Our team at Sustainable Wellness has a special passion for getting to the root of our clients’ symptoms and struggles. Two of our favorite treatment approaches, EMDR therapy and Brainspotting Psychotherapy have both similaries and differences. Read more about them below.
Similarities between EMDR and Brainspotting
Both utilize Bilateral Stimulation (BLS).
Bilateral Stimulation is any type of stimulation that occurs on both sides of the body. Bilateral stimulation is used to activate and integrate information from the brain’s two hemispheres. In both EMDR and Brainspotting, the stimulation occurs in an alternating rhythm. BLS serves to create balance between the right and left hemispheres of the brain, which enhances a feeling of calm in the body. This helps to lessen the activation of distressing memories and change the brain’s wiring related to that memory.
Examples of bilateral stimulation include using alternating right to left stimulation such as tapping on the knees, legs or shoulders, tapping toes or feet on the floor, or eye movements.
Both focus on the eyes and eye movements.
Research has consistently found that eye movements lower the vividness and emotionality of memories, and intrusive thoughts of negative memories. While EMDR and Brainspotting have different ways of focusing on the eyes, both use the eyes to help clients effectively process distressing trauma memories and ongoing pain.
Both use specific evidence-based research protocols.
In EMDR, the process that the therapist follows is called a protocol. In Brainspotting, it’s referred to as a set up. Both of these treatment approaches make note of physical and emotional activation in the body using the Subjective Unit of Disturbance (SUD) scale.
Both use resourcing and grounding.
EMDR and Brainspotting both have methods for helping to ensure that clients are grounded and resourced. It’s not uncommon for resources to naturally show up in an EMDR or Brainspotting session.
Therapists have to be specially trained to conduct both approaches.
EMDR and Brainspotting therapists both go through extensive specialized training, which involves understanding the neurophysiology of trauma and the brain. As part of these (separate) trainings, therapists learn how to focus on a client’s thoughts, memories, physical sensations, and emotions as a core part of the healing process.
Differences between EMDR and Brainspotting
Eye movements and eye positioning are different.
With EMDR, clients eyes are directed to move from side to side following a moving light or their therapist’s fingers. Bilateral stimulation may also occur using alternating sounds or tones, or through tappers, which are small vibrating paddles that buzz alternatively in the client’s hands (tactile stimulation).
In Brainspotting the eyes remain largely fixed on a particular spot (or spots). Brainspotting clients often use biolateral sounds, which are specifically designed to play alternatively in headphones. Many clients find these sounds to be relaxing. At times, the specific soundtrack can naturally evoke certain emotions or memories. Bilateral stimulation, however, is optional with Brainspotting as it’s not the component that makes Brainspotting work.
Each uses different devices to support therapy.
EMDR therapy and Brainspotting both use devices to support the therapeutic modalities. If you’re used to talk therapy and/or new to these approaches, these devices may look strange at first. EMDR’s devices might include a light bar, tappers or headphones to enhance bilateral stimulation. Brainspotting may include a wand, goggles or headphones. Either way, these help to enhance clients’ processing of information
The protocols have some differences.
While it’s not a client’s responsibility to understand the protocols or set up of these therapies, it may be helpful to know there are slight differences in each approach. As of the time this blog post was written, each of our therapists who are trained in Brainspotting are also trained in EMDR therapy. So, they’ll know how to navigate these protocols to best suit your personal needs.
Interested in trying either EMDR or Brainspotting?
Our bodies have a natural ability to heal, even through PTSD and complex trauma. You can read more about EMDR therapy and Brainspotting below, or check out our other specialized services here.
The eight phases of EMDR therapy provide a framework to understand the treatment process. They act as a map for the EMDR therapist to follow. All eight phases contribute to the overall effectiveness of EMDR therapy, however, not all phases may be used in one EMDR therapy session.
EMDR’s 8 phases
Phase 1: History and Treatment Planning
This first phase includes a discussion between the therapist and client regarding what brings the client into therapy and whether EMDR therapy may benefit that client. The therapist and client begin to build a secure working relationship. This phase generally takes one or two sessions at the beginning of treatment and continues throughout therapy, especially as new issues or “stuck points” arise.
