EMDR Therapy

16 Minutes

Edited & clinically reviewed by THE BALANCE Team

Fact checked

CONTENTS

What does EMDR stand for? In 1990, psychologist Francine Shapiro pioneered a new style of psychotherapy known as Eye Movement Desensitization and Reprocessing (EMDR). Individuals suffering from anxiety disorders, panic attacks, post-traumatic stress disorder, and trauma may find EMDR treatment to be a particularly useful rehabilitation technique.

Eye Movement Desensitization and Reprocessing (EMDR) is a systematic therapy that allows the individual to temporarily concentrate on traumatic memories while simultaneously undergoing bilateral stimulation (typically eye movements). EMDR has been shown to be linked with a reduction in the intensity of emotions associated with traumatic memories. The term refers to a type of psychotherapy that helps people recover from the physical and mental discomfort brought on by traumatic life experiences. In spite of the fact that it is a therapeutic treatment, it is built on a variety of psychotherapeutic principles, including the tenets of cognitive-behavioral therapy (CBT).

Unlike other types of therapies which focus on the behaviors, thoughts, and emotions associated with negative experiences, EMDR therapy primarily focuses on the particular memory in order to modify the way it is retained in the brain. Numerous studies demonstrate that by practicing EMDR therapy, individuals can achieve the same level of benefits that previously took years to achieve with conventional methods of psychotherapy.

It is claimed by Shapiro (1995, 2001) that EMDR therapy provides access to the traumatic memory network, hence enhancing information processing and generating new connections between the painful experience and more adaptive experiences or thoughts. These new connections are intended to result in more thorough information processing, storing memories anew, reducing emotional distress, and developing novel cognitive insights.

Treatment with eye movement desensitization and reprocessing (EMDR) involves three steps: (a) processing of prior events that contributed to dysfunction, establishing new intuitive links with adaptive information; (b) targeting of current conditions that cause distress and desensitization of direct, indirect, or external and internal triggers; (c) incorporation of introspective templates of future events to assist the patient in developing the skills necessary for adaptive functioning.

It is commonly believed that major emotional trauma requires a long period of time to heal. This is not necessarily true. Trauma-informed cognitive behavioral therapy (CIBT) has demonstrated that the mind, like the body, can recover from psychological trauma. When you cut your hand, your body begins to repair the wound almost immediately. If the wound is irritated by a foreign item or repeated injury, it persists for longer and produces pain. As soon as the impediment is removed, the healing process can resume.

According to the findings of EMDR therapy, mental processes follow a similar sequence of actions. When it comes to mental well-being, the information processing system of the brain naturally gravitates toward it. Because of the disruption or imbalance caused by a traumatic event, the emotional wound can fester and cause excruciating agony for the individual. Through the use of specialized protocols and procedures acquired during EMDR therapy training sessions, clinicians assist patients in activating their natural healing processes.

It is believed that EMDR therapy helps the accessing and processing of painful memories and other negative life experiences in order to transform them into a more adaptive state. The effects of EMDR therapy are reduction of affective suffering, negative beliefs are reformed, and physiological arousal is reduced after the completion of the treatment. Within the context of EMDR therapy, the patient attends to emotionally painful information in brief sequential doses while simultaneously focusing on external stimuli. Even though therapist-directed lateral eye movements are the most commonly employed external stimulus, other stimuli, such as auditory stimulation and finger tapping, are also frequently used.

EMDR treatment is a multi-phase procedure that takes place across several sessions. It is necessary to use eye movements (or other bilateral stimulation) during a portion of the session. In order to narrow the focus of the patient’s attention to a specific memory, the clinician directs them to consider various aspects of the event or thoughts while using their eyes to follow the therapist’s hand as it glides back and forth through the patient’s field of vision. Internal associations are formed as a result of this, and for reasons that a Harvard researcher believes are related to the neurological mechanics underlying Rapid Eye Movement (REM) sleep, patients begin to process the memories and bad feelings they have experienced. EMDR therapy follows a standardized eight-phase process that involves the following:

Phase 1: Assessing the patient’s background and developing a treatment plan. The therapist will assess the patient’s situation, including their capacity for tolerating distressing memories. They will then develop a treatment plan for the individual based on their symptoms and the behavioral patterns that need to be modified.

Phase 2: Preparation of the patient. By building a therapeutic relationship with the patient and educating them about EMDR, the therapist will lay the framework for the treatment. Additionally, they will teach the individual self-control strategies, which are methods for dealing with unpleasant memories that resurface.

