Eye Movement Desensitization and Reprocessing (EMDR) Therapy

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Eye Movement Desensitization and Reprocessing (EMDR) Therapy

THC Editorial Team December 29, 2020
Textile Design with Alternating Stylized Flowers and Leaves, 1840, The Metropolitan Museum of Art (article on EMDR)
Textile Design with Alternating Stylized Flowers and Leaves, 1840, The Metropolitan Museum of Art

Contents

What Is EMDR?

Eye movement desensitization and reprocessing (EMDR) therapy is a form of psychotherapy. Its main goal is to help people directly access distressing memories and process any lingering trauma associated with them. EMDR was initially developed by Dr. Francine Shapiro in 1987 as a technique to treat posttraumatic stress disorder (PTSD), which may occur after people experience but fail to fully process trauma in situations such as military action, physical or sexual abuse, or serious accidents.1 Some people with PTSD may experience unpleasant physical sensations and extreme negative emotions when they think of unprocessed trauma related to such events, and accessing these stored memories can trigger symptoms of PTSD. Living day-to-day with the weight of potential triggers may be extremely stressful. Practitioners developed EMDR to help change the way memories are stored in the mind by reconsolidating their contents. This involves recalling those memories in order to attach a different emotive response, which helps reduce the effect the triggers and symptoms may have on an individual.

EMDR was founded on the notion that human minds have the ability to productively process stressful life experiences, and it offers a support structure to help people achieve that. Although practitioners continue to debate the merits of this fairly new form of therapy, many studies have proven its effectiveness among children and adults.

How Does EMDR Work?

Practitioners use EMDR not only with individuals who have experienced trauma but also with people who have problematic memories, beliefs, emotions, or bodily reminders related to any past event. This form of therapy is guided by an adaptive information processing model. EMDR works to desensitize emotionally charged memories and relink them to more positive ones.

The practitioner directs the client to undergo bilateral stimulation exercises of their body and mind, such as rapid lateral eye movements and successive tapping of specific points and/or other audio tones, while focusing on the traumatic memory to reduce its vividness and emotional impact.1,2 The eye movements are thought to help take away the power of the trauma. For some people, briefly reliving triggering events while their attention is diverted by the eye movements allows for a greater reveal of the suppressed thoughts or feelings that contribute to the emotive response when reminded of the trauma.3

What to Expect in EMDR Therapy

EMDR sessions may last as long as 2 hours, and a client will usually attend one to two sessions per week. Studies have shown that within 12 sessions, clients are able to emotionally distance themselves from their traumatic memories and critically analyze them instead of being overwhelmed by emotions.4 However, every client is different, and the number of necessary sessions may vary. EMDR relies primarily on dual forms of stimulation: eye movements and audio stimulation or vibrations. Before individuals are ready to undergo this treatment, certain crucial steps must be taken. Although each practitioner’s approach may differ, the following key steps are always included.

  1. Collecting personal history. Practitioners ask clients to discuss the trauma they have experienced and what they remember about it. Practitioners collect a full background history on the client and discuss the client’s therapeutic goals.
  2. Preparing clients mentally. Practitioners explain the procedure to their clients and have them practice the associated eye movements. Practitioners teach clients how to remain calm and feel safe while the treatment occurs. They note that clients may stop at any time and that it is up to each client decide how fast they want the therapy to proceed. Practitioners may also discuss additional resources clients may use to cope with any symptoms of traumas they have experienced.
  3. Identifying target memory. Practitioners will try to specifically identify which memory needs to be activated during the session. They will discuss the elements of the specific memory and how the visual, physical, and emotive sensations may affect the client.
  4. Processing the memory until resolution. The actual treatment occurs during this step. Clients will focus on the target memory and talk about it while they move their eyes as the practitioner instructs them. This process of combined actions helps alleviate trauma associated with the accessed memory by transforming it into a less distressing memory paired with new information. The specific tools practitioners use to disrupt the traumatic memory may vary. For instance, some may ask clients to track a blue light that moves from left to right in a light bar while they also hold a buzzer that sends gentle vibrations.
  5. Evaluating results. After a client reprocesses a memory, the practitioner evaluates the client’s mental state to determine whether the positive effects of the process were maintained post-intervention. If the client still experiences any form of trauma when they recall a particular memory, the practitioner will devise a plan for the next EMDR sessions.

Practitioners must have a valid license as a mental health care professional in order to conduct EMDR. They must also have a minimum of 2 years of experience in their original licensed field (e.g., if they received a PhD in clinical psychology, they must have worked as a clinical psychologist for at least 2 years). Additionally, practitioners must complete the EMDR International Association’s training program, at least 50 clinical sessions in which they use EMDR, and 20 hours of consultation in EMDR. Letters of recommendation are also required. These high standards ensure that practitioners are prepared to successfully administer EMDR.5

Effectiveness of EMDR

EMDR has been proven effective for the following conditions:4,6,7,8,9,10,11

  • low self-esteem
  • sexual dysfunction
  • trauma
  • anxiety
  • depression
  • sexual or physical abuse
  • stress management
  • grief
  • chronic pain

In a study conducted by researchers from the Netherlands, a team investigated whether EMDR could act as a stand-alone treatment for major depressive disorder. The research revealed a significant decrease in the study participants’ depressive symptoms, posttraumatic stress, anxiety, somatic issues, and social-emotional functioning. In this study, only six 1-hour sessions were required to reduce depressive symptoms among adolescents. The trauma-focused EMDR approach in the study was deemed safe and was associated with significant improvements in severe symptoms.5

