EMDR for PTSD: My Understanding of Why and How It Works

imageEMDR (Eye Movement Desensitization and Reprocessing) is a therapy for PTSD that works surprisingly well.  I will discuss here my understanding of how and why it works.

I am not a trained medical professional.  My understanding seems more intuitive than how it is being currently presented (source). The underlying principles being simple makes EMDR a powerful and easy-to-apply treatment with rapid relief.  Since I’ve had to explain my model several times, writing it down in hopes that it may help. With that said…

The Simple Brain Model & PTSD

  • Let’s assume that a human brain is a graph.  A collection of nodes connected to each other.
  • Then PTSD is when a trauma event (T) causes trigger nodes (N1, N2, … ) to have a disproportionately strong connection to a negative emotional response (N)

For example, if someone experiences a shooting, trauma causes a disproportionately strong connection between a negative emotional response and triggers like loud claps.

As the brain is a neural network / computer, seems natural that:

  • The brain has limited capacity for processing information.
    (can only think about so many things at a time)
  • Processing information strengthens a relationship between the nodes involved.
    (if you remember ice cream and rollercoasters right after each other, you strengthen the connection between the two)

So the goal is to recalibrate the brain.  Specifically, the goal is:

  • to weaken connection between trigger nodes and negative emotional response
    (if there is a clap, it should not evoke a strong emotional response)
  • this can be achieved by strengthening the connection between a trigger node and a positive emotional response (P)
    (remember the clap, remember warm sun, now you will feel just a little better when you remember the clap)

Note that, because the brain has limited capacity, the following is a reasonable conclusion:

  • if you introduce a secondary stimulus, the brain cannot 1) recall, 2) process secondary stimulus, and 3) have an emotional response
    (if you are asked to remember trauma while following fingers moving back and forth, you don’t have enough bandwidth in the brain to feel bad at the same time)

This last bit is the key to EMDR.

EMDR – Recalibrating the Brain

To recalibrate, we need to trigger recall in a guided manner to strengthen positive response without a triggering negative response.  Here is how it may be done:

  1. Get Positive Assets:
    The Guide asks Subject for things that have positive emotions and writes them down into a library (A)
  2. Recall Trauma w/ Secondary Stimulus:
    The Guide asks the subject to recall traumatic events (T) verbally while providing a secondary stimulus – a distraction.  This can be following a moving object back and forth with your eyes, paying attention to rhythmic taps, or perhaps anything that distracts.  Since the brain has limited ability to process information, it cannot process A) recollection of trauma, B) secondary stimulus, and C) emotional response all at once.  As a result, trigger nodes (N1, N2, …) are recalled / processed, but emotional response is prevented / delayed.
  3. Halt on Escalation:
    As soon as the Subject’s negative emotional response is triggered, the Guide stops recall and immediately…
  4. Trigger Positive Assets:
    The Guide asks Subject to recall a positive event (A from Step 1).  This recall brings the trigger nodes (N) and positive emotion (P) into temporal proximity.  This strengthens the positive connection thus recalibrating emotional response to the trigger nodes.
  5. Continue:
    Once the Subject’s emotional state is restored to normal, the recall of trauma is continued.

So what we see is that the Subject recalibrates their response to the various triggers by 1) remembering triggers while 2) blocking negative emotional response, and then 3) triggering a positive emotional response.  The result is recalibration.

I’ve had several friends who have asked me to do this with them and, according to them, they received immediate and lasting relief.

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