As you might have surmised already EMDR is different than traditional talk therapy. Here is a quick take on some significant differences:
1.
First of all, EMDR is a Form of Limbic System Therapy
Trauma doesn’t reside in the part of the brain that is concerned with reason and insight; it inhabits “deeper parts” that shape our temperament, the way we understand the world, and our automatic reactions.
In therapies that target the Limbic System we are creating new experiences that allows the brain to reorganize and reprocess experiences that have been stored maladaptively. The goal is to help the “emotional brain” get unstuck from the pattern the trauma has created.
This approach to therapy is often referred to as a “bottom-up approach”. This is a reference to how the brain is structured.
The rational, conscious brain (AKA the prefrontal cortex) is the youngest part of our brain and, evolutionary-speaking, has only been around for a little bit. It is also smaller than the rest of our other brain parts. Located up front just behind our forehead it is nestled up against larger, and much older, parts of the brain. Just behind the prefrontal cortex is the Limbic System (or “Mammalian Brain”) which is primarily responsible for assessing threat. And just beyond that, connected to the spinal cord, is the oldest part of the brain comprised of the hypothalamus and brain stem (AKA the “Reptilian Brain”). This part of the brain is responsible for autonomic processes such as breathing, temperature regulation, and hunger.
The limbic system and the brainstem together are considered the "emotional brain". And their main job is to regulate us. So if we come across something that is stressful we will get a shot of stress hormones to let us know what's going on and a whole bunch of other processes go into effect before we even get a chance to think about it.
For example, let’s say you are walking in the road and see a snake. Without even thinking you may jump back reflexively and find your heart beating faster. You notice you are poised and ready to run or defend yourself against the snake. Turns out the “snake” is only a hose, but that doesn’t matter to your “emotional brain”. Years of evolution have programmed it to “serve and protect” so it does (without any regard to the prefrontal cortex, or “thinking” Brain). And this reflexive response, as the Limbic System sees it, is an act of kindness. (After all, if it had waited until checking with the prefrontal cortex it might be too late and we would have received a dose of deadly Venom!)
These are the systems at work when dealing with trauma. Therefore, our work consists in getting our protective system to calm down because it’s efforts to “protect us” are causing mixed signals in the brain and getting in the way of us living our lives in a peaceful way.
The emotional brain initiates pre-programmed flight plans. The systems are automatic and go into effect even before our conscious brain knows what's happening. This is why an insight-based regimen of “talk therapy” may not always be appropriate for certain symptoms we are experiencing. And this is why we often feel that even though we me have a cognitive understanding of why we are unhappy, it is difficult to get our system to react differently. Many clients come to therapy with a lot of self-blame--"Why can't I just get over this?! I know I'm safe now! But my mind won't let me rest." It can be helpful to remember that healing trauma isn't about sheer willpower. Traumatic "relivings" are actually a normal human reaction to difficult events in our personal history.
When treating trauma, then, we need to create a new experience that contridicts the lesson that specific part of the brain has learned from the trauma experience. That new experience can reprocess and re-wire what the trauma has done to us.
2.
Another difference in EMDR therapy is that we may talk less.
In EMDR therapy there is a distinct emphasis on giving your brain time to process rather than giving you time to verbalize all that you have experienced or are experiencing. This doesn’t mean that we don’t talk at all; it just means that we need to remember that the “real work” is done while processing and you may find that you aren’t talking as much in the way we often assume we will in traditional therapy.* The important thing is that you are aware of what you are experiencing in the moment (images, sensations, thoughts, feelings) not whether you can communicate all of that to me or not.
3.
That brings us to another difference in EMDR therapy: You don’t have to share everything you have experienced or are experiencing for it to work. As long as you have, say, the image in mind and are aware of it you are free to select what you share with me and what you don’t. True, verbalizing often helps focus our awareness of what we are experiencing and I still encourage you to share with me what you are noticing while processing, but you may choose to say something like this, “I have an image I’d rather not share” and we can still process it together.
4.
Lastly, EMDR therapy is different than traditional talk therapy because it utilizes bilateral stimulation (BLS) or left/right movements while processing. To some this is the “weirdest” part of EMDR therapy. I invite you to read my article on BLS and ask me as many questions as you like about the process so you feel totally comfortable with your experience.
**One more word about talking. I believe that talk therapy is “processing” as well; albeit, a less direct form of processing. Those who do EMDR therapy may find it helpful to share with their therapists something like “Today I just need to talk.” Meaning, you would like to take time to verbally break down what you are experiencing. At other times you may sense that you just need to jump into processing.
My personal preference is the client decides where we go in session. I’m never going to force processing on anyone. I will sometimes ask at the beginning of session, “Are we going to jump into processing today?” but ultimately you decide the direction we go. Therefore, it is often helpful for you to decide what would be best—processing or “talking”—as we go into session together.
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