EMDR may help improve the following mental health conditions and disorders:5,12,13,14,15,16

Depression is extremely prevalent, and research has shown that current treatment approaches, such as medication or psychotherapy, do not work for some clients. In response, a group of researchers initiated a study to investigate EMDR’s ability to treat depression among clients who experience recurrent or long-term depression. The researchers measured levels of depression before and after treatment and at follow-up appointments. They concluded that EMDR could be effective and useful in cases where first-line approaches, such as cognitive behavioral therapy or counseling, do not work.17

Here are a few ways to find an EMDR specialist:

  • Use the EMDR International Association website. The EMDR International Association, or EMDRIA, provides a wealth of information about EMDR therapy, EMDR communities, credible publications and resources, as well as an EMDR practitioner directory. Using the directory, you can call specialists in your area and ask whether they have available appointments, accept your insurance, and/or make provisions for people who do not have insurance.
  • Ask a professional you already know and trust. You can ask your physician, dentist, counselor, or even lawyer if they know about any local EMDR practitioners. Many psychotherapists work in private practices, and a trusted professional in your life may already be familiar with such networks and may be able to suggest a practitioner.
  • Ask friends or family if they know any practitioners. Other people in your life may know about EMDR and may be able to provide you with recommendations about which practitioners to contact.

References

  1. EMDR Institute. (2020). Francine Shapiro, Ph.D.Retrieved December 15, 2020, from
    https://www.emdr.com
  2. Christman, S. D., Garvey, K. J., Propper, R. E., & Phaneuf, K. A. (2003). Bilateral eye movements enhance the retrieval of episodic memories. Neuropsychology, 17(2), 221–229.
    https://doi.org/10.1037/0894-4105.17.2.221
  3. Jeffries, F. W., & Davis, P. (2012). What is the role of eye movements in eye movement desensitization and reprocessing (EMDR) for post-traumatic stress disorder (PTSD)? A review. Behavioural and Cognitive Psychotherapy,41(3), 290–300.
    https://doi.org/10.1017/s1352465812000793
  4. American Psychological Association. (2017, May). Eye movement desensitization and reprocessing (EMDR) therapy.
    http://apa.org/ptsd-guideline/treatments/eye-movement-reprocessing
  5. Jongh, A. D., & Broeke, E. T. (2009). EMDR and the anxiety disorders: Exploring the current status. Journal of EMDR Practice and Research,3(3), 133–140.
    https://doi.org/10.1891/1933-3196.3.3.133
  6. Griffioen, B. T., van der Vegt, A. A., de Groot, I. W., & de Jongh, A. (2017, November). The effect of EMDR and CBT on low self-esteem in a general psychiatric population: A randomized controlled trial. Frontiers in Psychology, 8, 1910.
    https://doi.org/10.3389/fpsyg.2017.01910
  7. Cotter, P., Meysner, L., & Lee, C. W. (2017). Participant experiences of eye movement desensitisation and reprocessing vs. cognitive behavioural therapy for grief: Similarities and differences. European Journal of Psychotraumatology, 8(1).
    https://doi.org/10.1080/20008198.2017.1375838
  8. Chen, R., Gillespie, A., Zhao, Y., Xi, Y., Ren, Y., & McLean, L. (2018, April). The efficacy of eye movement desensitization and reprocessing in children and adults who have experienced complex childhood trauma: A systematic review of randomized controlled trials. Frontiers in Psychology, 9, 534.
    https://doi.org/10.3389/fpsyg.2018.00534
  9. Perlini, C., Donisi, V., Rossetti, M. G., Moltrasio, C., Bellani, M., & Brambilla, P. (2020). The potential role of EMDR on trauma in affective disorders: A narrative review. Journal of Affective Disorders, 269, 1–11.
    https://doi.org/10.1016/j.jad.2020.03.001
  10. Imširović, F., & Hasanović, M. (2018). Application of EMDR in the treatment of sexual dysfunctionality after hysterectomy—A case report. Psychiatria Danubina, 30(Suppl. 5), 297–301.
  11. Paauw, C., de Roos, C., Tummers, J., de Jongh, A., & Dingemans, A. (2019). Effectiveness of trauma-focused treatment for adolescents with major depressive disorder. European Journal of Psychotraumatology, 10(1).
    https://doi.org/10.1080/20008198.2019.1682931
  12. Jongh, A. D., & Broeke, E. T. (2007). Treatment of specific phobias with EMDR: Conceptualization and strategies for the selection of appropriate memories. Journal of EMDR Practice and Research,1(1), 46–56.
    https://doi.org/10.1891/1933-3196.1.1.46
  13. Schubert, S., & Lee, C. W. (2009). Adult PTSD and its treatment with EMDR: A review of controversies, evidence, and theoretical knowledge. Journal of EMDR Practice and Research, 3(3), 117–132.
    https://doi.org/10.1891/1933-3196.3.3.117
  14. Shapiro, F. (2009). EMDR solutions II—For depression, eating disorders, performance, and more. W. W. Norton.
  15. Shapiro, F. (2007). EMDR, adaptive information processing, and case conceptualization. Journal of EMDR Practice and Research, 1(2), 68–87.
    https://doi.org/10.1891/1933-3196.1.2.68
  16. EMDR International Association. (2020, July 22).EMDR practitioners.
    https://www.emdria.org/find-a-therapist/
  17. Wood, E., Ricketts, T., & Parry, G. (2018). EMDR as a treatment for long-term depression: A feasibility study. Psychology and Psychotherapy, 91(1), 63–78.
    https://doi.org/10.1111/papt.12145

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