I went through EMDR training seven or eight years ago in Austin.
Like a lot of therapy trainings, we didn't just sit around learning the theory. We practiced some of the work with each other, which meant that at some point I went from being Jeremy the Therapist Learning EMDR to Jeremy the Person Actually Doing EMDR.
I was working with a clinician I had just met that weekend, and we got stuck.
There was clearly something happening for me. I could feel it. But when we tried to put language around the experience, I couldn't really do it.
We kept getting curious about that.
Eventually, what emerged seemed connected to an early medical experience from infancy — something that had happened before I had language available to describe it.
I wasn't expecting that.
And I want to be careful about what I'm saying here. EMDR isn't a magical way of retrieving perfectly accurate memories from infancy, and our memories aren't video recordings stored somewhere in the brain waiting to be recovered.
What mattered to me was that we had reached an experience my body seemed to know something about even though I couldn't explain it very well with words.
Working with it shifted something.
Not in a movie-ending, everything-is-healed-now kind of way. But afterward, I began noticing changes in some of my immediate responses to things happening in my current life.
That experience has stayed with me.
Because sometimes your mind knows you're safe long before the rest of you seems to get the message.
Maybe you've had this experience.
You know your partner isn't the person who hurt you before.
You know the doctor's appointment is routine.
You know your boss isn't your parent.
You know the argument happening right now isn't the argument that happened ten years ago.
You know you're safe.
And still, your heart starts racing.
Your chest tightens.
You freeze.
You want to get out.
You become intensely angry.
You go completely blank.
Or you suddenly feel much smaller than the adult person you know yourself to be.
This can be one of the frustrating things about trauma.
We can understand something intellectually and still have an emotional or physical response that seems to be operating from an entirely different set of information.
Traumatic experiences can continue to be triggered by cues in our current lives, bringing with them distress, negative beliefs, and physiological reactions that belong partly to what happened before. That's one reason trauma-focused treatments work directly with traumatic memories and their meaning rather than simply trying to convince someone that they shouldn't feel the way they feel. EMDR is one of the trauma-focused psychotherapies with strong evidence for treating PTSD.
Sometimes you already know you shouldn't be this scared.
Knowing isn't the problem.
EMDR stands for Eye Movement Desensitization and Reprocessing.
Which is a lot of words.
The basic idea is that instead of only talking about an experience, EMDR helps you intentionally bring aspects of a distressing memory into awareness while also paying attention to something happening in the present.
This usually involves what's called bilateral stimulation.
You might follow a light moving back and forth across a bar with your eyes. You might follow your therapist's fingers or hand. You might hear sounds alternating from one side to the other. Some therapists use tapping or small handheld devices — often called "buzzies" — that alternate between your hands.
It looks a little weird.
That's okay.
Therapy is allowed to be weird sometimes.
During the processing portions of EMDR, you may hold an image, thought, feeling, or physical sensation associated with an experience in mind while engaging in that back-and-forth stimulation. You don't necessarily have to narrate every detail of what happened out loud for your therapist.
For people who have spent years trying unsuccessfully to find exactly the right words for an experience, that can be particularly interesting.
I know it was for me.
This is usually the part where explanations of EMDR start sounding very neuroscience-y, very quickly.
The more responsible answer is:
We don't completely know.
EMDR works as a treatment for PTSD. That's well established enough that major clinical guidelines recommend it alongside other trauma-focused treatments such as Cognitive Processing Therapy and Prolonged Exposure.
Exactly why its bilateral-stimulation component helps is less settled.
There are several proposed explanations for what's happening, including effects involving attention and working memory. Research specifically examining the eye-movement component has produced a more complicated picture than the simple claim that moving your eyes back and forth somehow "activates both sides of your brain." Some research supports a benefit from the eye movements, particularly for reducing subjective distress, but we don't have one tidy neurological explanation that accounts for EMDR's effectiveness.
I'm okay with saying we don't completely know.
