Eye Movement Desensitization and Reprocessing (EMDR) Defined

emdr

There are multiple approaches that one can take in treatment of mental illnesses. From psychodynamic therapies, to behavioral, cognitive, and or holistic therapies. Some people even opt to be treated with medications. All these approaches have research for and against them. Eye movement desensitization and reprocessing, also known as EMDR, is a fairly new and “unorthodox” type of psychotherapy. According to WebMD, this form of therapy is considered unorthodox or nontraditional because it does not rely on talk therapy or medications like the common psychotherapies do. Instead, EMDR approaches mental illnesses in an unusual way, usually through the patient’s own rapid, rhythmic eye movements.

Definition

Eye Movement Desensitization and Reprocessing is a form of interactive psychotherapy technique used to help alleviate stress by encouraging patients to focus on past trauma memory while simultaneously experiencing bilateral stimulation (usually eye movements) which is associated with a reduction in the vividness and emotion associated with the trauma memories.

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. The aim is to therefore eliminate the problematic symptoms. 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 are often less emotional and or upsetting.

Diagnoses Associated

Post -traumatic stress disorder– This is a mental health condition that is triggered by a past traumatic event or experience. Symptoms includes flashbacks, nightmares and anxiety that maybe severe. EMDR therapy was initially developed for the treatment of PTSD . It is believed that because one is reliving distressing or traumatic experiences while without experiencing strong psychological response (due to the distraction), EMDR helps to lessen the impact of those memories. EMDR is thought to be particularly most 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 it. EMDR is thought to be effective for people who have challenges in talking about their past. American Psychological Association conditionally recommends  EMDR in treatment of PTSD.

Depression – This mood disorder is one of the most common mental illnesses in America.  According to the Center for Disease Control and Prevention, 8.1% of American adults aged 20 and over had depression in a given 2-week period during 2013–2016. Like PTSD, depression can be caused by trauma and other adverse life experiences, hence the need for some researchers like Hase et al., (2015), to study how EMDR can alleviate mood disorders. There have been several studies in which comorbid depressive symptoms were assessed in studies investigating EMDR treatment of participants diagnosed with PTSD. Van der Kolk et al. (2007) for example, in a randomized controlled trial, found EMDR more effective than antidepressants in reducing PTSD and depression symptoms. A meta-analysis by Ho and Lee (2012) also determined that EMDR was more effective at reducing these comorbid depressive symptoms than CBT. There has not been an abundance of  research to demonstrate  the effectiveness of EMDR in treating Major Depressive Disorder; EMDR is not considered an evidenced-based approach due to the lack of adequate research trials. Individuals with co-occurring depressive symptoms with PTSD might find EMDR more effective.

Anxiety Disorders– EMDR has become a more popular treatment for panic disorder. Individuals who experience intense fear with physical symptoms on perceived threat may benefit from EMDR through exploration of traumatic events that might be causing these fears. EMDR may allow you 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 can last usually between 6 to 12 sessions. EMDR occurs in a structure 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 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 and/or other basic life support and mental exercises.

Phase 3 – Assessment of the target memory

Here, the memory that is being targeted will be activated. 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 is associated with the picture, then record responses using these measurements.

Phase 4 to 6 – Processing the memory

This includes desensitizing the clients to these disturbing emotions.  Helping client concentrate and increase the strengths of positive beliefs that that have 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, seeing if there are any residual tension left. EMDR is not considered successful until the client is able to bring back target memory without feeling of tension or unease.

Phase 7 – Closure

This is used in ending the session. Client will make plans on how to keep the positive progress that they have made and habit 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 in order to compare baseline to the current state of the client. 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 reaction.

Lightheadedness, vivid dreams, an increase in distressing memories, or heightened emotions during sessions can occur.

Conclusion

Although, EMDR is relatively new compared to most other psychotherapy techniques, there has been quite a number of positive supports for it 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.


Adebolanle A.I. is a Mental Health Social Worker and Registered Behavioral Technician. She has many years of experience writing and advocating for mental health awareness. She runs a mental health and lifestyle website, where she shares tools to help individuals work through daily life challenges.