Aphantasia & EMDR

I found EMDR to be very annoying. Some of that was probably because I have aphantasia and could not keep what I was meant to be processing in my brain while also doing the bilateral stuff. The other part was that I have doubts that the bilateral stuff actually does anything other than be a distraction for people who have very vivid images while desensitizing them to thinking about the trauma.

If you have PTSD, you might consider Prolonged Exposure (PE) or Cognitive Processing Therapy (CPT). PE relies heavily on telling the story and hearing your story. By hearing it over and over and also talking about it with a therapist you get to the point where you are no longer as triggered by simply thinking about the trauma. As it is designed there is a not a lot of visualizing. CPT involves quiet a bit of writing and finding “stuck points” or beliefs that were created or reinforced by the trauma that are unhelpful in the present. There isn’t any visualization really unless you bring it into the story. Both are evidence based for trauma and have actually more research behind them than EMDR. They are very effective if done correctly.

I don’t know the research on doing them on yourself, but knowing the treatments, I’d be more likely to try CPT than EMDR or PE as a “self-treatment.” Both PE and EMDR involve desensitization or habituation as a way of reducing trauma symptoms. However, there is a risk with both of re-traumatization if you get the emotion too high. CPT is more about cognitive restructuring.

Michael, I’m currently doing EMDR treatments for PTSD. After the first 3 sessions I had to explain to my therapist that I have aphantasia. She had no idea what it was and thankfully talked to other psychologists who have worked with clients who have aphantasia. My PTSD was from a car accident. She was trying to have me visualize back to the accident which I was unable to do. She also tried me to feel the emotions of the accident or my fears. I was unable to do that either as I know longer ‘feel’ anything. Due to having a concussion also I was unable to watch the ball going across the screen but I was able to do the audio and zapper. We focus on the sensations that I feel when doing the actual therapy instead such as fuzziness in head, eyes fluttering, holding my breath, twitching, throat closing. Once those physical symptoms surface I then repeat the my positive statements I’m working on such as It’s over, I am safe now. Honestly I’ve done 18 sessions now and at first I didn’t think it was working but now that we are focusing on the here and now, I usually have a rise in panic attacks for a day or two and then a break through. 8 months ago I couldn’t even sit in the drivers seat, then I was able to graduate as a passenger but still having severe panic attacks where I would scream, hiss and cry uncontrollably. Now I am able to drive up to 20 minutes. I have been doing indirect breathwork and honestly have found more success with that.

Hi Michael,
I’m a fellow aphant currently doing EMDR. I see zero imagery when I’m awake so I’ve been focusing on the senses of the memories. Sometimes the scenes start slipping away from me so I occasionally have to remind myself to stay there. Regardless, I definitely notice improvement in my reactivity to triggers.