Using EMDR to Address Eating Disorders
What is EMDR?
EMDR stands for Eye Movement Desensitization Reprocessing. A big name for a relatively simple but highly effective method for dealing with trauma or what I like to call “emotionally stuck places.” It involves what is called bilateral stimulation of both hemispheres of the brain with a variety of methods. These methods can include eye movements to the left and right, an auditory tone in each ear or alternating vibrations in each hand. When I first started working with EMDR I was very skeptical that such a simple procedure would make any difference for my clients struggling with long standing issues around food, weight and body image. The results varied from incremental but profound shifts to complete turn-a-rounds. Here is the story of a client who experienced immediate results using EMDR.
Case Example: Using EMDR to address Pat’s Bulimia
(Name and story altered to protect identity)
Pat came to me because she wanted to stop what she described as “wrecking my body.” She was binging and purging everyday sometimes a few times a day. Pat was 35 years old. She had a job she enjoyed but as a newcomer to San Francisco she missed having a friendship circle. Because her evenings were consumed with binge/ purge episodes she had little time for developing a social life. In any case she usually felt too awful after an episode to even think about going out.
The first step with EMDR is to develop a ‘target.’ I asked Pat what part of her destructive cycle around food felt the most emotionally charged and stuck? Pat did not hesitate: “After work when I open the door to my home, I just know that I am going to be going out within the hour to buy food for my binge. I know it’s messed up but I can’t stop myself!” This moment of homecoming became Pat’s target for her EMDR session because it was at this point that Pat started to feel the most out-of-control with her bulimia. It was a highly charged feeling that occurred daily. I have found that EMDR seems to work best when the target carries a lot of emotional charge and feels stuck.
After the preliminary set up for her target was complete Pat was ready to begin the bilateral stimulation. She had a headset that was emitting a tone in each ear, at regular intervals and she was holding vibrating pods in each hand. I prepped her to start with her target and then let her creative unconscious free associate. She immediately started to have memories from her childhood of coming home from school to an empty house after her parents divorce. I encouraged her to imagine she was on a train and to just let these memories go by like scenery. Memories came flooding back as she re-experienced the intense anxiety and loneliness around her parent’s divorce, having to move, losing her best friend and more memories associated with this time. Pat went through a whole array of feelings including anger and tears. It was as if a tightly wound ball of feelings and memories had started to unravel.
Periodically I checked in with Pat to measure the level of upset she felt around her original target on a scale of 0-10. When this level was down to 1 (i.e very little to no disturbance upon coming home after work) we were done. I instructed Pat to take it easy that evening and that she might feel more vulnerable or “raw” than usual.
Disclaimer: Although I have found EMDR helpful with most of my clients it is not for everyone. Some people feel little to no effect or change. More research is needed to evaluate why EMDR can be so effective for some and others not at all.
Follow-Up
A week later I saw Pat again. Her binge/ purge episodes had stopped happening every night. She had even started setting up some social events in the evenings. Pat told me: “It’s like someone turned the volume down on my bulimia voice. It just isn’t quite as loud as it used to be and it definitely does not have as much power over me!”
We explored the night that she did have a binge/ purge episode. This was after a particularly difficult day at work and had a different set of triggers associated with it that was more related to stress and perfectionism. We talked about using EMDR to address this different set of triggers for a future session.
Pat was beginning to peel away the different layers of emotions and triggers that fueled her bulimia. She was starting to free up her evenings for socializing and felt less alone as a result. As her “bulimia voice” became less prominent Pat started to feel that she could make healthier choices and had more options to dealing with challenging feelings. She was on the road to recovery.
Is EMDR for you?
Call or write Ondina Hatvany, MFT with any questions or concerns.