Eye Movement Desensitization and Reprocessing Therapy (EMDR)

What Is EMDR Therapy?

EMDR therapy was developed as an individual therapy (provided by one therapist to one patient) specifically to treat post-traumatic stress disorder (PTSD) and associated traumatic memories. It has expanded to be used in the treatment of emotional symptoms tied to many different types of trauma, as well as mental health disorders with a trauma component.

EMDR therapy uses a structured approach to treatment, generally consisting of one to two sessions per week for a total of 8-12 sessions.

In EMDR, the aim is to help a person’s brain reprocess traumatic memories in a healthier way so that they can heal. It starts with at least one session where the therapist asks the patient important questions to understand their history. After this, the core sessions involve engaging the patient in unique eye movement patterns to change how the traumatic memory is stored in their brain, thereby reducing or eliminating problematic symptoms. During this process, the therapist guides the patient through a variety of instructions in which they review traumatic memories and work to shift their thinking into a more positive space.

The use of EMDR therapy is quite common, as the American Psychological Association has identified it as one of their recommended treatment approaches for traumatic stress (along with cognitive-behavioral therapies). The Department of Veterans Affairs and Department of Defense also lists EMDR as a “best practice” in treating PTSD in veterans.

The EMDR Therapy Process

EMDR therapy involves a high level of collaboration between the patient and the therapist and is a highly structured psychological treatment that consists of eight phases.

These phases include:

History-Taking And Treatment Planning

In the initial phase of EDMR treatment, the therapist gathers the patient’s complete history. Then, the therapist and patient work together to develop a treatment plan that identifies treatment targets. These targets might include goals, current triggers, or memories.

Preparation

During preparation, the therapist educates the patient on the EMDR process, including eye movement patterns, emotion management plans, and safe/calm place exercise protocol.

Assessment

In this phase, the target memory is activated. The images, emotions, and body sensations associated with the memory are identified and assessed.

Desensitization

In this fourth phase of treatment, the patient focuses on the target memory while doing certain eye movements as instructed by the therapist. This can involve the therapist moving their fingers in front of the patient’s face, light tapping on one’s shoulders, buzzers, music, a light bar, or another device to guide the patient to move their eyes from left to right and back rhythmically. This process may be used multiple times over several sessions until the patient no longer feels upsetting emotions around the target memory.

Installation

In this phase, the patient and therapist work to establish and strengthen positive emotions and thoughts around the target memory.

Body Scan

The patient is then instructed to notice their physical experience while thinking about the target memory. Any leftover physical stress or discomfort is addressed.

Closure

Closure techniques are used to end each EMDR therapy session so the patient can resume normal activities between sessions, even if the target memories have not yet been fully processed and healed.

Re-Evaluation

Each EMDR therapy session starts with this phase so that the therapist can assess the patient’s current emotional state and whether the work of the past session has been maintained. The therapist might also assess if new traumatic memories have been experienced or emerged, and what the goals are for the current session.

Why Is EMDR Therapy Used?

The goal of EMDR therapy is to help you cope with traumatic memories or experiences in a healthier, more functional way. EDMRs founder, Dr. Francine Shapiro, hypothesized that traumatic memories are stored in our brains differently than non-traumatic memories. Instead of networking memories together with other, similar memories, traumatic memories are stored in a way that disconnects them from other parts of your brain.

As such, effective healing from these traumatic memories becomes difficult. When healing does not happen, our brains do not understand that the danger (from the trauma) has passed. We are then stuck in a loop of traumatic memories (and possibly flashbacks, susceptibility to triggers, nightmares, etc) from which it is very difficult to heal.

EMDR therapy is an alternative to more traditional talking therapies (for example, cognitive-behavioral therapy). According to a review of EMDR studies published in The Permanente Journal,EDMR works faster and can be more effective than cognitive-behavioral therapy. It doesn’t require homework, so it can be done on consecutive days, which is different from other types of therapy.

Who Could Benefit From EMDR Therapy?

EMDR therapy was initially developed for people experiencing symptoms of PTSD. This could include combat veterans, people who experienced an assault or crime, or victims of accidents. Since it does not require detailed discussions of the traumatic event or memory, EMDR is a good option for people unwilling or unable to spend a lot of time talking about past traumas. Adults, adolescents, and children can benefit from EMDR.

Since its inception, EDMR’s use has expanded to include many different trauma-related concerns. It is intended to help shift negative emotions and reduce symptoms of stress, anxiety, and depression associated with traumatic events and deeply distressing circumstances. However, it is not used in conditions that are inherited or other mental or physical health conditions that do not relate to trauma.

What Conditions And Problems Does EMDR Treat?

Historically, EMDR has been used to treat PTSD. It can also be used to treat those suffering from PTSD-like symptoms, including:

• Flashbacks
• Nightmares
• Increased startle response
• Intrusive thoughts of the traumatic memory

Other traumatic events or circumstances that EMDR has been used to treat include:

• The grief of losing a loved one
• Coping with life-threatening diseases and their loved ones
• Burn victims
• Suffering from migraines or chronic pain

More recently, EMDR has been used to treat a wider variety of mental health disorders, including:

• Eating disorders
• Anxiety disorders
• Depression
• Dissociative disorders
• Obsessive-compulsive disorder (OCD)
• Body dysmorphic disorder
• Hoarding disorder
• Personality disorders

What Are The Advantages And Disadvantages Of EMDR?

EMDR therapy has several advantages over other types of psychological treatment.

• EMDR has been extensively studied and proven to be effective
• It does not involve as much talking as some other forms of psychological treatment, which is appealing to some patients
• Patients who use EMDR therapy sometimes report experiencing faster relief of symptoms than other forms of therapy
• EMDR does not typically require between-session assignments to be effective. The work of the therapy is done in the session
• EMDR is a structured therapy so that patients have a good idea of what to expect from each session, as well as how long the treatment will take

However, there are some disadvantages of EMDR therapy. For one, while EMDR has been used for 30+ years, it is still relatively new when compared to other forms of psychological treatment (for example, talk therapy). As such, not all therapists are trained in EMDR therapy, so finding one may require patience and extra effort.

How To Find A Therapist Who Specializes In EMDR

There are several therapist search tools that you can use to search specifically for a therapist in your area who is skilled in EMDR therapy. You could also ask your primary care provider or other trusted medical professional if they have EMDR referrals. Once you reach an EMDR therapist, you might ask the following questions:

• How often do you use EMDR techniques?
• Do you have experience working with people like me (similar age, gender, symptoms, diagnoses)?
• Are you taking new patients?
• Do you take my insurance plan (if this applies to you)?

If you or a loved one is interested in exploring EMDR therapy, a mental health professional can help you evaluate if it’s the right fit for you.

Getting Started With EMDR

EMDR therapy is an effective form of psychological treatment, particularly when used to treat trauma and symptoms of PTSD. Many who undergo EMDR treatment experience relief after just a few sessions

If you or a loved one could benefit from participating in EMDR, contact your doctor or reach out to a mental health provider to learn more.