Phase 3: Assessment. The therapist will discover the unpleasant memories that the patient intends to resolve at this stage. The patient will next select a picture to represent each memory, taking note of any negative beliefs or bodily feelings associated with them. They will then choose a positive concept to substitute for negative thoughts.

Phase 4: Desensitization. Desensitization entails minimizing the client’s distressing responses to the traumatic memories, including the physical reactions associated with them. Physical symptoms may include a rapid heartbeat, excessive sweating, or abdominal discomfort. Desensitization is facilitated by the therapist controlling the client’s eye movements as they concentrate on the painful content.

Phase 5: Installation of the ideas. This stage focuses on inserting the good concepts identified by the patient in phase 3.

Phase 6: Body Scan. A body scan is a meditative practice in which a person scans their entire body from head to toe in order to become aware of physical sensations. The therapist will next focus on these physical sensations for additional processing during EMDR.

Phase 7: Closure. At the conclusion of each session, the therapist will utilize the self-control strategies discussed in phase 2 to stabilize the patient. The therapist will inform the patient of what to anticipate between sessions. Additionally, they will advise the client to keep track of any unpleasant experiences so that they can address them during the following meeting.

Phase 8: Reevaluation. The final phase includes an evaluation of the treatment’s effectiveness so far. Additionally, the therapist and the patient will determine any further traumatic repercussions to treat. The processing of a particular memory typically takes between one and three sessions. EMDR therapy is distinguished from other trauma-focused treatments by the absence of prolonged exposure to the traumatic memories, extensive descriptions of the incident, and confronting dysfunctional beliefs.

EMDR therapy is usually given one to two times per week for a total of 6 to 12 sessions by licensed professionals. Sessions are normally an hour long. Theoretically, EMDR works because the “bilateral stimulation” bypasses the part of the brain responsible for memory processing that has become stuck as a result of the trauma. When a distressing memory becomes trapped, it stops the brain from properly processing and retaining it. Individuals process memories safely during EMDR, which results in a peaceful resolution. The experience results in enhanced understanding of both prior distressing occurrences and unfavorable self-images that developed as a result of the initial traumatic event.

CPTSD Symptoms and Causes

The emotional meaning of traumatic events can be transformed with successful EMDR therapy. For example, a rape survivor may go from feeling hopeless and self-disgust to having the unshakeable confidence that “I survived it and I am strong.” In contrast, to talk therapy, patients gain insights into EMDR treatment as a result of their own fast emotional and cognitive processes throughout the treatment process. As a result, persons who have had EMDR therapy report feeling strengthened by the very experiences that had previously disparaged them. It is no longer just that their wounds have healed; they have also evolved at the end of the treatment. Patients’ thoughts, feelings, and behavior all serve as reliable indicators of emotional health and resolution as a natural outcome of the EMDR therapy process – all without the need for long conversations or homework assignments that are common in other types of therapies.

Over 30 controlled outcome studies have been conducted on EMDR therapy, all of which have found it to be effective. The results of a research study showed that after only three 90-minute sessions, between 84 and 90 percent of single-trauma victims showed significant improvement in the symptoms of post-traumatic stress disorder. According to one study, after only six 50-minute sessions, 100 percent of single-trauma victims and 77 percent of multiple-trauma victims were no longer diagnosed with post-traumatic stress disorder (PTSD). Another study discovered that after 12 sessions, 77 percent of combat veterans were cured of post-traumatic stress disorder (PTSD).

When 31 patients with dental phobia were randomly assigned to either EMDR or a waitlist control group for one year, researchers discovered that the treatment, which focused on processing traumatic dental memories, significantly reduced dental anxiety and avoidance behavior compared to the control group. Additional research is needed to confirm these findings and to determine whether EMDR is superior to imaginal or in vivo exposure with regards to incremental improvement.

A short pilot study discovered that EMDR therapy was both safe and effective for treating PTSD in individuals diagnosed with a psychotic condition. The treatment aided in the reduction of stress and anxiety symptoms, as well as enhancing self-esteem. A 2017 study found that EMDR therapy for treating panic disorder symptoms and enhancing patients’ quality of life was just as effective as CBT.