The therapist takes a thorough client history and discusses with the client the impact of a specific problem(s), including behaviors and symptoms stemming from that problem. With this information, the therapist will develop a treatment plan that defines the specific “targets” on which to use EMDR. The therapist also assesses the client’s internal and external resources.
Phase 2: Preparation
Most clients spend about 1-4 sessions in the Preparation phase. For those with complex traumas, more severe trauma histories, or certain diagnoses, a longer time may be necessary. In this phase, the therapist helps the client learn specific techniques in order to tolerate any emotional disturbance that may arise during treatment. This may include learning a variety of relaxation or grounding techniques.
By the end of this phase, the therapist will have explained the theory of EMDR, how it’s implemented, and what the client can expect during and after treatment.
Phase 3: Assessment
In the Assessment phase, the therapist works with the client to “set up” the first target. This includes identifying the target event, along with images, beliefs, feelings, and sensations about the event. The therapist assesses initial baseline measures using the Subjective Units of Disturbance (SUD) scale and the Validity of Cognition (VOC) scale. The goal of the following phases, is for SUD scores of disturbance to decrease while the VOC scores of positive belief increase.
Phase 4: Desensitization
This Desensitization phase focuses on the client’s disturbing emotions and sensations as measured by the SUD rating. This phase focuses on the client’s responses (ie. other memories, insights and associations that may arise) as the targeted event changes and its disturbing elements resolve.
The therapist leads the person through sets of BLS with appropriate shifts and changes of focus until the SUD levels reduce to zero.
Phase 5: Installation
During the Desensitization phase, the client will have decreased the disturbance intensity of the negative belief. Phase 5 strengthens and “installs” the positive cognition with the goal of helping the client accept the full truth of the positive self-statement at a VOC level of 7 (completely true). It’s important to remember that EMDR cannot make a client believe anything positive that is not appropriate for that client.
Phase 6: Body Scan
After the therapist guides the client through strengthening and installing the positive cognition, the therapist will ask the client to bring the original target event to mind to assess whether the client notices any residual tension in the body. If so, these physical sensations are then targeted for further reprocessing.
An EMDR session is not considered successful until the client can bring up the original target without feeling any body tension. Positive self-beliefs are important, but the client has to believe them on more than an intellectual level.
Phase 7: Closure
Phase 7 occurs at the end of every individual treatment session. If the client does not completely process the traumatic target event in a single session, the therapist will assist the client in using a variety of self-calming techniques in order to regain a sense of equilibrium. The client remains in control during the EMDR session, and it’s important that the client continue to feel in control outside the therapist’s office.
The therapist also briefs the client on what to expect between sessions. For examples, processing may continue and some new material may arise. Clients may journal or record these experiences and use calming techniques to self-soothe in life outside the therapy session.
Phase 8: Reevaluation
The Reevaluation phase reopens at the beginning of every new session. This phase guides the therapist through the client’s treatment plan in order to determine the success of treatment over time.
Although clients may feel relief almost immediately with EMDR, it’s important to complete all eight phases of treatment to maintain the modality’s effectiveness. EMDR therapy is not complete until attention has been brought to the past memories that are contributing to the problem, the present situations that are disturbing, and what skills the client may need for the future.
Our services
Our bodies have a natural ability to heal, even through trauma and PTSD. We offer individual EMDR therapy and EMDR Intensives for our clients, all conducted by clinicians who have completed an EMDRIA-approved training. There is no shame in seeking the treatment you need. Contact us at hello@sustainablewellnessny.com to begin your healing journey.
Trauma is an emotional response to experiencing or witnessing a severely distressing event, or series of events. In short, trauma is what happens when our system becomes overloaded.
Our brains and nervous systems are built to automatically protect us and help us survive. This automatic reaction is called the fight, flight, or freeze response. Trauma is a normal response to an abnormal situation. This means that trauma is not a defect or something someone has done wrong. The consequences, however, are that the threat – or perceived threat – from the traumatic event, can disconnect us from the moment, our reactions, or from those around us.
