Understanding Trauma and EMDR: How Traumatic Experiences Can Be Processed and Healed

What is trauma?

In psychology, traumatic experiences are defined as experiences that threaten an individual’s psychological integrity and overwhelm their capacity to cope. Trauma typically elicits feelings of intense fear, helplessness, hopelessness, terror, shame, or a sense of having no control.

While trauma is often associated with life-threatening situations such as serious accidents, assaults, natural disasters, war or situations involving significant danger, it can also develop through experiences that appear less obvious.

Childhood abuse or neglect, invalidation, family violence, parental substance abuse, and generally growing up in unsafe environment affect a child’s sense of safety and self-worth, especially when people they depend on for safety are involved.

Trauma can also arise within relationships and in workplace settings: emotional abuse, controlling behaviour, bullying, discrimination, humiliation, intimidation, can all have a significant psychological impact, particularly when a person feels powerless or unsupported.

Furthermore, challenging medical or reproductive experiences, significant financial stress, and other life circumstances in which a person feels overwhelmed, without control or unable to cope can be perceived as traumatic.

The impact of adverse experiences varies greatly: the same event affects different people differently, depending on their personality traits, developmental stage, available support, previous experiences, and the meaning they make of what happened. What matters clinically is not only what occurred, but how the experience was experienced, and what impact it continues to have.

How can trauma affect us?

Our brains are designed to process experiences, learn from them, and integrate them into broader understanding of ourselves and the world. Trauma experiences cause disruptions in the way memories are processed and stored. When a person has experienced trauma, even seemingly unrelated reminders of the event can suddenly bring the memory back and trigger the same emotional, physical, and thought responses they experienced at the time, even though the person is no longer in danger and the current situation does not warrant the same level of response.

Common trauma responses are intrusive memories, disturbed sleep, anxiety, hypervigilance, emotional overwhelm, avoidance, low mood, shame, guilt, feelings of worthlessness, physical sensations, and difficulties with trust or relationships. These responses can be understood as attempts by the brain to respond to experiences that were overwhelming at the time, and which continue to significantly affect an individuals’ ability to manage everyday activities, relationships, or work.

For some people, these experiences meet criteria for Post-Traumatic Stress Disorder (PTSD).

What is EMDR?

Eye Movement Desensitization and Reprocessing (EMDR) is an integrative psychotherapy approach developed by psychologist Dr Francine Shapiro in the late 1980s.

EMDR is based on the idea that trauma-related psychological difficulties are linked to partially processed and poorly integrated traumatic memories. EMDR treatment supports the brains natural capacity to fully process traumatic experiences, so they are stored like ordinary memories. It is not about erasing a memory, but reducing its negative impact on the present.

How does EMDR work?

During the processing phase, distressing memories are brought to mind while simultaneously engaging in bilateral stimulation, such as eye movements, alternating taps, or tones. This is thought to activate the brains natural information-processing system, similar to what happens during the rapid eye movement (REM) phase of sleep. This helps a distressing memory lose its emotional charge, and lessen negative beliefs and the physical sensations associated with it.

EMDR uses a three-pronged approach to addresses difficulties across interconnected memory networks and time-frames: the past, the present and the future. The treatment targets the original (“feeder”) memories that underlie a person’s psychological distress, shape how they view themselves, and influence how they respond to the world. Present-day triggers are identified and processed to help reduce distress in situations that activate old distress, anxiety, or physical sensations and reactions linked to traumatic experiences. Anticipated future scenarios or upcoming challenges where the old trauma may have an impact are also addressed, by helping the client develop and rehearse handling difficult situations with more confidence and coping responses. By utilising a three-pronged approach, EMDR aims to reduce the ongoing impact of past experiences, support more balanced responses in the present, and help clients approach the future with greater confidence and a stronger sense of control.

What to expect?

EMDR treatment involves 8 phases:

1. Client’s History and Treatment Planning – This involves learning the client’s history, identifying the memories and experiences to be addressed in the treatment, assessing client’s suitability for EMDR therapy.

2. Preparation – Building the therapeutic relationship, teaching the client stabilisation skills and grounding tools to be used both in and between sessions.

3. Assessment – Identifying the target memory: images, associated negative beliefs, identifying positive beliefs, emotions and location of bodily sensations. Subjective distress is rated (Subjective Units of Distress, SUD scale: 0 - 10). Building memory maps.

4. Desensitisation – Active processing: client follows bilateral stimulation while holding the memory of the trauma event, reduction of trauma-associated distress.

5. Installation – An alternative, positive belief is strengthened and linked to the trauma memory. Positive belief is rated (Validity of Positive Cognition, VOC scale: 1 - 7).

6. Body Scan – Scanning for any remaining tension, physical sensations are processed.

7. Closure – Session is closed with the client feeling grounded and safe, regardless of whether the processing of a memory is complete.

8. Re-evaluation – Checking up on a previously processed memory – what has shifted, what remains problematic, what is next.

Before traumatic memories are processed, the therapist guides the client to develop strategies to regulate and stabilise emotions, so distress is managed and client remains grounded during treatment.

Is EMDR evidence-based?

EMDR is an evidence-based trauma treatment. It is endorsed by a number of Australian and international clinical guidelines for the treatment of trauma and PTSD.

Healing does not mean forgetting

Processing trauma does not mean forgetting what happened or minimising its significance. The aim is for the experience to become a memory of the past, rather than something that continues to shape a person’s sense of safety and identity in the present.

As traumatic memories are processed and integrated, they become less emotionally distressing, and associated beliefs, sensations and reactions decrease. This allows individuals to respond to current challenges based on their present circumstances rather than being driven by past experiences, fostering more adaptive beliefs, emotional freedom and a sense of choice.

At our clinic, several of our psychologists offer EMDR therapy. Contact us to find out more about EMDR and whether it may be suitable for you.

References

American Psychological Association. (2017). Clinical practice guideline for the treatment of posttraumatic stress disorder (PTSD) in adults.

de Jongh, A., de Roos, C., & El-Leithy, S. (2024). State of the science: Eye movement desensitization and reprocessing (EMDR) therapy. Journal of Traumatic Stress, 37, 205–216. 

Phoenix Australia. (2020). Australian Guidelines for the Prevention and Treatment of Acute Stress Disorder, Posttraumatic Stress Disorder and Complex PTSD. Phoenix Australia.

Shapiro, F. (2001). Eye movement desensitization and reprocessing: Basic principles, protocols, and procedures (2nd ed.). Guilford Press.

World Health Organization. (2013). Guidelines for the management of conditions that are specifically related to stress. Geneva: World Health Organization.