Eye Movement Desensitization and Reprocessing (EMDR) is an interactive psychotherapy technique used to help alleviate trauma-related distress by encouraging patients to focus on past traumatic memories while simultaneously experiencing bilateral stimulation (usually eye movements). The goal of this treatment is a reduction in the vividness and emotional pain associated with these memories.
There are multiple approaches that one can take in the treatment of mental illnesses such as traditional psychodynamic therapies, CBT, exposure therapy, holistic therapies, and others. Some people even opt to be treated with medications. All these approaches have research in favor and against them. EMDR is a relatively new and “unorthodox” type of psychotherapy. It is considered nontraditional because it does not rely on talk therapy or medications like the more common psychotherapies do. Instead, EMDR approaches mental illnesses in an unusual way; through the patient’s own rapid, rhythmic eye movements.
Background of EMDR
EMDR therapy was developed initially in the late 1980s by Dr. Francine Shapiro, mainly for the treatment of post-traumatic stress disorder (PTSD). Unlike other forms of psychotherapy that aim to change behavioral patterns, emotions, and responses resulting from traumatic experiences, EMDR focuses directly on changing the memory of the event and how it is stored in the brain. Because your attention is diverted during an EMDR therapy session and your working memory is trying to process different things at once (usually the traumatic event and the movement in front of you) recollection of these traumatic events is often less emotionally disturbing and upsetting.
Applications of EMDR
Below are the more common conditions therapists treat with EMDR therapy.
Post-traumatic Stress Disorder
This is a mental health condition that is triggered by a past traumatic event or experience. Symptoms include flashbacks, nightmares, and anxiety that may be severe. EMDR therapy was initially developed for the treatment of PTSD. It is believed that because one is reliving distressing or traumatic experiences without experiencing a strong psychological response (due to the distraction), EMDR helps to lessen the impact of those memories.
EMDR is thought to be particularly effective in treating PTSD, compared to other mental illnesses, because it directly brings past (traumatic) memories and or events to the surface with an easy way to address them. EMDR is thought to be effective for people who have challenges in talking about their past. American Psychological Association conditionally recommends EMDR in the treatment of PTSD.
Depression
One of the most common mental illnesses, depression can be caused by trauma and other adverse life experiences. There have been several studies in which comorbid depressive symptoms were assessed in studies investigating EMDR treatment of participants diagnosed with PTSD. One study found EMDR more effective than antidepressants in reducing PTSD and depression symptoms. Another meta-analysis also determined that EMDR was more effective at reducing these comorbid depressive symptoms than CBT. However, there has not been an abundance of research to demonstrate the effectiveness of EMDR in treating major depressive disorder and therefore EMDR is not considered an evidenced-based approach due to the lack of adequate research trials.
Anxiety Disorders
EMDR has become a more popular treatment for panic disorder. Individuals who experience intense fear with physical symptoms of perceived threat may benefit from EMDR through the exploration of traumatic events that might be causing these fears. EMDR may allow you to gain a new perspective that can help facilitate a higher level of self-esteem and enhance your personal beliefs about your abilities and values.
Treatment Period
EMDR is a relatively short therapy method. This individual therapy usually consists of 2 sessions per week, that might be consecutive. The entire treatment usually lasts between 6 to 12 sessions. EMDR occurs in a structured eight-phase approach that includes history-taking, preparation, assessing the target memory, processing the memory, and evaluation of results.
Phase 1 – History Taking
This usually occurs during the first week of treatment. The therapist takes a psychosocial assessment of the client. This includes gathering the full history of the individual’s mental health and social well-being. The therapist will gather information regarding the client’s painful memories, events, and trauma from the past, while also identifying current stressors. The therapist will also work with the client here to identify the goals and targets for treatment.
Phase 2 – Preparation
The therapist will explain the process of the treatment to the client. He or she will introduce the client to the procedure that will be used, they will practice eye movement or other basic life support and mental exercises.
Phase 3 – Assessment of the Target Memory
The memory that is being targeted will be activated by the therapist. Two measures are used during EMDR therapy sessions to evaluate changes in emotion and cognition: the Subjective Units of Disturbance (SUD) scale and the Validity of Cognition (VOC) scale. While the individual describes the visual picture they have in their head during the stimulation, the therapist will ask them to identify the emotions that are associated with the picture, and then record responses using these measurements.
Phase 4 to 6 – Processing the Memory
This includes desensitizing the clients to these disturbing emotions, thereby helping them concentrate and increase the strengths of positive beliefs that have been identified in replacement to their original negative beliefs. After desensitization and installation of positive beliefs, the therapist will then do a body scan. Here, the client will be guided to bring back the original target event to mind, and see if there is any residual tension left. EMDR is not considered successful until the client can bring back the target memory without feeling tension or unease.
Phase 7 – Closure
This is used in ending the session. The client will make plans on how to keep the positive progress that they have made and habits after the treatment has ended.
Phase 8 – Evaluation
The therapist will discuss the goals once again and if it has been achieved. He or she will re-evaluate to compare the baseline to the current state of the client. The therapist will also discuss ways to cope with future or current stress.
Side Effects
EMDR is a relatively safe form of psychotherapy. Unlike prescription medications, which can usually have unexpected side effects, EMDR causes much fewer adverse reactions.
Lightheadedness, vivid dreams, an increase in distressing memories, or heightened emotions during sessions can occur.
In Conclusion
Although EMDR is relatively new compared to most other psychotherapy techniques, there has been mounting support among researchers and practitioners for its effectiveness in treating trauma and PTSD. According to the EMDR Institute, more than 30 controlled outcome studies on EMDR therapy have shown that it has positive effects.
Individuals who would like to know more about EMDR should speak to a mental health professional who specializes in the practice.
Sources
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- Admin. (2023, April 23). EMDR Institute. EMDR Institute – EYE MOVEMENT DESENSITIZATION AND REPROCESSING THERAPY. https://www.emdr.com/
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Adebolanle Ade is a Mental Health Social Worker and Registered Behavioral Technician. She has many years of experience writing and advocating for mental health awareness.