An Intro to EMDR
An interview with therapist John Loppnow on the basics of EMDR
Hey everyone! This week I decided to collaborate with one of my subscribers to talk about EMDR on his Presence and Practice podcast!
Eye Movement Desensitization and Reprocessing (EMDR) is one of those techniques that seems strange at first. It isn’t really what someone would consider within the realms of traditional therapy. But when I was in counseling school and researching about various therapeutic techniques for Post Traumatic Stress Disorder (PTSD), I discovered that there were pretty convincing studies that showed that EMDR was effective in some cases.
As I was planning the content for Heem Publication, I knew I wanted to talk about EMDR to perhaps help demystify what it was. But to be honest, I’m not an expert. That’s when I reached out to John Loppnow, a subscriber who I’ve been chatting with over the past few weeks on Twitter.
John Loppnow is a licensed Marriage and Family therapist, has a certificate in EMDR training, and is based in California with over 20 years of experience. He also runs Loppnow Relationship Center, a private practice, with his wife Sungshim Park Loppnow.
Below is a timestamped Youtube video of the podcast where we talk about EMDR. I’ve also included a transcript of our conversation underneath. If you want to learn more about me and why I started Heem Publication, feel free to listen to the full podcast.
Presence and Practice Podcast Interview
From [30:18]
Andrew Yang: What exactly is EMDR?
John: EMDR is “Eye Movement Desensitization Reprocessing.” That comes from Francine Shapiro, and she’s a therapist who did research, and if she could rename it she would just name it Reprocessing or something around that, but because the research started with EMD, it has this long name, which basically people just use the acronym, EMDR. And it references how she learned about it, which is the eye movement. She was taking a walk in the park in 1987—her research came later—she was thinking about something upsetting and she noticed her eyes were moving back and forth, and after that, she felt that the distress was less. And so she was curious! I tell this story because it is the origin of EMDR, but it’s also fascinating—as you’re going on your everyday life, who knows, maybe you’ll discover something that is a powerful part of how we function as human beings. So she just realized, “Oh wow,” when her eyes moved back and forth, the distress of the experience or the emotions went down. So, it’s fascinating to me.
Andrew Yang: Okay, wow. So could you briefly describe what a session might look like? Because it seems a little—it’s not normal, or a typical experience I think.
John: Right, because it’s more than simply listening and offering—of course, that’s the core foundation: good listening, good empathy, that’s a component of it. And there might be a few sessions before you get to EMDR. Some people get to it in the first session, some people you gotta listen, take some history. There are eight phases of which I won’t name all of them but you can Google it. But it would be listening, it would be identifying a specific memory that is distressing, painful, upsetting, and it could be as big as a major trauma that people think of—a car accident, physical abuse, it could be that, or even more subtle like being left out or being yelled at. We’ve all been yelled at, and that’s not emotionally small, but it’s what we normally think of as small, because it’s like, Oh, we’ve all been yelled at. In a sense, we all have some trauma to deal with, the way Peter Levine and Stephen Porges talk about trauma. I want to name this so we know how EMDR functions. Peter Levine talks about trauma as going through something painful without a compassionate witness, which we all have experienced.
Andrew Yang: Yeah, under that definition there’s a lot of trauma!
John: There is! There absolutely is. And Stephen Porges—these are therapists—Stephen Porges says trauma is a chronic disruption of connection. So it’s that prevalent. In a sense most people could benefit from some EMDR, but usually people come when there’s enough distress. So we’ll zero in, we’ll make sure we’re grounded, we’re in a good place, so we can return to that. That’s really important to the therapist and the client, that you’re here now, you’re grounded, you feel strong enough, and then you go back to the painful memory—that’s guided by the therapist. So the therapist is the guide, or the shepherd, or the pastor to that, and stays in tune with them, and what Francine [Shapiro] found through her own experience is: eye movement, back and forth, that is guided by—there’s a light bar that some therapists use, some therapists use their finger or a pen, some use audio that goes back and forth, just a simple beep, some use tapping on the knees or the hands. You can even do a little bit yourself, like a butterfly hug, where you give yourself a hug and tap on your shoulders left and right. These are things you can do when you’re feeling distress, though when it’s guided by a professional, they know when to stop and pause, guide and redirect. And that’s the “unusual” part: you’re feeling this distressful memory, and the therapist is having you do some eye movements periodically, and they don’t last that long. We may do a number of sessions but they last 10, 20, 30-ish [seconds] back and forth, and the therapist will just check in and say, What do you notice?
Andrew Yang: So what about that experience of the eye movements, the touching, and thinking about the traumatic experience, what about all of this formula, why is it effective? Why does it work?
John: We have some intelligent guesses and research. One, it integrates the entire body and nervous system. Left and right brain, our nervous system, different parts, parasympathetic to sympathetic, so it integrates the nervous system, so that’s one way we can understand it and look at it. Just to reference Dan Siegel, he says his one-word definition of mental health is Integration. So when we integrate differentiated parts and link them together, that’s how we move towards mental health. So this eye movement can help with that. One reference that I’ve heard people say is, there are drugs that we give people or that we take, but the doctors just know that it works, they don’t know the mechanism of how it works. There are medications that all of us as a population are taking, but we don’t know exactly how it works, so EMDR is like, we don’t know exactly, there’s theories out there, there’s an adaptive information processing model that Francine talks about, so it integrates parts of memories and our nervous system that are disconnected that we reconnect, and the eye movement helps, or the touching on the bilateral—alternating stimulation—helps. So it just integrates parts of us that are disconnected and we reintegrate it into our system.