Fight-flight-freeze
The fight-flight-freeze response prompts our bodies into survival mode by increasing our heart rate, releasing stress hormones, and increasing blood flow to prepare for running or protecting ourselves. Adrenaline and other neurochemicals rush to the brain. These reactions impact certain parts of the brain, including the amygdala, hippocampus, and prefrontal cortex.
The amygdala acts as the brain’s emotional alarm system, or watchtower, when we feel unsafe.
The hippocampus assists with long-term memory storage.
The prefrontal cortex monitors rational thought and helps us control emotional responses.
When activated by trauma, the amygdala may disrupt signals to the hippocampus. This is why trauma memories may seem fragmented. The prefrontal cortex may also go off-line when the amygdala signals the need for alarm. This happens because the body doesn’t have time to think under threat. Any additional time spent thinking could jeopardize survival.
Our fight-flight-freeze response explains why thinking our way out of threatening situations becomes difficult. It’s also why trauma memories often become associated with images, feelings, and body sensations, rather than rational thoughts. The chemicals released during a trauma response prohibit the brain’s reasonable side from helping the emotional side escape memories of the trauma. In other words, a disconnect occurs from the side of the brain that handles reasoning and cognitive processing.
Recognizing trauma
People who have experienced trauma often appear shaken and disoriented. Some signs and symptoms of psychological trauma include, but are not limited to: confusion, difficulty concentrating, mood swings, anxiety, depression, and intrusive thoughts.
Because trauma changes the brain, it also impacts a person’s perspective. For example, trauma may lead someone to perceive a situation as dangerous, even when there is no actual safety threat. It may include consistent feelings of guilt and responsibility (self-blame), feeling ashamed, and feeling different from or misunderstood by others. To a traumatized brain, it can become difficult to distinguish threat from reality.
Trauma may also involve major emotional shifts, including difficulty regulating anger, as well as self-destructive behaviors, including unhealthy patterns related to food, substance use, and hurting oneself to relieve pain. Difficulties staying present may include feeling mentally disorganized, or detached from one’s own body and mind.
Other shifts include relationship challenges, such as difficulties trusting others, feeling disconnected from loved ones, or struggles with intimacy. Many people with trauma attempt to protect themselves from being hurt, which often lead to unsuccessful or unhealthy coping patterns over time.
What is PTSD?
Post-traumatic stress disorder (PTSD) is a diagnosis in the DSM-5 and refers to a specific set of criteria regarding trauma symptoms. PTSD occurs when the symptoms and reactions caused by a traumatic event do not resolve in a few months.
It’s possible to experience trauma and not develop PTSD. In these cases, the person will be able to process, or make sense of the event and feel okay with moving on after the experience. Someone whodoesdevelop PTSD will remain so overwhelmed by the event that it does not resolve, remaining stored in the brain and nervous system in an unhealthy way. In these cases, trauma memories linger and disrupt everyday life.
There are many reasons why someone might develop PTSD. Sometimes one single trauma event (ie. natural disaster, car accident) can cause PTSD. Other times, repeated events from childhood or ongoing traumatic events can create conditions for PTSD. Regardless of the reason, PTSD will occur when the body and brain’s ability to cope is disrupted and overwhelmed.
PTSD symptoms generally fall into four areas:
Re-living symptoms: flashbacks or nightmares.
Avoidance symptoms:staying away from activities, people, or places that are reminders of the trauma.
Cognition and mood symptoms:negative thoughts about self and world, extreme guilt, or lack of interest in things that used to be enjoyed.
Increased arousal symptoms:startling easily, having angry outbursts, and difficulty sleeping.
You can heal from trauma and PTSD!
Our bodies have a natural ability to heal, even through trauma and PTSD. Our team at Sustainable Wellness offers specialized services to heal your traumatized brain. We support your healing with therapies such as:
There is no shame in seeking the treatment you need. Let us help you understand why. Contact us athello@sustainablewellnessny.comto begin your healing journey.
