Difficult experiences can affect people in very different ways. For some, the impact of an event gradually becomes easier to manage. For others, memories, emotions or physical reactions connected to an experience can continue to interfere with everyday life long after the event itself has passed.
Eye Movement Desensitization and Reprocessing, commonly known as EMDR therapy, is one approach psychologists may use when working with trauma and other distressing experiences.
At Reform Health + Wellness in Red Deer, EMDR may be incorporated into psychological care when it is appropriate for the individual, their experiences and their treatment goals.
But what exactly is EMDR, and what does an EMDR therapy session actually involve?
What Is EMDR Therapy?
EMDR stands for Eye Movement Desensitization and Reprocessing.
It is a structured form of psychotherapy most strongly associated with the treatment of trauma and post-traumatic stress disorder (PTSD).
Rather than simply trying to forget a difficult experience, therapy may focus on helping a person process memories that continue to produce significant emotional distress, negative beliefs or physical reactions.
During certain stages of EMDR, a therapist may ask a client to briefly focus on aspects of a distressing memory while engaging in bilateral stimulation.
This often involves guided eye movements from side to side, although other forms of bilateral stimulation may sometimes be used.
EMDR is not hypnosis, and the client remains awake, aware and in control throughout the process.
How Can Trauma Affect Us?
People sometimes associate trauma only with catastrophic events. In reality, difficult experiences can take many forms, and people can respond to similar events very differently.
Experiences that may have a lasting psychological impact can include:
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Motor vehicle collisions
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Workplace incidents
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Serious injuries or medical events
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Violence or abuse
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Difficult childhood experiences
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Sudden loss
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Military experiences
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First responder or emergency-service work
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Relationship trauma
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Repeated exposure to distressing situations
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Other events that leave someone feeling unsafe, overwhelmed or powerless
Someone does not necessarily need to meet the diagnostic criteria for PTSD to find that a past experience continues to affect their present life.
Signs That a Difficult Experience May Still Be Affecting You
Trauma does not always look like frequently thinking about what happened.
Sometimes its effects appear in less obvious ways.
A person may notice:
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Unwanted or intrusive memories
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Nightmares
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Avoiding certain places, situations or conversations
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Feeling constantly on edge
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Irritability or anger
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Difficulty sleeping
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Trouble concentrating
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Strong emotional reactions that seem difficult to control
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Feeling disconnected or emotionally numb
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Anxiety in situations that previously felt safe
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Negative beliefs about yourself or the world
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Difficulty trusting others
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Physical reactions when reminded of an experience
These symptoms can also occur for many reasons unrelated to trauma. A psychologist can help explore what may be contributing to them and whether trauma-focused treatment is appropriate.
What Happens During EMDR Therapy?
One misconception about EMDR is that a person begins talking about their most difficult experiences immediately.
EMDR is a structured therapeutic approach, and preparation is an important part of the process.
1. Understanding Your History
Therapy generally begins with getting to know you, your concerns, your experiences and what you would like to change.
Your psychologist may explore current symptoms, important experiences, relationships, coping strategies, supports and other factors that could influence treatment.
Not every client who has experienced trauma will necessarily use EMDR.
Treatment should be individualized.
2. Preparation
Before processing distressing memories, your psychologist may work with you on strategies for managing difficult emotions and staying grounded.
The amount of preparation required varies considerably between individuals.
The goal is to make sure there is an appropriate foundation before moving into more intensive trauma-processing work.
3. Identifying a Target
When EMDR is appropriate, therapy may focus on a particular memory or experience along with the thoughts, emotions and physical sensations associated with it.
Your psychologist helps guide this process rather than simply asking you to relive an experience on your own.
4. Bilateral Stimulation
During the processing portion of EMDR, you may be asked to briefly focus on aspects of the memory while following a therapist's hand or another visual target from side to side.
Other forms of bilateral stimulation can sometimes be used as well.
The psychologist periodically pauses the process and checks in about what you are noticing.
5. Processing and Re-Evaluation
The goal is not to erase a memory.
Instead, treatment aims to reduce the distress associated with the experience and help it become integrated in a way that is less disruptive to your present life.
Progress is reviewed over time, and treatment can be adjusted according to how you respond.
Do I Have to Tell My Psychologist Every Detail?
This is a common concern for people considering trauma therapy.
