EMDR Therapy Online: Can EMDR be Done Virtually?
What is EMDR Therapy and Can EMDR be Done Virtually?
EMDR therapy is a powerful body-and-brain-based therapy that has shown remarkable results for reducing symptoms of trauma and post-traumatic stress disorder (PTSD) anxiety, depression, and various other mental health conditions. It can be difficult however to find a skilled and experienced EMDR therapist near you to work with, especially one who has received the advanced training and engages in the requisite ongoing continuing education to be an EMDR-certified therapist through a reputable certifying institution such as the EMDR International Association (EMDRIA). Online therapy can make accessing a qualified EMDR therapist easier, but many people wonder if EMDR can be done virtually and how to do EMDR online effectively.
Can You Do EMDR Therapy Online?
EMDR traditionally utilizes guided eye movements to help the brain recall and reprocess impactful, overwhelming, and traumatic experiences to shift how these memories are stored in the mind and body to ultimately reduce suffering. When therapeutic care is moved from the office setting to a virtual video-based platform, the science behind EMDR needs to be considered so that the method can be adjusted while still preserving the benefits of EMDR therapy.
How Does EMDR Work?
There are a number of posited components behind the 8 phases of EMDR and how they work to change how the brain stores traumatic memories. Dr. Francine Shapiro, the founder of EMDR, focused on a few key features of the EMDR process. She asserted the idea that some life experiences are so intense that they overwhelmed the brain’s ability to process them adaptively using the capacity of the whole brain when they initially occurred. Because these events were not processed fully before being stored in our long-term memory, they shape or stick with us differently than memories of events or experiences that were fully and adaptively processed by our whole brain before being stored away.
Shapiro added that in general day-to-day experiences, the left hemisphere of the brain, which is largely responsible for processing language, using logic, sequencing, and solving problems typically communicates with the right side of the brain, which processes emotions as well as non-verbal content of communication or experiences. Bringing together both sides of the brain to process an experience allows logic and emotion to work together to more fully make sense of the event and incorporate it into our overall life experiences and sense of self in relationship to the world.
Because intense experiences can overwhelm the brain’s “circuit board,” these situations may not have had the benefit of being fully processed by the whole brain when they happened. As a result, the individual may have been left with poorly digested memories that can remain highly emotionally charged and disconnected from logic when they are activated by some reminder in the present. For a more detailed description of EMDR therapy and how EMDR works, this article can help.
Bilateral Stimulation and EMDR Therapy Online
Shapiro’s solution to the problem of incomplete processing of intense experiences was to gently coax the incompletely processed event out of the memory stores in the brain and body so as not to overwhelm the system, and encourage the right and left hemispheres of the brain to work together to progressively complete the processing of this experience. By supporting whole-brain processing of the experience, the emotional intensity related to the event is reduced, and logic and emotion become connected. Shapiro emphasized the importance of Bilateral Stimulation (BLS), or stimulation of both the right and left hemispheres of the brain for this process to occur.
In its initial stages, EMDR used guided eye movements for this bilateral stimulation, as moving the eyes back and forth from the left side of the visual range to the right side causes input to be received alternatingly by the right and left hemispheres of the brain. Over time, BLS has been modified in response to individual needs and circumstances to incorporate other methods of stimulating both hemispheres of the brain. These have included the use of modified headphones to transmit music alternatingly to one ear and then the other; handheld devices sending vibrations to one hand and then the other; guided marching alternating weight-bearing movements from one leg to the other; guided tapping movements where the person hold their hands crossed over their chest and repeatedly taps themselves on one side and then the other; and many other adaptations.
When EMDR is done online, therapists often utilize one of the methods above to incorporate the BLS piece into the EMDR process. Using a video platform for virtual EMDR therapy online allows a therapist to watch a person's facial expressions, body movements, and other non-verbal indicators of processing to guide the pace and duration of bilateral stimulation to support healthy and full processing during EMDR.
