Eye Movement Desensitization Reprocessing (EMDR) works in processing traumatic experience by utilizing something called dual attention stimuli.
If you choose EMDR therapy, I’ll lead you through a series of bilateral stimulation techniques to generate this physical sensation. By focusing both on the traumatic memory and on the eye movements or tapping and auditory tones at the same time.
During this process there is the traumatic image or thought in your brain with all of its terror and at the same time you are holding this other space—call it the space of peace and calm. That other place is beckoning you out of the disturbing image or thought.
That place of peace and calm has been there with you all along and even during the terror. It’s just that at the time of the trauma your brain went offline and lost connection with it.
With EMDR you’re supporting the brain’s ability to heal itself. It’s about stepping back and letting your brain do its thing to restore itself in the best way it knows how.
So what’s happening in that moment of trauma when the brain goes offline?
Let’s talk a little bit about the brain and its structures. First there is the prefrontal cortex. The prefrontal cortex is involved in executive functioning. You use it to focus and set your attention on something.
Because the prefrontal cortex collects general knowledge it enables you to generalize and anticipate the future. When your limbic brain wants to react, the prefrontal cortex helps you to separate out present day experience from what might be triggering your past experience.
For example, it helps you to control situations let’s say where your boss says something that you may similarly have heard from an abusive caregiver in the past and to distinguish the intent of your boss’s comment from the intent of the comment that may have come from your abusive caregiver.
So that maybe in that example you can have social reserve and not fly off the handle. The thalamus allows for the transfer of information between different parts of the brain and helps with things like regulating states of sleep. It also assists with motor functioning.
The thalamus receives all of the information coming into the brain and does the initial sorting of it to the various places it needs to go. It sends explicit memory information to the hippocampus and implicit memory information to the amygdala.
Explicit memory is composed of facts and general knowledge. It places you in space and time. Implicit memory is composed of emotional responses and bodily sensations. Implicit memory holds your reflexes and any classically conditioned responses.
Implicit memory does not help with the recalling of self in space and time. With implicit memory you remember your heart racing, the impulse you had to pull away, the physical pain you may have experienced from the traumatic event.
The thalamus also sends implicit information to the prefrontal cortex, but this information has to go through additional layers of processing. It gets to the amygdala first.
So that when you see a bear and run, because the information hits the amygdala first, you might first respond with fight/flight/freeze and run only later does the prefrontal cortex come online with exactly how fast to run and where to run, etc.
The amygdala is the brain’s smoke detector. It scans the environment for danger and determines if, like in the example above, you need to fight/flight/freeze. In other words, if it perceives danger, it initiates a response.
The hippocampus processes a substantial amount of explicit data and moves that data through sequential stages of memory—sensory memory, working memory, long-term memory, and cortical consolidation.
Traumatic events disrupt the processing of information by the brain instantly because of the extreme arousal they cause. All of the parts of the brain discussed are affected except for the thalamus. The thalamus continues to sort.
In a traumatic event a rapid rise in neurotransmitters, especially norepinephrine, take the prefrontal cortex offline. Cortisol and adrenaline also rise. This makes the hippocampus shut off because it is sensitive to these hormones.
Remember the hippocampus processes explicit data. When the hippocampus stops processing information continues to be taken in and sorted by the thalamus into implicit memory, but it does not get processed through all of these other structures.
Think about that.
That means the orienting of place and time, the accessing of facts and general knowledge that Is explicit information processed by the hippocampus does not get integrated with implicit memory or the bodily sensations and emotions taken in at the time of the trauma.
The deletion of unnecessary information doesn’t occur in the same way because of the hippocampus going offline, so there is all of that information you had taken in both explicitly and implicitly and it’s all sitting there en masse disconnected and fragmented.
Memory becomes unprocessed, in other words, and is frozen or neurologically held in its original disturbing state. So that even though you might take in new information as you leave the event and go about living your daily lives, your memory of the trauma remains pretty stable and unaltered.
For example, the person who gets bitten by a dog at the age of 3—even though they have spent the past 20 years walking through neighborhoods never getting attacked by dogs—still might have fear when they take a walk at the age of 22.
They may see from the periphery of their vision a dog getting loose from its owner’s leash and their heart may stop a little.
The past becomes present. The implicit memories are still alive and not integrated and oriented to their proper time and place at the true moment of fear.