Trauma leaves lasting impacts on our lives. We’re an emotional and reactive species, and those emotions have a huge impact on our mental state.
Sometimes, a traumatic memory is stark and clear. The pop culture depiction of “seeing it when you close your eyes” or repeatedly dreaming the same event happening over and over are examples that really happen. In these cases, a therapy like EMDR has a clear target and can grant you relief through sessions of work.
Other times, traumatic memories don’t stick around, but the triggers, anxiety, PTSD, and other psychological impacts very much do. What’s happening there, and can therapies like EMDR still work? Let’s talk about it.
DISCLAIMER: This article is for informational and educational purposes only and should not be considered medical or psychological advice. The information presented here is not intended to diagnose, treat, cure, or prevent any mental health condition or replace professional therapeutic care. Every individual's experience with trauma and mental health is unique. Please consult with a qualified mental health professional, therapist, or healthcare provider to determine the most appropriate treatment approach for your specific situation. If you are experiencing a mental health crisis or emergency, please contact your local emergency services or crisis hotline immediately.
Why Traumatic Memories Disappear
There are many cases in life where memories fail to form. How many people remember what they had for breakfast six months ago? Not many.
With traumatic experiences, those memories form, but they are often rendered inaccessible. It’s a neurological protective mechanism to help keep you from constantly suffering the emotional and mental damage of those traumatic experiences.
The memories are there, like a shadow on the wall, but all you experience are the side effects. The PTSD, the depression, the anxiety, phobias, and other mental health challenges can all stem from these hidden memories.
One possible theory is called state-dependent learning. Some studies have indicated that memories formed while in certain altered mental states then fade from consciousness and are only really retrieved when in that same mental state.
For a traumatic event like a serious car crash, for example, a whole cocktail of stress chemicals like adrenaline surges through the body. Later, memories of the event can be fuzzy, but they could come back into sharp detail in a similarly stressful time.
The trouble here, of course, is that this makes it very difficult to recall, discuss, and work through those memories. Traditional talk therapy aimed at addressing traumatic memories will struggle because there’s no reasonable (let alone ethical) way to induce the same kind of mental state necessary to recall them.
Another common possibility is repression, where the brain knows about the memory, but keeps it hidden from conscious thought to avoid the damage it causes upon recall. Repression can be somewhat conscious but more often unconscious, and again, makes it difficult to recall the memory to address it in therapy.
Sometimes memories aren’t retained at all, or are retained in fragments. In particularly traumatic and stressful times, emotional and cognitive overload make it impossible for the brain to form memories of anything other than the “bad vibes” of the incident, which linger.
Even without accessible memories, effects like PTSD can still develop, which have a lasting impact on all facets of life.
Can EMDR Still Work When You Don’t Remember Your Trauma?
The good news is, yes, EMDR can still work even if you don’t remember much of your trauma.
First, a brief refresher: how does EMDR work?
EMDR is Eye Movement Desensitization and Reprocessing therapy. It’s a fairly new therapy, having been first developed in 1989. It works by having a therapist guide you through recall of what you remember of your traumas, while also guiding you through eye movements back and forth from side to side. For a deeper review and a comparison to traditional talk therapy, check out our guide to them both.
What happens is that the eye movements split your attention and focus in a way that stimulates the brain to recall and process the traumatic memories through channels that aren’t the ones normally used in the recall of those memories. This change in how the memories are recalled allows for a healthier reprocessing of those memories, to reduce the traumatic impact and negative repercussions that come with it.
Through repetition, EMDR helps process, desensitize, and reduce the impact of those traumatic memories. Negative associations fade, and positive or neutral associations can replace them. The memories don’t go away, and they aren’t forgotten, but they won’t cause as much harm to recall, and will eventually be essentially neutral.
EMDR has been proven in high-level testing to be effective, especially for PTSD. It’s reasonable to wonder, though, whether or not it’s effective when there are no real core memories to focus on. After all, if you don’t have a memory to target, how can you desensitize it?
Fortunately, it can work for a few different reasons.
EMDR Starts with What You Do Remember
First of all, the truth is, most people don’t have perfect recollection of their traumatic experiences. The baseline expectation is somewhere with fuzzy memories, fragmented recall, and a lot of repression or dissociative amnesia involved. In fact, EMDR is built with this expectation in mind.
Before you even get to the eye movement part of EMDR, you will work with your therapist to take inventory of your current state of trauma, PTSD, and the impact those recollections have on your mental state. EMDR uses a standardized set of scales to measure these factors, and those same scales judge your progress through re-evaluation each session.
So, while you might not have full recall of a traumatic event or set of experiences, you have some memories associated with it, and even those threads are enough to pick at to get EMDR to work.
After all, if you truly had zero recall at all, they wouldn’t impact you, and it wouldn’t be traumatic, right?
EMDR Evolves with Changing Recollections
Every session of EMDR opens up with an inventory of your current state, and works to make progress on what is standing out the most that day. Each session closes through a process that “shelves” anything in progress so it’s not a rough edge to be abrasive all day, and an evaluation that can set you up for more progress next time.
