When EMDR Meets the ADHD Brain: Why Trauma Processing Can Look Different

As a therapist, I knew trauma intellectually.

As a patient, I learned trauma lives in the body.

For almost 20 years, I lived with medical trauma.

As a therapist, it was not that I avoided help. I sought help. I tried to function through it. I understood trauma cognitively, but my nervous system never truly felt safe. My body continued reacting as if I were still trapped in the MRI room where much of my trauma began.

Research suggests PTSD can remain chronic for many individuals, sometimes lasting decades without adequate treatment. In a recent study involving veterans with chronic PTSD, participants reported living with symptoms for an average of 19 years prior to treatment (Sessa et al., 2024). This long delay is often linked to avoidance, stigma, emotional numbing, misdiagnosis, or difficulty recognizing trauma related symptoms.

Then something unexpected happened.

I took my dog to get spayed.

Watching her terrified before surgery pushed my nervous system into full fight or flight mode. My body reacted as if I was preparing for an important medical appointment myself.

For nearly three weeks:

• I barely slept

• I lost almost 4 kilos

• I could not regulate my emotions

• My body stayed on high alert

• I became irritable and angry

• My children felt it

And with trauma often comes the cycle many survivors know too well:

Trigger → shame → guilt → anger → more shame

That was the moment I finally started EMDR therapy.

And honestly, it changed my life.

What Is EMDR Therapy?

Eye Movement Desensitization and Reprocessing, commonly called EMDR, is an evidence based trauma therapy developed by Francine Shapiro. EMDR helps the brain reprocess distressing memories so they no longer feel emotionally and physically overwhelming.

Unlike traditional talk therapy, EMDR focuses heavily on how trauma is stored in the nervous system and body.

Research has shown EMDR to be effective for PTSD, anxiety, panic, medical trauma, and other trauma related conditions (Shapiro, 2018).

ADHD and Trauma: Why EMDR Can Feel Different

I also have ADHD.

And that became very important during EMDR.

My therapist once explained that my ADHD brain often took the “scenic route” during processing.

That description stayed with me because it perfectly explained what was happening internally.

What Is ADHD?

Attention-Deficit/Hyperactivity Disorder is a neurodevelopmental condition that affects attention, emotional regulation, executive functioning, working memory, and processing speed.

About 8.7% of adults are estimated to meet criteria for ADHD at some point in their lives (Kessler et al., 2006).

Many adults with ADHD are highly intelligent, creative, emotionally sensitive, and deeply associative thinkers. But during trauma therapy, that brain style can create unique challenges.

The “Scenic Route” Brain in EMDR

A neurotypical EMDR process may sometimes look like this:

Memory → emotion → body sensation → insight

But an ADHD brain may process more like this:

Memory → sound → childhood memory → emotion → random association → body sensation → another memory → insight → back to original memory

To the outside world, it can sometimes look disorganized.

But it is not “wrong.”

The ADHD brain is often highly associative. It rapidly connects networks, emotions, sensations, memories, and meanings.

Sometimes my therapist had difficulty following where my brain was going because my mind connected experiences so quickly. One thought triggered five others.

What looked unrelated often turned out to be deeply connected.

Why ADHD Brains Process Trauma Differently

Research suggests ADHD is associated with differences in executive functioning, attention regulation, emotional regulation, and working memory (Barkley, 2015).

During EMDR this may lead to:

• Faster associations

• More jumping between memories

• Difficulty staying on one target

• Emotional overwhelm

• Dissociation or distraction

• Multiple trauma networks activating at once

But there are strengths too:

• Creativity

• Strong symbolic thinking

• Deep emotional access

• Rapid insight

• Powerful connections between experiences

The scenic route is not a broken route.

It is simply a different nervous system pathway.

Trauma Lives in the Body

One of the hardest parts of PTSD is that the body reacts before the mind catches up.

My nervous system was not reacting to logic.

It was reacting to danger.

That is why trauma survivors often say things like:

“I know I’m safe, but my body doesn’t believe it.”

That was true for me.

And it is true for many of the clients I now work with as a trauma informed therapist.

My own EMDR journey changed how I understand trauma, shame, and nervous system regulation. It taught me that healing is not simply about “thinking differently.”

Sometimes healing means teaching the body that the trauma is over.

Final Thoughts

If you have ADHD and struggle during EMDR because your brain feels “all over the place,” it does not mean therapy is failing.

Your brain may simply process information differently.

The scenic route can still lead to healing.

Sometimes it even uncovers deeper connections that would otherwise remain hidden.

And if you are exploring trauma treatment options, do not forget to ask your therapist about Ketamine Assisted EMDR (KA EMDR), an emerging approach that combines the nervous system regulation and neuroplasticity effects of ketamine with the trauma reprocessing framework of EMDR. For some individuals, especially those with chronic trauma, dissociation, or nervous system hyperactivation, this combination may help access and process trauma in ways traditional therapy alone could not.

Follow for more trauma informed mental health content:@ShirliMindBodyGuide

Website:www.HealthyFamily4Life.com

References

Barkley, R. A. (2015). Attention deficit hyperactivity disorder: A handbook for diagnosis and treatment. Guilford Press.

Kessler, R. C., Adler, L., Barkley, R., Biederman, J., Conners, C. K., Demler, O., Faraone, S. V., Greenhill, L. L., Howes, M. J., Secnik, K., Spencer, T., Ustun, T. B., Walters, E. E., & Zaslavsky, A. M. (2006). The prevalence and correlates of adult ADHD in the United States. American Journal of Psychiatry, 163(4), 716–723.

Sessa, B., Higbed, L., O’Brien, S., Durant, C., Sakal, C., Titheradge, D., Williams, T. M., & Nutt, D. (2024). Psilocybin therapy for chronic PTSD in military veterans. Journal of Psychopharmacology.

Shapiro, F. (2018). Eye movement desensitization and reprocessing (EMDR) therapy: Basic principles, protocols, and procedures. Guilford Press.