EMDR is a trauma processing technique that resembles the Japanese art of kintsugi (金継ぎ) – “repairing with gold.” Just as kintsugi connects broken shards with gold to create a new, unique whole, EMDR restores inner wholeness by linking separated and traumatized parts of the psyche. Instead of trying to hide scars, EMDR gives our painful experiences new meaning, thus creating greater value in our personal development story. Just as kintsugi makes objects more beautiful through their repairs, EMDR allows our traumatic experiences to become an important part of our journey to healing and personal growth, gaining deeper value and significance.

  1. WHAT IS TRAUMA?

Big “T” Trauma (serious life-changing events)

Definition and Examples of Big Traumatic 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 [1]. 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.

Emergence and 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 [2-4].[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.

Triggers of “T” Trauma: 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, violent behavior in the environment, or threatening, coercive communication.

Signs of “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.

Treatment of Big “T” Trauma: If you’ve read this far, you might pleased to know that EMDR is one of the most effective therapeutic methods for processing big “T” trauma, with several studies proving its effectiveness [5, 6]. 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 [7].

Small “t” Trauma (long-term and systemic emotional injuries)

Definition and examples of small traumatic 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.

Distinguishing 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.

Triggers of Small “t” Trauma: 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).

Manifestations 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.

Treatment of Small “t” trauma: 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 [8, 9]. Trauma psychotherapy should include phases of stabilization, processing, and integration, with both the therapist and client collaborating on defining the pace, imtensity 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.

  1. WHAT IS EMDR/TRAUMA PROCESSING?

EMDR (Eye Movement Desensitization and Reprocessing) was developed in the 1980s by psychologist Francine Shapiro and has since undergone extensive research. It is highly effective in treating post-traumatic stress disorder (PTSD) and other traumatic conditions. Today, EMDR is recognized and acknowledged as one of the most effective therapeutic methods for processing trauma, and it is included in PTSD treatment recommendations by many professional organizations, including the World Health Organization (WHO).

EMDR helps process traumatic experiences through alternating stimuli applied to both sides of the body (bilateral stimulation). This can include alternating eye movements, auditory signals, or tactile stimuli. Studies suggest that this alternating (bilateral) process activates synchronization between the hemispheres as well as the integration of the limbic system with the prefrontal cortex [10]. This stimulation reduces the activity of the amygdala (linked to fear) while facilitating adaptive connections of traumatic memories in the hippocampus (memory) and prefrontal cortex (restoring the ability to rationally process encapsulated emotional burdens and temporally organize fragmented memories). Some studies suggest that bilateral stimulation in EMDR may trigger processes similar to those occurring during REM sleep, a phase associated with emotional processing and memory consolidation [2, 11].

The result of the EMDR process is that the brain completes what trauma interrupted: it processes and metabolizes originally unintegrated or blocked traumatic experiences so that they lose their emotional intensity and become neutral. As a result, the emotional impact of traumatic memories on daily life is significantly reduced or eliminated. In this sense, EMDR helps “extinguish” (weaken, dampen) strong emotional traces that can unexpectedly activate in certain situations—such as in specific relational dynamics (e.g., when criticism arises from a close person), thoughts (e.g., feelings of guilt or worthlessness), or sensory stimuli (e.g., loud noises or certain smells that remind one of a traumatic event). With this method, traumatic memories are metabolized, becoming less intense and ceasing to interfere with our work, relationships, and psychological balance.

Today, EMDR is a recognized independent therapeutic discipline that is continuously evolving and adapting to new areas of trauma treatment, helping patients at various stages of recovery from traumatic experiences. In the case of post-traumatic stress disorder, EMDR is considered more effective compared to other approaches such as cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), or other traditional narrative-focused therapeutic methods [1, 12]. This is because EMDR directly impacts the bodily—neurobiological—mechanisms of trauma processing and allows for quicker integration of traumatic experiences into consciousness [1, 13].

  1. 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 small “t” traumas can be accelerated and become more efficient [14, 15].

  1. WHICH PSYCHIC DIFFICULTIES ARE NOT CONSIDERED TRAUMA?

There are also psychological issues that are not considered trauma but can cause difficulties that require professional help. These issues can arise when we are exposed to prolonged stress or live in unfavorable relationships and conditions, even though the intensity of the stress and adversity does not exceed levels typical of big or small “t” trauma. For example, if parents consistently neglect (neglected) our needs, are (were) overly demanding or critical, or are (were) indifferent and do (did) not give clear rules, this could have caused psychic problems that are not of “traumatic” orgin. As a result, we may nevertheless feel inferior, depressed, anxious, insecure, lonely, sad, or ashamed. We may have trouble regulating emotions, and in relationships, we may react to various situations with outbursts, irritability, anxiety, shame, or avoidance. While these problems are not trauma, they can also lead to significant psychological difficulties. Fortunately, we can learn to manage them, for example, through psychoanalysis, psychoanalytic psychotherapy, ITSDP, or AEDP.

  1. Van der Kolk, B., The body keeps the score: Mind, brain and body in the transformation of trauma. 2014, New York: Penguin UK.
  2. Pagani, M., et al., Eye movement desensitization and reprocessing and slow wave sleep: a putative mechanism of action. Frontiers in psychology, 2017. 8: p. 1935.
  3. Pagani, M., et al., Neurobiological correlates of EMDR monitoring–an EEG study. 2012.
  4. Vojtova, H. and J. Hasto, Neurobiology of eye movement desensitization and reprocessing. Activitas Nervosa Superior, 2009. 51: p. 98-102.
  5. Shapiro, E. and L. Maxfield, The Efficacy of EMDR Early Interventions. Journal of EMDR Practice & Research, 2019. 13(4).
  6. Organization, W.H., Guidelines for the management of conditions that are specifically related to stress. 2013.
  7. Seidler, G.H. and F.E. Wagner, Comparing the efficacy of EMDR and trauma-focused cognitive-behavioral therapy in the treatment of PTSD: a meta-analytic study. Psychological medicine, 2006. 36(11): p. 1515-1522.
  8. Monteleone, P.O.K., Intensive Short-Term Dynamic Psychotherapy for the Treatment of Trauma, in Experiential Therapies for Treating Trauma. 2024, Routledge. p. 75-89.
  9. Del Prete, A., Healing Trauma: AEDP Improves Attachment and Self-Perception in Adults With Diverse Childhood Trauma Histories: A Quantitative Study. 2022, The Wright Institute.
  10. Valiente-Gómez, A., et al., EMDR beyond PTSD: A systematic literature review. Frontiers in psychology, 2017. 8: p. 1668.
  11. Rho, Y.-A., J. Sherfey, and S. Vijayan, Emotional Memory Processing during REM Sleep with Implications for Post-Traumatic Stress Disorder. Journal of Neuroscience, 2023. 43(3): p. 433-446.
  12. Van der Kolk, B.A., The body keeps the score: Memory and the evolving psychobiology of posttraumatic stress. Harvard review of psychiatry, 1994. 1(5): p. 253-265.
  13. Maxfield, L. and L. Hyer, The relationship between efficacy and methodology in studies investigating EMDR treatment of PTSD. Journal of clinical psychology, 2002. 58(1): p. 23-41.
  14. RalaUS, D., Spracovanie traumatických zážitkov pomocou očných pohybov EMDR. Psychiatria, 2006. 13: p. 167-76.
  15. Rydberg, J.A. and J. Machado, Integrative psychotherapy and psychotherapy integration: The case of EMDR. European Journal of Trauma & Dissociation, 2020. 4(3): p. 100165.

[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.