Eye Movement Desensitization and Reprocessing (EMDR) as a Trauma Treatment and some Potential Contributions of Traditional Yoga
A basic visual representation of what I see when doing an EMDR session online with a client.
On this International Yoga Day 2025 I was inspired to share my thoughts on how yoga can be integrated into one of my favourite psychology interventions: Eye Movement Desensitization and Reprocessing (EMDR) for the treatment of trauma and similar forms of distress.
First and foremost, how is trauma currently defined?
The majority of humans will at some point in their lives face highly challenging situations which are extremely hard to accept, let alone to overcome, especially when the circumstances can be ongoing for long periods of time outside of one’s immediate control, something we unfortunately see much more often in our society lately. These experiences can threaten, deep down to our cores, to negatively and permanently change the ways in which we think about, understand, and respond to our own selves, others, and/or, the world at large, intensifying our pain and narrowing our ability to see the full spectrum of options that may be available to us, greatly limiting our lives.
Trauma exposure for many pushes their nervous system out of what has been called, the Window of Tolerance (WoT) - a termed put forward by Dr. Daniel Siegel. The WoT is the internal, physiological range of arousal within which a person feels grounded, safe, and is able to process emotions with clarity, as well as, respond wisely even to stressful circumstances. In this way it is the optimal state of stress and/or stimulation wherein a person is able to function and thrive within their everyday life. Trauma, whether a single event or prolonged exposure to adverse conditions, can severely narrow this window leading either to hyperarousal: Anxiety, panic, and hypervigilance, or hypoarousal: Numbness, depression, and disconnection.
One primary point of trauma treatment then, is to help to bring people back into a healthy WoT out of which they were typically knocked when exposed to the distress, so that the brain is able to validate and acknowledge those experiences fully and compassionately, while also diminishing, closing up, and resolving the physiological, emotional reactions, to it in a way that feels authentic to the unique person who experienced it. This allows the brain and nervous system to truly recognize the trauma as officially over so that they can proceed onward with courage and a wider appreciation of all options in life available to them now.
The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, Text Revision (DSM-5-TR) criteria for a diagnosis of Post-Traumatic Stress Disorder (PTSD) highlights experiencing a traumatic event as the first criterion, and then, exhibiting specific symptoms across four clusters: intrusions, avoidance, negative alterations in cognitions and mood, and changes in physiological arousal and reactivity. These symptoms must cause significant distress or functional impairment and cannot be attributable to other causes such as, substance use or medical conditions. Though we tend to think of trauma as something physically violent such as, soldiers immersed in battle during war, most traumas that humans go through are social and psychological in nature nowadays, e.g., unrelenting financial strain and poverty, abusive relationships, racism, prejudice, etc.
“The WoT is the internal, physiological range of arousal within which a person feels grounded, safe, and is able to process emotions with clarity, as well as, respond wisely even to stressful circumstances. In this way it is the optimal state of stress and/or stimulation wherein a person is able to function and thrive within their everyday life.”
Enter EMDR…a more somatic and subconscious approach to the treatment of trauma
A rough visual representation of what my client sees (if using eye movement as bilateral stimulation) on their end when we are doing an online EMDR session via teletherapy.
Eye Movement Desensitization and Reprocessing (EMDR) is a well-validated psychological treatment primarily implemented to treat PTSD but it is also increasingly used to work with high anxiety, stress, burn-out, etc., and other similar conditions typically stemming from chronic exposure to very difficult experiences.
EMDR, a much less cerebral (analytical, cognitive) and more somatic (physiological and energetic) intervention to trauma treatment, encourages individuals to disengage from sticky, sometimes excruciating, repetitive, mental events (thoughts, beliefs, disturbing images), emotions, and related physical sensations, which are usually showing up out of the blue, highjacking attention, and impacting the ability to move forward in clear, meaningful ways in line with heart-felt core values.
