How Does Bilateral Stimulation (BLS) Work in EMDR Therapy?

Bay Area CBT Center

August 4, 2024

Bilateral stimulation (BLS) in Eye Movement Desensitization and Reprocessing (EMDR) therapy uses sensory stimuli like eye movements, taps, or sounds to engage both hemispheres of the brain. This process helps in reprocessing and healing traumatic memories. In this article, we will explore how does bilateral stimulation BLS work in EMDR therapy and why it’s a crucial component for trauma recovery.

Key Takeaways

Bilateral stimulation (BLS) in EMDR therapy engages both brain hemispheres using sensory stimuli such as eye movements, tactile sensations, and auditory cues to aid in the reprocessing and healing of traumatic memories.
Different BLS techniques include eye movements, tactile stimulation, and auditory cues, each facilitating the processing of traumatic memories by engaging both brain hemispheres and promoting desensitization and emotional regulation.
Research supports BLS’s effectiveness in treating PTSD by significantly reducing physiological arousal linked with traumatic memories and altering brain structures to enhance memory processing, though some controversies and debates about the mechanisms persist.

Understanding Bilateral Stimulation (BLS) in EMDR Therapy

Illustration of brain hemispheres activation through bilateral stimulation in EMDR SF and EMDR therapists

Bilateral stimulation (BLS) in EMDR therapy utilizes sensory stimuli such as sounds, including bilateral music, tapping, and eye movements to stimulate both brain hemispheres. The term “bilateral” means affecting both sides, which in this context, targets both brain hemispheres to reprocess traumatic memories. Simultaneously engaging both brain hemispheres with this method aids individuals in processing and healing from traumatic experiences.

BLS is not just confined to EMDR therapy sessions; it is seamlessly integrated into many daily activities. Consider walking or swimming—these activities naturally engage both sides of the body and brain, helping to reduce stress and promote emotional processing. Walking, for instance, is a natural form of BLS that can help suppress the amygdala’s response, aiding in emotional regulation and stress reduction.

EMDR therapists employ BLS to stimulate the brain’s natural healing process by facilitating the reprocessing of traumatic memories. The activation of both brain hemispheres through BLS aids in desensitizing and reprocessing trauma, making it increasingly manageable and less distressing over time. This process is a cornerstone of EMDR, supported by organizations like the EMDR International Association and various clinical practice guidelines.

Types of Bilateral Stimulation Techniques

Illustration of various bilateral stimulation techniques in EMDR San Francisco

EMDR therapy employs various bilateral stimulation techniques, each with its unique approach to activating both brain hemispheres. These techniques include eye movements, tactile stimulation, and auditory cues. Each method has its benefits and applications, making EMDR a versatile and adaptable form of therapy.

Eye Movements

Eye movements are perhaps the most well-known and researched method of bilateral stimulation in EMDR therapy. During EMDR sessions, clients are asked to follow the clinician’s fingers, a lightbar, or virtual cues on a screen with their eyes. This process is designed to replicate the natural eye movements that occur during REM sleep, a critical phase for processing memories. The synchronization of cortical activity at a slow-wave sleep frequency helps in processing traumatic memories, making them less distressing over time.

Commonly, tools such as a light bar or wand are used to facilitate eye movements that clients follow with their eyes. This method, known as eye movement desensitization, is not only effective but also allows clients to feel more engaged and focused during their therapy sessions. The repetitive back-and-forth motion helps to desensitize the emotional impact of traumatic memories, facilitating their integration into the broader context of one’s life experiences.

Tactile Stimulation

Tactile stimulation is another effective method used in EMDR therapy. This technique can involve:

Electronic tapping devices with paddles that clients hold, alternating between left and right hands
Patting shoulders or knees alternately
Using vibrating ‘buzzers’ held in their hands

These tactile methods help clients feel more connected to their body sensations, enhancing the therapy’s effectiveness.

The physical sensation of tapping or vibrating can help clients remain grounded and present during sessions. This connection to the body is crucial for processing traumatic memories, as it encourages clients to stay engaged with the therapy rather than dissociating or becoming overwhelmed by their emotions. By simultaneously experiencing bilateral stimulation, clients can better manage and process their distressing memories.

Auditory Stimulation

Auditory stimulation in EMDR therapy involves clients wearing headphones and listening to alternating beeps, music, or tones in each ear. This method helps activate both hemispheres of the brain by crossing the midline of the body with sound. Some auditory devices used in EMDR therapy generate music instead of just beeping tones, providing a more soothing and engaging experience.

