EMDR AND TRAUMA PRECESSING

EMDR is a trauma processing technique that resembles the Japanese art of kintsugi (金継ぎ) – “repairing with gold.” Kintsugi does not conceal or hide the cracks, but connects them with gold, turning them into a more beautiful and unique work of art. Similarly, EMDR does not erase painful memories or hide inner scars, but helps process them so that they are no longer a source of suffering, but become part of inner harmony, deeper self-awareness, and add new value and strength to our story.

EMDR was developed in the 1980s by psychologist Francine Shapiro and has since undergone extensive research. It is considered one of the most effective therapeutic methods for processing trauma, particularly post-traumatic stress disorder (PTSD) [1, 2]. Today, it is recognized by many professional organizations, including the World Health Organization (WHO).

EMDR has evolved into a specific therapeutic discipline that continues to adapt to new areas of trauma therapy. Studies show that EMDR is more effective in PTSD therapy compared to cognitive-behavioral therapy (CBT) or dialectical behavioral therapy (DBT) [3, 4], because it directly affects the neurobiological mechanisms of trauma processing and enables the rapid integration of traumatic experiences into consciousness  [4, 5].

HOW DOES EMDR AND TRAUMA PROCESSING WORK?

In the EMDR process, alternating stimuli are used, such as eye movements (e.g., following the therapist’s fingers), rhythmic sounds (e.g., finger snapping near the ears or sounds in headphones), or touches (e.g., tapping on the hands or under the collarbones). This process enhances parasympathetic regulation, thereby reducing the stress response and creating a sense of safety. At the same time, it activates both hemispheres of the brain, decreases amygdala activity, and facilitates memory processing in the hippocampus and prefrontal cortex [6]. It also triggers processes similar to REM sleep, which processes emotions, consolidates memory, and helps integrate fragmented memories into a broader orientational—temporal and spatial—context [7, 8].

As a result, EMDR enables the brain to complete what trauma had interrupted—processing blocked experiences and reducing their emotional intensity. This, in turn, decreases their unexpected activation in situations such as criticism, feelings of guilt, or sensory triggers (e.g., nonverbal cues, loud noises, smells) that originally evoked a traumatic response. By doing so, EMDR promotes better orientation in the present, reducing the impact of past emotional experiences on daily life, relationships, and psychological balance.

FOR WHOM IS TRAUMA PROCESSING (EMDR) SUITABLE?

All traumatic experiences can be treated. EMDR is suitable for those who have faced traumatic experiences with a big “T” (e.g., accidents, violence, loss of a loved one, assault, medical procedures with severe consequences), as well as for those who have experienced trauma with a small “t” (neglecting, manipulative, and coercive relationships) or complex developmental trauma (e.g., prolonged childhood stress, bullying, neglect, abuse). It is effective in treating post-traumatic stress disorder (PTSD) and related difficulties such as anxiety and depression.

In cases of simple, one-time traumatic experiences in individuals with sufficient inner resources, EMDR can bring relief after just a few sessions. However, in cases of prolonged or repeated traumatization, especially if it stems from childhood, treatment may require more time, a combination of various therapeutic approaches (e.g., psychoanalysis, ITSDP, AEDP), and a lot of patience from both the patient and the therapist.

EMDR allows the emotional charge of memories to be processed without the need for detailed analysis, which is especially beneficial for those who feel emotionally exhausted and do not want to return to repeatedly revisiting the past. When integrated with other therapies, the treatment of traumas can be accelerated and become more efficient [9, 10].

WHICH PSYCHIC DIFFICULTIES ARE NOT CONSIDERED TRAUMA?

There are also psychological difficulties that may not be classified as trauma but can, under certain circumstances, lead to serious consequences and require professional help. These difficulties may arise when we are exposed to prolonged stress or live in unfavorable relationships and conditions, even if their intensity does not reach the level typical of Big “T” or small “t” trauma.

Such difficulties can also stem from the parenting style we grew up with. If our parents were overly protective, permissive, neglectful, authoritarian, dominant, disengaged, excessively caring, or if they suffered from serious illness, depression, anxiety, or addiction, it could have affected our development. While these circumstances may not be considered traumatic in the strict sense, they can negatively impact our self-esteem, resilience, emotional regulation, and ability to form relationships.

As a result, we may feel inferior, depressed, anxious, lonely, or sad. We may struggle with emotional regulation and react explosively, anxiously, shamefully, or avoidantly in relationships. Even though these experiences are not classic trauma, in some cases, their consequences can significant interfere with our daily lives. Fortunately, therapeutic approaches such as psychoanalysis, psychoanalytic psychotherapy, ISTDP, and AEDP can help us manage these difficulties.

