What IS EMDR Therapy?

EMDR treatment is a type of psychotherapy that helps people to heal from emotional distress that comes from disturbing life experiences.

EMDR therapy was developed by Dr. Francine Shapiro in the 1980s.1 Research shows that EMDR treatment gives people the benefits of therapy that used to take much more time to accomplish.2 In the past, it would take longer to treat emotional distress because language was the only way issues were addressed. EMDR therapy uses rhythmic eye movements, taps or tones to help people heal from psychological distress and trauma.

What Does EMDR Stand For?

EMDR stands for Eye Movement Desensitization and Reprocessing. It works mainly through the subconscious to effect change. By contrast, talk therapy relies on the conscious mind to effect change, which takes a lot longer in many cases.

How Does EMDR Work?

When we have a wound, our body works to close it. If something is lodged in the wound or it is injured again before healing, the wound can become painful and infected. Once these obstacles are removed, the wound heals.

EMDR therapy works much in the same way, but mentally. By nature, the brain’s information processing system moves toward mental wellbeing. If the system has blocks or imbalances due to disturbing experiences, the emotional wound remains open and irritated. This can cause profound distress and suffering. Once the block is removed, healing begins.

The procedures used in EMDR treatment training sessions by therapists help clients activate their brain and body’s natural healing system.

EMDR therapy is also based on the ancient Chinese energy system of chi. It is built upon the theory that chi becomes unbalanced by physical or emotional factors or trauma. EMDR treatment seeks to balance this system to reduce or eliminate the problems from these causes quickly.

How is EMDR Performed?

EMDR treatment is performed in eight stages and combines different methods and mechanisms to maximize its benefits. EMDR therapy targets the past, present, and future time periods.

  • Past: Disturbing memories and their related events from the past are identified.
  • Present: Current situations that are causing distress are identified.
  • Future: Skills and renewed attitudes needed to cause positive future actions are developed.

EMDR therapy addresses the past, present, and future within eight stages of treatment.

Phase 1: Background and History

The first stage sets the foundation for the different symptoms that need to be addressed. It also helps determine what the client needs to have a fulfilling future.

In the first phase, the therapist takes down the person’s past history. The therapist sees if the client has a willingness to change. A treatment plan is then developed.

The client and therapist work together to develop a list of possible areas to incorporate in EMDR treatment processing sessions. These areas can include:

  • Disturbing memories
  • Current situations causing emotional distress
  • Relevant incidents from the past
  • Developing specific skills and behaviors to deal with future situations

To address these target areas with EMDR treatment processing, childhood events may be the focus initially. This is done to see if problems in childhood are affecting the client’s life. Then, adult stresses are explored. As the client gains insight into the situation, emotional distress clears up, and behaviors change.

Phase 2: Preparation

The therapist makes sure the client has a few different ways of dealing with emotional distress. The client learns imagery and stress reduction techniques for handling negative emotions during and between EMDR treatments. One focus of EMDR therapy is to create quick, effective changes while the client stays balanced during and between sessions.

During EMDR treatment stages three to six, a target is identified and processed using EMDR therapy methods.

Phase 3: Assessment

The client identifies:

  1. A detailed image that is related to the memory
  2. A negative belief about oneself
  3. The emotions and body sensations related to the image and belief

Also, the client identifies a positive belief. The EMDR therapist helps the client grade the positive belief. The client also rates the severity of the negative emotions.

Phase 4: Desensitization

Next, the client is guided to concentrate on the image, negative thoughts, and physical sensations while also doing EMDR processing. It may use sets of sweeping eye movements, taps, or sounds. The type and length of these sets will vary by client. The client is asked to pay attention to what naturally happens.

After each set, the therapist asks the client to allow the mind to go blank. Then, the client is asked what thoughts, feelings, images, memories, or sensations pop into the mind. Depending on the client’s answers, the therapist chooses the next area of attention.

The sets of movements, taps, or sounds, along with directed attention, happen many times during the session. If the client experiences distress or finds it hard to get through the session, the therapist uses EMDR therapeutic procedures to help the client get back on track.

Phase 5: Installation

Once the client says there is no distress related to the targeted memory, the client is asked to think of the chosen positive belief that was identified at the start of the session. During this period, the client may change the positive belief if needed and then focus on it during the next set of upsetting events.

Phase 6: Body Scan

The sixth phase is a review of any past traumatic experiences that may be creating tension. If any tensions remain, the client and therapist continue to work on those specific targets to reprocess associated emotions.

Phase 7: Closure

During phase seven, the therapist asks the client to keep a journal. The journal should list any related material that may come up. The journal’s purpose is to remind the client of the imagery and stress reduction techniques that were learned in phase two.

Phase 8: Reevaluation

Phase eight reviews the progress that has been made. The therapist and client go over all the related past events, current incidents that cause upset, and future events that will need different responses.

What is An EMDR Session Like?

The amount of sessions someone will need depends on the person. Sessions can last an average of 60 to 90 minutes.

Brief sets of sweeping left to right eye movements, taps, or sounds are used for about 30 seconds. As this happens, the brain makes the necessary connections that change the memory into a learning experience and takes it to a resolution. New memories, emotions, and thoughts can appear.

As the person shifts through what comes up in the session, useful things are learned, and useless negative reactions, thoughts, and emotions are cast off.

Memories Arranged Chronologically

First, your therapist will ask you about your history. Then, once the memories that you want to target are identified, they will be arranged in chronological order.

