One of the things Dr. Shapiro discovered in her famous walk in the park, when her thoughts were moving from negative to positive, was that her eyes were moving laterally and rapidly. Hence the name Eye Movement Desensitization Reprocessing. EMDR started out as EMD, Eye Movement Desensitization. Initially it was observed that a memory that was targeted became desensitized. As experience progressed it was noticed that people were accessing other memories besides the initial target, thus Reprocessing was added to the name. We still use EMD in certain circumstances as needed to contain overwhelming emotions to desensitize.
Dual Focus
One of the things we know is that for EMDR reprocessing to be effective a person has to be able to dual focus. There are two components to that.
1. You have to be able to pay attention to what you are experiencing during the reprocessing at the same time you are watching the visual bilateral stimulation, eye movement tools for facilitating your eye movements.
2. You also have to stay present in present time as you are observing what occurred in the past. When people lose present time, they often relive the memory not reprocess it. Essentially, they are flashing back to the past and it feels like it is happening to them right now. With dual focus, being anchored in present time disrupts how the memory is stored.
When you are doing eye movements, because your eyes are open, you stay in present time, you have to move your eyes back and forth and notice what is coming up (different aspects of the memory, sights, sounds, smells, tastes, sensations, beliefs, locations, circumstances, other memories).
Essentially when you focus on two things at once you are taxing working memory. Focusing on two things at once does not allow you to do either effectively. Although there are a lot of people who would disagree with that. But this is how the brain works. It also disrupts how the components of memories are stored. Images become less vivid, more distant, sometimes go to black and white, sometimes fade altogether. Sounds fade, tastes and smells go away. Uncomfortable or painful sensations become neutral. Ways you view the memory and beliefs about yourself change and become more accurate, neutral, positive.
I can’t tell you how many times when a client finishes reprocessing a memory, they report that the memory is irrelevant. And this can be horrific memories. It is stunning! “It doesn’t matter.” “It is in the past and does not matter any longer.” “It’s over.”
Bilateral Stimulation - Eye Movements * Tactile * Auditory
When I started with EMDR in 1991 eye movements were all we used. As more clinicians were using it more and more feedback came in that some people were having difficulty with eye movements. Clinicians began using other forms of bilateral stimulation, tactile and auditory. I am also trained as a body-centered psychotherapist, so I had a propensity toward using more tactile means. Of course there was no research on any of this back then.
One of the things I began to notice over time was that my clients were not getting the same depth of change with tactile and/or auditory bilateral stimulation. So, I returned to doing eye movements and to both myself and my clients’ surprise they were getting better results and more depth of change.
The research is now bearing that out. All three tax working memory. What does that mean? Here is a research article if you that may give you more specific details.
Essentially eye movements are three times more effective. But tactile and auditory do work.
I find that most people are not even offered eye movements, which should always be the number one choice. I have had many clients over the decades who had never even been offered eye movements. In all cases they had a much more efficient and deeper change with eye movements. Some were really angry they were never offered the option in their previous EMDR sessions.
It seems that some clinicians offer what they prefer instead of starting with eye movements and then offering alternatives if needed.
Now the other thing to be aware of is that you may not like it, or think you cannot do it, or that it is too hard. I use eye movements with my clients 100% of the time, unless there is a physical issue that prevents them from being safe. How do I do that?
People seem to have to learn to do eye movements, in this day and age. When I started in the 1990’s it was not an issue. People could do them with relative ease. I have to teach people how to do them now. First of all, everyone does them when they are sleeping. Your eyes move rapidly when you are in REM sleep, so you are physically capable. I find much of what makes it hard is people are looking back and forth rather than letting their eyes slip back and forth. There is nothing to look at. Everything may very well be blurry; it does not need to be in focus. The strain they are experiencing is that they are looking, trying to focus, not relaxing and letting the eyes slip. Essentially, they have to let go of their eyes to let them slip. This resolves 99% of the problem.
It can make a difference if people are looking up slightly, at eye level, or looking down slightly. Trying each is how you discover which works best.
Sometimes it can take a month or two to learn to let eyes slip. But this is also true of learning to let go and let whatever happens happen in reprocessing. It can be a learning curve.
