EMDR stands for Eye Movement Desensitization and Reprocessing, a type of psychotherapy that was developed in the 1980s and used primarily as treatment for Post-Traumatic Stress Disorder (PTSD) in veterans. In the past 10 years, it has become a more widely used and discussed method. This therapy combines more familiar “talk therapy” or Cognitive Behavior Therapy (CBT) concepts and techniques with new methods that do sound a little strange. The “eye movement desensitization” involves the practitioner moving their finger, or an object, back and forth and having the patient follow this left to right pattern with their eyes.
Sounds weird, right?
A little like the hypnotist and the pocket watch, “…you are getting sleepy.” There might have been something to that trick called bilateral stimulation, which just means both sides of the brain are being stimulated, and this is what the EMDR therapist is doing.
When we are frightened our body goes into red alert, pouring the “flight or fight” hormones into our system. And, our thinking brain, the pre-frontal cortex, pretty much gets shuts off due to a flood of adrenaline or nor-epinephrine. It’s impossible to process the event calmly or logically at the time. So, those memories are tied to the panic and fear response. If we have not been able to emotionally and cognitively resolve and make sense of these events enough to recover, we are stuck in a memory = pain loop.
All the different components of that difficult, traumatic memory still live in our bodies–the emotional, cognitive, sensory, and physiological components, are so overwhelming they can be buried and yet still cause reactions. This is because the components have not been sorted, processed, and stored in a healthy way in our brains so that they no longer cause stress responses such as fear or anger from something that may trigger a memory. For example, the terror of a car accident that happened years ago may still trigger panic and terror just by getting into a car.
During EMDR therapy, along with eye movements, the therapist may tap your right and then left hand, or have you wear headphones and listen to tones that alternate from your right ear to your left ear. These methods serve to distract and calm the mind while you recall the upsetting events, leaving you more open to accepting the therapist’s suggestions of new positive ways of thinking and feeling going forward. This is the “reprocessing” which engages both sides of the brain.
The Therapy Program
EMDR therapy is broken down into eight different phases, and the entire treatment usually takes about 12 sessions. The goal is to break the association between past events and your negative symptoms. Each phase helps you work through emotional pain, then learn skills to better cope with current and future stress. Therapists have varying treatment models but here is the basic outline:
Phase 1 History and Treatment Planning
You and your therapist will go over your history and your current symptoms of distress. During this evaluation phase you will talk about your trauma and identifying potential traumatic memories to treat specifically.
Phase 2 Preparation
You will be taught stress management techniques such as mindfulness, meditation, breathing, or peaceful visualizations, that will help you cope with the stress of revisiting and discussing your trauma. These tools will also help you manage future stress, help reduce the effect of flooding from the fight or flight hormones and help you self-soothe.
Phases 3-7 Desensitization, Reprocessing
These sessions are where the hard work of sorting through specific traumatic memories occurs and discussion about how they make you feel emotionally as well as physically. In a safe environment and only when you are ready, a trained therapist will gently guide you to talk about how these events and your reactions to them make you feel about yourself, both negative and positive. You and your therapist will analyze the truth of your beliefs. The EMDR stimulation will be used during these discussions. The stimulation will be repeated again and again, different kinds, depending on whether you’re starting to feel positive physical sensations or you are still experiencing negative ones. Repetition is the key until you are no longer experiencing distress from your memory of the incident.
Phase 8 Evaluation
In the final phase, you’ll be asked to evaluate your progress after these sessions, and discuss the need for further treatment.
EMDR for Other Mental Health Conditions
While EMDR was initially used to treat trauma and PTSD, it is now being used to treat a variety of mental health conditions. It can be used on its own or in combination with other psychotherapy techniques (such as CBT). Some are finding it helpful for:
What the Researchers Say
There is some controversy among professionals about the therapy and how and why it works. The most common theory is that the eye movements or tapping serve as a distraction, and therefore create enough relaxation to allow for new thinking. Some offer the explanation that it is a synchronizing of the brain’s two hemispheres, or that the eye movements mimic the rapid eye movement of (REM) sleep and that opens the mind to desensitization and then integration.
A 2014 research study looked at 24 randomized controlled trials that did support the effectiveness of EMDR therapy for the treatment of trauma. The results of some of these studies suggested that EMDR therapy is more effective than CBT for trauma. More studies are being done, and organizations such as the World Health Organization (WHO), the American Psychological Association, and the Department of Veterans Affairs currently recommend EMDR as a treatment option for PTSD. More studies are being done to establish EMDR as effective treatment for many psychological disorders, including Obsessive Compulsive Disorder (OCD) which is not typically considered to be trauma based.
There are LOTS of videos online with people promoting themselves as EMDR therapists.
As with all treatments, it is essential to trust yourself to a well-qualified and respected practitioner–do ask questions and get recommendations. There are practitioners doing this therapy online this past year, and although not ideal, reports are that it is still effective.