Bilateral Stimulation Considerations: From Finger Eye Movements to Technology and Other Options
Bilateral stimulation (BLS), a core component of Eye Movement Desensitization and Reprocessing (EMDR), encompasses various techniques ranging from eye movements and tapping to auditory and tactile tools like headphones and handheld buzzers, often referred to as tappers.
Diverse Approaches and Therapist Perspectives
The most traditional and researched BLS method involves clients following the therapist’s finger movements. Despite the predominance of eye movements (EMs) in early EMDR studies, clinical experience suggests that all forms of BLS are effective in processing, though therapist preferences differ. For instance, while some therapists routinely incorporate BLS technologies like those from Neurotek, others express reservations about these methods, favoring more traditional techniques.
Client-Centered Adaptations
Many clients prefer to close their eyes during EMDR, finding deeper processing through tactile or auditory stimulation. Techniques include ‘tapping in’ resources, a method derived from Laurel Parnell’s 2007 book, Tapping In, which utilizes items like magic wands, music wands, puppets, and drums to facilitate a positive, relaxed state during both the preparation and processing phases of EMDR.
Technology in EMDR
Despite some therapists’ reservations about technological BLS interfering with the therapeutic relationship, tools from providers like Neurotek or Theratappers, have been integral in many practices, including mine. These devices, which combine tactile and auditory stimulation, are featured in numerous EMDR training programs. They support a variety of BLS methods, from the tactile-focused Mega Pulsars—durable devices with lighting options that enhance EMs—to applications like EMDR Elite, which integrate BLS into mobile technology.
There are also excellent applications for our electronic device such as EMDR Elite and later models used for telehealth as well as in-office therapy.
Educational and Practical Considerations
In learning EMDR, I believe it is important to master eye movements first, given their extensive research backing and significant role in reducing the vividness and emotional intensity of distressing memories. For that reason, eye movements are most powerful in acute and crisis protocols to provide immediate reduction in distress and symptoms.
However, flexibility in BLS methods is crucial, especially when clients encounter challenges with one form or have specific preferences or needs, such as issues with the eyes,seizure disorders and TBI’s, that make alternative methods like tapping or auditory cues more suitable.
Individual Preferences and Therapeutic Flexibility
The choice between different BLS methods often depends on individual client needs and preferences, with some finding certain types more comforting or effective based on their personal experiences or the nature of their issues. For example, tactile methods are often preferred for initial resourcing, while auditory or eye movement methods may be more effective for deeper processing.
Summary and Future Directions
As EMDR practitioners, our approach to BLS should be informed by both empirical research and clinical feedback. It is essential to offer a range of BLS options to accommodate diverse client needs and preferences, ensuring that each individual receives the most effective and comfortable therapeutic experience. Continuous learning and adaptation of new BLS methods will further enhance our practice and client outcomes.
References:
This discussion includes insights from recent studies and expert opinions, underscoring the ongoing evolution of BLS techniques within the field of psychology. For a deeper understanding, please refer to the listed research articles and resources.
References and Further Reading:
- Neurotek: Visit Website – Offers a variety of BLS technologies tailored for EMDR therapy and resourcing, with replacement parts
- Theratapper: Visit Website – Offers alternating BLS for EMDR processing, tapping in and replacement parts
- Tapping In by Laurel Parnell, 2007 – A book that explores the use of tactile and auditory stimulation in therapeutic settings.
- EMDR Elite: Available thru Apple’s app store, with similar app products for google and other devices – integrates various BLS methods, supporting flexible therapeutic approaches, retains private client settings and data
- A Systematic Review Exploring the Role of Eye Movements in EMDR Therapy from a Working Memory Perspective – Carter, Claire and Ferrell, Derek, University of Worcester (2023). EMDR Therapy Quarterly, Spring 2023. Read Article
- Bilateral Alternating Auditory Stimulations Facilitate Fear Extinction and Retrieval – Boukezzi, Sara et al. (2024). Front. Psychol., 13 June 2017, Sec. Psychology for Clinical Settings, Volume 8 – 2017. Read Article
- Use of the Flash Technique in EMDR Therapy: Four Case Examples – Manfield, Philip; Lovett, Joan; Engel, Lewis; Manfield, David. Journal of EMDR Practice and Research Vol 11 Issue Jan 2017, DOI: 10.1891/1933-3196.11.4.195
These resources provide additional information and empirical support for various BLS methods and their application within EMDR therapy
Bonnie Mikelson LISW