Listening to alternating sounds or tones can be particularly effective for clients who may find visual or tactile stimulation overwhelming. The rhythmic alternation of sound between the ears helps to calm the nervous system and facilitate the processing of traumatic memories. By engaging the auditory senses, this method provides a versatile option for those seeking relief from trauma through EMDR therapy. Some benefits of using alternating sounds or tones in EMDR therapy include:

Calming the nervous system
Facilitating the processing of traumatic memories
Providing a versatile option for clients who may find visual or tactile stimulation overwhelming

The Science Behind Bilateral Stimulation

Illustration of amygdala inhibition in bilateral stimulation in EMDR SF

The underlying science of Bilateral Stimulation (BLS) in EMDR therapy is both compelling and solid. BLS helps to inhibit the amygdala, the brain’s fear center, reducing the physiological arousal associated with traumatic memories. Inhibiting the amygdala is vital to calm the nervous system, enabling individuals to process traumatic experiences without feeling overwhelmed.

Research supports the effectiveness of BLS in altering brain structures. A study by Bossini et al. found significant changes in brain scans, including increased grey matter volume in specific regions following EMDR treatment. These changes suggest that EMDR therapy can lead to tangible, positive alterations in the brain’s architecture, enhancing its ability to process and store memories more effectively.

The Adaptive Information Processing (AIP) model, developed by Francine Shapiro, PhD, provides a theoretical framework for understanding how BLS works in EMDR therapy. According to this model, the brain stores memories differently depending on whether they are normal or traumatic. BLS helps to replicate the natural processing that occurs during REM sleep, a critical phase for memory consolidation and emotional regulation. By engaging both hemispheres of the brain, BLS facilitates the integration of traumatic memories into the broader context of one’s life experiences.

Bilateral Stimulation and Traumatic Memory Processing

Illustration of traumatic memory processing using bilateral stimulation EMDR San Francisco EMDR therapists

In EMDR therapy, Bilateral Stimulation (BLS) is instrumental in accessing, desensitizing, and reprocessing traumatic memories. This process involves holding distressing memories in the mind while simultaneously experiencing bilateral stimulation, which helps to soothe the nervous system and enhance the processing of these memories.

This method enables individuals, including those dealing with veterans affairs, to stabilize and recover from their traumatic experiences, such as posttraumatic stress disorder.

Accessing Traumatic Memories

Accessing traumatic memories is a crucial step in EMDR therapy. During traumatic events, the amygdala and hippocampus become overstimulated, reducing the control of the pre-frontal cortex and making it difficult for the rational brain to manage emotional responses. These memories often remain ‘stuck’ in the amygdala-hippocampal complex, making them feel as though they are occurring in the present when triggered.

Bilateral stimulation aids in calming the nervous system, thereby making it less risky to engage with distressing material. By mimicking the low-frequency stimulation typical of slow-wave sleep, BLS can weaken traumatic memories and make them more accessible for processing. This creates a distance between painful memories and the body’s reaction to them, allowing clients to confront and work through their trauma more effectively. Take our trauma test to assess your level of complex trauma.

Desensitization Process

In movement desensitization and reprocessing (EMDR) therapy, the desensitization process employs rapid bilateral stimulation to connect and solidify negative memories with positive beliefs, thus reducing emotional distress. During REM sleep, normal memories are processed and moved out of the amygdala-hippocampal complex into the neocortex, a process thought to be mimicked during EMDR therapy. This phase helps to reduce the emotional intensity of traumatic memories, making them less distressing.

Fast bilateral stimulation during desensitization can:

Bring up and allow the processing of traumatic material that is dysfunctionally stored in the client’s neural networks
Reduce the emotional distress associated with traumatic memories
Pave the way for healing and recovery

This phase is crucial for the effective treatment process, including talk therapy, as recommended by the World Health Organization.

Reprocessing and Positive Beliefs

Reprocessing and reinforcing positive beliefs are integral parts of EMDR therapy. Bilateral stimulation helps to link and consolidate negative memories with positive beliefs and qualities, fostering a sense of wellbeing. Slow bilateral stimulation is used in the early phases of EMDR therapy to help clients maintain dual attention on both the stimuli and a positive thought or image.

BLS helps develop positive associations for the future by creating new pathways for painful memories. This reinforcement of positive beliefs and connections between pleasant memories and the body can significantly enhance a client’s overall mental health and outlook on life. In fact, the American Psychiatric Association also emphasizes the importance of mental health in overall well-being.

