Self-administered EMDR without a therapist is very useful for a lot of things!

post by EternallyBlissful (anton-rodenhauser) · 2023-05-25T17:54:13.389Z · LW · GW · 10 comments

Contents

  How to do self-administered EMDR
  How I do self-administered EMDR
  Some personal anecdotes
  The risk of doing EMDR without a therapist: Re-traumatization
None
10 comments

EMDR (Eye Movement Desensitization and Reprocessing) therapy is a structured therapy that encourages the patient to focus briefly on a traumatic memory while simultaneously experiencing bilateral stimulation (typically eye movements, but also tones or taps), which is associated with a reduction in the vividness and emotion associated with the traumatic memories.

EMDR is usually done with a therapist. However, you can also just do self-administered EMDR on your own - as often and whenever you want without any costs! Most people don't seem to know this great "do it on your own" option exists - I didn't. So my main goal with this post is to just make you aware of the fact that: "Hey, there's this great therapeutic tool called EMDR, and you can just do it!". And bearing some important caveats in mind, I highly recommend it. I've been doing emotional work like extended meditation retreats, Internal Family Systems (IFS), Ideal Parent Figures (IPF), Focusing, etc., for a long time, but self-administered EMDR has actually been one of the most helpful techniques of them all to me! 

Also, I've found EMDR helpful for a much broader set of problems than the official EMDR protocol implies. You can use it for anything "trauma" in the broadest sense of the word - any unhelpful emotional schema; any strongly negatively charged emotion, belief, or memory that is kind of stuck in unconsciousness.

EMDR also doesn't have to be this complicated thing at all. I don't think you need to know more than there is in this blog post. You can totally 80/20 this, i.e. get 80% of the benefits from just 20% of the knowledge/effort.

How to do self-administered EMDR

Read here how to do EMDR with a therapist: https://www.helpguide.org/articles/therapy-medication/emdr-therapy.htm 

For self-administered EMDR, you simply do the same, just without the therapist! So to summarize the most important steps of the official protocol, you:

Here's what you can do for bilateral stimulation:

You can also combine some or all of the above stimulations, which is probably a good idea and often done. I have an EMDR software by Psylaris that does even more: You see a dot moving in random patterns on a screen, you hear the binaural clicks, and every few seconds, you see one of three symbols on the screen, with the instruction being to tap yourself at a different body part depending on the symbol. Additionally, you can also set it up such that you get shown a calculation task every 10 seconds or so with the instruction to say the answer aloud. Also, the ball changes colour every few seconds, and you hear a popping sound each time it does so. 

I think the general idea with EMDR is that you tax your working memory as much as possible such that you can still just barely also focus on your traumatic target and/or your positive/negative belief, all while activating/engaging as many as possible different brain areas and senses. 

How I do self-administered EMDR

Sometimes I actually follow the official EMDR protocol described above, but most of the time I don't. One big problem (which turns out not to be a big problem) is that I don't really know my traumas! I don't have any obvious ones. Instead, all of the following have worked well for me as targets:

Also, most of the time I don't go through the formal steps of "identify the target, a negative belief, a positive belief". Instead, my approach is much more "just do it on the go”, often spontaneously whenever something interesting arises.

Example use cases:

Some personal anecdotes

Ever since the beginning, whenever I meditated more than a few hours a day for more than a few days in a row, the following experience has been consistently happening to me over and over again: I generally became extremely happy throughout my days in a fairly deep sense of the word. But, the deeper my meditation got, the more obviously I also noticed a certain "sense of doom," a certain tension in my chest, a strong unpleasant Felt Sense of "something just isn't right." This "sense of doom" Felt Sense in the chest would only be there during the deep concentration of long mediation sessions and would immediately go away afterward. 

I've been mystified by this for many years, and I've tried everything I can think of to deal with it. I calmly ignored it for hours while just focusing on the breath, but it would just get stronger and stronger. I've spent whole retreats focusing on it directly, making it the exclusive object of meditation, and "bravely stare at it with my mind wide open" - but it never changed anything. 