Andrew Yang: I did a little bit of research on EMDR when I was in counseling school, and one of the aspects that I think works is that with trauma, it tightens up your body and it locks you down. And it’s really hard for you to re-experience that trauma. What EMDR does is that, as you go through that experience, as you’re doing these eye movements and this physical sensitization stuff, it almost desensitizes the traumatic experience so that you can dive into it more and it allows you to experience it in a way that doesn’t lock you down and it’s not so powerful. That’s also part of the process of why it helps and why it works.
John: Yes. You re-experience, you get to be in touch with the pain of it, it will be upsetting, and I would say in a session, the upsetting part is 10-20 minutes, 20 minutes of feeling distress, and it can be intense, but also it can just be mild or moderate, depends on the experience, knowing that you have a compassionate witness with you. You are relationally connected to another human being, and these mechanisms help to be exposed to the painful memory, you’re connected to another person, and they help facilitate that “fight or flight,” so that you’re not engaged in running or freezing, you might experience it but then you know you’re connected, and it softens that reactivity.
Andrew Yang: Right, and just for some context: one of the ways that people process trauma, or “get better” from trauma is to re-experience it in a way that doesn’t lock you down. That’s a scary thought because it was such a painful experience for a lot of people, but that’s why it’s important to have a compassionate person next to you who will love you as you go through that experience. Your definition was it’s without having a compassionate witness, but that compassionate witness is there now who will help you and love you while you go through that, and that’s key to this whole process.
John: And for people who believe in a higher power or believe in God or believe in Jesus, that can be accessed—I mean, sometimes trauma disconnects us from accessing that presence, but that’s why another human being helps us access, “Oh, God is here,” and then that can actually be a greater resource. There is something called post-traumatic growth. That trauma extends our capacity too far, but then when we experience healing, we have increased capacity than before. So there is hope in when we get healing we actually have more capacity. After EMDR people often experience the emotional distress is hugely relieved, and I’ve seen so many clients say, “This is weird, I feel way better, I don't understand, but I actually do.” That’s the in-person response. And then, the negative beliefs about themselves, about the world, they shift, and are transformed right in front of my eyes. And that’s one reason why I do love that, and then their physiological experience is more calm.
Andrew Yang: Yeah, because trauma is not just mental, but it absolutely is physical too. You have a strong, biological response to the memory. Another question I have is, What situations, in what contexts is EMDR useful for?
John: A lot of research around post-traumatic stress disorder, veterans, war, rape, car accidents, the big traumas that we all think about, definitely those. Especially multiple experiences—single incidents like a car accident, those are fairly readily taken care of, but all the big traums are, and just regular old anxiety that we all experience, phobias are hugely helped, it can help with depression, even chronic pain, and I’m just naming the ones with research. Therapists are finding ways of integrating it in all aspects of life, but those are the big ones with the research.
Andrew Yang: One of my last questions is, Does it always work?
John: It is a magic pill and it heals everything—No, obviously you know I’m joking. It is very effective, 80% of specifically trauma survivors have experienced no symptoms after three sessions. I would say almost with everyone, does it work, we’d have to define what work means, does it reduce tension and fight-flight, I would say it does, but that doesn't mean there aren’t other aspects and other venues and avenues that we have to engage to experience fullness of healing. It’s been super helpful for all the clients that have used it, it doesn’t heal everything 100% but one of the fastest ways of experiencing healing, and building on your strengths, or Asian-Americans, or men, sometimes people don’t want to speak the content of the trauma. And with this you don't need to. You just need to be able to report to the therapist, “Okay I am experiencing it.” But you don't have to actually say it, which is a huge freedom for a lot of people.
Andrew Yang: Yeah that’s a really good point, especially with an honor and shame culture, I can imagine saying, “Yeah, I don’t want to tell you what I’m going through.”
John: And they don't need to! They just need to be in touch with it, and as long as there’s a trusting relationship, like okay, the client’s actually there, you don't have to tell me the details. 100% no need.
Andrew Yang: That’s crazy. One of my last thoughts is that, with any intervention that a therapist suggests, it’s not going to be a 100% success rate. And the reason for that is because we’re human. Each one of us is different, and we respond differently to different things, and so to me it’s encouraging that EMDR for the most part seems to be successful. And if you’re going through trauma, and if you’re going through depression or severe anxiety, maybe it might be helpful for you to talk to someone and get EMDR. Treat that as an opportunity to better yourself or to get help, but if it doesn’t work, I just want to encourage you and say that it’s okay if it doesn't work because it’s not going to work for everybody, so don’t be discouraged, don't think that something’s wrong with you, just know that sometimes it works and sometimes it doesn’t. John, thank you so much for sharing all that because, honestly, EMDR can seem a little strange and a little weird to somebody on the outside who has never experienced anything like that before, and so I love that we can have a conversation and you break down how it works, why it works, the history behind it, and just to normalize that experience so that hopefully other people might be more open to the idea of getting it.
John: I hope so, because I do see it bring relief to people, to myself, to clients, and that’s such a gift for people to experience.
Andrew Yang: Love it. Alright John, well thank you so much for this conversation.
H/t Stephen Chow for the transcription.
Discussion Questions
Have you heard of EMDR before? If so, what were your impressions of it?
What did you learn from the interview?
Has your opinion on EMDR changed?
Do you know of anyone who received EDMR treatment? How did it go for them?