Our eyes are really fascinating parts of who we are.  Did you know that each of our eyes contains over 2-million working parts or that our eyes are the most complex organs in our body, following the brain…of course?  Did you know that our eyes can distinguish over 10-million different colors or that our eyes can see the flame of a candle up to 30-miles away or even that the muscles that work to control our eyes are the absolute fastest muscles in our entire bodies?  Did you know that our eyes blink about 30,000 times a day, that babies are born color blind, or that most of our eyes are hidden deep within our heads?  Did you know that tears are not just present to show others that we are sad and actually work to lubricate and protect our eyes?  Or that our therapists often look to see how our eyes respond in order to conclude how we are feeling?  With all of this information, it’s easy to say that our eyes are amazing.  In therapy, our eyes work as very important links between our brains, our emotions, and what we share with our therapists.  

The simple truth is that our eyes are important in every part of therapy but especially in trauma-focused therapies, such as with Eye Movement Desensitization and Reprocessing (otherwise known as EMDR) therapy.  Our eyes are deeply connected with how we process our memories, our emotions, and even our own sensations throughout our bodies.  Think of it this way, our eyes are not just passive observers but rather active participants in our overall emotional processing; they offer connection, insight, and even ways for us to heal.  Therapists work to monitor our eye movement in order to look for ways we are feeling about what we are sharing and how we are responding.  

Therapists often observe our eyes for clues to our emotional processing, such as if we are trying to avoid something (this is probably seen by us looking away from our therapist) or feel strongly about something (this is probably when we are blinking a lot or widening our eyes when someone like our therapist is talking), or even for trauma recall (our eyes probably dilate every time we recall something scary or emotionally distressing).  Our eyes send out messages that say “STOP”, “I’m okay”, “I’m distressed,” and more.  Janna Cachola, who is a New Zealand actress/singer, said that our “Eyes are the windows to the soul.  A smile is the mirror of the heart.”  While this quote may be beautiful and altogether powerful, is this actress/singer also telling us that hidden in our eyes are the secrets that we most likely want to process even if our mouth isn’t forming the words?  

What is EMDR?

EMDR stands for Eye Movement Desensitization and Reprocessing and is a type of therapy that uses our eyes to process, heal, and let go of our “stuck” traumas by releasing our emotional distress.  EMDR has three prominent parts to it, which include:  (1) recall, (2) bilateral stimulation (often referred to as “BLS”), and (3) processing/re-processing.  

1. RECALL

The process of bringing up a past traumatic event or experience and reliving it.  In this phase, you bring up stored information (i.e. emotions, images, sounds, sensations, physical reactions, visceral sensations, and more) until the brain reports that we are safe.  For instance, a few weeks ago my auntie passed away.  While it was not sudden, this was still traumatizing because she had fought her cancer hard for so long; over twenty years as a matter of fact.  She was a focal point of our family and a true pillar of her community in Malibu, California.  When I think of it now, I remember my sister’s text like it was yesterday.  “She passed last night” was all the text read.  Because of the perceived threat of this traumatic experience, my brain went into action.  Meaning that my amygdala tagged this traumatic memory as a threat for myself and thus stayed on high alert.  Because of the high alert, my hippocampus failed to see that the event was “over” and it began to get “stuck” on a loop of “What will happen to my children when I pass away?” which only was made worse by my prefrontal cortex’s lack of ability to apply logic to the situation at hand.  I was not in danger.  I was experiencing a traumatic experience.  Even now during the recall of this, my brain will go through this loop repeatedly until my prefrontal cortex can apply enough mindfulness and grounding techniques to calm my fear and relax my central nervous system.  This jumping into action is why our most traumatic memories often feel frozen in time; they feel stuck in our brains in a certain way.  

2. BILATERAL STIMULATION

In therapy, such as with EMDR  or Cognitive Behavioral Therapy, recall is often a guided and intentional process that leaves the person feeling supported and safe.  There is no difference between BLS and other systems of support, other than the fact that an EMDR trained therapist works to activate both hemispheres of our brains alternately using a rhythmic stimulation while we focus on a traumatic event, horrendous thought, or distressing memory.  Think of it this way, the term “bilateral” is a term used to describe “both sides” whereas “stimulation” refers to sensory input.  

In EMDR therapy, the therapist is trained to use visual/auditory, or tactile sensations to stimulate the bilateral messaging in our brain.  Some examples include: the therapist moving a light bar or a wand to stimulate the visual bilateral experience; the therapist alternates beeps/tones in the left and right ears (using headphones) to stimulate the auditory bilateral experience; the therapist uses buzzers, tappers, or even movements to stimulate the tactile bilateral experience.  EMDR uses side-to-side movements that mimic REM sleep, which is where  the brain naturally processes memories (both good and bad).  

