EMDRHave you heard of EMDR therapy before?  (It stands for Eye Movement Desensitization and Reprocessing.)  I first heard about it around 20 years ago.  At the time, I thought it was a strange concept. And I filed the idea away as something I’d look into.  Sometime.

Then, a few years later, I read about EMDR in the wonderful book, The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma.  I learned a bit more about the research that proves its effectiveness.  And, once again, I filed it away as something I’d look into more.  Sometime.

A few years after I read that book, I had a boss who confided to me that she found immense relief for herself by using EMDR therapy for trauma relating to growing up with an alcoholic father.  And what did I do with that information?  Yep.  You guessed it.  I filed it away as something I’d look into more. Sometime.

Last year, however, as I continued to struggle with family traumas and parental abandonment in my own life, I finally decided to take the EMDR suggestion seriously.  At the time, I was so frustrated that traumas that had happened decades earlier in my own life were still plaguing me.  Still causing my body to go into uncomfortable states of panic.  Why couldn’t I seem to shake these reactions, no matter how much “work” I did on myself, through cognitive behavioral therapy, books, groups, etc.?

When I got serious about it, found an EMDR therapist, and dug in, I found so much relief.  I can’t explain the science behind it.  But I can tell you, experientially, that this type of therapy has been amazingly helpful to me.  Over a 9-month period, I worked through a complex web of family traumas.   The effects of the trauma have largely been neutralized in my body.  Now, on the other side, I want to spread the word about how much this tool can help.

Why am I sharing this on a blog related to working parenthood?  Because I know *so* many people in this (and other) parent communities who have experienced birth trauma.  And these birth traumas affect our parenthood and our careers.  If EMDR was so helpful for me in feeling resolution around complex traumas from my childhood, it should sure as heck be helpful around traumas relating to the experience of birth, right?  (Yes, it sure is.  As you’ll read below.)

It turns out EMDR practitioners agree that EMDR is a great option if you’ve experienced birth trauma.  (Or any other trauma for that matter.)  I decided to interview 4 EMDR clinicians for this piece.  These therapists are Emma Basch, Psy.D., Julie Bindeman, Psy.D, Sultana Karim, M.A., LCPC, LPC, CCTP, Megan MacCutcheon, LPC, PMH-C.

I’ve included each of their responses in full, which I know makes this piece quite long.  They each brought such helpful and unique insights to each question, though (while being quite consistent in their messages!). I was, therefore, reluctant to consolidate their information into single responses.  Here is their wisdom.



Question from Mindful Return: Generally speaking, what is EMDR?  How does it work?

Emma: EMDR is an effective, empirically supported treatment for trauma. Unlike traditional talk therapy, EMDR is a “bottom-up” approach.  This means we are focused on addressing how trauma is stored in the body.  EMDR addresses the way unmetabolized traumatic memory gets “stuck” in the base structures of the brain. In EMDR we use bilateral stimulation to help patients process traumatic memories, while staying anchored in the present moment.  We do this so a patient doesn’t become overwhelmed or flooded by their memories. EMDR addresses the emotions, body sensations, and thoughts associated with a traumatic memory.

Julie: EMDR can be seen as a complete therapeutic modality or as a targeting treatment that has been empirically validated to treat trauma.  EMDR works by “unsticking” the trauma memories in our brains so that our brains can rewire with more adaptive information. When we experience trauma, our brain (to protect us) goes into a fight/flight/freeze mode. Thus, the triggers in the situation (environmental, sights, sounds, smells, feelings, etc.) get associated in our brain to that trauma response. When those triggers come up, our brain has filed away that older information.  Our brain will then react in the same way to what it perceives as danger. Even if danger isn’t present.

Sultana: EMDR was developed by Francine Shapiro in 1987. EMDR is used in therapy to treat symptoms such as anxiety, guilt, anger, depression, panic, sleep disturbance, addictions, loss, pain and medical illness, Posttraumatic Stress Disorder (PTSD), dissociative disorders, eating disorders, and other traumatic or distressing experiences. EMDR encourages a client to focus on a traumatic memory, while simultaneously experiencing bilateral stimulation (through eye movement, butterfly taps, audio, swaying, etc.) to reduce the distress and emotions that are attached to the traumatic or distressing experience that was not fully processed at the time of the event.

