ARTICLE

EMDR: An Indispensable Tool for Trauma Therapists

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EMDR trailblazer Laurel Parnell explains how training in EMDR can help therapists work with clients with traumatic backgrounds (which is pretty much everyone).


Omega: Why would a therapist want to include Eye Movement Desensitization and Reprocessing (EMDR) in their toolbox?

Laurel: First of all, this is an evidence-based therapy with decades of research behind it. Next, and this is something that trauma specialist Bessel van der Kolk talks a lot about, is that if you’re basing your trauma work on talking, you're not reaching where the trauma is stored. Trauma is stored in fragments in the right side of the brain. Talking is based in the left side of the brain and also uses the frontal lobes, which are offline, so to speak, when somebody is lit up in trauma. You’re going to be much more effective if you go where the trauma is.

Omega: How would a therapist know if a client is a good candidate for EMDR?

Laurel: There are a wide range of clinical applications for EMDR. It’s for anyone with a "big-T" trauma, which are the kinds of trauma that lead to post-traumatic stress disorder, like war or horrible accidents—anything that causes flashbacks, nightmares, anxiety, or hypervigilance.

It’s also good for clients with "small-T" traumas, which all of us have. These are traumas that create a narrow view of ourselves and what we can do in the world, like humiliation, shame, or not feeling seen or understood. It’s also the accumulation of hurts we experienced as we grew up. Working with these requires more skill on the part of the therapist, but it’s possible.

Clients who are very unstable and are currently psychotic, self-harming, or completely flat, with no affect, are not well suited to EMDR. Also clients who don’t respond well to bilateral stimulation or who are not motivated or willing to do the work to feel the feelings, like sociopaths—it wouldn't work for those people.

Omega: Can you explain what Resource Tapping™ is and how therapists can use it as part of EMDR?

Laurel: It was formerly called resource installation, and was part of the original EMDR protocol. You imagine a peaceful or safe place and once you feel relaxed by that, you pair those feelings with bilateral stimulation (tapping on the side of your legs or crossing your arms and tapping opposite shoulders or holding a stimulator button in each hand) to lock the image and the sensation into your nervous system so you can access it later.

Over time, those of us who work with severe trauma and childhood trauma realized we needed more than just a safe place, so I added to it and I called it the four foundational resources. We use the peaceful place plus nurturing figures, protector figures, and wise figures. We install these resources in the nervous system to stabilize and strengthen people before doing the trauma processing work.

I wrote a book for the general public and instead of calling it resource installation, I called it Tapping In. It’s a more user-friendly term that reflects that you’re activating your inner resources.

Omega: How is this different from the Emotional Freedom Technique (EFT), which is also called tapping?

Laurel: With tapping and EMDR, we're working with neural circuits. We light things up and then link them with the tapping. Or we light them up and use the tapping to allow this rapid processing effect to link information that’s not linking up on its own. So there’s free-associative processing and the linking up of neural networks.

With EFT you tap on specific acupressure points to open up energy channels, or meridians, that have been blocked. You’re not linking up neural circuits; you’re unblocking things that have been blocked energetically. It’s an energy therapy.

Omega: Can you describe the particular approach you have created, Attachment-Focused EMDR?

Laurel: The whole neurobiology of trauma and the recognition of the importance of attachment and attachment repair is changing how we work with people. For example, let’s say someone is diagnosed with borderline personality disorder. When I bring an attachment-focused lens to that diagnosis, I learn that there is an insecure attachment. That is, this person came from a home that was disrupted. Maybe there was abuse. Maybe there was neglect. Whatever it was, there was not a stable, loving parent to attach to in a safe way.

To help them emotionally regulate, this person does all kinds of things that show up on the list of behaviors and symptoms of someone with borderline personality. It’s not easy, but we can work with someone to change this. My contribution to the evolution of EMDR is using tapping—the imagination and bilateral stimulation—to repair developmental deficits like this.

If people have never had a secure attachment in their life—if they didn’t have a loving, secure family life—something is missing. It’s not that something happened to them, it’s like they’re missing an internal structure for healthy relating.

What I’ve found is that if they can imagine a loving mother, loving father, or loving family, they can go back and redo their development using imagination and bilateral stimulation within the context of a healthy therapeutic relationship. This is how we're rewiring people for healthy attachment and we're getting amazing results with this.

Omega: Could you give an example?

Laurel: Let’s say you never had a stable home life. You went from foster home to foster home, you had addictions, you had a family with addictions, your foster homes were insecure, and maybe there was abuse involved.

What's missing from your life is a basic internal template for healthy relating. You just don't have it. If you want to self-soothe, there's no template for self-soothing. There were never loving arms that held you when you were distressed.

We go back and create a loving mother who really understands and fits this person's needs. This isn’t a “good enough” mother. This is the ideal mother. They get to have exactly what they need. They imagine her and feel it and then we add bilateral stimulation. Now they’ve created in their mind what they needed.

Then we go back and we imagine being in the womb of this mother who loves you and understands you and is happy. And then we add bilateral stimulation. Then we slowly move up the developmental scale, moving through birth, skin on skin time, loving gazing, and so on, reimagining what the person needed. We pair each stage with bilateral stimulation, linking it and knitting it into the person’s nervous system. This is what changes people.

Omega: Does a therapist have to be an attachment therapist to take your EMDR trainings?

Laurel: No, they just have to be a licensed mental health practitioner who is licensed to practice independently.

Omega: Where is the current frontier for EMDR therapy and our understanding of the brain?

Laurel: There are some people who don’t seem treatable. For example, sociopaths who don’t have a conscience because they were born that way. It’s not like they experienced a trauma to get that way, they just came in that way. We need to learn more about what their brains are like. If they truly are untreatable, then how do we name it as a brain function issue and keep those people in check? How do we work with that societally? Individually?

Many sociopaths are charismatic and they become leaders, whether they’re leading a cult or a country. So we need to ask how their brains operate, but we also need to ask how our brains operate in response. We see how easily people do whatever leaders say, even sociopathic ones, and we need to learn how to wake up to that phenomenon and not go to sleep and just follow blindly. Really understanding the brains of the perpetrators at the top and the brains of the people who are susceptible to their rhetoric is the question of our times.