this treatment when I was in graduate school, the Eye Movements (EM) part of EMDR sounded too similar to 1950s hypnosis. I was skeptical and wanted nothing to do with it. I wanted therapy to be scientific, rational, and objective and this sounded too “swishy.” Once I was seeing clients, I needed something that was effective for the severely traumatized clients I was interacting with every day. Talking about it often made things worse. I began hearing reports from friends that EMDR was working extremely well for their clients. Then, I started reading vigorously about trauma and attended excellent and intensive EMDR trainings. Now, it’s at the core of what I do with clients all day long. It can be a little awkward introducing to clients. I have found that a good way of dealing with the strangeness of the bilateral stimulation part (eye movements, hand tappers, headphone tones, or tapping on the client’s knees) is to explicitly acknowledge its strangeness… “so this part is a little strange, but….” I have also learned that it is best not to try to explain EMDR, or any trauma treatment, in detail to clients before they have become comfortable with the initial coping skills that I’m teaching them. As they see that these initial interventions help them better regulate emotion, I gain a small measure of trust that I can use for other things… including some things that may sound strange or different.
I typically introduce EMDR to clients after they have basic coping skills in place to manage anxiety and acute trauma symptoms (flashbacks, etc). I often introduce the idea of trauma treatment by giving the client options, although I do tend to stack the rhetorical deck in favor of EMDR. We do usually do some mix of both anyway:
There are two main ways that I’m trained to help people resolve traumatic memories. We could talk about it and talk about it and talk about it. This could include interacting with it in other ways, too, like through art and writing. The point is to keep interacting with it in ways that are different than those that you’re used to. Over time, this can help you change your relationship with those memories and they might feel a little less horrible. Or, there is another way that I’m trained to do that involves very little talking. It involves holding a traumatic memory and simply noticing your response to holding that memory. Every 30 seconds (or so) I will check in with you and ask you what you’re noticing. You’ll tell me and we’ll continue until that distressful memory is no longer distressing. Again, this way does not require a lot of talking. This way can work much faster than the talking way. The strange part about this therapy is that it involves some form of left-right stimulation. You can hold tappers that will shake left then right or you can wear headphones that will beep left then right. There are other ways that the left-right stimulation can happen too. I can show you the equipment if you are interested. It works well for most people and I think that you would do well with it. Either way, there are things that we need to do and work on to make sure that you have everything in place to do this work. I think that you may be ready to start soon if you are interested. We can do a mix of the talking way and the noticing way if you like.
After we have identified resources and tapped them in, I’ll often say something like the following before we start a reprocessing session (some of this will be a repeat from tapping in resources from the prior session):
There is something about holding a traumatic memory and simply noticing your response to it with any real judgement. You will just hold it (or play a piece of video memory) on one hand and notice what comes to you on the other. The tappers I’m giving you will shake right, then left, then right… and you don’t need to pay attention to them at all. Just hold them in any way that is comfortable. You can’t really do this wrong. Thoughts, memories, emotions, or body sensations may change or shift. Just notice what you notice and let me know when I check in with you. We can call on the resources that you have tapped in and strengthened last session if we need to… they’re right there waiting for you if you need them. We can always stop or take a pause.
I have also found that clients have become more comfortable trying EMDR the more comfortable that I have become in administering it. This is one of those things that gets better the more you do it.