EMDR utilizes bilateral stimulation, most often, via physical eye movements (left to right, up and down, or diagonally) but can also incorporate tapping the body first on one side then, the next, or listening to sounds going into each opposing ear, one at a time, while concurrently having people bring to mind a situation or event that has been extremely upsetting. Through continuous remembering of the trauma at the same time as the bilateral stimulation, EMDR allows the experience to be remembered while significantly dampening or totally eliminating the fight-flight-freeze or fawn reaction (i.e., hyper or hypoarousal) to it.
Dual Attention Theory posits that bilateral stimulation, such as, eye movements, compete for the brain's limited working memory resources such that focusing on a distinct form of neutral information while concurrently being asked to recall trauma keeps an individual grounded in the body while doing so, fostering a gentle rhythm that coaxes and encourages them to remain present with very hard memories, and also allowing the brain to do it’s own work behind the scenes to reduce the intensity of reactivity, and to make sense of and perhaps nurture a new, more helpful narrative around the trauma.
Why EMDR?: Bottom versus Top down interventions
The reason interventions like this can be beneficial is largely because the other more analytical approaches, such as Prolonged Exposure (PE; also offered along with EMDR, here at Inner Thriving Holistic Psychology; ITHP) and Cognitive Processing Therapy (CPT), both of which are Cognitive Behavioural Therapy (CBT) interventions, do not work for everyone. These interventions concentrate on reframing thoughts and beliefs through cerebral processes in a top-down, mind-to-body fashion. EMDR in contrast, taps into bottom-up modes of healing by nurturing reprocessing on a subconscious, physiological level.
Though there is a huge amount of empirical evidence supporting the top-down approaches, in still many cases, people already know that the way(s) they are thinking and reacting are not beneficial, but nonetheless, remain unable to change their actions and physiological reactions despite this knowledge. EMDR helps some people get under the surface of the conscious mind, so that it can release the physiological and energetic signature of the events that were imprinted by trauma and distress, and which keep arising automatically, often out of the ability to control rationally. In this bottom-up approach, once you change the neurological piece which is hypothesized to have been disrupted by trauma exposure, any meaningful and helpful cognitive shifts that are needed, are believed to flow more easily afterward.
“EMDR utilizes bilateral stimulation, most often, via physical eye movements (left to right, up and down, or diagonally) but can also incorporate tapping the body first on one side then, the next, or listening to sounds going into each opposing ear, one at a time, while concurrently having people bring to mind a situation or event that has been extremely upsetting.”
EMDR proceeds across 8 phases
1. History Taking and Treatment Planning: Involves gathering important information about a client’s past experiences and presenting symptoms and goals for therapy so that specific targets for EMDR therapy can be chosen collaboratively, and any obstacles to beginning right away can be identified and perhaps addressed first, before starting the main aspects of the intervention.
2. Preparation: Is where the psychologist or mental health professional explains more about the EMDR procedure and spends concentrated and dedicated time on the generation of emotion regulation and grounding skills. Little hint – this is particularly where traditional yoga can be an amazing gift.
3. Assessment: Involves the therapist and client selecting specific target memories for reprocessing. Often there will be more than one and in some cases, choosing the most upsetting if possible, can lead to resolution of all others.
4. Desensitization: Involves using bilateral stimulation while a client brings up the selected target memory for gradual reduction in distress in reaction to it. Another hint - yoga may be used here too to help with integration.
5. Installation: Is when integrating a positive, helpful way of interpreting themselves, others, and/or following the trauma occurs.
6. Body Scan: Involves the therapist guiding the client in a gentle awareness of how the body is reacting to the trauma after many sets of the bilateral stimulation – stopping only when the event no longer invites any physiological discomfort at all.
7. Closure: Involves the therapist ensuring in collaboration with the client that there are no residual thoughts, beliefs, physical or emotional reactions to the chosen target memory.
8. Re-evaluation: Is when the therapist and client either choose to end therapy or to move on to work with another traumatic memory and/or. another type of therapy, if deemed necessary.