While your psychologist needs enough information to understand your experiences and provide appropriate care, EMDR does not necessarily require an exhaustive verbal retelling of every detail of an experience during each processing session.
You remain an active participant in treatment and can communicate with your psychologist if you are uncomfortable with the pace or direction of therapy.
Developing a sense of safety and trust within the therapeutic relationship remains important regardless of the treatment approach being used.
Is EMDR Evidence-Based?
EMDR has been extensively studied as a treatment for PTSD and is included in major clinical guidelines as a trauma-focused psychological treatment.
Research continues to examine how EMDR works and how it may be used with different populations and concerns.
As with any psychological treatment, EMDR is not necessarily the best approach for every person. The decision to use EMDR should take into account the individual's symptoms, history, goals, preferences and clinical circumstances.
How Long Does EMDR Therapy Take?
There isn't one answer.
The number of sessions someone may benefit from depends on factors such as:
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The concern being addressed
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Whether there was a single event or multiple experiences
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How long symptoms have been present
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Current stressors
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Other mental health concerns
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Available supports
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Treatment goals
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How the individual responds to therapy
Some people work on a relatively specific concern, while others have more complex experiences that require a longer course of therapy.
Your psychologist can discuss expectations with you after gaining a better understanding of your situation.
EMDR Is Only One Part of Psychological Care
A good treatment plan does not need to fit neatly into a single therapy model.
Depending on the individual, psychological care may incorporate aspects of several evidence-informed approaches.
At Reform Health + Wellness, psychological treatment may draw from approaches including:
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Eye Movement Desensitization and Reprocessing (EMDR)
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Cognitive Behavioural Therapy (CBT)
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Dialectical Behaviour Therapy (DBT)
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Acceptance and Commitment Therapy (ACT)
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Solution-Focused Therapy
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Trauma-informed and developmentally informed approaches
The approach used should ultimately reflect the person sitting in the room rather than trying to make every person fit the same treatment model.
Trauma Therapy for First Responders and Veterans
Some professions involve exposure to situations that most people rarely encounter.
First responders, military members and veterans may experience repeated exposure to serious injuries, death, violence, danger and highly stressful environments.
The effects of these experiences can sometimes extend well beyond the workplace and affect sleep, relationships, mood, physical health and everyday life.
Trauma-informed psychological care can provide a confidential space to address these experiences and develop strategies for managing their impact.
At Reform, psychology services are available for first responders, veterans, military members and others working in high-stress environments, with treatment individualized to the person rather than their occupation alone.
Trauma and Chronic Pain Can Also Overlap
Physical and psychological health do not exist independently of one another.
Living with persistent pain or recovering from a serious injury can affect sleep, mood, activity levels, relationships and confidence.
Likewise, stress and previous difficult experiences can influence how people cope with pain and injury.
For some people, addressing the psychological impact of an accident, injury or persistent pain may be an important part of their overall recovery.
As a multidisciplinary clinic, Reform can coordinate psychological care with other members of a client's healthcare team when appropriate and with the client's consent.
What If I'm Not Sure EMDR Is Right for Me?
You do not need to know which type of therapy you need before speaking with a psychologist.
In fact, that is part of the psychologist's role.
A first appointment is an opportunity to discuss what you are experiencing, what you would like help with and which approaches may be appropriate.
Sometimes EMDR may be recommended. In other situations, another therapeutic approach—or a combination of approaches—may make more sense.
The important part is developing a treatment plan based on your individual needs and goals.
EMDR & Trauma Therapy in Red Deer
If difficult experiences continue to affect your emotions, relationships, work, sleep or everyday life, psychological support may help you better understand what is happening and determine your options for moving forward.
Gillian Goheen-Smith, Registered Provisional Psychologist at Reform Health + Wellness, provides psychology and counselling services for children, adolescents and adults in Red Deer and Central Alberta.
Her areas of focus include trauma and PTSD, anxiety, emotional regulation, chronic pain, difficult childhood experiences, relationship trauma, veterans, first responders and individuals working in high-stress environments. Gillian incorporates EMDR alongside other therapeutic approaches when clinically appropriate.
Interested in Psychology or EMDR Therapy?
If you have questions about therapy or are unsure whether EMDR may be appropriate for you, you can book an appointment or a free 15-minute consultation with Gillian to discuss what you are looking for and possible next steps.