We don't have to dress therapy up in brain language to take it seriously.
What matters more to me as a clinician is whether the treatment has good evidence behind it, whether it makes sense for the particular person sitting in front of us, and whether we're doing the work together in a way that feels safe enough to be useful.
That last part matters a lot.
Sometimes people imagine trauma therapy like this:
You walk into the room.
Your therapist hands you the buzzies.
You immediately begin excavating the worst thing that has ever happened to you.
Please don't do that.
EMDR is an eight-phase treatment, and processing traumatic material is only part of it. Before reprocessing begins, there is history-taking, treatment planning, preparation, and work on ways of managing distress. Some people need considerably more time in those preparation phases than others.
I think this is especially important because trauma treatment isn't supposed to be an endurance contest.
The goal isn't to prove that you can withstand being overwhelmed.
Your therapist should be helping you develop a stronger felt experience of what it is like to be present and regulated enough that, when difficult material comes up, there is somewhere to return.
And you should always know where the ripcord is.
There's something I talk about in my own relational therapy work that I call ongoing consent.
Before therapy begins, there's informed consent. We talk with you about the kind of work we're doing, what you can expect, potential risks and benefits, and you decide whether you want to participate.
That's important.
But then we actually start doing therapy.
And sometimes we end up somewhere neither of us could have completely anticipated.
That's where ongoing consent matters.
Agreeing to therapy doesn't mean you've agreed in advance to follow your therapist wherever the work goes.
Your therapist might think there's something important worth staying with.
You might notice that you're reaching the edge of what you can tolerate that day.
We have to keep sorting that out together.
I sometimes think of it as knowing where the ripcord is.
You should be able to say:
I want to stop here for now.
I'm starting to feel overwhelmed.
I don't trust that I can go further into this today and find my way back on my own.
Or simply:
No. I don't want to go there.
EMDR is structured to include preparation for managing distress before reprocessing begins, and the treatment involves returning attention to the present while working with painful material from the past.
But I think the principle is bigger than EMDR.
Regardless of what kind of therapy you're doing, you should have a voice in how the work unfolds.
The goal isn't to keep you perfectly comfortable. Therapy would be pretty limited if we never went anywhere uncomfortable.
But discomfort and overwhelm aren't the same thing.
And your therapist doesn't get to make that distinction for you without you.
That's ongoing consent.
The ripcord isn't evidence that therapy failed.
Knowing you can pull it may be part of what makes it possible to go somewhere difficult in the first place.
I love talk therapy.
This is probably unsurprising given what I've chosen to do with most of my waking hours.
There is enormous value in finding language for our experience. Sometimes saying something out loud to another human being for the first time is profoundly important.
But not everything that has happened to us arrives neatly organized into a story.
Some experiences happened when we were very young.
Some happened so quickly that we never really made sense of them.
Some were so overwhelming that when we try to talk about them, we lose access to words.
And sometimes we've talked about something for years.
We understand exactly why we respond the way we do.
Our therapist understands.
Our partner understands.
We could probably give a PowerPoint presentation about it.
And our body still reacts.
That's one of the places where EMDR can offer a different way of working.
It doesn't mean talking has failed.
It means words aren't always the only doorway into an experience.
When I think back to that weekend in Austin, what stays with me isn't some dramatic recovered memory.
It's the experience of getting somewhere I couldn't explain very well and discovering that we could still work there.
My body seemed to have something to say before I had words for it.
And after we paid attention to it, something about the present felt different.
That's one of the reasons I remain interested in EMDR.
Sometimes people come to therapy frustrated with themselves because they already understand everything.
I know I'm safe.
I know this person isn't going to hurt me.
I know what happened wasn't my fault.
I know I don't have to keep protecting myself this way.
And yet something in them still braces.
You don't necessarily need another explanation for why you shouldn't feel what you feel.
Sometimes healing isn't learning that you're safe.
You already know you're safe.
Sometimes the work is helping more of you experience that the danger isn't happening now.
