Why do we do the weird eye movements in EMDR?

Good morning. Or I guess whatever time it is when you're watching this. It's been actually quite a while since I've put up anything on YouTube and figured it's probably a good time for this. I've been doing a lot of videos otherwise for other purposes and other companies recently, especially on the topic of emdr, been doing a lot of live trainings in EMDR and online trainings as well. And so I wanted to do something, I don't know, maybe it'll be 10, 15 minutes, something like that. But a video specifically about EMDR, a piece of EMDR that's confusing for a lot of people, clients as well as, I think clinicians. And I wanted to say a little bit about it. So the topic is bls, das. So BLS stands for bilateral stimulation. DAS stands for dual awareness stimulation. So if you have had any exposure to emdr, either as a client or as a clinician, you know that there's kind of this magical quality to it that I think is kind of a turn off to some people and maybe is intriguing to other people. But the piece of it that seems sort of mystical and a little bit confusing is the eye movements. So if you're a client, you've done emdr, you know that you usually the therapist is moving their fingers and you're watching them go back and forth. You may alternatively had EMDR where you have the little sensors in your hand called the theratapper, these little buzzies in your hand. And in both cases you've probably noticed that it's been bilateral. So you're moving your eyes from one side to the other, or you're having this bilateral tactile stimulation, one hand and then the other. I think some therapists do a really good job at explaining this, but I find in some of my trainings that even therapists who've been doing EMDR for a while don't always have a good understanding of what the hypotheses are behind bls. And so it can be good to understand this, I think, not only if you're a client a client, but also if you're a clinician doing emdr. It can be helpful to know why exactly we're doing this. So the application of bls, that bilateral movement or stimulation is really a key aspect of emdr. And in my opinion, it's one of the main things that separates EMDR from other therapies. Because without that, a lot of what EMDR is, is maybe a little bit of focus on somatic work and a lot of cognitive restructuring. And in a lot of ways it's good old fashioned exposure therapy, which we know is awesome, right? So that's not something, a criticism of it. But really what makes EMDR different is the application of the Blsdas. So why are we doing this? Let me start off with a little bit of a history about this. We associate this with emdr and there's no question that Francine Shapiro was an absolute genius. Totally discovered this on her own, where she was walking through the forest and she was thinking about something traumatic. This is how the story goes around 1989. And she's walking and she's darting her eyes back and forth as she's walking through the forest thinking about something really distressing. And she starts to notice that the images are dulling as she's doing this. So the memories are getting less intense and her experience of it is dulling, including the images. And this is really her discovery of using bilateral movement to dull or process through strong negative emotional content. Know though that this wasn't actually first discovered by Francine Shapiro. So yes, it was discovered by her, but it was not first discovered by her. So we think aboriginal cultures have been using this for thousands of years. And by this I mean incorporating bilateral movement to process strong emotions. So think especially weddings and especially funerals in terms of using it clinically. We know it was being used clinically even in the 1700s. There's a guy named Franz Mesmer. So if you've ever heard the term getting mesmerized, that's Mesmer sort of inching toward the origins of hypnosis, but not quite. In the 1700s, Franz Mesmer started using bilateral movements and then James braid in the 1800s. We think of him mainly as the developer. I don't know if discoverer is the right word, but developer of hypnosis, he was really the first to use bilateral movements in the way that's actually very similar to how we're using them in EMDR today. So EMDR has its roots in hypnosis. Allegedly in this source is kind of hard to track down, but allegedly also Freud used this late 1800s where he was combining his talk therapy psychoanalysis with bilateral eye movements in clients. And there are, there is some documentation of this where he talks about how effective this is and he actually says that this is more effective than anything else had ever been. So when he was combining his talk therapy with bls, it worked substantially better. Why this fell out of vogue, though, it's a little bit unclear, but it fell out of vogue maybe around 1900 or so. Not entirely positive about this, but at the time there were some political things happening and there was a lot of concern at that time about witchcraft, magical things. And the theory is that he was concerned about being perceived in that way. He was quite well known and quite famous and didn't want to be perceived as a witch or I guess a sorcerer, didn't want to be perceived as doing these things that were. That had this magical or mystical quality to them. So actually ended up abandoning this, but later wrote that nothing had worked so well. So this has been used throughout history, different times. Even the NLPers call them NLPers. The Neuro Linguistic Programming researchers around 1975 started developing Neuro linguistic programming and incorporating sometimes some BLS in that too. And then Francine Shapiro after that, by about 1989. So I say all this to say that bilateral movement, bilateral stimulation is not really a new thing. It is really what makes emdr. Emdr. I think there's no doubt that EMDR is new and that it was not put together in this way prior to Francine Shapiro. But know that the application of BLS is something that's been common for years, for centuries, and it's something that we know tends to work pretty well. And what I mean by that is that it helps people process negative emotional information faster than if we were to not apply the bls. Okay, so it speeds up the process by which you process. That's basically it. There's nothing really actually super magical. I don't think about it. I will throw at you. Also, you see the time here. Been talking about seven minutes. Let