Bilateral coordination is a term that is interchangeable with bilateral stimulation and bilateral tapping. Bilateral coordination is something we engage in every day when we walk, eat or read, to cite a few examples. Occupational therapists regularly help their patients engage in bilateral coordination activities when someone shows a deficit, such as struggling to complete two-handed tasks. Mental health therapists use bilateral stimulation as part of their treatment when using therapies such as EMDR (eye movement desensitization and reprocessing) therapy. Bilateral tapping is a term that fits under both terms: bilateral coordination and bilateral stimulation. This article will review the history, the misconceptions and the vast benefits of bilateral coordination in our lives.

What is Bilateral Coordination

Bilateral coordination is the integration of using two parts of the body together to complete various activities, such as clapping, riding a bike or writing.  (1) Good bilateral coordination is an indicator that both sides of the brain are communicating effectively and sharing information. (2) Occupation therapists design activities to cross the midline of the body, such as touching opposite hand and knee. These exercises help build the left and right hemispheres of our brain ability to communicate effectively with one another. This strengthens our physical coordination and our hand-eye-coordination tasks, such as drawing or catching and throwing a ball. (3) This communication between hemispheres also improves our ability to read and to focus better.

This History of Bilateral Coordination

Bilateral coordination has been a part of our existence from the very beginning. During pregnancy, at around 20 weeks, the corpus callosum begins to form. This part of the brain acts as the telephone between the two hemispheres, so they can communicate effectively. It becomes more strongly developed as a child grows up. You need bilateral coordination to complete almost every task you engage in. (1) Bilateral coordination is also linked to body awareness. This means knowing how high to lift your leg when climbing stairs, etc. (2)

The History of Bilateral Stimulation through the lens of EMDR therapists:

EMDR (eye movement desensitization and reprocessing) therapy teaches that bilateral stimulation was discovered in a spontaneous, unexpected way.  When attending a Basic Training for EMDR therapy, the history of this therapy is given. “In 1987, Francine Shapiro was walking in the park when she realized that eye movements appeared to decrease the negative emotion associated with her own distressing memories. She assumed that eye movements had a desensitizing effect, and when she experimented with this she found that others also had the same response to eye movements…” (4) Dr. Shapiro goes on to develop EMDR therapy which is now utilized all over the world.

Misconceptions of Bilateral Stimulation (BLS) through the lens of EMDR therapists:

There are two main misconceptions about the role of bilateral coordination, more commonly known as bilateral stimulation to therapists learning EMDR therapy.

Misconception #1

At the Basic Training, the focus is on the eye movement part of Dr. Shapiro’s story. But, in actuality, there are two forms of bilateral stimulation going on at the same time. “…Francine Shapiro was walking in the park when she realized that eye movements appeared to decrease the negative emotion associated with her own distressing memories…” Walking is a form of bilateral coordination and it is never given credit for the role it played in helping Dr. Shapiro feel less distressed.

Misconception #2:

The teaching from trainers and consultants follows the line of thinking stemming from Dr. Shapiro’s view on using bilateral stimulation independent from a therapy session. In Dr. Shapiro’s book written for the general public, “Getting Past Your Past”, she is teaching people the benefit of creating a safe or calm place and adding bilateral stimulation to help in this process. “When we concentrate on the safe or calm place we only tap slowly back and forth four to six times. That’s about five seconds. We don’t do long sets, and we don’t do it very rapidly because the very rapid or long sets that we use in EMDR reprocessing can sometimes bring up unpleasant associations as new memories emerge.” (5)

The belief that has been repeatedly taught is that bilateral stimulation is the activating ingredient in this exercise. But is it?

Is Bilateral Stimulation the activating ingredient or the calming ingredient in a therapy session?

Francine Shapiro is making her initial discovery of eye movements decreasing the negative emotion she was experiencing in 1987. (4) The 1990s were known as the “decade of the brain” and began the onset of neuroimaging. (5)

Dr. Scaer stated, “With the use of fMRIs, we now can view the what regions of the brain in play at any given moment, as well as identify their function based on the experience we are testing.” It is now possible to watch what happens when a someone is “perceiving, reliving, or reading a script of a traumatic event”, the limbic system lights up, “including the amygdala” and the thinking brain and speech expression are inhibited or shut down.” Dr. Scaer states that to settle the nervous system down, “we can actually use techniques that stimulate each cerebral hemisphere in an alternating pattern to inhibit the amygdala.” He describes humming a song and counting, or “alternating left and right visual, auditory, or tactile stimuli…during all of these exercises, the amygdala will be inhibited…” (7)

Based on current research, bilateral stimulation is actually helping the nervous system calm down so the trauma can actually be reprocessed in a therapy session. Why does someone get upset when reprocessing a traumatic event? Because the traumatic event that has not been reprocessed is activating the nervous system as described by Dr. Scaer.

Dual attention bilateral stimulation is not the same thing as a stand alone resource of bilateral tapping

A skilled therapist will do many things to manage a therapy session, including having a client maintain dual attention of some aspect of the trauma while focusing on the bilateral movement, in the form of eye movement, auditory sounds or tactile. (tapping in an alternating pattern)

When bilateral stimulation is used as a stand alone resource, it becomes an interchangeable word with bilateral coordination.

The vast benefits of bilateral tapping

When you isolate bilateral tapping as a stand alone resource, you are helping your brain do what it was naturally made to do. You are helping both sides of the brain communicate automatically. You notice the left tap and then the right tap and back and forth. This process helps someone who is anxious, feel calmer in a short amount of time. Focus improves, reading scores improve, sleep improves. Our brain loves bilateral tapping and with the tappers, you have a resource to help your nervous system function at it’s very best. You can use your tappers anytime you need them. The great thing about Bi-Tapp (short for bilateral tapping) is that you don’t have to stop what you are doing to get the benefit of the bilateral tapping.

If you happen to not have your tappers with you and you aren’t in a place where you can go for a walk, simply tap your feet back and forth. You can also tap back and forth on your thighs with your hands.

Even though we have engaged in bilateral coordination our entire lives, for mental health therapists still unsure if bilateral tapping is okay to use outside of the therapeutic setting, watch this interview with Tom Hill, an EMDR therapist.

References:

1. All About Bilateral Coordination
2. What is Bilateral Coordination and Why Is It Important? Aug 6, 2014, Occupation Therapy Blogs.
3. Kalish, L. Feb 3, 2016. 10 Benefits of Cross Crawl – Brain Hemisphere Synching Exercise.
4. EMDR Institute, emdr.com
5. Shapiro, Francine. 2012. Getting Past Your Past. Rodale Inc. New York, NY.
6. Schore, Allan. 2019. Right Brain Psychotherapy. W.W. Norton & Company, New York, NY.
7. Scaer, Robert. 2012. 8 Keys to Brain-Body Balance. W.W. Norton & Company, New York, NY.