EMDR, Brainspotting, Trauma, and PTSD
EMDR (Eye Movement Desensitization and Reprocessing) and Brainspotting are two novel therapeutic methods that grew out of the personal and clinical experiences of psychologist Francine Shapiro, PhD, developer of EMDR, and more recently psychotherapist David Grand, PhD, developer of Brainspotting. Both clinicians have worked extensively with survivors of trauma. EMDR and Brainspotting are conceptually related but have significant differences. Look further down the page for more detailed discussion of these therapies and the distinctions between them.
In My Practice
I am trained and experienced in EMDR and Brainspotting. While there is still debate about how and why these therapies work, I deal in the practicalities. I have seen EMDR and Brainspotting resolve trauma in my own practice, and often sooner than I expected. Experiences vary, but significant relief is commonly felt already during or shortly after the first treatment.
My clientele is diverse; many come to me for relational issues, workplace issues, or other personal matters unrelated to trauma. Others come to me specifically to recover from trauma. I am an integrative therapist, able and qualified to offer these therapies where I believe a client would benefit from them, but always in the larger context of the whole person and their life situation and wellness – not merely the traumas they may bring. Each of us is far more than the sum of our traumas, more than the sum of any of our problems, and it is that larger sphere in which I strive to bring about whole-life wellness. With many clients the subject of EMDR or Brainspotting just doesn’t come up. But I know first-hand the remarkable healing power of these therapeutic modes for those who need them.
One thing that has struck me is that although these therapies are best known for their work specifically in major trauma, there are other life situations that might be characterized as "subtle traumas" in which brief EMDR or Brainspotting can also have value. In fact, anything with a close connection to the primitive brain – grief or loss; phobia or avoidance; panic; specific or generalized anxiety; and more – may benefit from including brief neurosomatic therapy as a component of our work together.
EMDR
EMDR is a highly structured protocol based on recalling and reprocessing memories while engaging in a series of regular side-to-side eye movements under the direction of the therapist. Variations have emerged that involve tapping on alternate sides of the body or listening to sounds that alternate from side to side.
What is perhaps most significant about EMDR is that patients and therapists sometimes report achieving dramatic results where more traditional modes of therapy have disappointed. The best formal validation of EMDR exists for its use in treating Post-Traumatic Stress Disorder (PTSD), for which it is has received support from independent authorities in treatment of stress and trauma. Some of the most impressive practical demonstrations have come from veterans of the Iraq and Afghanistan conflicts in defusing aftereffects of traumatic war-zone experiences. Indeed it is largely from such veterans, directly or indirectly, that the broader American public has come to recognize the term PTSD. But many who have used EMDR have found it useful in other conditions as well.
Brainspotting
Brainspotting emerged more recently from David Grand’s observations as an EMDR therapist himself. He noticed certain recurrent “hiccups” in the guided eye movements of his patients undergoing EMDR and began to explore the significance of these irregularities and the spots at which they occurred. Gradually he developed a new therapeutic model based on his understanding of the neurology of these eye hiccups.
Brainspotting is a more flexible and exploratory protocol than EMDR, making it more attractive to some patients and therapists and less attractive to others. Because it is a much newer mode of therapy, it has not yet undergone the same degree of independent clinical validation. But Dr. Grand’s explanations of the neurosomatic (brain-body) mechanisms underlying it are intriguing. He has extensively treated Iraq and Afghanistan veterans, survivors of the World Trade Center attack, survivors of Hurricane Katrina, and many others who have experienced natural or man-made disasters.
The general public understands the idea of memories and their role in phobias, PTSD, and other forms of anxiety. It surprises nobody that if you are attacked by a dog, you may develop a visceral fear of all dogs, maybe even to the point of trembling, sweating or perhaps blacking out in their presence. Older therapies have been based on exposure and on processing such thoughts and associations on a conscious and subconscious level – but even on the subconscious level, it has still been about the idea or the visual image of “dog.” They have approached the trauma through the “thinking brain” in order to reach the "feeling brain."
Much of what is new in EMDR and Brainspotting is the belief that through novel ways of stimulating the primitive brain, these therapies connect more directly to the limbic system that processes emotions and the “lizard brain” that processes primitive sensation and physiological response. These parts of the brain do not deal directly with ideas or images like "dog" but instead with our emotions and physiological reactions.
Most traumas, say theorists, but especially severe or early-life/pre-language traumas, make an imprint in these primitive parts of the brain. There is a nerve-memory of terror frozen into these non-verbal parts of the brain that EMDR and Brainspotting strive to reach and to defuse in a safe, controlled environment. Traditionally the term "psychosomatic" has been used to describe the mind-body interface, where we take "mind" to mean the higher brain activities: conscious and unconscious thoughts, attitudes, and most emotions. For these newer therapies, the description "neurosomatic" or (Dr Grand's preferred) "neurophysiological" may better describe the more primal brain-body spheres through which they are said to work.
Of course for the clinicians and clients who use these therapies, the healing they experience feels much more important than any neurological how-and-why.