EMDR therapy: When difficult memories stay with us
Sometimes, something from the past can stay with us in ways we do not always expect. A certain smell, sound, place or situation can bring back a memory and the feelings that came with it – even when we know we are safe now.
You may understand that something happened a long time ago, yet find yourself feeling tense, overwhelmed or on edge when something reminds you of it. It can be confusing when your mind knows that the experience is over, but your body and emotions still seem to respond as though it is happening in the present.
For some people, these difficult experiences may continue to affect the way they think, feel, behave or relate to the world around them.
This is where EMDR therapy may help.
What is EMDR Therapy?
Eye Movement Desensitization and Reprocessing (EMDR) is a structured form of therapy that helps people work through distressing or traumatic experiences that may continue to affect them in the present.
Rather than requiring you to talk through a difficult experience in extensive detail, EMDR involves briefly focusing on aspects of the memory while remaining connected to the present. During the process, a therapist may guide you through bilateral stimulation, such as following their hand movements with your eyes, listening to alternating sounds or experiencing gentle taps.
As you focus on the memory, you may notice different thoughts, emotions, physical sensations or images arising. With your therapist’s guidance, these experiences can be explored and processed at a pace that feels manageable for you.
The goal is not to erase or forget what happened. Instead, EMDR aims to help the memory feel less overwhelming, so that you can remember what happened without feeling as though you are experiencing it all over again.
How does EMDR work?
Our experiences are closely connected to the way our brains process and store information. Memories are not simply facts that we remember. They can also be connected to emotions, physical sensations, images, sounds, beliefs and other experiences.
This is why a particular smell, sound, place, image or physical sensation can sometimes bring a memory back very vividly. For example, the smell of a particular perfume may suddenly remind someone of a person or period in their life, bringing back not only the memory itself but also some of the feelings associated with it.
EMDR incorporates bilateral stimulation, such as rhythmic left-to-right eye movements, sounds, or taps while a person briefly focuses on a distressing memory. During this process, different thoughts, feelings, images, or sensations may arise and change. Over time, the memory may become less vivid or emotionally overwhelming.
Understanding the Adaptive Information Processing (AIP) model
EMDR is based on the Adaptive Information Processing (AIP) model, which provides a framework for understanding how distressing experiences may continue to affect us.
The AIP model suggests that our brains have a natural capacity to process and integrate experiences. When an experience is processed adaptively, the information from that experience can become connected with other memories and knowledge. We can remember what happened, learn from it and understand that it belongs in the past.
However, when an experience is particularly overwhelming and distressing, the information associated with it may not become fully integrated in the same way. The memory may remain closely connected to the experience when the event occurred.
For example, someone who experienced an accident may logically know that they are safe now, while still experiencing a strong sense of danger when they hear a sudden noise or sit in a car. Their present-day reaction may feel much stronger than the situation itself seems to warrant. In this way, reminders of the original experience can continue to trigger a response as though the danger is still present.
The AIP model views these unresolved memories as contributing to ongoing distress. EMDR aims to help the person reprocess this information so that the memory can become more integrated and less emotionally disturbing.
Reprocessing and Creating a Different Relationship with the Memory
EMDR provides a structured way of accessing distressing memories while maintaining awareness of the present. As the memory is reprocessed, new thoughts, emotions, images or insights may arise. The way you understand the experience may begin to change, and the emotional or physical response connected to the memory may become less intense.
This does not mean that the event itself changes, or that you forget what happened. Instead, the aim is for the memory to feel more like something that happened in the past, rather than something that is still happening in the present.
For someone who once thought, “I am not safe” for example, processing the memory may eventually allow them to recognise, on both an emotional and intellectual level, “That happened to me, but I am safe now.”
What does EMDR Therapy involve?
EMDR follows an eight-phase approach. These phases provide a framework for treatment, but they do not necessarily happen as eight separate sessions. The amount of time spent in each phase can vary depending on the individual, their experiences, goals and readiness for processing.
Phase 1: History Taking and Treatment Planning
Your therapist will learn more about your experiences, current concerns, and what you hope to work on in therapy. Together, you will identify memories or experiences that may be helpful to focus on during EMDR.
Phase 2: Preparation
Your therapist will explain how EMDR works and what you can expect during the process. You may also learn grounding and coping strategies to help you feel safe and supported when difficult emotions arise.
Phase 3: Assessment
You and your therapist will identify a specific memory or experience to work on, along with the thoughts, emotions and physical sensations connected to it. You will also explore how you would prefer to think or feel about yourself in relation to the experience.
Phase 4: Desensitization
You will briefly focus on aspects of the distressing memory while engaging in bilateral stimulation, such as guided eye movements, sounds, or taps. As the memory is processed, the emotions, thoughts or sensations connected to it may begin to change or feel less distressing.
Phase 5: Installation
Once the distress associated with the memory has reduced, your therapist will help you strengthen a more positive or adaptive belief about yourself. For example, you might move from “I am powerless” towards “I have choices now.”
Phase 6: Body Scan
You will be guided to notice how your body feels while thinking about the memory and the more adaptive belief. This helps identify physical tension or discomfort that may still be connected to the experience.
Phase 7: Closure
Each session ends with a focus on helping you feel grounded and settled, even if the memory has not been fully processed. Your therapist may use relaxation or grounding techniques to help you return your attention to the present.
Phase 8: Reevaluation
At the beginning of a subsequent session, you and your therapist will check in on what has changed since the previous session. You may discuss how you now feel about the memory and decide together what to focus on next.
Who can EMDR help?
It is best known for its use in treating trauma and post-traumatic stress disorder (PTSD), but it may also be used as a part of treatment for other disorders. This includes:
Anxiety disorders
Depression disorders
Dissociative disorders
Eating disorders
Obsessive-compulsive disorders
Personality disorders
Trauma disorders
Importantly, EMDR is not a one-size-fits- all approach. A trained therapist will consider your history, current circumstances, coping resources, and readiness before deciding whether EMDR is appropriate for you.
EMDR is not about forgetting what happened.
When we experience something painful, it can sometimes feel as though the past is still present. Triggers may unexpectedly bring back a memory and the emotions that came with it. Even when we know logically that the event is over, our body and emotions may continue to respond as though we are still in danger.
EMDR does not aim to erase these memories. Instead, it provides a structured space to process them so that they can become less distressing and more connected to a sense of safety in the present.
Healing does not mean forgetting what happened. It can mean being able to remember what happened without feeling like you are back there again.
References
EMDR therapy: What it is, procedure & effectiveness. (2022, April 5). Cleveland Clinic.
https://my.clevelandclinic.org/health/treatments/22641-emdr-therapy
Eye Movement Desensitization and Reprocessing (EMDR) Therapy. (2017, July). Clinical
Practice Guideline for the Treatment of Posttraumatic Stress Disorder. https://www.apa.org/ptsd-guideline/treatments/eye-movement-reprocessing
Gainer, D., Alam, S., Alam, H., & Redding, H. (2020). A FLASH OF HOPE: Eye Movement
Desensitization and Reprocessing (EMDR) Therapy. Innovations in Clinical Neuroscience.
