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.
Dry eyes are another issue that comes up for many. If your eyes become irritated and you have trouble with slipping your eyes it could be because your eyes are too dry. This can be a simple fix. Clients often make sure they bring artificial tears or eye drops their eye doctor has recommended so they can use them during session. Of course, you can always ask your eye doctor and EMDR practitioner to consult with each other as well.
Speed of eye movements makes a difference as well. The eyes have to go fast enough for reprocessing to occur but not so fast that it is distracting. It can take some time to find that sweet spot. I find people often start out slower and with time as they learn to let go and let their brain do what it knows how to do, they are able to speed up their eye movements, which means reprocessing occurs faster as well.
Reprocessing vs thinking. – If you are thinking you are not reprocessing
One of the things I began to notice is that some people were only reporting changes in the memory we started with, and no other memories were popping in and out. I realized they were thinking and desensitizing but not reprocessing. I had to ask certain questions to see what they were experiencing.
This is not unusual since we tend to be control freaks and have to hold on and control everything. I did not see this as much when I first started learning EMDR in 1991. People were easily able to just watch what occurred and let whatever happen, happen. When a client is first starting to reprocess, I have to check in regularly to see what they are experiencing in the process itself, not just the change in emotions and content. This is one of the things I spend time on in Phase 2 of EMDR therapy now to prepare people to be able to dual focus and letting whatever happens happen.
Make sure you take your time and BE PATIENT. Allow yourself to learn what works for you with eye movements.
Now of course if you have physical issue where rapid eye movements will injure your eyes then do not do eye movements. This is where tactile or audio are great alternatives. I have had clients who had detached retinas and could not use eye movements. I did notice there was a depth of change they did not get but their results were still very good.
Do make sure that if you are using audio or tactile that you keep your eyes open while reprocessing. It is very easy to lose present time, dissociate, or relive a memory when eyes are closed. Remember dual focus. Taxing that working memory is what disrupts how the memory(ies) are stored. Keeping eyes open will help you get effective change.
DO NOT DO EYE MOVEMENTS ON YOUR OWN!!! Why? Without proper assessment and stabilization, you can get yourself into real suffering. Some people need specialty protocols. Right now, I am talking about the Standard Protocol. Not everyone can do the standard protocol right out of the box. Plus, there are interventions that often have to happen during the reprocessing that you will not have the training for. I know there are people who do demonstrations and post them on the internet making it look easy, but it is not always easy. And can be extremely harmful.
If anything, EMDR has taught me is that what I think will happen is not necessarily what will happen. In the early days what I thought would be easy to change would take a turn into a network of memories that was both surprising for the client and really difficult to reprocess. In other cases what I thought was going to be a huge deal would clear quickly. What EMDR taught me in the early days is that staying out of the way and having no expectations or agenda was the most effective for the person’s progress.
There are some people who have absolutely no memory of some pretty horrific memories. The brain does a lot to protect us when needed. At some point when a person’s innate wisdom feels the person has enough life experience, or resources now available, those memories come forward so they can be reprocessed. Doing eye movements on your own can speed that process up without the life experience or resources being in place.
Again, you should always be started with using eye movements for reprocessing, unless of course you have a physical condition with your eyes where rapid eye movements could cause harm. It can take three to six months for a person to learn to slip their eyes with ease. It takes some good coaching from a clinician to develop this capacity in some cases. You may find yourself eventually able to do much faster eye movements than when you started. This is a good sign. The faster the eye movements go the more quickly memory networks are reprocessed.