Why yoga can be a wonderful adjunct to standard EMDR?
As briefly alluded to above, phases 2 and 4 of EMDR are particularly where grounding and self-soothing can come in. Traditional yoga offers a myriad of techniques that are especially powerful for this. One thing I think psychology as well as yoga are increasingly agreeing upon, is that there is for sure, no “one-size-fits-all” approach to human nature and in that regard, to healing. Because yoga is thousands of years old, I know that many would be astonished to know of how advanced many of the practices are, as well as, with the amount of specific techniques offered. In fact, the Gitananda tradition of which I am a student, teaches hundreds of pranayama as well as many visualization practices, each carefully developed for and tailored toward addressing various needs. Though yoga is not inherently designed to make you feel better and is more about helping people evolve into the highest versions of themselves which often requires discomfort, it is still useful as an adjunct to other interventions in reducing symptoms of anxiety, etc., as well as, improving feelings of overall well-being, distress tolerance, and endurance. How you may ask? Well…
Heart-brain coherence and yoga
Heart-brain coherence is a state of physiological harmony wherein the heart and brain function in sync, leading to improved mental clarity, emotional equanimity, cognitive function, and overall well-being similar to being within one’s very own WoT.
That is, scientists have discovered that there is a neural network inside the human heart - filled with approximately 40, 000 specialized cells - sensory neurites - that sense, feel, think, remember - totally independently of the brain.
The heart has a massive magnetic field larger than the brain’s and is able to communicate with the brain, giving it guidance as to how to regulate the body in wise and loving ways despite circumstances.
The reason that yoga psychology is such an amazing contribution to this all is because the heart has a totally unique and different language - not always conveyed or understandable with words. Therefore, in order to tap and tune into this beautiful, vast, and precious peaceful, loving, and grounded space, we may need to use unique and skillful practices.
Three ways to initiate heart-brain coherence with yoga?
According to Gregg Branden, there are three ways to enter heart-brain coherence.
Use of skills to shift the attention from the outside, inward, to the heart space, inner body, and beyond these - this is called Pratyahara in traditional yoga.
Yoga contribution: My yoga mentor and teacher Dr. Anandaji calls this the “forgotten limb of yoga” with good reason I think! :) Pratyahara practices allow us to slowly and gradually, typically through a light focus on one or two senses at a time, withdraw the attention from the outside world to the internal one in profound ways. This step is the beginning of quieting the mind so that other practices can become more accessible. An example of this could be via listening to and following on one sound that is far away, then, on one that is nearer, then, one that is closest, and back outward again, for several minutes, each.
A change in breathing - typically slowing of the breath in specific ways, with extending the length of the exhale to make it longer than the inhale, known to activate the parasympathetic system - rest-digest-tend-befriend, system.
Yoga contribution: Pranayama is not a simple breathing exercise - it is focused attention and deep concentration as well as purposeful awareness of subtle shifts in, and movements of, energy, as one breaths in refined and distinct ways which allow people to control and filter their own energy in ways they may need/want to. In traditional yoga, breathwork can be broken up into phases each of which can be manipulated in various ways, with intention.
Puraka (Inhalation):
This is the act of drawing air into the lungs for certain counts, tempos, filling and expanding them, in either a smooth or more intense manner.
Rechaka (Exhalation):
This is the act of releasing air from the lungs in certain counts, tempos, as completely as possible by contracting the chest cavity in a smooth or intense way.
Kumbhaka (Breath Retention):
This involves holding the breath inward for certain counts, tempos, after inhalation.
Shunyaka (Breath Suspension):
This involves holding the breath outward for certain counts, tempos, after exhalation.