TRAUMA WITH BIG “T”

In a nutshell, what is trauma with big “T” ?

Big ‘T’ traumas are deep psychic wounds caused by severe, life-altering events.

Define big “T” Trauma more closesly and give examples of such “T” events

Big “T” trauma (wound, injury) occurs due to extremely stressful and shocking events that threaten our life or physical integrity, causing a sense of helplessness and exceeding our coping abilities [4]. Typical examples of traumatic events include industrial or traffic accidents, severe illnesses, physical or sexual violence, rape, sudden loss of a loved one, abuse, war conflicts, and natural disasters. It also includes medical malpractice with severe consequences, complicated births, or long-term exposure to physical or psychological violence in relationships.

When does trauma with big “T” emerge and what are the consequences?

When we find ourselves in a traumatic situation and lack sufficient support from a close person, the brain’s natural ability to process these horrific events and meaningfully integrate them into our personality may stop working. This can also block the auto-regulation (self-healing) process. The unbearable emotions and bodily reactions we experience during the traumatic event remain isolated. Our psyche dissociates (i.e., “separates,” “closes,” “encapsulates,” or “locks”) these experiences into unconscious parts of our system, primarily into implicit memory and bodily tension patterns [8, 11, 12].[1] In this way, short-term survival and functioning are ensured, but these isolated experiences can lead to post-traumatic symptoms over the long term.

When and in what typical situations can unresolved ‘T’ trauma start affecting our feelings and behavior?

Unprocessed experiences remain unconsciously present in our body, and we do not have conscious control over them. They are usually reactivated in situations where we encounter a person or circumstances that remind our brain of the traumatic event. Triggers can be various sensory stimuli, such as loud sounds, smells, or touches, or the sight of objects that evoke the traumatic event. For example, if we experience a traffic accident, the trigger might be driving a car, hearing the engine’s sound, or the screeching of tires. Or if we were a victim of sexual violence, we might experience strong bodily reactions to touches in certain areas. If we experience trauma in a relationship, the trigger could be the presence of an authoritative person, certain non-verbal movements, violent behavior in the environment, or threatening, coercive communication.

What are typical signs and symptoms of “big T” Trauma?

Trauma typically manifests through emotional hypersensitivity (sudden panic, fear, anxiety, avoidance, but also aggressive and irritable behaviors), emotional deactivation (emotional isolation; passive observation of life), bodily symptoms (sudden stiffness, shaking, headaches, abdominal pain, fatigue), dissociation (feeling detached from the body, the world, reality; fogginess or memory loss; identity changes, nightmares), or flashbacks (sudden vivid reliving of the trauma, sudden loss of contact with the present moment). We may feel a persistent sense of danger, have difficulties trusting others or ourselves, or have problems maintaining or forming deep relationships. We might even see ourselves as weak, helpless, shameful, or irreparably damaged.

How is Big “T” Trauma treated?

First of all, you might be pleased to learn that EMDR is one of the most effective therapeutic methods for processing big “T” trauma, with several studies proving its effectiveness [1, 2]. EMDR is here to help us return to emotional stability and process these difficult “T” experiences. Psychotherapy for mental trauma involves clear and understandable explanations of the causes, manifestations, and treatment procedures, which I provide through psychoeducation. We create a safe environment with agreed boundaries, allowing us to actively participate in decisions regarding the course of therapy. Successful therapy helps us transform still vivid traumatic experiences into memories, leaving the past behind [13].

TRAUMA WITH SMALL “t”

In a nutshell, what is trauma with small “t”?

Small ‘t’ traumas, refer typically to emotional injuries caused by long-term, systemic emotional stress or repeated experiences of emotional neglect and harm.

Define small “t” Trauma more closely and give examples of such “t” events

Small “t” traumas are frequent, recurring stressful, and frustrating experiences that gradually undermine one’s self-worth and self-confidence. Although they are not life-threatening, they can be emotionally painful, often involving repeated feelings of insecurity, shame, guilt, or emotional injury. Their long-term impact on the psyche depends on the frequency, duration, and intensity of the experiences, as well as individual protective factors such as the support of close people, personality resilience, and the ability to process unpleasant experiences.

A typical example of small “t” trauma includes chronic emotional neglect (e.g., parents/partners long-term ignoring or trivializing our emotions; a parent being chronically depressed), repeated criticism (e.g., using criticism by a parent/partner as a tool for discipline instead of constructive feedback), bullying (long-term devaluation, belittling, or mocking by parents, siblings, classmates, or partners), or excessive demands and psychological pressure (e.g., parents/partners manipulating our emotions and exerting pressure to achieve success in school/sports or take responsibility for people/things that aren’t our duty). Some forms of sexual coercion or inappropriate sexual behavior may constitute small “t” trauma (e.g., a parent exposing us to inappropriate sexual comments, a partner exerting psychological pressure in sexual matters), though sexual abuse itself is usually considered a big “T” trauma, especially if it involves physical violence or threats.