In 2017, a review of published studies found that EMDR is helpful in treating trauma-related symptoms in patients with anxiety disorders, psychosis, bipolar disorder, unipolar depression, substance use disorders, and chronic back pain. Additionally, the analysis discovered evidence that EMDR may help relieve various non-traumatic symptoms associated with mood disorders and may be beneficial as an adjunct treatment to help patients who suffer from chronic pain. EMDR therapy can bring rapid relief. It may even help you feel better immediately following the first session. However, individual responses to EMDR are quite variable.

Due to the volume of research conducted on EMDR therapy, organizations such as the American Psychiatric Association, the World Health Organization, and the Department of Defense now recognize it as an effective method of treating trauma and other distressing situations. Given its widespread acceptance as a successful treatment for trauma, it’s easy to understand how EMDR therapy would be effective in healing the “everyday” memories that contribute to poor self-esteem, feelings of helplessness, and the countless other problems that bring individuals into therapy. The therapy is used by over 100,000 doctors worldwide. Over the last 25 years, millions of people have been effectively treated.

EMDR’s benefits go beyond PTSD and recovery from trauma. Several potential advantages of this therapeutic approach include the following:

Breaks the pattern of negative thought processes. EMDR can help you recognize and uncover, challenge, and might change the negative thoughts that persistently occupy your mind.

Alleviates chronic discomfort. Bilateral stimulation activates the part of the brain associated with relaxation and pleasant feelings, according to research.

Enhances self-esteem. EMDR works by focusing on traumatic memories and negative self-talk. By identifying them, you can begin the process of processing and healing.

Involves minimum talking. Unlike talk therapy, EMDR does not require you to share every detail of your terrible event. This makes EMDR particularly beneficial for individuals who have difficulties discussing their experiences.

Known for quick effects. EMDR is a short form of psychotherapy that produces rapid outcomes. While each individual’s experience is unique, between 80% and 90% of people report positive changes within the first three sessions.

Initially developed to treat post-traumatic stress disorder (PTSD), EMDR is currently used to treat a number of mental health disorders, including the following:

Drug Abuse/dependence
Mood disorders
Specific Phobias
Eating disorders
Anxiety disorders
Chronic pain in cancer patients
Panic and Anxiety attacks

EMDR can be used alone or in conjunction with other psychotherapeutic treatments (such as cognitive-behavioral therapy or medication).

The majority of people would undoubtedly agree that counseling can occasionally be unpleasant. Meeting and conversing with someone you are unfamiliar with can be humiliating and awkward. While a part of you may take comfort in the professional aspect of the interaction, sharing your personal thoughts and feelings with the therapist is not always easy.

However, if you have a history of trauma, whether recognized or unrecognized, treatment is likely to be more difficult for you. Indeed, treatment for trauma survivors’ is usually triggering. Trauma survivors often struggle with trusting themselves and others. Due to the fact that so much of human trauma includes other people, it is common for our survival reactions to be activated during therapy.

EMDR is generally believed to be safe with comparatively fewer adverse effects. While this method can be highly effective, it does have some potential drawbacks:

Increased awareness: You may experience a surge of emotion or physical sensation that lasts longer than the duration of your therapy session. Several individuals report having terrible nightmares when they begin to reabsorb traumatic occurrences.

Risk of traumatization: When EMDR is not used properly, it can leave individuals feeling traumatized and can take them back to the emotional state as they experienced with the initial trauma.

The surfacing of new traumatic memories. Concurrent trauma memories that are no more a concern for the patient might resurface and cause distress. In some rare cases, a new incomprehensible trauma memory can be generated due to the sensory stimulation of the various brain centers in the basal ganglia associated with mood and memory.

Physical symptoms. Lightheadedness, headache, uneasy feeling, or generalized fatigue after a session of EMDR are some of the usual short-term side effects reported by patients.

Another potential downside could be the possibility of multiple sessions before actual positive effects could be seen. This may constitute a financial hurdle for some as well as this method might not suit individuals who require prompt treatment. Reflection of traumatic events can be painful, more so at the start of therapy.

Usually, these symptoms will subside as treatment progresses. Individuals should communicate their experience between sessions to the therapist in order to work on emerging memories and symptoms in subsequent sessions.

Numerous controlled and independent research indicate that EMDR therapy is an effective treatment for PTSD. It is even a highly recommended treatment option for PTSD by the Department of Veterans Affairs.

In a 2012 research of 22 persons, it was discovered that EMDR therapy benefited 77% of those with psychotic conditions and PTSD. It discovered that after treatment, their hallucinations, delusions, anxiety, and depression symptoms greatly improved. Additionally, the study discovered that therapy did not increase symptoms.