Dual Attention and EMDR Therapy Online
Another important aspect of EMDR is the idea of dual attention. Shapiro acknowledged that the emotional intensity of an event or experience could inhibit the brain’s capacity to fully and adaptively process it using the whole brain. Accordingly, Shapiro realized that if a memory of an overwhelming or traumatic event was recalled with the full force of its initial intensity for EMDR processing, the brain would likely be flooded again, and full processing would not occur. Even worse, the trauma could be intensified by re-experiencing it at its full strength.
Shapiro incorporated a number of ways to help regulate the intensity of EMDR processing to support healing. One of these was to focus on dual attention as a means of helping a person connect to their past memory for processing, while also maintaining an awareness that they had not fully returned to the past experience so that they did not become flooded by it. Another way to think of dual attention is that the person has a sense that they have one foot in the past as they connect with, and work through a memory, but they have another foot firmly grounded in the present. They maintain some level of awareness that they are choosing to visit this memory, but they are not going to slip back into that moment entirely. This awareness allows an individual to shift their focus away from the past and into the present as needed to reduce the strength of their emotions so that processing can occur at a pace and a level of intensity that safely supports healing.
Therapists support dual attention by visually monitoring people throughout EMDR processing for cues that the individual may need a break from the intensity of a memory, or encouragement to connect to it at a deeper level. Clinicians guide dual attention by talking to people at points throughout EMDR processing; using techniques to help the person process “small bites” of a memory without becoming overwhelmed; cueing the individual to connect to aspects of the present moment through their senses or their breath; or using questions or prompts to help them connect to aspects of their memory.
EMDR Therapy Online: Keys to Success
So in answering the question, “can EMDR be done virtually? ” the response is yes. EMDR is a therapeutic treatment approach that is able to be well-translated online, an assertion that has been supported in the research literature(1). When therapists do EMDR online using both video and audio, they can use the same, or comparable, methods to guide a person through EMDR using dual attention and bilateral stimulation that they would use in an office setting. If a qualified and experienced EMDR therapist works with a person and determines that EMDR would be an appropriate therapeutic technique for addressing their symptoms and treatment goals, they can likely support this work as effectively online as they would in an office.
There are some situations in which a therapist might recommend that EMDR be done in an office setting. These may include situations in which the person’s home environment is not an emotionally or physically safe setting for processing difficult memories, or when the individual struggles to regulate their emotions and behaviors in a safe or healthy way when they experience big feelings.
Many people report actually preferring to do EMDR therapy online from their home, where they may feel more comfortable and secure. For some individuals, the physical distance inherent in virtual EMDR therapy enhances their ability to maintain dual attention. For others, being physically separated from the therapist helps them to feel safer being emotionally vulnerable as they dig into their past, and thus can accelerate their therapy progress.
Find an EMDR Therapist Online
Shore Therapy is a suburban Chicago, Illinois therapy practice that provides therapy online in Illinois and in over thirty other states across the US with specializations in EMDR therapy, affirming LGBT therapy and neurodiversity affirmative therapy with marginalized adults; therapy for parent burnout and caregiver burnout; and trauma and PTSD therapy.
If you are interested in exploring EMDR therapy to help reduce symptoms of anxiety, stress, burnout, and depression or to treat PTSD or trauma, I may be able to help. I am a certified EMDR therapist and use virtual EMDR therapy online daily in my work. Contact me for a free 15-minute phone consultation to see if online EMDR therapy with me might be helpful for you. More information about me and my training and experience can be found here. I look forward to connecting with you.
If you want to learn more about EMDR therapy, and how to have the best online therapy experience, read on.
(1) Fisher, N. (2021, January 1). Using EMDR therapy to treat clients remotely. Journal of EMDR Practice and Research. Retrieved November 18, 2022, from https://pesquisa.bvsalud.org/global-literature-on-novel-coronavirus-2019-ncov/resource/pt/covidwho-1138628