Megan: EMDR is a modern therapy tool used to process trauma and disturbing events. It utilizes bilateral stimulation (left-right eye movements, or can also be done using audio stimulation, or tactile stimulation via tapping or holding vibrating buzzers). Bilateral stimulation allows the brain to process information, memories, and sensations, similar to the process that happens in REM sleep. It’s different from talk therapy, in that there are specific protocols and series of questions the therapist will ask.  There are also rating scales that may be used to measure the level of disturbance or how true various statements feel.

Mindful Return Question: Why might EMDR be a good option for someone who has experienced birth-related trauma?

Emma:  EMDR is a great option for addressing birth trauma, or any trauma for that matter. I think patients appreciate not having to tell or retell their stories repeatedly and benefit from the way in which EMDR addresses body-based memory and trauma.

Julie: Birth trauma is an experience affecting an “individual’s ordinary systems of care that give people a sense of control, connection and meaning” (Judith Herman’s definition).  EMDR is a way to assist that person to regain that sense of control, connection and meaning.

Sultana: EMDR may be a good option for someone who identifies that their birth experience was traumatic.  They may believe that the birth, or parts of the birth, was scary, disturbing, and/or overwhelming.  They may find themselves stuck in the disturbing memories and/or feel as if the traumatic or distressing experience may be happening at the present moment. Even if it happened years ago. This happens due to their brain’s inability to process their experience like it would naturally do when processing disturbing events.

Megan: EMDR is an excellent option for anyone who has experienced or witnessed a birth trauma. (This includes moms, partners, support people, hospital staff, doulas, etc.)  EMDR allows you to access and process the experience, while staying grounded in the present moment. EMDR works to address memory, emotions, and physical sensations.  It alleviates symptoms at a cellular level. Because birth is such a physical experience, and because we know that trauma is stored in the body, it’s vital to address birth trauma through a mind-body approach.

Question from Mindful Return: Why might someone want to work through birth-related trauma?

Emma:  If we don’t treat and heal from an experience like birth-related trauma, we can get continuously triggered by situations that feel connected to or remind of us that experience. That could include a subsequent birth, yes.  But it could also include going to a doctor’s office, or even parenting, if the experience elicits enough similar cognitions, emotions, or body sensations to that trauma. In that way, the singular experience of birth trauma can continue to impact daily functioning.

Julie: Because memories build on older experiences, it would be important for a person to work through a traumatic birth, especially if they might want to have more children. Additionally, depending on the experience of trauma, it might impact the attachment or bonding between the person who gave birth and the infant. The trauma can result in a person not receiving medical care, because of lingering impact, distrust of others, difficulty to communicate with others, and a difficulty managing emotions.

Sultana: Someone may want to work through their birth-related trauma, if they were unable to process their traumatic or distressing experience.  They may have disturbing memories, dreams, or flashbacks.  They may avoid reminders (people, places, etc.) and have bodily sensations related to the trauma.  Additionally, they may experience anxiety and mood changes (depression, anger/rage), and may have negative beliefs about themselves (for example, “I am failure,” or “It is my fault”).

Megan: Birth traumas or disappointing deliveries can create distress that impacts overall functioning and creates feelings of overwhelm, anxiety, and depression. Moms who have experienced birth traumas often experience intrusive flashbacks or overwhelming emotions.  This can make it hard to think about their birth or truly enjoy their new baby and motherhood. Some moms report that the PTSD from the experience impacts their ability to bond with their baby and to truly heal postpartum. Many moms also choose to work through a birth-trauma prior to a subsequent pregnancy or delivery, so they are less likely to be triggered and can better enjoy the experience.

Question from Mindful Return: Does someone need to try other therapies before trying EMDR?

Emma:  Nope. In fact, I recommend starting with EMDR or another bottom-up validated trauma treatment.

