What is EMDR? Can it help with trauma?
Trauma is a psychological injury
At the most simple level, trauma is a psychological injury. Humans are resilient beings and we get through many difficult experiences with few issues. As an example, perhaps you and a friend are driving and almost get hit by another car. You are OK but pretty rattled that you almost had an accident. You talk about what happened and keep driving and with some time you settle down and eventually the almost accident is a story that you might share with friends. You might also have a very clear memory to be extra careful when driving on that particular stretch of road. In this case something scary happened (a near miss) and your brain was able to process what happened, your emotions shifted from terror to overwhelm to rattled to calm with some time passing.
What if this wasn’t a near miss but a bad accident? While your brain may be able to process what happened, sometimes in moments of terror and overwhelm it can’t. Perhaps as time passes things become better (you recover from physical injuries, you get a new car, etc.) but your brain keeps reliving the experience of what happened. When you drive you get triggered and you respond like you were still in the accident. Maybe you can’t even go near the road where the accident happened because it is too overwhelming. It is like the memory of the moment of the accident is locked in your brain and won’t change. This is trauma.
Big t and little t trauma
The car accident I mentioned above is an example of a single very overwhelming traumatic event. Often when we consider trauma we think about big experiences like accidents or being the victim of a crime or a soldier experiencing combat. However, trauma can also happen when there are a series of smaller, less overwhelming experiences that nonetheless cause psychological injury. Being bullied constantly at school as a child is a good example of this. While one bad day at school might not have been as overwhelming as a car accident, years of being bullied can cause the same psychological injury.
How is trauma different from PTSD?
Trauma and PTSD are often used interchangeably but aren’t the same. Trauma is a psychological injury that occurs after a single incident or a series of multiple incidents. PTSD (post-traumatic stress disorder) is a mental health diagnosis based on a series of symptoms resulting from trauma. Not all trauma can be diagnosed as PTSD but all PTSD involves some form of trauma.
Can trauma cause anxiety and depression?
By definition trauma means that something bad happened and it may be over, but you feel like it is still happening. These are called intrusive symptoms and they show up differently for everyone. Some individuals get triggered and feel a sense of overwhelm, dread, anxiety, terror, etc. Others feel rage and anger and some people feel more depressive symptoms. In all cases, something in their environment triggered the trauma memory and their nervous system became overwhelmed. It can feel like anxiety or depression or even numbness. Often individuals who seek out help for symptoms like anxiety or depression have underlying trauma that causes their symptoms.
How EMDR works and how it can help
In the car accident examples above, the difference between the two is that in the first example the brain was able to process what happened and recover. The emotions tied to the memory were able to subside and what was left was a useful memory (remember to be careful on that stretch of road), however, in the second, the brain didn’t get to do it’s usual processing work, it was stuck in the emotions of what happened in the moment. The memory associated with the accident was full of emotion, like the person was still there and it was still happening.
This is where EMDR can help. To understand how EMDR works it can be useful to start with sleep, specifically dream sleep or REM (rapid eye movement) sleep. REM sleep is the state of sleep when memories get processed and stored for later retrieval. In the first example it is where the near-miss accident gets processed and stored as a useful memory about driving carefully. When we wake up from sleep we often can recall what happened before but without the same emotional content (as the saying goes: you’ll feel better after sleeping on it).
With EMDR, the painful experience is revisited and processed using a protocol that incorporates rapid eye movements. EMDR replicates the rapid eye movements of sleep by using lights, tones, taps, and/or sounds. When EMDR is used to work with traumatic memories it can help memories shift from painful emotional experiences to helpful, adaptive information. While you can still very easily recall everything that happened in your past, there is no longer as much painful emotion associated with it. EMDR can be used for a single traumatic incident like a car accident and it can also be used for more complex trauma like being bullied as a child or for victims of child abuse.
The goal of EMDR is to reduce psychological pain.
Ultimately EMDR is targeting painful emotional memories and helping them transform into more adaptive memories. This means that experiences like anxiety and depressive symptoms, as well as other symptoms like intrusive flashbacks, often decrease after EMDR treatment. When symptoms decrease you can spend less time struggling and more time moving toward the life that you want to live.