EMDR as “Wound Care”

Eye Movement Desensitization and Reprocessing (yes, it’s a mouthful!) is a therapeutic modality that supports individuals in reducing the emotional impact of traumatic memories, thoughts and feelings from the past.

I often use the metaphor of “emotional wound care” to describe the EMDR process to my clients. If not cleaned and cared for properly, physical wounds can become infected, painful, or sensitive. Similarly, unaddressed trauma can create a wound that doesn’t heal properly.
EMDR supports the process of gently opening up the wound, cleaning out what has been stuck, and implementing tools and mechanisms that will honor continued healing.

The Intersection of Brain Injury and Trauma

Many individuals navigating a brain injury also experience trauma-related symptoms due to the injury itself or surrounding circumstances. Additionally, those with a history of trauma that occurred before their brain injury may notice an increase in trauma symptoms post-injury, due to changes in their ability to access previously effective coping mechanisms.

Unresolved trauma—regardless of its origin—can compromise a person’s emotional and cognitive recovery. Trauma often goes untreated when symptoms are mistakenly attributed to the brain injury alone.

For example, a client may present with:

  • Impaired memory or difficulties with working memory
  • Reduced processing speed
  • Emotional dysregulation
  • Increased sensitivity to stimulation
  • Difficulty with abstract reasoning or insight

All of these symptoms could be attributed to brain injury- but they are also common markers of trauma.

Benefits of EMDR for Clients with Brain Injury

Clinicians who are well-versed in both brain injury and trauma can apply appropriate modifications within EMDR to target symptoms rooted in the nervous system. When used thoughtfully, EMDR can offer symptom relief even when the source — brain injury or trauma — is not clearly defined.

A few benefits of EMDR to those with brain injury include:

  • Nonverbal processing: Clients do not have to retell the traumatic event in detail.
  • Reduced demand on working memory: BLS paired with visual, auditory, or tactile tasks can lower cognitive load while still facilitating reprocessing.
  • Flexibility: EMDR allows for titration, resourcing, and containment, which is ideal for clients with fluctuating cognitive or emotional stamina.

Trauma doesn’t occur in isolation, and trauma treatment shouldn’t either. By slowing the process down, honoring how each brain functions uniquely, and approaching therapy with flexibility and creativity, EMDR clinicians can support individuals with TBI in finding meaningful healing and integration.