Despite the name Eye Movement Desensitization and Reprocessing, eye movement is not a necessary part of EMDR. Tactile and Auditory stimulation are also well-researched, proven options, making EMDR therapy more accessible to people with varying needs and abilities.
What is the Purpose of Eye Movement in traditional EMDR?
The underlying purpose of the eye movement in EMDR is bilateral stimulation (BLS). BLS is a therapeutic technique that involves stimulating both sides of the body or brain in a rhythmic and repetitive manner. During BLS, your therapist will guide you as you focus on specific stimuli that alternate between the left and right. This back-and-forth movement or stimulation is thought to mimic the natural processing that occurs during rapid eye movement (REM) sleep which is when you dream, enabling the reprocessing of traumatic memories when you are calm.
Further, this process allows your brain to consider, perceive and interpret the traumatic experience in a different way, one that is adaptive. As mammals, when we are overwhelmed, scared, upset or angry, our brain's job is to keep us safe and as a result, we fight, flight, freeze or fawn. When this happens, we lose access to our cognitive capacity and our ability to process that experience in a rational, calm, adaptive way diminishes. As a result, your brain stores information in a maladaptive way and your triggers begin to manifest. When triggered, it is as though we are reliving that trauma and again, we fight, flight, freeze or fawn as we did back then.
It is important to know that BLS also encourages you to maintain awareness of your present surroundings, and any changes in your thoughts, emotions or physical sensations as you revisit your traumatic experience. You can read more about dual awareness here.
In the most common form of BLS, EMDR clients will follow a moving object or a light with their eyes. However, there are other modalities that can be just as effective, such as gentle tapping on different sides of the body (tactile), or listening to alternating sounds through headphones (auditory). At times, your EMDR therapist may use a combination of forms of BLS, perhaps eye movement and sound.
Are other forms of bilateral stimulation effective?
While most EMDR research involves eye movement, emerging evidence on alternative modalities is very promising. One of the benefits of EMDR is that it is highly adaptable, and some clients may actually find these alternatives to be a better fit than bilateral stimulation involving the eyes. This is especially true for individuals who have the following conditions:
Seizure disorders, Traumatic Brain Injuries (TBI), and/or Functional neurological disorder, which may be triggered by rapid eye movements
Certain visual impairments
Challenges with focus (for example, due to ADHD)
Dry eyes (for example, due to Sjögren’s syndrome)
What other types of Bilateral Stimulation (BLS) are used for EMDR in Canada?
EMDR Therapists may use one or more of the following techniques, depending on their preferences and the needs of their client.
BLS for Online EMDR Therapy
For online therapy, Sally-Anne's choice is to email you the link to her account at www.bilateralstimulation.io This tool provides the eye movement, auditory and tactile (if the tappers are purchased) BLS required for EMDR Therapy. Yannick, the founder of this company experienced EDMR Therapy themselves and created this program at the beginning of Covid to enable their former therapist to provide EMDR Therapy online and the tool went viral. If you'd like to learn more about the origin story & mental health entrepreneurship of co-creators, Yannick & Benjamin, listen to the Apple podcast here.
This video below is what the www.bilateralstimulation.io tool may look like for your EMDR treatment. You would choose your preferences for background image, moving object or sound. Further, you can choose to close your eyes at anytime, to have either no audio, no eye movement or have your therapist upload a preferred image for the background. If you are unable to have a dual screen (your therapist will need to see you throughout the processing time), you can either tap, follow the therapists hand with your eyes or use a metronome app on the therapist's phone.
Using Touch (Tactile Bilateral Stimulation/BLS)
This can be done through:
Tappers or buzzers: These instruments are typically placed on or held by the client and deliver a very soft, gentle tactile bilateral stimulation.
Manual self-tapping: The client can use a “butterfly hug” to tap on either side of their body, or tap either leg as instructed by the therapist.
Wearable buzzers: These often attach to the client’s wrist or other body part, delivering bilateral vibrations electronically.
TheraTapper brand tappers are Sally-Anne's personal favourite for in person sessions as they allow the client to close their eyes and imagine past experiences and a preferred future template as they move through their intentional 8 phase EMDR Therapy process.
Using Sound (Auditory Bilateral Stimulation/BLS)
This can be done through:
Bilateral music: Using headphones, the client listens to musical tones that rotate between ears.
Beeper/tones: Again, using headphones, the therapist delivers beeping noises that rotate between ears.
Snapping fingers: The therapist uses their hands to make noises on either side of the patient.
Individual preferences are integral to your care. Some clients may feel more at ease with a certain modality and this depends on your personal history, background, sensory sensitivities, and beyond. Clients may prefer tappers because of the buzz sensation, which can feel nice on the skin, or because of the light that often accompanies the tactile feeling. It is a good idea for you and your therapist to have a discussion regarding you preferences in order for you to make a well informed decision.