Small “t” traumas also include sudden or long-term losses with strong emotional impact (e.g., the loss of a close person during childhood, social exclusion, loss of property) and chronic relationship situations where we feel rejected, misunderstood, or helpless. This can be long-term emotional alienation (e.g., our expressions of love and interest being repeatedly rejected by parents/partners), repeatedly ignored efforts to explain (when we try to clarify something but face indifference), or hopelessness in attempts to change relationship dynamics (e.g., repeated attempts to resolve conflicts that remain unaddressed). Small traumas may also result from financial insecurity and a sense of injustice (e.g., long-term stress from job loss or financial problems). Prolonged exposure to these factors can lead to psychological consequences similar to trauma, especially if linked to a sense of helplessness.

How do we distinguish Small “t” Trauma from Big “T” Trauma?

A key feature of small “t” traumas is their recurring nature and systemic quality, where injuries and stress accumulate and may have long-term effects. In this context, it is important to distinguish between small “t” trauma and big “T” trauma – the latter often involves extreme, life-threatening experiences, whereas small “t” trauma pertains to less violent and intense, but more chronic and systematic (accumulated over time) injuries in relationships. Small “t” traumas are not as explicitly dissociated as in big “T” traumas but can accumulate and gradually change our perception of ourselves, our relationships, and our behavior.

When and in what typical situations can unresolved ‘T’ trauma start affecting our feelings and behavior?

Triggers for small “t” trauma are often relationship-based. These can be various sensory stimuli such as unpleasant or rejecting reactions, criticism, emotionally cold behavior, or ignoring (which may evoke strong anxiety, feelings of shame, insecurity, or even anger). A trigger could occur when a peer, partner, or close person suddenly criticizes, judges, rejects, or ignores us (evoking intense pain and fear of rejection). Triggers might also occur when during a confrontation, our parent/partner withdraws and denies us closeness (creating sudden fears of abandonment), or verbally devalues and belittles us (triggering strong feelings of fear, shame, guilt, or helplessness).

What are typical signs and symptoms of small “t” Trauma?

The manifestations can resemble those of trauma with a big “T.” We may feel overwhelmed by everyday life, suffer from internal insecurity in relationships, and overestimate or underestimate the importance of our feelings and needs. We may feel helpless, inferior, incapable, or inadequate. Doubts or beliefs that we are broken, defective, or unworthy of attention and love can arise. A typical manifestation involves difficulties in relationships, where situationally we may be flooded by emotions that we cannot regulate (freezing, panic attacks, outbursts of anger, intense feelings of abandonment, fear of rejection, fear of decision-making, social anxiety, heightened sensitivity to criticism). This includes persistent doubts, uncertainties, and difficulties in distinguishing whether our thoughts, behaviors, or emotional reactions are appropriate or disproportionate to the situation or event.

An example of long-term coping with small “t” trauma can also be heightened perfectionism, avoidance of confrontations, taking on the victim position, excessive worry about the future, difficulty relaxing, chronic need for control, or excessive care for others. These reactions may serve as strategies to maintain a sense of safety and avoid further emotional discomfort, although over time they may lead to exhaustion or reduced psychological flexibility.

How is small “t” Trauma treated?

Treating small “t” trauma often involves a combination of different therapeutic approaches [5]. While EMDR therapy helps process specific painful memories, psychodynamic therapies such as psychoanalysis, ISTDP, or AEDP support a deeper understanding of emotional patterns and their connection to current experiences [14, 15]. Trauma psychotherapy should include phases of stabilization, processing, and integration, with both the therapist and client collaborating on defining the pace, intensity and direction of the therapeutic process. Integrating these approaches further enhances the therapeutic process, with psychotherapy helping to transform traumatic experiences into “normal” memories and preventing them from lingering in our psyche.

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[1] Based on the cited studies in psychotraumatology, one can assume that during a traumatic event, the amygdala becomes hyperactivated, triggering a stress response—not only fight or flight but especially freezing. A hyperactivated amygdala simultaneously reduces the activity of the hippocampi and the prefrontal cortex, which are responsible for rationally processing and temporally organizing memories. As a result, when the amygdala is overly active, memories are stored in an unprocessed, fragmented form—as isolated sensory and emotional impressions rather than coherent and comprehensible narratives.