I’ve also tried various visualizations and other things. For example, I've spent hours and days visualizing warm pleasant golden light flowing directly into that sinking feeling in my chest. Or, I visualized an all-powerful superhumanly beautiful healing goddess putting her warm comforting hands directly on my chest right where the pain is strongest. It all just never changed anything!

Only after years, once as I started doing EMDR whenever this feeling came up while focusing on it as hard as possible, did I finally make progress! As I looked at my waving finger in front of my eyes for the first time while focusing on that doom-y feeling, the feeling of tension in my chest became almost unbearably intense, and I got all sorts of very strong bodily reactions. I started to breathe heavily, my whole body shivered, I started to sweat. I also felt strong electrical currents flowing through my whole body. It was extremely intense and lasted for about 20 minutes! And all the while, an enormous flood of thoughts, memories, and intense emotions whirled through my consciousness. I also got glimpses of completely new memories from my childhood. And when it was finally over, my whole body felt a massive sense of relief, an extremely pleasant warm feeling of lightness and relaxation - as if a huge weight had been lifted off my chest.

By now, I've done EMDR with that sinking feeling as my target about 20 to 30 times. Sometimes I get no reaction, and most of the time I get a much weaker reaction than the initial time, and maybe 2 to 4 times I got an equally intense experience. The feeling of doom is still coming back occasionally during meditation, but much less now than it used to. And if it does, I continue to “EMDR it away” and make progress with it.

The risk of doing EMDR without a therapist: Re-traumatization

Many people warn you that doing EMDR alone is very dangerous because you risk re-traumatization. Or, at the very minimum, you risk bringing stuff to the surface that is very destabilizing. I admittedly don't know that much about it, and I'm a bit unsure how to feel about it. Anyway, here's how you minimize the risks of self-administered EMDR:

My intuitive sense is that the risk of re-traumatization from self-administered EMDR is vastly overblown, and I am personally somewhat annoyed by that because I feel like there's this great tool and almost no one is using it because of this vague fear that something could go wrong. Consider what fate meditation would have if it was discovered only today by some eminent psychology professor at Stanford. My guess is that they would run some studies with this "new therapeutic tool called meditation" and find it very promising but certainly with some risk. And because the medical system is always way too cautious, we would probably end up in a world where meditation is never done on your own but always only with a trained therapist, and lots of people would warn you that it's very dangerous to do this on your own because "it might be destabilizing." And in the end, almost no one would end up with a normal meditation routine - it would only be this somewhat obscure thing mostly done by people with very serious mental health problems in specialized clinics. I feel like that's what happened to self-administered EMDR!

That said, you really shouldn't take EMDR lightly. My guess is the risk is somewhat similar to doing a multi-day silent meditation retreat. Even if you have no idea what you're doing going into such a retreat, you're probably fine. Thousands of people do that every year, and only very few of them end up regretting it. But some people do end up regretting it!! Even if you know exactly what you're doing, there's still some risk, especially if you ignore the tips above on preventing re-traumatization.

But also keep in mind what re-traumatization is NOT. It's not the process of previously unconscious suppressed beliefs, emotions, or memories now suddenly spooking around in consciousness, causing you to temporarily feel much worse for potentially quite a long time, maybe weeks. This is entirely normal, and in a way, it's actually precisely what you want to happen! Bringing unpleasant suppressed material to the surface just is what needs to happen for emotional healing. But this can be pretty destabilizing temporarily and may even feel like you've re-traumatized yourself.

10 comments

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comment by ChristianKl · 2023-05-26T00:21:18.240Z · LW(p) · GW(p)

When it comes to retraumatization, stronger memories carry stronger risk. You likely first want to use a technique like this with medium-level memories and not memories that are strong enough to produce panic attacks. 

In clinical settings where people are completely dysfunctional in their lives because they have strong post-traumatic stress disorder there's a higher risk of retraumatization than for most memories that most people have. 