3. PROCESSING / RE-PROCESSING 

This portion of EMDR therapy has us actively experience a thought, emotion, or even body sensation related to some form of trauma so that we can work to make sense of it in a new way using bilateral stimulation. Once we process the experience, we work with the therapist to reprocess the memory so we don’t have to have or feel as much pressure from the trauma as we did before.  The act of reprocessing in EMDR therapy means to change the way the memory is stored in the brain.  EMDR would work to decongest emotional memory networks making the traumatic experience feel less intense. While the memory cannot change, its emotional charge and the meaning we applied to it does, in fact, change.  

I remember when I went through the EMDR training.  I was terrified of the sound glass makes when it breaks.  I had a really bad experience where someone broke a window in my home years ago and the sound truly was traumatizing for me even years later.  While I will never forget what happened to cause the glass to break, I no longer shut down due to the broken glass and feel like the experience is definitely less vivid.  The fear of broken glass, for me, is now something that is less painful of a fear; one where I no longer shut down if I break a cup accidentally while doing the dishes at the end of a long, hard day.  I truly think about my experience with broken glass without the same physical and emotional distress that I once did.   

In EMDR therapy, you recall a traumatic memory, your therapist waves their fancy wand in front of you thus creating bilateral stimulation, and then you reprocess the experience that you originally recalled.  Sounds easy, right?!  Well, what if I told you that it’s our eyes (well, technically, our brain–the part that controls our Central Nervous System) that guides us through this process.  Francine Shapiro noticed in 1987, while out for a walk in the park, that her distressing thought felt less distressing after the spontaneous side-to-side movement of walking.  More than a few people have said that our eyes are an extension of our brains, which is possibly because our eyes are part of our Central Nervous System.  Not only was she looking around, Francine was moving from side-to-side while thinking about a traumatic thing that she, herself, was going through.  What a crazy observation to make while out on a walk and while using her Central Nervous System.

How does EMDR work with the Central Nervous System?

Think of our Central Nervous System as the driver of our protection – the command center – if you will.  As our body wants to protect ourselves from all possible danger or imminent threat of danger, we often trigger ourselves to enter what we call the “Flight, Fight, Freeze, or Fawn” response; we do this because we are accepting all new information into the command center and working to decipher if it’s a threat for us or not.  Our threats are then judged, sent to the CNS, and action quickly takes place.  It is our Central Nervous System that decides how we should respond to the threat, such as if we should stop/Freeze; leave/Flight; get stuck in space/Fawn; or kick into action/Fight.  While it is completely natural for us to go into the “Fight, Flight, Freeze, or Fawn” stages, it can also become problematic when we do, especially if it follows some sensation of trauma.

• Fight – A burst of adrenaline and/or cortisol prepares our body for an impending or perceived threat and has the person acting out to the threat through verbal aggression/assertion or verbal arguments.
• Flight – Our body wants to get away from the impending or perceived threat and has the person engaging in some form of avoidance tactic or they, themselves, leaving the situation.
• Freeze – Because our body is unable to leave or lash out, we will often freeze.  Freezing does not have to do with our bodies and can also include the idea of depersonalization and disassociation.  
• Fawn –  This response is commonly known as the “tend and befriend” response where the person tries to appease the threat by befriending, people pleasing, over apologizing, and other tactics.

When we experience any form of trauma, the protective parts of us can become very dysregulated and lead to symptoms clinically described as anxiety, depression, panic, stress, and even post-traumatic stress disorder, otherwise known as PTSD.  When we experience any form of trauma (like the ones that lead to what I just listed off), our trauma memories can get “stuck”.  

Remember that our bodies, minds, and spirit can and often do become dysregulated.  This act of dysregulation is directly what causes the “stuck” memories to occur.  These “stuck” memories are stored in the brain improperly, due to the dysregulation, and cause a disruption in the normal processing of information that we, just as normal people, encounter.  In EMDR therapy, our eyes work to process/reprocess these “stuck” memories (the traumatic memories; the ones that we are often most triggered by) by moving our eyes from side-to-side through what trained therapists call bilateral stimulation.  Sure, it is the bilateral stimulation (moving our eyes back and forth) that helps our brain process these “stuck” memories but it is our eyes that help us re-regulate our nervous system by allowing us to feel more balanced and calm.  

Why does this matter?

Let me ask you a question… knowing what we now know about the CNS, why do you think this matters?  We need to know how to calm and regulate ourselves because EMDR makes us relive traumatic experiences.  So, take a moment to think about it!  Take a few breaths.  In your nose; out your mouth.  Listen to some calm music.  Use aromatherapy.  Go for a walk.  Release some endorphins by having a moment to stretch.  Take a bubble bath.  Get yourself as grounded as possible … .because knowing why your Central Nervous System matters is a crucial component of EMDR because it allows us to understand our reactions, aids us in building resilience, and enhances our ability to internally regulate.  By doing the things that were listed right after I asked the question (or choosing only a few) can all work to help us through the calming of our nervous system as we work to unstick our “stuck” memories.

