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EMDR therapy: Everything you need to know

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Eye movement desensitization and reprocessing, or EMDR, is a technique that some psychotherapists use to treat people experiencing psychological distress.

Research suggests that EMDR is a relatively safe and effective therapy. Organizations such as the World Health Organization (WHO) and the American Psychiatric Association (APA) recommend it for people with post-traumatic stress disorder (PTSD).

In this article, we discuss the potential benefits of EMDR and look at the research behind it.

What is EMDR?


Therapists can use EMDR to help treat PTSD, anxiety, and phobias.

Francine Shapiro, an American psychologist, developed EMDR therapy in the late 1980s.

Practitioners initially used it to treat people with traumatic memories, but they now use it to treat a variety of disorders, including:

The therapy consists of eight phases. During the treatment, people recall traumatic experiences while moving their eyes back and forth. The therapist will direct this eye movement.

The aim is to allow people to process and integrate these traumatic memories into their standard memories. The theory behind this method is that remembering times of distress while distracted is less upsetting. Over time, exposure to these memories should reduce their effects.

EMDR is similar in some respects to cognitive behavioral therapy (CBT) — another PTSD treatment — as it involves remembering or discussing the traumatic event as well as identifying and altering the thoughts.

These processes are called exposure and cognition.

How it works

The theory behind EMDR is that traumatic memories make changes in the brain. These changes stop the mind from processing information properly, which causes anxiety and intrusive thoughts.

Experts believe that remembering the traumatic events while performing rapid eye movements allows the brain to process these memories correctly and integrate them into the story of the person's life.

The eight phases of EMDR therapy are as follows:

Phase 1: Client history and treatment planning

The therapist will evaluate the client's case, including their ability to tolerate exposure to distressing memories.

They will then formulate the treatment plan based on the person's symptoms and the behaviors that need modifying.

Phase 2: Preparation

The therapist will lay the groundwork for the treatment by establishing a therapeutic relationship with the client and educating them on EMDR.

They will also teach the person self-control techniques, which are ways to cope with distressing memories that arise.

Phase 3: Assessment

During this phase, the therapist will identify the traumatic memories that the client needs to address.

The client will then choose an image to represent each memory, noting the negative beliefs and physical sensations that accompany these memories. They will then identify a positive thought to replace the negative beliefs.

Phase 4: Desensitization

Desensitization involves reducing the client's disturbing reactions to the traumatic memory, including the physical sensations that they have when thinking of it.

Physical sensations may include a rapid heart rate, sweating, or stomach problems.

The therapist facilitates desensitization by directing the client's eye movements while they focus on the traumatic material.

Phase 5: Installation

The focus of this stage is on installing the positive thoughts that the client identified in phase 3.

Phase 6: Body scan

A body scan is a meditative technique in which a person scans their body from head to toe to notice the physical sensations that are occurring.

During EMDR, the therapist will target these physical sensations for further processing.

Phase 7: Closure

At the end of each session, the therapist will stabilize the client using the self-control techniques that they discussed in phase 2.

The therapist will explain what the client can expect between sessions. They will also ask the client to keep a record of any negative experiences that occur so that they can target them in the next meeting.

Phase 8: Reevaluation

The final phase involves a review of the effectiveness of the treatment so far. The therapist and client will also identify any additional traumatic effects to target.

Benefits


Studies suggest that EMDR can have positive effects.

Most of the research on EMDR looks at its benefits for people with PTSD and other trauma-related symptoms.

Research suggests that EMDR may also treat symptoms that accompany a traumatic experience, such as self-harm, stress, and anger.

However, practitioners use it to treat a variety of other conditions and issues, including:

  • addiction
  • anxiety
  • attention deficit hyperactivity disorder (ADHD)
  • chronic pain and phantom pain
  • depression
  • eating disorders
  • panic attacks
  • psychotic symptoms
  • self-esteem issues
  • stress-induced flare-ups of skin problems

Preliminary research supports its application for some of these issues, such as psychotic symptoms and chronic pain.

In some cases, people may choose to do EMDR alongside other treatment options for the best results.

Is EMDR effective?

According to the EMDR Institute, more than 30 controlled outcome studies on EMDR therapy have shown that it has positive effects.

In some of these studies, as many as 90% of trauma survivors appeared to have no PTSD symptoms after just three sessions.

Other studies that the EMDR Institute cite showed very positive outcomes for the majority of participants after six to 12 sessions.

Organizations such as the WHO, the APA, and the Department of Veterans Affairs currently recommend EMDR as a treatment option for PTSD.

A 2014 research study looked at 24 randomized controlled trials that 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.

Some research indicates that EMDR may be effective for other mental health issues. For example, it may have a positive effect on psychotic symptoms (in people with both psychosis and PTSD), such as:

  • hallucinations
  • delusions
  • anxiety
  • depression
  • self-esteem issues

Research also suggests that the benefits of EMDR persist over time. The authors of a small 2015 study reported that people who underwent EMDR treatment for depression were less likely than those in the control group to experience relapse or problems relating to depression in the year following treatment.

However, many of the studies on EMDR have small sample sizes and limited follow-up information.

As a result, several researchers have called for additional research into the treatment.

Side effects

Doctors generally consider EMDR therapy to be a safe treatment. It typically causes fewer adverse reactions than medications for depression and trauma symptoms.

Also, unlike some medications, EMDR may maintain its effectiveness after treatment ends.

Even so, EMDR and other forms of psychotherapy may cause some side effects, such as:

  • an increase in distressing memories
  • heightened emotions or physical sensations during sessions
  • lightheadedness
  • vivid dreams
  • the surfacing of new traumatic memories

These symptoms will typically resolve as treatment continues. Individuals should tell their therapist about their experiences between sessions so that they can work on new memories and symptoms in future sessions.

What to ask a doctor


A person should speak to a healthcare professional for more information about EMDR.

Individuals who would like to know more about EMDR should speak to a doctor or mental health professional who specializes in the practice.

Questions to ask include:

  • Do you have the appropriate training and credentials?
  • How many people with my particular issue have you treated using EMDR?
  • What is your success rate?
  • Do you keep up to date with the latest EMDR training and research?
  • Am I a candidate for EMDR?
  • How many sessions will I need?
  • How many sessions will we have before beginning EMDR therapy?
  • What will happen in each session?
  • Do treatment effects last over time?
  • What are the potential side effects?

Summary

Therapists have been using EMDR for more than 25 years to treat PTSD and other mental health conditions. A growing body of research suggests that it is effective and safe in reducing distress, anxiety, and other symptoms.

People who would like to know more about EMDR treatment should speak to their doctor or a licensed therapist.

Emdr therapy: Everything you need to know Your Psychology

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