Effectiveness of Bilateral Stimulation in Treating PTSD

The use of Bilateral Stimulation in EMDR therapy has demonstrated significant effectiveness in treating Post-Traumatic Stress Disorder (PTSD). Numerous studies and clinical trials have demonstrated high success rates in reducing or eliminating PTSD symptoms. For example, a 2020 study showed that most patients who experienced a traumatic event needed fewer than 10 EMDR sessions to stabilize their mental state.

EMDR has been effective in various formats, including:

Weekly one-on-one sessions
Intensive 10-day daily group sessions for veterans with PTSD
Group protocol for children suffering from PTSD following an Italian plane crash

These success stories highlight the versatility and efficacy of EMDR therapy in different settings and populations.

In randomized clinical trials, EMDR was found to be as effective as cognitive-behavioral therapy (CBT) for PTSD, without requiring homework between sessions. EMDR has also been more effective than routine treatment in reducing PTSD symptoms in adult sexual assault survivors. These findings underscore the potential of EMDR therapy to provide significant relief for individuals struggling with trauma and PTSD.

Common Experiences During Bilateral Stimulation

During EMDR therapy, clients undergoing bilateral stimulation frequently report experiencing a variety of physical sensations, emotional changes, and cognitive shifts. Typical sensations include tingling, warmth, or other physical sensations in different parts of the body. These sensations indicate the body’s response to the bilateral stimulation and the processing of traumatic memories.

Emotional shifts, such as moving from a state of distress to calmness or relief, are also common during EMDR sessions. Some clients experience unexpected feelings, such as sudden happiness or sadness, as their emotions are processed and regulated. Additionally, cognitive changes often occur, with clients gaining new insights or seeing their traumatic memories from different perspectives. These experiences are crucial for the healing process and the integration of traumatic memories into a healthier mental framework.

Controversies and Misconceptions About Bilateral Stimulation

Despite its proven effectiveness, Bilateral Stimulation in EMDR therapy is not exempt from controversy and misconceptions. A significant point of contention is the role of eye movements, with some researchers believing they are essential, while others see them as unnecessary. Skeptics argue that EMDR may simply be an exposure technique without the need for eye movements, questioning whether these movements are merely a placebo effect.

Ongoing research continues to explore these controversies to determine the true efficacy and mechanisms behind BLS in EMDR therapy. While some suggest that eye movements are not needed for the therapy’s effectiveness, others point to studies showing significant benefits. This ongoing debate highlights the need for further research and a deeper understanding of how BLS works in EMDR therapy.

Summary

In summary, bilateral stimulation (BLS) is a cornerstone of EMDR therapy, offering a powerful tool for processing and healing from traumatic memories. By engaging both brain hemispheres, BLS helps to desensitize and reprocess trauma, making it less distressing and more manageable. The various techniques of BLS, including eye movements, tactile stimulation, and auditory cues, provide versatile options for clients seeking relief from their traumatic experiences.

The science behind BLS, coupled with numerous studies and clinical trials, underscores its effectiveness in treating PTSD and other trauma-related conditions. While controversies and misconceptions remain, ongoing research continues to shed light on the true mechanisms and benefits of BLS in EMDR therapy. Ultimately, BLS offers hope and healing for individuals on their journey to recovery.

CBT Quizzes

Uncover Your Limiting Beliefs!

take Quizzes

Therapy Matching Quiz

Discover Your Ideal Type of Therapy!

Start Quiz

Book a Call

Matching Consult

Book a call

Exploring the Stages of EMDR Therapy With Bay Area CBT Center

An illustration symbolizing the building of a therapeutic relationship.

How ACT at Bay Area CBT Center Helps Couples Overcome Communication Barriers

A woman in glasses, seated on a chair, is talking to a man. She has a clipboard on her lap and gestures with her hands, embodying the approach of an experienced CBT therapist in Oakland.

Find Peace of Mind: Unlock Calm with CBT Therapy at Bay Area CBT Center

Two women are seated in a room; one with her back to the camera and the other raising a finger as if explaining or demonstrating something, possibly related to EMDR Therapy.

EMDR Therapy Explained: Understanding Trauma Treatment at Bay Area CBT Center

A man in a suit gestures while speaking to a woman in a white blazer, whose thoughtful expression suggests she is processing his words. They seem engaged in an indoor discussion with subtle undertones of manipulation, against a softly blurred background.

