Working With Distressing Memories and Experiences
Sometimes an experience is over, but our response to it is not.
You may understand intellectually that something happened in the past while finding that a memory still brings up fear, shame, anxiety, or a strong physical reaction. Certain situations may trigger responses that feel immediate even when you know you are safe in the present.
EMDR (Eye Movement Desensitization and Reprocessing) is a structured approach to psychotherapy that can be used to work with distressing memories and experiences that continue to affect you.
I provide EMDR therapy in Washington, DC, as part of an integrative approach to trauma treatment.
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What Is EMDR?
EMDR was developed by psychologist Dr. Francine Shapiro in the late 1980s and has since been extensively studied as a treatment for trauma and PTSD.
During EMDR, you briefly attend to aspects of a distressing memory while engaging in bilateral stimulation, most commonly guided eye movements.
Rather than repeatedly describing the experience in detail, you are asked to notice what comes up—thoughts, emotions, images, physical sensations, or other associations—as processing unfolds.
Over time, a memory may become less distressing or feel less immediate, while different associations or perspectives can emerge. The goal is not to erase what happened, but for the experience to have less power to pull you back into the same emotional or physical response.
What Happens During EMDR Therapy?
EMDR is more structured than many forms of talk therapy, but it does not mean beginning immediately with the most difficult experience in your life.
The work typically develops in stages.
Understanding What Brings You to Therapy
We begin by talking about what you are experiencing now, relevant aspects of your history, and what you would like help with.
We also consider whether EMDR is appropriate and whether there are factors that may affect how we approach the work.
Preparation
Before working directly with difficult memories, it is important to understand what happens when you become emotionally activated and what helps you remain present.
For some people, preparation is relatively brief. For others—particularly those who become easily overwhelmed, shut down, or experience significant dissociation—this phase may require more time.
There is no advantage in moving into trauma processing before you have sufficient capacity to remain present with what emerges.
Identifying What to Work On
When you are ready, we identify a particular memory or experience to work with.
This may involve noticing an image associated with the experience, a belief about yourself, emotions that arise, and where you feel the response physically.
You do not need to provide an exhaustive account of everything that happened.
Bilateral Stimulation and Processing
During processing, you bring aspects of the experience to mind briefly while following guided eye movements or another form of bilateral stimulation.
Between sets, I will ask you to notice what comes up.
There is no particular response you are supposed to have. Memories, emotions, physical sensations, thoughts, or unexpected associations may arise. At other times, very little may seem to happen initially.
My role is to help guide the process while paying attention to how you are responding and whether the pace remains manageable.
Closing and Reviewing
An EMDR session does not simply stop when the appointment time ends.
We allow time to bring the session to a close and make sure you feel sufficiently grounded before leaving.
At subsequent sessions, we review what you have noticed and whether anything has changed before deciding where to go next.
What Can EMDR Be Used For?
EMDR has been extensively studied as a treatment for PTSD and trauma-related difficulties, although it may also be incorporated into therapy when particular distressing experiences continue to affect someone in the present.
These might include experiences involving:
- Accidents or frightening events
- Assault or abuse
- Medical trauma
- Loss or other distressing life events
- Childhood experiences
- Experiences associated with persistent fear, shame, or self-blame
Whether EMDR is appropriate depends less on fitting into a particular category and more on understanding what you are experiencing and what we are trying to address.
EMDR and Complex Trauma
When someone has experienced a particular traumatic event, identifying what to work on may be relatively straightforward.
Complex trauma can be different.
There may be many experiences rather than one clearly defined event, and difficulties may involve longstanding patterns that developed over time.
In these circumstances, EMDR may still be useful, but it is not necessarily the first or only approach I use. We may need to spend more time understanding what happens when you become activated, developing stability, or working with other aspects of your experience before deciding whether to approach particular memories directly.
You can read more about this on my Complex Trauma Therapy page.
EMDR and Dissociation
Dissociation requires particular attention when considering trauma processing.
If you tend to become numb, disconnected, lose track of what is happening, or feel far away from yourself when emotions intensify, moving too quickly into distressing material may not be helpful.
In these situations, therapy may initially focus on recognizing dissociation, increasing the ability to remain connected to the present, and understanding what helps you return when you begin to disconnect.
EMDR can then be considered within that broader context rather than approached as something that needs to be pushed through.
You can learn more on my Dissociation Therapy page.
How I Use EMDR
I am an EMDR Certified Therapist and use EMDR as one part of a broader trauma-informed approach.
I do not assume that every person who has experienced trauma needs EMDR or that processing memories is always the most useful place to begin.
Depending on what we are working on, I may also draw from Somatic Experiencing®, Parts Work (Ego State Therapy), DBT skills, mindfulness-based approaches, or relational psychotherapy.
The particular approach depends on what you are experiencing, what we come to understand together, and what feels manageable.
Frequently Asked Questions
Will I have to describe everything that happened?
No. EMDR does not require you to recount every detail of a traumatic experience.
We need enough information to understand what we are working with, but you can determine how much of the experience you want to describe.
Is EMDR only for PTSD?
EMDR has been most extensively researched for PTSD, but clinicians may also use it when other distressing experiences continue to affect someone in the present.
Whether it is appropriate is something we can consider based on what brings you to therapy rather than simply on a diagnosis.
What if I don’t remember everything that happened?
You do not need a complete narrative of your past in order to begin therapy.
We can work with what you do know and, when appropriate, with the emotions, beliefs, physical responses, or particular memories that are available to you.
There is no need to try to recover memories that you cannot recall.
Is EMDR right for everyone?
No therapy is right for everyone.
EMDR may be useful for some people and less appropriate for others, or it may become useful at a later stage of therapy rather than at the beginning.
Part of the initial work is determining whether EMDR makes sense for you and, if so, how it can be used safely and thoughtfully.
How many EMDR sessions will I need?
There is no standard number.
The amount of time depends on what you are working on, your history, how you respond to the process, and whether the difficulty involves a particular experience or more longstanding patterns.
We can periodically assess how the work is progressing rather than deciding in advance how long it should take.
Getting Started
You do not need to know whether EMDR is the right approach before contacting me.
We can begin by talking about what you are experiencing, what you would like help with, and whether EMDR, another approach, or a combination of approaches seems most appropriate.
I offer in-person therapy in Washington, DC, as well as secure online therapy throughout Washington, DC, Maryland, Virginia, and Florida.