Replies from: anton-rodenhauser
comment by EternallyBlissful (anton-rodenhauser) · 2023-05-28T12:05:04.775Z · LW(p) · GW(p)

That's true. However, it's hard to know in advance how severe a trauma is. 

Replies from: ChristianKl
comment by ChristianKl · 2023-05-30T16:13:20.176Z · LW(p) · GW(p)

I think the cases that motivate the advice to worry about retraumatization are mostly cases where it's very clear that there's severe trauma.

comment by RHollerith (rhollerith_dot_com) · 2023-05-25T18:20:56.427Z · LW(p) · GW(p)

Thanks for the report. With these kinds of reports, I give more weight to reports by those with more experience in the subject matter of the report, so it would be nice to know how long ago you first tried self-administered EMDR.

Replies from: anton-rodenhauser
comment by EternallyBlissful (anton-rodenhauser) · 2023-05-28T12:08:02.883Z · LW(p) · GW(p)

I've started doing self-administered EMDR about 6 months ago, and I've been using it very regularly since then, maybe 4 times a week. About half of the time that I do it it feels like it does "something", and maybe every 1 in 10 times it feels like a bigger breakthrough. I've noticed big changes in my behaviour and emotional life over the last 6 months. However, I've been combining a lot of therapeutic stuff, not just EMDR.

comment by Chris Ahrweiler (chris-ahrweiler) · 2023-11-05T00:02:37.246Z · LW(p) · GW(p)

Feel free to try "self EMDR" with https://emdr.chat/me

comment by Blacknsilver · 2023-05-28T02:05:08.912Z · LW(p) · GW(p)

I was just reading about EMDR in "The Body Keeps the Score" and thinking how nice it'd be if my psychiatrist wasn't stuck in the 19th century. I will try this out on my own and edit (or maybe reply) later on with my thoughts and experiences.

comment by Kaj_Sotala · 2023-05-27T09:50:48.487Z · LW(p) · GW(p)

Thanks, I'd tried self-administered EMDR sometime before and didn't get much out of it. Now I gave it another shot and it caused some stuff to surface, so seemed to be doing at least something even if I didn't get to the root of the issue yet.

Do you have any thoughts on how I should try to balance the external stimuli vs. the internal content? I notice that it's easy for either the EMDR stimuli to push the emotional content out of consciousness or vice versa. Should I try to keep them exactly balanced, or predominantly emotional content with some stimuli, or predominantly stimuli with some emotional content?

I also wondered about, when I was focusing on a felt sense and memory fragments started coming up, should I "make more room" for those memory fragments or just ignore them and keep allocating exactly the same amount of mental space to the felt sense.

Replies from: anton-rodenhauser
comment by EternallyBlissful (anton-rodenhauser) · 2023-05-28T12:13:16.213Z · LW(p) · GW(p)

These are all excellent questions! Unfortunately, I don't have definite answers. I've read somewhere that the idea is to tax the working memory as much as possible such that you can just barely hold an emotional felt sense at the same time as well.
I'd be very interested if someone does some more reading and research on this!
What I personally do: The more intensive the felt sense feels, the harder I focus on the EMDR "distractions", and vice-versa. 

comment by pandamonium · 2023-06-28T17:06:31.450Z · LW(p) · GW(p)

Thanks for the post ! I have tried doing EMDR by myself following these instructions after struggling to find a reliable EMDR therapist and it's definitely a new addendum to my therapeutic toolbox. It's great to process difficult events that happened in the past and the subsequent feelings.

In the link you refer to, there is a phase at the beginning where the therapist teaches self-care techniques to handle strong emotions (or they ensure that the patient already has such tools). This was lost in your post and I think it is important in order to avoid retraumatization and bad experiences. I felt confident trying the technique because I know how to soothe myself if needed and be present with my feelings, but I am pretty sure it would have been a scary or even maybe a painful experience otherwise.