The Cleveland Clinic explains that following a “stuck” memory, even newer experiences “can link up to earlier experiences and reinforce a negative experience over and over again.  That disrupts the links between your senses and memories. It also acts as an injury to your mind.  And just like your body is sensitive to pain from an injury, your mind has a higher sensitivity to things you saw, heard, smelled, or felt during a trauma-related event.”  It is important to remember that our memories can get “stuck” with things we can remember happening but also things that we have suppressed.  Think of suppressed memories like this:  you know already not to touch a hot stove but do you know who told you not to touch it or why they told you not to touch it?  

EMDR does not try to help someone remember something.  Instead, because of the way we work to process information through the use of our eyes and the act of bilateral stimulation, people may recall certain things more clearly during the process.  EMDR does not create memories but it can help us find an association between the things that we are using to help keep our traumatic memories “stuck”, such as with sights, smells, sounds, tastes, or any other form of trigger.  

How Long Does EMDR Therapy Take?

So, let’s break this down:  EMDR therapy consists of eight different and very active phases.  It’s not like you can just go into a therapist’s office and tell them that you want to do EMDR and have them start waving that fancy wand, you know the one I told you about earlier in this article, immediately in front of you.  While some therapists will choose to do resourcing in the first or second session, the therapist has to get to know us and our eyes (well, most likely our reactions to what is happening in bi-lateral stimulation).  

To be completely straightforward, there are 8-phases of EMDR therapy with each phase consisting of different and multiple sessions.  Let me give you an example:  you decide to go see a therapist who specializes in EMDR therapy following a car accident that totaled your car and left you in agonizing pain.  From this example, everyone can tell that this is definitely a more complex memory and while it may not be one that is “stuck”, rather disturbing.  For a single yet disturbing event/memory, it can take between three to six sessions to work through this memory.  Likewise for longer-term trauma, such as abuse, a relationship breakup, or something more complex, you may have to work with a therapist for eight to twelve sessions (maybe even more) to work through the “stuck” trauma and get your eyes to relay the “I’m safe” message to our CNS enough times that we are able to process and reprocess that trauma.

The 8-Stages of EMDR:

1. History Taking – the therapist figures out the client’s history and work to isolate traumatic memories that are “stuck” so that the next step can occur.
2. Client Preparation – the therapist helps the client build coping skills.
3. Assessment – the therapist and client corroborate together to identify different sensations that are associated with the “stuck” trauma.
4. Desensitization – the therapist uses bilateral stimulation.
5. Installation – the therapist helps the client replace negative beliefs with positive ones.
6. Body Scan – the client focuses on the body sensations that come up while thinking about the combined negative experience with the positive thought.
7. Closure – the therapist will check-in with the client about how they are feeling and ensure that the client’s Central Nervous System feels regulated, even if the memory is not fully processed.
8. Re-Evaluation – the therapist works with the client to process the effectiveness of treatment as a way of maintaining progress towards the re-processing of the targeted (or “stuck”) memories.

While EMDR is quick, it still takes time.  We have to process and actively re-process different moments that were traumatizing for us, which takes time.  The reason for the fact that EMDR therapy can take as little as six to twelve sessions is the fact that the therapist guides you, but your own brain is doing the healing through its natural capacity to reprocess experiences. Another reason can be that unlike traditional talk therapy, EMDR does not require us to describe the traumatic memory in detail, which often makes it more accessible for people who struggle to rehash the traumatic experience they went through.  So, if you are struggling to rehash your trauma, are afraid to process some memory or experience, or just feel “stuck”, please know that you do not have to go through this alone.  

Knowing when to seek professional help for yourself or a loved one is the first step of changing the way you feel when you are feeling “stuck”.  If you or someone you know is struggling, please reach out.  There are trained therapists at Fresno Family Therapy here to help through the use of EMDR therapy and other modalities that are trauma-informed.  Please call (559) 795-5990 today; we are here to help.  Looking forward to waving my magic wand in front of you soon!

Resources:

PTSD-UK. “What happens in an EMDR therapy session?”  Retrieved at:  https://www.ptsduk.org/what-happens-in-an-emdr-therapy-session/  

Cleveland Clinic.  “EMDR Therapy.”  Retrieved at:  https://my.clevelandclinic.org/health/treatments/22641-emdr-therapy 

Manhattan Wellness.  “What happens to the brain during EMDR therapy?”  Retrieved at:  https://manhattanwellness.org/what-happens-to-the-brain-during-emdr-therapy/  

About the Author: 

Tammie Makely, LMFT

Licensed Marriage and Family Therapist #113186

• Addiction
• Trauma
• Couples Therapy
• Sex Addiction
• Anger Management
• Sexual Abuse
• EMDR
• Grief/Loss
• Anxiety
• Depression
• Stress management
• Co-Occurring Disorders
• Codependency Issues