Summary
Robin Kivett and Jordan Rich interview licensed clinical social worker Lauren Manassa about her journey to EMDR and how it works for treating trauma, particularly in clients with eating disorders and body image issues. Lauren traces the historical roots of trauma understanding from Freud through Vietnam-era PTSD research to modern approaches, framing trauma as a brain injury that can be addressed through bilateral stimulation. Lauren explains EMDR using the metaphor of scar tissue in the brain that bilateral stimulation helps break down, allowing the brain to find its natural resilience. She describes how clients hold buzzers, listen to alternating tones, or watch hand movements while recalling distressing memories, and how this process helps reduce the emotional charge of traumatic experiences. The conversation touches on the connection between EMDR and internal family systems therapy, the concept of big-T versus small-t trauma, and how EMDR can lead to profound self-compassion and even forgiveness.
Key Points
- Trauma is conceptualized as a brain injury that creates something like scar tissue, preventing proper processing of experiences
- EMDR uses bilateral stimulation (buzzers in hands, alternating tones, eye movements, foot tapping) to help break down this scar tissue
- Nobody fully understands why bilateral stimulation works, but studies confirm its effectiveness
- EMDR has eight distinct phases and involves identifying a target memory (the first or the worst), the associated negative self-belief, and a preferred positive belief
- During processing, the therapist does very little talking while the client lets the memory wash over them with bilateral stimulation
- Results can range from rapid relief within minutes to months of processing the same target before the distress releases
- EMDR connects to narrative therapy and internal family systems through its focus on different parts of the self disrupted by trauma
- The therapy can lead to self-compassion and even compassion for the person who caused the trauma
Key Moments
Trauma as brain injury and the scar tissue metaphor for EMDR
Lauren explains EMDR through the metaphor of trauma creating scar tissue in the brain. Bilateral stimulation somehow breaks down this scar tissue, like an ice cube melting, allowing more flexibility and plasticity so the brain can find its resilient place.
"hits somewhere in your brain and it's like it builds up a piece of scar tissue, right? Some kind of scarring that's left there, right? You can function still, maybe it doesn't hurt all the time and you don't maybe notice it, but there's something there that's getting things stuck, right? And the way that EMDR works is,"
How bilateral stimulation works during an EMDR session
Lauren describes the practical mechanics of bilateral stimulation during EMDR, where clients hold buzzing devices, listen to alternating tones, watch hand movements, or tap their feet while recalling a troubling past experience. The alternating left-right stimulation appears to help break down the emotional charge of traumatic memories.
"I have in my office, I have little buzzer thingies and they hold them in each hand and the buzzer goes buzz in one hand, buzz in the other. And something about that process seems to kind of break down that scar tissue as they're talking about it."
EMDR results can range from minutes to months of processing
Lauren describes the range of EMDR outcomes, from clients whose distress drops dramatically within minutes to others who need months of repeated processing before the traumatic memory releases its hold. The goal is reducing emotional distress without erasing the memory itself.
"It's remarkable to watch sometimes within a matter of minutes, I noticed people really settling. Sometimes it can take months and months and months of the same thing processing over and over till it really releases its hold on them."