Julie: Not at all. EMDR is a cohesive modality, where a person can learn the tools they need in the earlier phases before the reprocessing piece. There is a common misconception that EMDR is ONLY about the reprocessing. But there is a lot that trained clinicians do first before we get to that step, like ensuring that we understand what is going on and making sure that our clients have a lot of tools to help calm their nervous system.

Sultana:  It is not necessarily for someone to try other therapies before trying EMDR. However, it is their choice on what they would like to do.

Megan: Nope. I’ve found that EMDR is the quickest and most effective way to resolve birth traumas. It’s helpful to have some experience with mindfulness or grounding tools.  But these can be taught in the first phase of EMDR, as needed.

Question from Mindful Return: What expectations should someone have going into EMDR treatment?

Emma: While EMDR is a structured treatment, treatment length really varies. Also, EMDR is a phased treatment with a lot of time spent on preparation. In practice, this means you and your therapist will do a lot of work on stabilization, safety, and coping, before you directly address traumatic memory.

Julie: Reprocessing doesn’t happen in the first session. :0)  Building trust with your therapist so that you can get to know one another is essential.  Learning coping tools is another important step.  We will spend time on your history–both directly related to the traumatic event, as well as events that might be more ancillary.

Sultana:  They should expect that it may take one or several sessions to process a traumatic experience and that there are 8 phases in EMDR treatment. They are: (1) History and Treatment Planning. (2) Preparation. (3) Assessment. (4) Desensitization. (5) Installation. (6) Body Scan. (7) Closure. (8) Reevaluation.

Once the therapist and client agree that EMDR would be a good fit, they will discuss the type of bilateral stimulation that would work for the client and utilize it when developing coping and resources skills.  They will also identify what traumatic or distressing experience the client wants to work on.

For the next phase, the client will be asked to focus on a specific event.  They will identify a negative image/picture, belief, emotion, and their body response or feeling, as it relates to that event/image/picture. Then, they will identify what positive belief they would like to believe instead, as it relates to the event/image. Afterwards, the therapist will ask the client to bring up the traumatic or distressing event/image/picture and the set of bilateral stimulation (butterfly taps, eye movements, etc.) will begin. After each set, the client will report what came up for them.  The client will talk about whether there is a shift in body response or changes in their belief, feeling, image, as it relates to that event. Sets are continued, until there is no distress related to the event/image/picture.

Megan: When going into EMDR treatment for a birth trauma, you should expect that the provider has experience both with EMDR, as well as training in maternal mental health / perinatal mood and anxiety disorders. One of the most important factors in whether any therapy will be helpful is your connection to and rapport with the therapist. Except to feel comforted, heard, and understood, in order to feel safe in engaging in the process.

Question from Mindful Return: Can you go to work / be a functional parent the same day you are doing EMDR treatment?

Emma:  Absolutely. EMDR sessions end with time for clients to ground, contain the therapy experience, and resources to make sure a client is ready to go about their day. Some people find EMDR tiring, though.  So if you can have a bit of a buffer between your session and the rest of your day, it’s always a great idea.

Julie:  Yes.  Your brain will be continuing to process (as it does when we sleep too!). Some people feel really tired after their EMDR sessions, which is normal. A qualified EMDR clinician will ensure that a client is able to “pack up” the work that was done, so that a person leaves the session intact emotionally.  This is such a common concern.

Sultana:  Yes, they can work and be a functional parent after EMDR. I usually tell my clients they may continue to process after the session.  They may notice new insights, thoughts, memories, or dreams. If this happens, notice their experience without judgment. Then, either take a mental note of it or write it down, so that we can discuss it at their next session. It is also important to use their coping and resourcing skills daily and to take care of themselves (i.e. hydration, eating a snack, getting sleep, etc.).

Megan:  Yes, you can absolutely go to work and function as a parent after an EMDR session. Part of the therapist’s role is to ensure you are grounded and stable toward the end of an EMDR session, so that you can safely drive and go about your day.  Sessions can sometimes be draining, though.  Many people feel tired after EMDR sessions, because your brain does a lot of work!  So it’s a good idea to plan for a quiet evening if possible the night of an EMDR session.

Question from Mindful Return: How does the intensity of the trauma, or the length of time between the trauma and now, affect the treatment and its effectiveness?

