EMDR Therapy for Anxiety
"I've gotten to the place where I'm okay driving on the highway now, but I will not go over that big bridge. I will leave the highway and drive on side streets even if it adds 20 minutes to the journey."
"It's fine once I'm on the date. I feel calm, I chat, I laugh. But beforehand? I literally freeze. I shake. I feel nauseous. I know in my head it doesn't make sense, I know I'll be fine when I meet up with the person, but I can't control what happens in my body as I get ready."
"Rationally, I know it's not going to hurt me. It's just a tiny spider. But my heart races and I can't even enter the room if I know it's in there."
Anxiety can sneak up on you
Anxiety is tricky. It can be a sneak. One moment you are calm and relaxed and then suddenly out of nowhere: racing heart, dizziness, fluttering stomach or nausea, difficulty breathing, trouble problem-solving, a real feeling of doom or impending danger.
What's also tricky about anxiety is how the symptoms and situations where someone feels anxious can become cumulative; one situation seems to build on to another.
Anxiety can be cumulative: one situation seems to build on to another
The different situations are drawn together as if to a magnet. As a result, the felt sense in the body intensifies and the physical discomfort and emotional intensity can increase.
As well, 'busy mind' can get triggered. A preoccupation with the felt discomfort or the future or the 'what ifs' may be all that the person can focus on.
EMDR Therapy can help to reduce or eliminate anxiety
How does EMDR Therapy help reduce or eliminate anxiety?
EMDR Therapy is an approach that integrates thoughts, images, emotions and body sensations. If a feeling or memory feels stuck in the body, EMDR Therapy can help to 'metabolize' or 'digest' what is stuck, allowing for a neutral sensation and freedom from busy thoughts/preoccupation, uncomfortable body sensations and distressing/disturbing images.
What else can EMDR Therapy help?
EMDR Therapy is helpful when people have experienced something traumatic (like a natural disaster, a violent crime, a car accident) or something personally upsetting (like betrayal, disappointment, humiliation, shame).
What kind of therapy is EMDR?
EMDR Therapy is a protocol-based therapy that uses an eight phase approach, and Phase 1 and 2, create an infrastructure to be able to do the processing. Over the first few sessions, (could be 3 to 5 sessions, could be longer) you will go through a process known as preparation and history-taking.
For more information about Phase 1 and 2, read What to Expect in the first few sessions of EMDR Therapy
How does EMDR work to reduce anxiety?
When using EMDR Therapy to manage or eliminate anxiety, we catalogue the situations where someone feels anxious. For some people it's fairly isolated (a phobia of heights for instance, but otherwise no tendency to feel worried or anxious), and for others it's a more familiar sensation (like most social situations or any public speaking or public gatherings etc.).
Targeting the distressing memories
As therapists we look for connections. Once we have done a thorough history to catalogue difficult experiences from the past that are still bothersome, and situations where the person feels anxious, we look for themes or connections between the situations. This helps us to organize a plan of what to 'target' or process.
Processing the memories
When people process memories or situations with EMDR, the body notices images, narrative, emotion, body sensation, thoughts and sometimes smells, tastes and sounds. It is not the purpose of the therapy to recall, this is more of a by-product of the therapy, that you do recall. Often it comes as fragments of information - an image, then a focus on a body sensation, then an intensification of the body sensation, then a thought, then another image, etc. For some people it's more of a cohesive sequential story "(Now he's walking in the room, now I feel scared, now I notice my upset stomach, now he is shouting at me, now I feel sad...)."
The processing occurs once we have established the nuance of the issue we are going to work on. We use eye movements or hand taps, or a machine with pulsars or headphones. With eye movements, the therapist moves his/her fingers back and forth and the client follows with their eyes; the machine makes the pulsars vibrate left then right, then left then right, likewise with the headphones with sound left to right. This stimulates the mind and body to recall, then process fragments of the story in bitesize, manageable pieces. A person tends to have images, thoughts, emotions and body sensations during the processing, and throughout the session the intensity/discomfort reduces as the memory is processed. The therapist is monitoring the progress and providing support, safety and occasional timely questions to direct the processing. Once the situation is neutralized, we work on building connection with the positive belief and how that feels in the body.
The Goal of EMDR Therapy with anxiety
Our goal when processing an anxious situation is to reduce the intensity of the anxious sensation, or sometimes eliminating the sensation entirely. The body may have learned that it 'should feel anxious' in a particular situation (driving over a big bridge I have to be cautious) but now that information is no longer correct or helpful or possibly never was accurate. So the purpose of our session would be 'metabolizing' the stuck information about bridges being scary and reconstructing the idea to '"I am competent" as a driver' or '"I am safe" (driving on the highway)(or at least as safe as I can be given the whims of other drivers)'.
Likewise with a phobia, we may break it down into incidents when you recall experiencing the fear. We may work chronologically or we may work according to which incidents feel most intense.
The role of the therapist in EMDR
The role of the therapist is to be curious, to be supportive, to provide the environment to do the challenging work, to provide an intention and direction to help you work through the difficult anxious situation. Your therapist should help you feel grounded, to send the message "I've got you", to let you know they believe you can work through this.
We will construct a plan or strategy to tackle your anxiety. We may start with the first memory you have of feeling anxious about the situation, or we may break it down into steps (1) preparing in my bedroom to do my speech in front of the class, 2) sitting in the class waiting to present, 3) standing with the rest of my group in front of the other students waiting for my turn, 4) presenting).
EMDR Therapy can help to reduce or eliminate anxiety. For more information on the process, please read about What to Expect in the first few sessions of EMDR Therapy and What to Expect in an EMDR Processing Session.