me also give you a little bit of history about the two theories about why this works so well. So there's two schools of thought on this, and the truth is probably a little bit of both or somewhere in between. But why this works so well. Let me take it from a neuroscience perspective on this. Some clients are gonna really appreciate this. Some really don't care. They're just gonna say whatever works, works. Just let's get this started. Other clients are gonna really want to know the ins and outs and are gonna be quite suspicious of this. So it can be good to have this information. Two theories, two theories about why BLS helps you process emotional information. One of them is called the working memory hypothesis, and the other one is called the interhemispheric communication hypothesis generally. And this is probably a little bit of an over generalization, but in my experience it seems to be that the working memory hypothesis is more supported by the neuroscientists broadly. Okay, so if you're a neuroscientist and you like the other theory. Okay. But generally speaking, working memory hypothesis seems to be more espoused by the neuroscientists. It seems like the inner hemisphere communication hypothesis. More like the EMDR fans are a fan of that. Not that you can't be both, but that's kind of the way it seems to go. I'm definitely an EMDR psychologist, but coming from a neuroscience background, that's pretty strong. So I'm probably going to go a little bit more the working memory hypothesis. But here's what they are. Okay, so working memory hypothesis, this basically says that when we apply bls, when processing emotional information, it speaks, speeds up that process because the BLS takes up some working memory capacity. In other words, it's a distraction. Okay, So I know that that like really demystifies it. I don't know, it's sort of. It could be kind of a downer actually, to think that that's maybe all it is, is that you're distracting. And I don't. Okay, I don't think that that's all it is. But let me say a little bit about this theory. Okay, so what we're doing in classic EMDR is we're pulling memories out of the hippocampus. And the hippocampus is this area of the brain that this limbic structure that holds long term memories. And they're explicit, declarative autobiographical memories. So the stuff that you can actually remember, when you try to remember it, it's the hippocampus. So think about the best birthday gift you've ever gotten in your entire life, or the best Christmas gift you've ever gotten in your entire life. You'd be pulling that out of long term memory. Okay? So explicit memory is the stuff that you can actually remember that's different than something like implicit memory, which would involve areas of the brain more like the basal ganglia, cerebellum, amygdala, different. Implicit memory is the stuff that you don't have explicit memory for, the stuff that you can't on purpose pull out of memory. So no conscious recall with it. And there's usually no. Well, there's always no language to those memories. So hippocampal memories, the stuff that you can actually remember. What we're doing in classic EMDR usually is we're having people pull out stuff from the hippocampus at a long term memory. And we're having them bring it up to these top areas here. The Prefrontal cortex, which is involved in working memory and like a million other things. But for our purposes, working memory, so you got your working memory right up here, pulling these memories out of the hippocampus into working memory. Hippocampus has a lot of storage. So long term memory is a huge storage unit. You can store thousands of things in here, thousands of memories in the hippocampus. But working memory, we know, has a very, very small capacity. Lot less stuff can fit into working memory. So if I were to ask you to remember a hundred different things all at the same time, you can't do it because your working memory capacity is not large enough. So what that means is that when we're pulling things out of long term memory, usually we can only pull a couple of things out or maybe one thing out at a time. So what we're doing in classic emdr, we're pulling out these memories out of the hippocampus, bringing them up to the prefrontal cortex into working memory, which has a very small capacity. The ideas that we're holding them there in working memory and doing something with them. Every time you remember something, you actually recreate it. So we're using that strategically where we're shifting, usually in some way or another, the client's emotional relationship to the memory, that can be changing what is emphasized, it can be shifting emotions, it can be paying attention to sensations and changing those. There's a whole lot of ways we can do this. But your pull pulling it up in working memory, and when you pull up that memory and working memory, especially when it's a trauma memory, it takes up the whole darn thing. So it feels really overwhelming. It feels like they're drowning in the memory oftentimes. So it's taking up 100% of this working memory capacity. And part of that is because these memories are so intense that they demand that much attention. So what we're doing when we're applying BLS is we are forcing the BLS to take up some working memory capacity. So if I'm moving my fingers back and forth and you're watching my fingers move, your brain has to process the fingers moving. And what that does is it takes up a little bit of space in working memory, otherwise you'll stop moving your eyes. So to keep up with the fingers, it requires a little bit of working memory capacity. And in fact, I know that the faster I go, I mean, I don't want to go so fast that I lose a client, but the faster I go, the more working memory capacity is taken up by the bls. The more working memory capacity that's taken up by the bls, the less can be taken up by the traumatic memory. So it may be the case when we apply BLS, that instead of 100% of your working memory capacity being taken up by the traumatic memory or the image that I'm having, you focus on, maybe it's only 80%, maybe it's 90%, maybe it's 70%, but it's less. And we know that when we have people focus on a traumatic memory, but they can't fully focus on it in the same way they can't allocate all their resources to it, their attentional resources, that it facilitates fading of the memory, okay? So it's less vivid and it facilitates a calmer reaction to it, so you actually react less strongly to it. So this is