A concentrated modification in felt emotions - this can be done through specific visualizations and/or purposeful selection of positive emotions to focus on. In yoga we are encouraged to sharpen our ability to trigger the visual cortex of the brain and/or other important and relevant regions that promote a conscious choice, expansiveness, a felt-sense of compassion, joy, loving-kindness, tranquility, courage, soothing temperature change, softness within the body, with groundedness, etc. This can be done by picturing pleasant scenes, inspiring individuals - real or imagined, colours, via the repetition of affirmations or phrases, humming/singing/chanting melodies, and/or, by bringing on specific, calming physical sensations (e.g., warmth).
Yoga contribution: When both Pratyahara and Pranayama are practiced before this step, we are better able to fall beneath the excessively analytical mind, underneath the noisy, mental waves and static, to a still space within that makes the invocation of these felt emotions more available to us.
In addition to the above three mentioned within the science of heart-brain coherence, gentle yoga Asanas (postures) and Vinyasa (breath-to- movement) - that invoke a sense of strength, courage, love, calm, etc., can also be practiced and held, in between EMDR sessions to help people ground and self-soothe where needed, and/or to enhance movement away from blockages showing up in EMDR:
Within phase 2 - EMDR preparation - many variations of the above can be used to get clients ready for EMDR - more grounded and capable of self-regulating tough emotional and physical reactivity - that may intensify in between sessions of EMDR.
Within phase 4 - EMDR desensitization - when a client is seeming “stuck” in their processing of a certain aspect of the trauma - Somatic interweaves - known in EMDR as specific ways to notice and gently invite change in terms of how the body is reacting to the trauma memory in order to jump start adaptive information processing and helpful perspective shifts - can be applied using some of the above-mentioned yoga skills. An example would be having a client bring mindful awareness to sensations showing up with soft curiosity while changing their posture - perhaps engaging in a helpful yoga asana (especially if using auditory or tapping bilateral stimulation to make this more possible) or breathing differently using a specific pranayama, while focusing on a certain aspect of the trauma memory where they appear blocked and while bilateral stimulation is applied concurrently. NOTE: This would only be done when a person is deemed capable of staying with these sensations without becoming too overwhelmed and after clients have already practiced the yoga skills beforehand for some time.
“Somatic interweaves - known in EMDR as specific ways to notice and gently invite change in terms of how the body is reacting to the trauma memory in order to jump start adaptive information processing and helpful perspective shifts.”
Conclusions
Yoga psychology then, offers a myriad of skills which can help individuals prepare for EMDR with regular, dedicated practice and/or, may help people move forward past blockages with some greater ease.
This type of holistic, spiritual, somatic work which honours the wisdom and intelligence of ancient, cultural traditions, is my passion, the foundation of my personal, daily practice, as well as, my work in psychotherapy with clients, where warranted and decided upon in collaboration. There is still more research to be done on EMDR in coming years but for now, it still serves as a beneficial option for many and yoga as an adjunct to this process, is promising.
References
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787
Bhavanani A. B. (2022, September 4). Yogacharya Dr. Ananda explores "Pratyahara", the forgotten limb of yoga: #60 [Video]. YouTube. https://www.youtube.com/watch?v=OHDzzENEWsE
Braden, Gregg (2025, April 25). 3 POWERFUL Steps to Awake the HEART & Brain Connection (and the SCIENCE of it) [Video]. YouTube. https://www.youtube.com/watch?v=Tak9vZJ66mg
EMDR International Association (2021, September 5). Introduction to EMDR Therapy [Video]. YouTube. https://www.youtube.com/watch?v=Pkfln-ZtWeY
About author
Dr. Kamala Pilgrim is a registered Clinical Psychologist (Ph.D., registered with the College of Psychologists of Ontario; #6285; Indian and Canadian yoga Alliances) trained in and offering both PE as well as EMDR for the treatment of PTSD. She is additionally a life-long yoga practitioner and ongoing yoga student, passionate about somatic and spiritual tools rooted in ancient wisdom traditions and what they can contribute to modern psychology. I offer teletherapy and so all interventions are carried out by her, online, for now.
