Finding the Touchstone Memory: What Happens During an EMDR Session?
By Ginger Poag, MSW, LCSW, Trauma Therapist at The Ranch
I am passionate about EMDR therapy, also known as Eye Movement Desensitization and Reprocessing, because I have so often seen it change people’s lives. Many people I see at The Ranch have never heard about this trauma therapy and are naturally skeptical. They don’t think it’s going to work, but they often leave a session saying, “Oh my gosh, I’m a completely changed person.”
I’ve found that because EMDR treatment is such a specialized therapeutic approach, people feel more at ease when I explain how it works. Below are some questions I commonly get from people interested in EMDR and details on what happens in an EMDR session.
What Is EMDR Used to Treat?
Research shows that childhood trauma can impact the brain in many ways, and if left unaddressed, can lead to:
- Anxiety disorders
- Mood disorders
- Post-traumatic stress disorder (PTSD)
Trauma memories get stored in the brain’s limbic system and EMDR therapy is a leading trauma therapy designed to encourage the brain to heal itself and help people address some of these issues.
How Long Does EMDR Last?
An EMDR session generally lasts from 60 to 90 minutes. The number of sessions needed varies from client to client. Many people start experiencing a decrease in symptoms in just three sessions, while others may need several EMDR sessions to really get to the root of their issues.
As a trauma therapist trained in EMDR treatment, I act as a guide to the client and offer prompts to help them access and heal these painful memories. This often requires going far back into their traumatic childhood and focusing on things that were ― and still are ― difficult and uncomfortable. The moment of accessing memories often feels like that moment is being relived. But the beauty of this therapy is that the brain does all the work of self-healing. Some people can reach this place pretty quickly, and others need more time.
What Are the Goals of EMDR Treatment?
Clients come in with depression, anxiety, addiction and substance abuse and the purpose of the EMDR session is to look at the root causes. Many people cannot remember the exact moment that changed their lives ― even if they generally have a good memory. A session is a chance to look at the instance in which they believed trauma occurred and follow it through.
- Exploring past history. The first step is to take a lengthy history and discuss some of the trauma that a client has experienced. They may be aware of a specific disturbing event in their lives but they may not always be cognizant of the impact it has had. They also may not remember it clearly, or immediately, until the part of the session in which the memories are prompted.
- Finding the touchstone memory. Childhood trauma can include neglect, sexual abuse, physical abuse or emotional abuse, so I work with the client to try to identify the memory at their youngest age. It’s called the touchstone memory, and it is the memory that all the other traumas in life are built upon. If trauma can be knocked out at its base, the trauma will be diminished. The actual memory does not go away, but it will not have the same negative impact.
- Sorting through multiple memories. Some people have many traumas to deal with. For example, with first responders, who have seen so much due to their occupation, the goal is to target certain kinds of memories rather than a specific one. I might suggest, “Thinking about all the traumas that you’ve had over your career, is there one that represents the worst?” That trauma memory will become the starting point.
- Diving in deeper. The session may begin with what is assumed to be the touchstone memory, but all of a sudden, there will be an “aha moment” and person may say, “I remember something even before that, a time when.…” As I work with a client on one memory, it very often will jiggle loose memories from an even younger age.
- Prompting hidden memories. Because memories can get locked into the limbic system, and some people have multiple traumatic moments in their lives, it is not always easy to identify the initial trauma. As a therapist, I often have to “tweeze” trauma out by prompting clients, moment-by-moment, to go as far back into their memory as possible, and to then go back even before that. A series of verbal prompts helps them follow the path all the way down to the first memory. The memory may not be fully formed. It could be the first time they can remember feeling something wasn’t right, feeling neglected or like they didn’t have their parents’ approval. Deeply traumatic memories, such as sexual abuse, are often buried. EMDR therapy helps unearth traumatic memories and release their power over the individual.
What Is EMDR and How Does it Work?
There are a couple of methods used for EMDR treatment, the original being that the therapist would sit in front of the patient using their fingers to direct eye movements. I typically use slightly more high-tech equipment. Regardless of which method a client opts for, an EMDR session always aims to stimulate the left and right hemispheres of the brain, using these tools.
- Light. There’s a light bar on a tripod and if the client prefers that method they can sit in a chair. I will move the light bar in front of them, and they will move their eyes from right to left, following the light. I can adjust the speed and the frequency of the light according to their needs.
- Tapping. We also have something called tappers, which are small hand-held devices that buzz softly in the hand. Most of my clients like these because it gives them something to hold onto, and they can close their eyes and visualize, or just let therapy do its thing without having to worry about following something with their eyes. The client sits comfortably and holds “tappers” in each hand. The tapper will alternate vibrating in the left and right palm, creating bilateral stimulation ― from the right hand to the left hand, then from the left hand to the right, etc.
Clients are invited to be present in the room as their adult selves looking at their childhood pain with all the maturity and ability they currently have. Even an adult with a career and a family still has a part of them that is like that small child who was hurt, ignored, neglected or abused. It is important that they remember that they are now grown up enough to deal with this old pain.
Change doesn’t happen overnight. People will often have multiple sessions and keep digging deeper into these memories. This trauma therapy doesn’t wipe away the memories. But it does lessen the possibility that memories will be triggered and lead to maladaptive behavior. Removing the emotional charge through EMDR therapy takes the power out of the memory.
In a sense, EMDR gives them a chance to grow up — for the first time — and leave the burdens of history behind.
Is EMDR Covered by Insurance?
If an individual’s insurance offers a behavioral health component that includes psychotherapy, EMDR will likely be covered. More and more insurances are recognizing EMDR as medically necessary for treating conditions like PTSD. Some insurances will require the provider have certain credentials (e.g., specially trained in EMDR and a licensed therapist or have a certain type of degree). Many insurances cover a set number of sessions per year.
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