Bilateral Stimulation: What It Is, Effects, & Use in EMDR

What Is Bilateral Stimulation?

Bilateral stimulation is the process of using sounds, tapping, or eye movements on one side of the body before crossing over to the next, therefore activating both hemispheres of the brain. Bilateral stimulation is actually what people often think EMDR therapy is; however, bilateral stimulation is only one powerful aspect of Dr. Francine Shapiro’s eight phases of EMDR therapy.¹ EMDR is often used in trauma-informed therapy techniques to treat PTSD, depression, and anxiety.

Some examples of bilateral stimulation techniques include:^{2, 3}

• Following a ball during a tennis match
• Alternating stepping on your left and right feet
• Patting your shoulders or knees with your hands, alternating between your left and right sides
• Rocking back and forth from left to right sides
• Listening to music, sounds, or tones with headphones that allow you to alternate between ears

How is Bilateral Stimulation Used in EMDR Therapy?

There are two types of bilateral stimulation used in EMDR therapy: slow and fast bilateral stimulation. EMDR therapy works to desensitize people to traumatic triggers. During the preparation phase of EMDR therapy, slow and short sets of bilateral stimulation are used to reduce anxiety and slow their thinking and breathing. On the other hand, fast bilateral stimulation will make connections to additional traumatic material the client may not have identified within their mind and body, from the past, present, and/or future.

This process facilitates integration of both negative and positive material. In both cases, it is vital the clinician ensures the supportive internal “scaffolding” of the client’s positive resources before exposing them to the traumatic material they seek to heal from.

Slow bilateral stimulation teaches clients to maintain dual attention by focusing on the stimuli as well as a positive thought, image, or experience. It also helps the client contain negative material, alter their relationship to the negative trigger, or shift their focus to more positive material. This is typically used during the preparation phases of EMDR therapy, to help clients feel ready for the more challenging phases of the process.

Fast bilateral stimulation can facilitate reprocessing and integration of negative traumatic material that is “stuck,” or dysfunctionally stored, in the client’s neural networks.⁶ Fast bilateral stimulation brings up negative material for the client, which can be very distressing.⁷ It is here that the client’s ability to pay “dual attention” to both their trauma and their existing coping skills is so important. Fast bilateral stimulation links, blends and consolidates the negative memories, emotions and physical sensations with positive beliefs, qualities, memories, and skills.⁸ The desensitization, installation, and the body scan phases of EMDR can be thought of as “updating the file” of negative past experiences with current information, perspective, emotions, and wellbeing.

Some examples of bilateral stimulation techniques used in therapy include:^{2, 3}

• Eye movements: In a therapy session, the clinician may instruct the client to use their eyes to follow the clinician’s fingers, a lightbar, or virtual technology on the client’s computer screen. In play therapy with children, the clinician may use a cute finger puppet or fluffy wand to make it more fun for the child to follow the clinician’s fingers with their eyes.
• Walking/running: This typically involves walking or running while stepping on the ground with alternating left and right feet. The clinician can teach clients these alternating foot motions in a session.
• Tapping/patting. The client may be instructed to pat their own shoulders or knees with their hands, alternating between their left and right sides while following the clinician’s pace. Some clinicians have “buzzers” that vibrate in the client’s hands, going between left and right sides.
• Drumming: Playing the drums involves rhythmic, alternating hand movements, which, in addition to the sound it creates, can be a powerful experience of bilateral stimulation.
• Rocking/swaying. Many parents instinctively know to rock their baby back and forth to soothe them, but may not be aware that swaying is an effective self soothing activity for many adults as well.
• Audio Tones. Some clinicians may play calming music or audio tones using special headphones that alternate sound from the left to right ear, crossing the midline of the body and activating both hemispheres of the brain.

Effects of Bilateral Stimulation

Bilateral stimulation can provide a new tool for people to process and recover from traumatic events. The client practices how to regulate their own body, get distance from negative aspects, and changes their perspective on the trauma. People should become familiar with what to expect after an EMDR session, depending on the EMDR phase they are currently exploring in therapy. Bilateral stimulation in EMDR therapy can help alleviate distressing emotional and physiological symptoms of many conditions, including childhood trauma and complex PTSD.

Some common effects of bilateral stimulation include:

• Decreased instances of emotional and physiological disturbances
• Increased relaxation
• Can help mitigate effects of trauma brain
• Improved executive functioning
• Allows clients access to some positive aspects of their recovery experience
• Increased awareness of social support systems
• Alleviates symptoms of PTSD, anxiety, stress, and trauma
• Greater sense of resilience
• Improved, healthier coping mechanisms to deal with trauma
• Provides emotional distance between the client and their trauma

How to Find an EMDR Specialist

For people struggling with recurrent and distressing memories, thoughts, flashbacks, and accompanying physiological responses, talk therapy alone does not eliminate traumatic symptoms and can even exacerbate the client’s physiological distress. Trauma-informed approaches to therapy, such as trauma-focused CBT, DBT for PTSD, and EMDR, seek to also educate clients about trauma and how to regulate their nervous system’s natural response to stress. EMDR can teach the client new skills, help them access their positive resources, and decrease the impact the trauma has had on their life.

When looking for an EMDR therapist, it is important to find a clinician who is certified in EMDR by the EMDR International Association (EMDRIA). These clinicians must undergo additional education and practical training to meet the certification requirements. You can find a therapist using an online therapist directory and filter by gender, additional specialties, insurance, in-person vs. online EMDR therapy, and more. It is always recommended that clients visit the EMDRIA website to confirm whether a specific therapist you’re interested in has met EMDRIA certification requirements.

Final Thoughts

Bilateral stimulation can be a powerful tool in EMDR therapy from the early stages of the preparation process, so it is important that clients and clinicians interested in EMDR therapy become familiar with the technique. Bilateral stimulation provides a number of benefits for people dealing with stress, anxiety, depression, and other concerns; if this sounds like you, finding an EMDR-certified therapist can help you manage your symptoms and improve your daily functioning.