Emma:  EMDR is effective for all types of traumas.  It also works whether trauma is recent or way in the past. If a client has a complicated and/or early trauma history that predates birth trauma, therapy will typically take longer. Additionally, some clients have established coping resources that can speed therapy along, and some need more time in therapy to develop those strategies.

Julie:  The length of time between trauma and treatment is unimportant with EMDR. There are many tools that qualified EMDR clinicians have that can manage recent events as well as historic ones.

Sultana:  The intensity of the trauma or occurrence of the trauma does not impact the treatment or the effectiveness. It is important to understand that EMDR therapy can be a very intensive emotional experience, though.

Megan:  EMDR can be done and effective at any time and with any intensity level. There is some benefit to doing EMDR as soon as possible (within the first 8 or 9 months) following the event, before the memory reconsolidates.

How long it will take depends on the individual, their history, and their cumulative experiences with trauma.  For example, a single incident trauma can be resolved fairly quickly.  Someone with an extensive trauma history may need more sessions, as past memories can get stirred up in the process.

Because memories that evoke similar feelings are often stored in the same memory network, present traumas may bring up past traumas. The good news is that EMDR can work to resolve all related traumas – often like killing two birds with one stone.

Note: I have been doing EMDR intensives for birth trauma.  These are 2 hour sessions that really allow time for processing with the goal of resolving the birth trauma in one meeting, if possible. Whether an intensive session will be effective depends on the individual, their level of trauma, whether it’s a single incident or multiple traumas, and what their history is.  But I’ve found it to be really successful and so helpful to not be rushed!

Question from Mindful Return: Is EMDR an option for a non-birthing parent who may also have witnessed or otherwise experienced a traumatic birth?

Emma:  Yes. A non-birthing parent typically has a different vantage point to the experience of birth trauma.  This comes with a whole different set of memories, body sensations, emotions, and cognitions. EMDR is a great option to use here.

Julie:  Absolutely! Birth trauma isn’t limited to the person birthing.

Sultana: Absolutely! If the non-birthing parent perceives the birthing experience as trauma, and they are experiencing distress due to witnessing this trauma, EMDR can help them process their experience.

Megan: YES! PTSD can occur in ANYONE who witnessed or experienced a traumatic birth. PTSD can occur from real or PERCEIVED threat. Partners can absolutely be traumatized witnessing something scary during birth.  This includes nurses, doctors, doulas, medical staff, etc. who may be present during a scary or traumatic birth. Non-present family members/friends can also be affected.  For example, a mother knowing her daughter is going into emergency surgery during a birth may be left traumatized by what she experiences while waiting for updates. EMDR is definitely a great option for anyone who felt disturbance surrounding a birth.

Question from Mindful Return: Is there anything else you think a working parents should know about EMDR?

Emma:  EMDR sessions are typically longer than a typical talk therapy session, because we need time to work through memory and make sure a client is well-resourced before we end the session. This can be a challenge for working parents since you may need to block a longer chunk of your day for therapy.

{Lori’s note: my first session was 90 minutes, but every subsequent session was only 45 minutes.}

Julie: It is really important to find a clinician who is qualified in EMDR.  Like many things, if it is done poorly, it can cause harm. Ideally, the clinician is certified (which means that they have had additional training and consultation after their basic training).  The EMDR International Association has a directory you can use to find qualified clinicians.

Sultana:  Yes, it is important that you feel comfortable and safe with the therapist that you are working with in EMDR treatment.

Megan: I know working parents are busy, and time is limited. There may be a tendency to put self-care and healing on the back-burner while juggling so many things. But your wellbeing is vital to your and your family’s happiness.

Birth traumas can create symptoms that get in the way of your ability to parent and to concentrate at work. EMDR is super effective at alleviating these symptoms and can be done relatively quickly in comparison to other forms of therapy.

If you are concerned about taking time off work for sessions, talk to your therapist to see if there is a helpful way to structure treatment. For example, I offer EMDR intensives, so we can meet for a longer period of time and really dive into the work in order to reduce the number of sessions needed. This option is often helpful for parents who are fitting treatment in with busy work schedules and the need for childcare.


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