the desensitization piece of emdr. If you're into the phase model, and you know what I'm talking about with that, that's of course, phase four desensitization. So that's what's happening with working memory. And so it really doesn't matter how you're doing the BLSDAs, as long as you're taking up some working memory capacity. Although some will argue that if you do the tactile stimulation, it's going to be maybe slightly less powerful because it's not going to distract your brain quite as much as the eye movements. Honestly, in the research, all of it works, Whether it's audio, tactile or eye movements, it all seems to work. But there is a slight preference in the research just a little bit for eye movements. If you're doing EMDR as a clinician or as a client, and with the eye movements, you can't keep the memory in mind because that's happened. And when I've done my own emdr, had EMDR done on me, I've had that happen before where at some point I even. I can't even get it in my mind. You may need to do the tactile stimulation. So there's different ways of working with this. But know that really what we're doing is we're manipulating working memory and working memory capacity essentially here. So I know that that's not super sexy as an explanation, but that's one of the theories. Again, I think there's some good evidence for both. I think the truth is kind of in both places with both theories. Let me describe a little bit about the other theory, though, about why BLS works. This is called the Inner hemispheric communication hypothesis. This is kind of an oversimplification, but the idea here is that got a left hemisphere, you got a right hemisphere of the brain and they do different things. Okay, we know that that's pretty much generally true. And the way the hypothesis goes is that the left hemisphere of your brain is responsible for encoding the who's, what's, where's and whens of a memory. Okay? So it's the facts of a memory that very much goes with left hemisphere, which is responsible for things like detail monitoring. More concerned with tasks than people. Think of this, I guess, as the logical rational hemisphere of the brain. Although I think there's a lot of arguments that can be made for the opposite, for the right hemisphere too. But the idea is that it's just the facts of the memory, the order of operations of when something happens, very much left hemisphere. And that the right hemisphere is more involved in the experience of a memory. So the emotions and the sensations in particular, very right hemisphere. And we know that with traumatic memories there's oftentimes fragmenting where these internal pieces of the memory aren't really going together. So people remember bits and pieces here and there, and sometimes different pieces can be triggered under different circumstances. And it can kind of feel like you're walking on broken glass, stepping on stuff, and you don't even know what you're stepping on or what's triggering what. And it's just these little chunks of things, these little pieces. Okay, so theory here is that with the bilateral movement, what's happening is that you're activating in sequence, left hemisphere, right hemisphere, left, right, left, right, left, right, left, right. So you're activating both hemispheres of the brain and encouraging inter hemisphere communication via these fibers that connect the two hemispheres called the corpus callosum. So facilitating that integration of the two hemispheres, thereby integrating this memory. So you're focusing on the memory while you're applying the bls. You're activating each hemisphere, left for the facts and the details, right hemisphere for the experience. And so now you get it integrated into one cohesive whole experience as opposed to having these fragments. I think there is something to this too. We do know that how memories are consolidated in the first place has a lot to do with rapid eye movement sleep or REM sleep. And it's thought that the application of bls, at least with the eye movement, is essentially replicating REM sleep and facilitating the integration of these memories. So again, some evidence for each. I think the inner hemisphere communication hypothesis is A little sexier, a little more alluring. Sometimes coming from the background I come from, just the neuroscience background makes me, like, slightly more cynical maybe. So I'm like, you know, maybe it's distraction, but regardless, we know that it works, and it works actually quite well. And so if you're a clinician and you're not trained in emdr, I strongly recommend getting some training in emdr. There are a lot of different organizations and opportunities for trainings in this. Definitely build that skill set. If you want to get certified by any particular organization, do that. But. But even that aside, just focus on the skill building and focus on the competence, because really, that's the most important thing. I've even used BLS with clients fairly loosely, where I'm not even doing, like, real emdr, but maybe they're just talking about something that's bothering them and I throw the thera tapper at them, the buzzies. Okay. And we're just kind of processing through, because I know that that can help facilitate the process. So you can use this loosely. You can use it in a more formal, structured way. With the eight phase model of emdr, some clinicians now are even doing walk and talk therapy. They're walking outside because walking, if you think of it, that is bilateral movement. When they're talking about something distressing, they speed up the walking, and then they start to slow down when the client is not processing negative information. So just know that BLS is something that can be used really creatively, loosely, or it can be used in a structured way to go through those eight phases of EMDR. Okay, let me see where I'm at. Oh, wow. 19 minutes. I always talk more than I think I'm going to. I'm gonna get going for my next session, but I'm gonna try to make some more of these videos, specifically EMDR videos, because I know that this is a topic that's really interesting to a lot of clinicians and also, I think, just members of the lay public. So definitely consider getting EMDR trained if you're a clinician. And if you're a clinician, your client, and you think that maybe you could benefit from it. Take a look@psychologytoday.com to see who in your area actually is trained in this. There is a little category where you can click a little box and look for EMDR therapists. Okay, bye.