One Memory at a Time

Each memory will be taken one at a time. During sweeping eye movements, tapping or tones, your therapist will discuss with you:

Let Your Mind Go Blank

After a memory has been recalled, you’ll be asked to let your mind go blank. You’ll be asked to describe the images, emotions, thoughts and physical sensations that arise. Depending on your feedback, your therapist may choose another image to work on or end the session.

You may feel a wide range of emotions as you process. That’s a sign that you are removing mental blocks, and EMDR therapy is working. You have created a safe space for your mind to heal and allow yourself to process the distress.

What is the image in your mind that relates to that memory?

What are the negative beliefs about yourself associated with that memory?

Describe how that memory makes you feel emotionally and physically.

What positive belief about yourself would you rather have associated with that memory?

Follow Up Sessions

In follow up sessions, you’ll review your traumatic memories and how you are handling them.

The EMDR therapy process is finished for a specific memory when it is no longer causing significant emotional distress. You’ll then keep a journal of any memories or feelings that may arise. Journaling memories and feelings helps provide closure. EMDR journaling also helps remind yourself of the techniques and coping mechanisms you created during therapy.

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More Details About EMDR Therapy

The Eye Movement Technique

The therapist rapidly moves her hand back and forth in front of the client’s face. The client moves just the eyes while tracking the hand’s movement. The client is instructed to think of the trauma.

After 20 or so hand movements, the client is directed to focus on the feelings, thoughts, or areas of the trauma that are at the forefront. Then the procedure is repeated for this new focus.

The problem is often easily resolved after just a few sessions compared to traditional therapy. Talk therapy can last for months or even years. However, EMDR may not work for everyone.

How REM Puts Distress in “Cold Storage”

EMDR therapy eye movements imitate the rapid eye movements (REM) that happen when an individual dreams. The eye movements during EMDR therapy are thought to reprocess the memory from short-term storage into long-term storage via REM. The result is a less emotional long-term memory. Rather than the memory feeling “fresh,” it’s remembered from “far away” with less emotional impact.

For many EMDR therapy clients, this shift quickly and effectively removes any negative blocks, reprocesses the information, and gives relief from the problem.

How Fast Does EMDR Therapy Work?

Generally, people with adult trauma from one event can be successfully treated in less than five hours.3 People experiencing multiple traumas may need longer treatment times. Long-lasting effects can be seen in only 5 to 8 weeks.

A research study compared people with PTSD who had EMDR therapy and those who did not. After 6 months:

75% of participants with adult trauma PTSD were free of PTSD symptoms in the EMDR therapy group.

And 0% of participants with adult trauma PTSD were free of PTSD symptoms in the group treated with just drugs.

Side Effects of EMDR

Since the therapist asks the client to remember distressing events that cause disturbances, EMDR therapy side effects may include:

A temporary increase in emotional distress and/or stress that can occur during or after a session.4

Unpleasant dreams that relate to the memories the client is processing. These dreams tend to stop after the processing is completed.

What Conditions Does EMDR Treat?

EMDR therapy is typically not a standalone treatment. An integrated approach is most effective. Other talk and behavioral therapies are needed for a successful recovery. With this in mind, the following is a review of how EMDR therapy can be integrated into treatment for certain mental health conditions:

Addiction Treatment

Much of the treatment for addiction involves addressing the underlying causes of a substance use disorder. EMDR therapy is one of the more promising treatments in this regard. Addictions can have many roots, and past trauma often plays a large part in an individual’s addiction. If trauma or anxiety contribute to a person’s substance use disorder, treating those conditions could also help in addiction recovery.

PTSD

PTSD can develop at any age. Combat veterans, abused children, and survivors of abuse, assaults, accidents, natural disasters, and other traumas can get PTSD. Some people develop PTSD from the sudden loss of a loved one. The National Center for PTSD reports:

About 7 to 8 out of every 100 Americans will have PTSD sometime in their lives.5

Approximately 8 million Americans have PTSD each year.

Approximately 10% of women develop PTSD at some point in their lives.

About 4% of men develop PTSD at some point in their lives.

The American Psychiatric Association, the Department of Veterans Affairs, the Department of Defense, and the World Health Organization all describe EMDR therapy as an effective trauma treatment.6

Research shows that EMDR therapy can significantly reduce the symptoms of PTSD. The reductions are long-lasting for most who undergo EMDR therapy.

Anxiety

Many people have anxiety that can come from bad experiences. The National Institute of Mental Health reports that:

About 19% of adult Americans had an anxiety disorder in the past year.7

More females (23.4%) had an anxiety disorder in the past year compared to males (14.3%).

Approximately 31% of Americans experience an anxiety disorder during their lives.

EMDR therapy has been shown to be effective in treating upsetting or painful life experiences that cause anxiety or trauma that is not PTSD-related.8

Trauma

Many people experience trauma. Research shows that almost 90% of Americans report exposure to at least one traumatic experience.9 Many in the study were exposed to more than one traumatic event.

Almost 30% of Americans have experienced sexual assault.

A little more than 53% experienced violent events including childhood physical abuse, physical assault, rape, and other sexual assault.

More than 43% of Americans have experienced physical assault.

Trauma can be devastating. Suffering through trauma can leave the person feeling helpless, fearful and out of control. EMDR therapy gives the power back to the client. A sense of emotional awareness that lets the person develop a more positive outlook can come from EMDR therapy. This renewed empowerment allows for a healthier and long-lasting recovery from trauma.

Is EMDR Therapy Right for You?

EMDR therapy carries a low risk of side effects. The potential benefits and rewards are high. When balanced, EMDR therapy has few downsides. Talk with your doctor or therapist about EMDR therapy. When EMDR therapy works, it can dramatically improve your quality of life.