It’s not as though there’s one set path for EMDR to take. It’s adaptable to your needs, to what bothers you the most, and to what stands out and needs work. As long as you’re experiencing the negative symptoms of trauma, EMDR can help work to resolve them.
EMDR Can Uncover More Repressed Memories
Many people who undergo EMDR describe the process as unpeeling layers of trauma. Some find this to be disheartening; the well feels endless, and it seems like every time you deal with one set of memories, another takes its place. Others enjoy the sense of progress being made, and the ability to recall more and deeper about these events without suffering in doing so.
There’s no switch to be thrown to jump from your current state to “cured”. It’s a process, and sometimes a lengthy one, to address and unravel traumas, especially when complex PTSD is involved. Taking each step can reveal a little more about how much path lies ahead of you.
What this means, though, is that even if you don’t remember much of anything about your traumatic experiences, EMDR can still start to address what you do remember, and can open up and uncover more along the way. As you go through your sessions, you may remember things you had forgotten, which can help connect you to other experiences and other memories, furthering your progress.
EMDR Can be Supplemented with Memory Prompts
In some cases, memory can be stimulated in other ways. If you don’t remember on your own, you might with some assistance. This is part of that state-dependent learning we mentioned above.
Prompts can be as simple as a news clipping or a photograph, a text message, or a letter. Essentially, they are trigger points that make your PTSD flare up, which can be used in a controlled, clinical setting to bring up those memories to then address them with EMDR.
It’s critical to know that your therapist will not attempt to use memory prompt items like this without your consent. If you’ve reached a point where you’ve hit a wall, they can be a way to break through, but they won’t be sprung on you or used unexpectedly.
EMDR Can Also Use Symbolic Memories
Some kinds of memories can be representative of the feelings associated with trauma without actually being the traumatic memories causing those feelings.
For example, a child who was neglected a lot and has traumatic effects because of it might not remember specific instances of neglect. But, they could remember spending a lot of time alone, and those memories of being alone (and the feelings associated with them) can be a target for EMDR. These, too, can then unlock other memories that can be a further avenue to seek deeper sources of trauma to address.
This is because the brain isn’t like a computer’s filing system. Everything is interconnected, and memories are more like a web of thoughts, feelings, images, and aspects of experience, any element of which can be grabbed as a source for EMDR.
EMDR Isn’t All About Specific Memories
Last (but not least) on the list of reasons why EMDR can still work for you is simply that it’s not actually as focused on “memories” as it sounds like.
The core of trauma is memory, yes, but the reason trauma is problematic is the way it makes you feel. The sensations of anxiety, of depression, of despair, the racing heart and fight-or-flight responses, the emotional numbness or dysregulation, even feelings like anger, sadness, grief, and more. All of this compounds into the kinds of overall negative reactions that characterize PTSD.
When your therapist is guiding you through an EMDR session, they won’t be asking you to recall some specific memory as if it’s a photograph you can pick out of a folder to work on. They’ll discuss a traumatic event or series of events, and have you focus on how you actually feel about them. It’s those feelings that you focus on, the bodily sensations and reactions that cause you to feel the way you do, and that you want to replace with more neutral or positive feelings.
Can EMDR Still Fail if You Don’t Remember Enough?
EMDR isn’t the one perfect therapy that works for everyone. If it were, there would be no reason for other therapies, after all.
There are some reasons why EMDR might not be right for you. It’s most ideal for PTSD, including CPTSD, but other mental health challenges can get in the way of being successful with EMDR therapy itself.
For example, a common stumbling block is ADD/ADHD. Since EMDR requires a lot of focus and introspection, having ADHD, especially untreated, can make it much more difficult to see results. This doesn’t mean it can’t ever work, but it does mean you may need to seek medication or another treatment for your ADHD first.
EMDR can also be challenging for people who sink into dissociation and have trouble feeling positive at all. Again, this isn’t a complete block on EMDR, but it does mean you may need to work with your therapist to lay a strong groundwork to learn those positive associations in the first place.
These kinds of reasons don’t necessarily mean that EMDR will fail, so much as that the approach may need more groundwork, or that it will take longer, progress more slowly, and need a more intensive analysis. Skilled providers can work with you to find the treatment that is effective for your specific needs.
It’s true, however, that EMDR isn’t right for everyone. Sometimes, a more traditional talk therapy like CBT or DBT will be more effective. Sometimes, more peer-focused and social therapies work better. Sometimes other therapies, like Post-Induction Therapy or Trauma Release Exercises, can be more effective.
At BMC-Troy, we’re proud to be able to offer all of these clinical services and more. Whether you have anxiety and depression, trauma or PTSD, or anything else, our providers will have something that can work for you. We can also do medication management, so if you need medications monitored and adjusted to suit your progress, you don’t need anyone else involved in the process.
If you’re interested in getting started, please fill out our new patient intake form directly online here. If you have any questions, feel free to call our office at 248.528.9000. You deserve care, and we can help you access it, so don’t hesitate to reach out.