Helping LGTBQIA+ People Heal from Trauma with EMDR Therapy

How can moving our eyes from left to right in a therapy session reframe traumatic memories to become positive?

Many behavioral health professionals are getting trained in a promising technique used to treat PTSD called Eye Movement Desensitization and Reprocessing (EMDR) therapy.

Trauma Risk

People who identify as lesbian, gay, bisexual, transgender, queer, questioning, intersex, asexual, pansexual, nonbinary, or genderqueer (LGBTQIA+) are at risk for trauma that is specifically related to their identities. 

Many LGBTQIA+ individuals have experienced microaggressions, discrimination, shaming, estrangement from families, assault, or sexual violence. This is in addition to the risk of trauma that the rest of the population experiences, from the disruptions and losses of the pandemic to personal losses and race-based discrimination. 

Some LGBTQIA+ individuals have undergone a particularly harmful process called “conversion therapy,” which has been shown to increase rates of attempted suicide.  

Furthermore, many trans people have distressing or traumatizing experiences in healthcare settings: spaces that ought to be welcoming them.

Healthcare Trauma

Another form of trauma experienced by LGBTQIA+ people, and trans people, in particular, is healthcare trauma. In the blog, Trans Forward, Stefan Simanovich, an EMDRIA-certified licensed clinical social worker and Connecticut Women’s Consortium Trauma & Recovery Conference presenter, writes about the ways healthcare systems and providers compound the stresses and trauma for trans people.

“Trans people experience disproportionate levels of healthcare trauma because of being misunderstood, objectified, and devalued in healthcare spaces, institutions, and dialogue around the trans experience, gender identity, and the body,” Simanovich writes. “Our healthcare system and providers too often recommend or enforce guidelines for trans people that increase emotional distress and thus negatively impact health through the pathologization of a natural human phenomenon, gender variance.”  

Simanovich and other behavioral health professionals are successfully using EMDR and other strategies to support the lives and identities of special populations in communities and clinical settings.

EMDR Basics

The EMDR International Association describes EMDR therapy as an “extensively researched effective psychotherapy method proven to help people recover from trauma and other distressing life experiences.” 

EMDR therapy is recognized by the American Psychiatric Association, the American Psychological Association, National Alliance on Mental Illness, and many other reputable organizations. 

The idea behind using EMDR to process trauma is that eye movements help the brain to process memories of trauma events and decouple those memories from the fight, flight, or freeze response. In other words, a traumatic memory can remain without the feeling of being triggered or being sent back into the distress of that moment.

The therapy was first developed in the 1980s by the late Francine Shapiro, Ph.D., who explored the link between eye movements and recurring traumatic memories.

Since then, thousands of studies have been conducted, and EMDRIA has more than 12,000 mental health professionals who are trained in EMDR techniques. 

It has proven especially effective in treating post-traumatic stress disorder (PTSD).

How Does It Work?

Sometimes EMDR therapy is conducted as a stand-alone treatment, and other times it is used within a standard talk therapy session.

When someone agrees to participate in EMDR therapy, a trained EMDR therapist works through 8 phases of EMDR. In a 60- to 90-minute session, the therapist encourages the client to focus on a negative image, thought, or bodily sensation connected to a particular traumatic memory. 

The therapist helps the client’s vision move from left to right, sometimes using a light, a tapper, or their hands. That’s called Visual Bilateral Stimulation (BLS). Both hemispheres of the brain are stimulated, similar to the way they are in deep (REM) sleep. The nervous system fixes on the movement and moves away from the memory and associated distress. A series of measurements are taken throughout sessions to discover the level of distress the client is experiencing.

According to Inspire Recovery, which offers EMDR to LGBTQIA+ clients, reframing occurs with the guidance of the therapist. For example, a survivor of a sexual assault can retrain their mind to associate the memory with the resilience of being a survivor. These are called “empowering effects.” 

This YouTube video demonstrates how EMDR works in a session conducted by Dr. Jamie Marich, who works with a survivor of a near-drowning. Dr. Marich goes through the 8 phases of EMDR, moving her hand back and forth in front of the client’s eyes. She checks in with the client on body sensations, cognitive signs, and emotional responses along the way. “I hope this lasts,” the client says at the end of the session, holding onto the statement: “I am powerful,” even when imagining going near water.

Using EMDR to Face and Overcome Shame

In this article, Jason Eccker, an EMDR-certified therapist in Seattle, describes his work with veterans and LGBTQIA+ clients. 

Eccker notes that LGBTQIA+ individuals often feel shame associated with their identities, and have experienced myriad traumas. They are three times more likely than the general population to experience substance use disorders. He believes EMDR is helping his clients let go of shame by reprogramming their brains to a place of self-acceptance and love.

He does caution, however, that therapists should be EMDR-certified because of the intensity of experiences that clients are bringing up in sessions.

Supporting LGBTQIA+ Individuals

It’s important for behavioral health professionals to learn about the specific forms of trauma that LGBTQIA+ individuals experience in their daily lives. They can also create welcoming spaces by using the names and pronouns provided by clients. 

In fact, a 2018 study in the Journal of Adolescent Health found that young people who were able to use accurate names and pronouns experienced

• 71% fewer symptoms of severe depression

• 34% drop in suicidal thoughts

• 65% drop in suicide attempts

No one should want to end their life because the people around them won’t accept their identity. 

When clinicians educate themselves and those around them about the full gender spectrum, we are doing our part to reduce the level of fear, trauma, and shame experienced by people who do not identify or conform with society’s prescribed roles.

When combined with therapies like EMDR, these steps toward acceptance and love will help more people feel comfortable in their own skins.