An older study indicated that when EMDR therapy was compared to traditional prolonged exposure therapy, EMDR therapy was more effective at relieving symptoms. Additionally, the study discovered that EMDR therapy had a decreased dropout rate. Both, however, demonstrated a reduction in traumatic stress symptoms, including anxiety and despair.

Numerous minor studies have also established that EMDR therapy is not only helpful in the short term but also has the potential to maintain its effects over time. One 2004 study evaluated individuals several months after receiving either “standard care” (SC) or EMDR therapy for PTSD. They discovered that EMDR was much more effective in reducing PTSD symptoms during and immediately following treatment. They also observed that subjects retained these benefits three and six months after therapy ceased. In general, the study discovered that EMDR therapy resulted in a more sustained reduction in symptoms than SC.

In the case of depression, one research of 32 participants conducted in an inpatient environment discovered that EMDR therapy has a promising role in the effective treatment of the disease. The study discovered that 68% of participants in the EMDR group had complete remission following treatment. Additionally, the EMDR group demonstrated a greater overall reduction in depression symptoms. Due to the small sample size, additional research is required.

It should come as no surprise that the majority of EMDR therapists are female. Therapists must be empathetic and able to listen to their patients’ issues, which may explain why more women have historically been encouraged to pursue such a vocation. However, there are no compelling reasons why males should not pursue careers as EMDR therapists. Alternative therapies like EMDR are usually at the dead-end of medical management, as most people would visit therapists after being disappointed with the results from their conventional treatments. Such patients should be dealt with the highest level of sensitivity by the therapist. The role of the EMDR therapist can be that of a savior for people who have lost all hope and struggling with their psychological and systemic illnesses.

Among the primary responsibilities of EMDR therapists are the following:

The first and foremost responsibility of an EMDR therapist is to do no harm and be as much beneficial in treating the given disorder as possible.
Recognize the patient’s present medical status in order to avoid exposing them to potentially dangerous therapies.
Listening to the patient’s needs and determining the treatment that would be most beneficial to them
Constantly assessing the client’s comfort level with the treatment being delivered
Discussing treatment plans with the patient and, if required, modifying them
Assessing the session with the customer following the conclusion of the therapy
Individualize treatment by providing a variety of options
Reading research on new medicines and staying current on medical advancements
Advising and recommending alternative treatments
Regular follow up with the patient to check the effectiveness of the specific EMDR method

FAQs

Is EMDR exposure therapy

No, EMDR therapy does not work on the principles of exposure therapy. Exposure therapy is a constituent of cognitive-behavioral therapy that involves the subject reliving a previous traumatic incident in order to overcome it. The therapist will ask the client to jot down or explain the painful events that occurred. The patient may be asked to name specific sights, sounds, and settings that they avoid as a result of the past experience and to score them according to their level of distress. The benefit of EMDR therapy is that the individual is not re-traumatized by recalling all the details of the trauma. EMDR therapy creates a learning condition in the brain that enables these experiences to be properly preserved. This is the primary distinction between exposure therapy and EMDR; the patient is not re-exposed to the trauma.

Does EMDR work for everyone?

There is no therapy that guarantees to be effective every time for everyone. EMDR is not a cure-all therapy. Certain research indicates that it may be useful in the treatment of trauma and some psychological disorders, whereas others put doubt on this. It is at least as successful as any other alternative treatment modality. In other words, EMDR therapy is simply another tool in a mental health professional’s toolbox. Therapists employ EMDR treatment to address a variety of issues: Panic attacks, stress and phobias, chronic Illnesses, Bipolar disorder and unipolar depression, disorders of dissociation and withdrawal, eating disorders, bereavement and loss, performance anxiety, challenges of personality, Post-traumatic stress disorder (PTSD) and other trauma- and stress-related conditions, mental rehabilitation of victims of sexual assault, sleep disorders, addiction, substance abuse and dependence on therapeutic drugs.

How to explain EMDR to clients

During trauma, our brain organizes and retains memories improperly. This faulty storage might lead to old memories feeling as if they are repeatedly occurring in the present. Related or unrelated triggers in the present can lead to patients responding as they did at the moment of trauma. In other words, the brain feels if the prior disturbing incident is happening currently.
EMDR therapy rectifies this improper storage of memories so that the painful memories linked with the trauma lose their impact. The patient can respond to stimuli in the present without the interference of the past.

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