How Couples Therapy at Bay Area CBT Center Fortifies Your Relationship Bond

A group of people sitting on yoga mats indoors, attentively immersed in books and notepads, as if participating in a retreat focused on inner growth and learning.

How CBT Therapy Helps Break the Cycle of Anxiety and Depression

A woman with closed eyes, embodying mindfulness, wears large earrings and a necklace as she rests her hands on her chest. Her short curly hair frames a serene expression, evoking calmness against a plain background—a portrait of tranquility amidst stress and anxiety.

How Mindfulness Based Cognitive Therapy Alleviates Stress

People rejuvenate as they meditate around a rectangular pool in a lush forest with dappled sunlight. A wooden building stands on the left, and lounge chairs with umbrellas await at the back, embodying the serene spirit of Costa Rica wellness retreats.

Costa Rica Wellness Retreats: Rejuvenate Your Mind and Body

A cozy, well-lit house nestled amidst lush greenery and trees serves as a perfect mental health retreat, with a wooden pathway gently leading up to its welcoming entrance.

Considering a Mental Health Retreat? Here’s What to Know

A person holds a glowing digital representation of a brain in their hand, symbolizing the power of metacognitive therapy, surrounded by a network of lines and nodes.

What is Metacognitive Therapy? Techniques and Outcomes

EMDR Therapy

Frequently Asked Questions

What is evidence-based therapy?

Evidence-based therapy involves interventions that are scientifically proven to be effective for particular issues. In this approach, a strong partnership based on trust and collaboration is formed between you and your therapist. Within this supportive and unbiased environment, you can freely express yourself without fear of judgment. Over a series of sessions, you and your therapist will work together to address obstacles and set goals aimed at personal growth and fulfillment. This method ensures that the techniques and strategies used are not only supportive but also empirically validated to help you achieve your therapeutic goals.

Who do we work with?

The Bay Area CBT Center provides therapy services for everyone, from children to adults, and welcomes individuals, couples, and groups. We help with various concerns like anxiety, depression, trauma, relationship issues, and behavior challenges. We value diversity and cultural differences, offering personalized and culturally sensitive care to each client.

Why is it so important to find the right therapist?

Studies show that the bond between you and your therapist, known as the therapeutic alliance, is a key factor in treatment success. This alliance is characterized by the strength of your relationship and how well you both agree on treatment goals. Research indicates that individuals with a solid therapeutic alliance experience better treatment outcomes including greater productivity at work, more satisfying relationships, improved stress management, and decreased engagement in risky behaviors.

What should I expect from the matching appointment?

You can expect a 15-30 minute phone call with our care coordinator, who is extensively trained in ensuring the perfect match for you. During this conversation, our matching expert will collaborate with you to understand your therapy needs, preferences, and scheduling availability. This discussion builds upon the information you provided during sign-up and offers an opportunity for you to address any personal questions or concerns you may have about therapy or our services at The Bay Area CBT Center. Following your conversation, we’ll pair you with the therapist who best aligns with your needs, goals, and preferences.

When will I be matched to a Therapist?

At your matching appointment, we will match you with a therapist specifically chosen for you and schedule your first session. Depending on your availability, you can expect to meet your therapist anywhere from one day to a week after this appointment.

Do you provide in-person or virtual therapy?

Our approach to therapy includes a flexible hybrid model, blending both online and face-to-face sessions. This option is perfect for clients situated close to our clinics in the Bay Area who prefer the flexibility of choosing between virtual consultations or meeting their therapist in person. Our aim with hybrid care is to ensure every client is matched with the ideal therapist and therapy environment, be it from the convenience of your own home or in one of our clinics.

Do you accept insurance?

At the Bay Area CBT Center, we accept PPO insurance plans that allow you to use out-of-network providers. This means if your insurance plan is a PPO and it includes mental health benefits, you could get back some or all of the money you pay for our services, depending on what your insurance company allows. When you see one of our therapists, they’ll give you a superbill. You can send this superbill to your insurance company to ask for reimbursement. If you’re not sure if your insurance covers services from providers not in their network, it’s a good idea to give them a call and check.

You may be eligible to have 60-80% of your costs covered by out-of-network benefits.

Also, if you have an FSA (Flexible Spending Account), you can usually use it to pay for individual counseling sessions. It’s wise to double-check with your FSA provider or talk to your accountant to make sure that counseling sessions are considered an allowed expense.