Author: Diana Schaefer, LCSW and clinically reviewed by Teri Schroeder, LCSW
Anxiety is a common issue that comes up for people. A little anxiety is a good thing and can motivate us to make needed changes. A lot of anxiety can be crippling and burn people out over time. If you had no anxiety you might not be motivated to do anything.
So, you may be wondering how EMDR works for anxiety in different situations; such as having to do public speaking, taking a test, or having to drive after having had an accident, or more generalized where you feel anxious but are not sure why.
Understanding How EMDR Works for Anxiety
Let me give a little background on EMDR in general. Eye Movement Desensitization and Reprocessing (EMDR) is a form of therapy with a strong evidence base for treating trauma and anxiety. But how EMDR works for anxiety specifically is a fair question, and one clients ask me often. There is a specific protocol and process and we will try to lay this out in a simple relatable manner.
The EMDR Process for Anxiety
1. Identifying the Trigger
Let me start by saying every individual’s experience with anxiety is unique. One of the foundational steps in EMDR therapy is pinpointing the primary triggers for the anxiety. For instance, if public speaking induces anxious feelings, the EMDR process begins by recollecting a past successful public speaking experience. This memory acts as a positive anchor. The individual is guided to recall their emotions during this successful event, the positive self-beliefs they held, their posture, body sensations, and even articulate a word or phrase that encapsulates the feeling of that moment.
Sometimes a current trigger might actually be tied to something much older. I once had a client whose current anxiety linked back to old events from childhood where a parent who struggled with substance abuse brought about a lot of unsafe and anxiety provoking situations. Part of the EMDR protocol and the brain’s efficiency helps us to target the correct triggering memory.
2. Bilateral Stimulation
As the name implies, this phase involves bilateral stimulation, a core aspect of EMDR therapy. Bilateral stimulation typically comprises rhythmic left-right patterns using visual, auditory, or tactile (tappers) stimuli. Research suggests that bilateral stimulation can help in integrating and processing memories and emotions, thereby diminishing their distressing intensity. As Rick Levinson, LCSW and EMDR trainer says, “this helps the brain to metabolise things that were stuck in processing.” This doesn’t mean the memories are lost, they are just no longer distressing.
3. Resourcing the Positive Experience
Processing the negative is only half of EMDR. The other half is anchoring the positive. The recalled positive memories and feelings are then anchored with a word or phrase. This “resource” becomes a tool the individual can use when faced with anxiety-provoking situations in the future.
4. Facing the Future Event
The next step is visualizing an upcoming anxiety-inducing event, like a future public speaking opportunity. The client is encouraged to identify the emotions, physical sensations, and irrational negative beliefs they associate with this situation. The intensity of their distress is rated on a scale of 0-10. Bilateral stimulation is then employed again, but this time focused on these distressing thoughts. A change often occurs and the negative perceptions shift toward the positive, and the individual’s anxiety levels drop. After each pass the distress level is marked until it reaches an ecological level of 0.
Studies on EMDR have shown a marked reduction in distress levels after this form of visualization combined with bilateral stimulation. The repetitive recall of distressing memories while undergoing bilateral stimulation has been found to reduce the vividness and emotional charge of these memories.
5. Rehearsing Success (Performance Enhancement EMDR)
Another EMDR technique involves mentally rehearsing a successful outcome. We also call this performance enhancement EMDR. In the context of public speaking anxiety, one would visualize the entire process, from preparing for the speech to its conclusion, while undergoing bilateral stimulation. Should anxiety arise during this mental rehearsal, the session pauses to address and process those feelings until they diminish. I have had clients use this for taking the MCAT, professional sports, and even capital raises for their startups.
Case Example
All identifying information was removed and scenarios altered to maintain anonymity.
I worked with a young woman who suffered from anxiety which she felt intensely whenever she had to be the center of attention. She was getting married and the thought of everyone staring at her terrified her. She had suffered from panic attacks in the past and was terrified she would have a panic attack at her own wedding and ruin the entire experience of her special day, or feel miserable the whole time.
Obviously, sometimes the anxiety is based on traumatic experiences that also need to be addressed. This was true in her case as she had a loss in life that left her feeling unprotected and vulnerable. We worked together for several weeks on having her imagine getting up that day, getting dressed and ready, walking with her father down the aisle of the church and doing this successfully without a panic attack.
Her level of anxiety before we started the process was at a 10+. We were able to get the anxiety level down to about a 3 which was fine with her. She wanted to feel in control but the anxiety made her feel out of control. We also worked on the deeper reasons behind her anxiety. She ended up having a little anxiety during her wedding (who wouldn’t?) but it did not limit her or prevent her from having a wonderful experience.
When she came back after her honeymoon she cried from the relief and joy she felt from being able to go through the event and enjoy it.
Explore EMDR Therapy in Austin, Texas
If you feel that you or a loved one could benefit from either anxiety counseling or EMDR therapy, you can contact us to make a counseling appointment. If you would like a more general perspective on EMDR, you can read How EMDR Works.
Photo by Amanda Dalbjörn on Unsplash
