EMDR Therapy and Eating Disorders: A Way to Process Past Trauma
Written by ‘Ai Pono Hawaii Staff Writer
EMDR, or Eye Movement Desensitization Reprocessing, is a psychotherapy designed to help trauma sufferers be able to process their experiences. “Process,” in this sense, does not mean talking about it. Rather, processing means setting up a mental state that allows harmful experiences to be fully “digested” and stored properly in the brain. EMDR therapy is based on the idea that present problems and harmful behaviors are the result of unprocessed memories, unmanaged current stressors, and the failure to prepare for future distressing events. It was first designed to address PTSD, but EMDR has also been widely used in an integrative approach to eating disorder treatment.
EMDR Therapy: How it Works
The best way to understand EMDR therapy is to think about how one heals from trauma, because that’s what EMDR therapy was originally made for. When it comes to trauma, emotional healing can be thought about in the same way as physical healing.
For example, when you have an open wound, the body works to heal it. But if there’s something in the wound, like a piece of glass, then it can’t.
Trauma is like that piece of glass: the mind wants to heal and be well. But unprocessed, painful, traumatic events keep it from being able to. These unprocessed events, the negative feelings they cause, and the negative self beliefs associated with them, all block the mind’s ability to heal.
The Adaptive Information Processing Model
EMDR therapy is based on the Adaptive Information Processing (AIP) model. It works like this: it is assumed that the mind is able to process and store information normally, and connect it to other memories. However, if this processing does not happen, for example, with a distressing event, that memory is not properly stored. Instead, it is stored in an unprocessed, emotionally charged form. When that memory is triggered by an internal or external stimulus, such as a particular thought or sensory input, the mind responds in a maladaptive way. Remembering is painful, and the mind wants it to stop in any way possible. A person develops unhealthy coping mechanisms to handle the pain: this is how past experiences cause present problems.
EMDR works to help an individual access painful memories in a safe environment, gather more information about the event and self beliefs associated with it, and eventually be desensitized from the event. Being desensitized means that if the memory of an event, or future encounter like that processed experience, occurs, the individual will not have such a strong response. They won’t need to use unhealthy coping mechanisms to manage their emotions.
Why the Eye Movement?
REM, or Rapid Eye Movement, is often associated with REM sleep. This is a stage of deep sleep, when information is processed and stored. The eyes move rapidly back and forth. Brain chemistry starts to normalize and new memories and associations are stored away.
But the REM stage of memory access and formation can be activated outside of sleep.This is done in EMDR by causing the eyes to move back and forth, in the same REM motion as when you’re sleeping. If you’re curious about how eye movement allows memory access on a neurological level, here is a simple explanation.
EMDR (recall that this stands for Eye Movement Desensitization and Reprocessing - it’s a long acronym, after all) is the process of consciously activating REM, which consciously activates previously blocked memories. Clinicians are able to guide the client to specific memories.
To see what REM physically looks like, watch this video.
What Happens in an EMDR Therapy Session?
The EMDR therapy process happens in eight steps. All of these steps are taken so the client feels safe enough to access painful memories.
History-Taking
The clinician will ask about a client’s current problems and past experiences, everything from childhood experiences to family relationships to current stressors. They ask about the emotional and thought responses clients have to these experiences, as well as the coping mechanisms currently in place to manage those responses. This typically takes one to two sessions, and can continue as therapy goes on, if new things come up.
Preparation
Clinicians then explain how EMDR works, and why it may be useful to help with the client’s current problems and maladaptive coping mechanisms. More importantly, clinicians teach clients rapid coping skills that allow clients to handle any severely painful emotions that may arise during EMDR therapy. And most importantly, the clinician must work to build a Pocket of Trust between the client and themselves.
Assessment
A client is then asked to recall a specific experience to process. They are asked to recall an image from an event discussed during their evaluation that most strongly represents the event. They are asked to notice the negative emotions that arise, and the physical sensations they feel when recalling the event (nausea, shaky hands, etc.). The next step is used to lessen the emotional impact of the memory, decrease the perceived truth of the negative belief, and increase the perceived truth of the positive one.
Desensitization
In this phase, the clinician moves their finger or a light back and forth and asks the client to follow it with their eyes. This stimulates REM, which allows direct access to the memory and the neural pathway that the memory comes from. Clients are able to process the event and gain insight from it.
This processing is repeated several times in a single session. After each reprocessing, the client is asked to rate their emotional distress. The goal here is to reduce the emotional power of the memory, allowing the client to become desensitized to it, and not need to use harmful coping mechanisms.
This is useful for the specific harmful event that the client is working through, but can also be helpful for resolving distress from events like it, whether they have already occurred, or might in the future.
Installation
During the recall, the client uncovers a negative self belief that exists because of the memory. Then, they consciously decide on a positive self belief they would prefer to believe. The statement should be something that invokes a sense of self-control, especially because traumatic events are associated with a sense of having lost control. The client is asked how true they feel the positive and negative beliefs are.
Here, the negative self belief is targeted. The client is desensitized from the emotion of the event, and can work on the self-perceptions that come with it.
For example, in this case study, Mike, a retired military flight medic, was reprocessing the loss of two fellow soldiers during a rescue mission. The outcome of this belief was this persistent belief: “I am a failure.” Throughout an EMDR session, this belief was minimized, and replaced with the positive belief: “I did the best I could.”
The goal, then, is for the client to install the positive belief as an accepted truth, and to let go of the negative one.
Body Scan
The body has a physical reaction to unresolved memories. The body retains the information associated with the traumatic events, and can’t be released until they have been processed. If any tension is stored in the body after a body scan, then that is targeted for processing.
Closure
This happens at the end of every therapy session. The clinician ensures that the client leaves feeling better than they did when they came in. If the trauma is not fully processed, the clinician ensures that the client has healthy coping mechanisms in place to retain a sense of balance and emotional control.
Reevaluation
This happens at the beginning of the next session. The success of treatment is evaluated. Often clients feel better as soon as they leave a session, but the treatment must be sustainable outside of therapy. Emotional distress should be lowered, maladaptive coping mechanisms reduced or eliminated, and future triggering situations prepared for.
EMDR and Eating Disorders
Trauma and eating disorders often present themselves together. But EMDR therapy can be useful for several eating disorder related experiences and beliefs, including:
Distressing memories of negative experiences
Fears related to the eating disorder
Eating disorder behaviors you feel compelled to use
Low self-esteem
Perfectionism
Negative body image
Eating disorder behaviors are used as coping mechanisms for distressing situations, feelings and memories. If these are processed in an adaptive way, then these behaviors will become less and less needed. Positive self beliefs are also very motivating for recovery.
EMDR therapy can help eating disorder sufferers reduce emotional distress and better manage triggers. EMDR may be used in combination with cognitive, narrative based and dialectical behavioral therapies, for a holistic approach to eating disorder treatment. By learning to manage stressors, and processing the underlying beliefs associated with food, full recovery is possible!
If you or a loved one is suffering from an eating disorder, take the first step today and talk to someone about recovery or start by learning about the eating disorder recovery programs we offer.