Recovering from and getting over traumatic episode(s) can be a huge challenge with all the flashbacks, panic attacks, and hypervigilance in mundane settings.
Eye Movement Desensitization and Reprocessing (EMDR) is an interactive psychotherapeutic approach used to alleviate psychological distress. It is generally used as a treatment for trauma and post-traumatic stress disorder (PTSD).
How does EMDR work?
EMDR is based on the idea that negative and disabling thoughts, feelings, and behaviors result from unprocessed emotions and memories. The treatment involves standardized approaches that include focusing simultaneously on:
- instant associations of traumatic memories, including; thoughts, images, emotions, and bodily sensations, along with
- bilateral stimulation that is used most commonly in the form of repeated eye movements
An EMDR therapy session can last up to 90 minutes, once or twice a week, for a total of 6 to 12 sessions.
Your therapist may move their fingers in oscillatory motions (back and forth/ side to side) in front of your face and direct you to follow these hand motions with your eyes. Simultaneously, your therapist will have you recall the specific traumatic event, including the emotions and body sensations that go along with it.
Some therapists may also use various alternatives to finger movements, such as hand/toe-tapping or musical tones. Steadily, your therapist will guide you to shift your thoughts to pleasant ones.
EMDR is considered effective because recalling traumatic events is usually less emotionally upsetting or distressing when your attention is diverted. This allows you to be exposed to disabling memories or thoughts without having an intense psychological response.
Over time, this technique is believed to eventually lessen the impact of the memories or thoughts on you. (Davidson, P.R. and Parker, K.C., 2001)
Using EMDR To Treat PTSD
EMDR therapy uses a standard structured eight-phase approach that includes:
Phase 1: History And Comprehension
Your therapist will first evaluate your history and comprehend where you’re at in the treatment process. In this phase, the patient will have to explicitly open up their trauma as well as identify the intensity and other underlying potential traumatic memories and triggers. Your therapist will then map out treatment plans and goals that are essential for sequential processing.
Phase 2: Preparing The Client
Your therapist will provide you with an overview of the treatment plan. They will then explain in detail the reasons they think are causing your symptoms and how you can start learning different ways to process and cope with your trauma in a healthy way. They may teach you some self-control techniques such as deep breathing, mindfulness, progressive muscle relaxation, etc., that can help you reduce your anxiety and calm your mind.
Phase 3: Assessing The Target Memory
In this phase, you and your therapist will work together to assess the target memory that triggers emotional distress:
The incident that caused the trauma (Was it an accident, the death of a relative, or sexual assault?)
The most persistent image is associated with the memory.
How is the traumatic incident relevant to the present?
During this phase of EMDR treatment, a positive belief may be introduced (“You are not responsible for the incident or you are safe now”) to help counteract the negative emotions caused by the trauma.
(Phases 4-7: Processing The Memory To Adaptive Resolutions)
Phase 4: Desensitization
In phase 4, the traumatic event is evaluated rationally. Your therapist will try to encourage and help you to change the way your brain associates your trauma with its trigger.
You will be asked to focus on the memory that evokes a negative reaction while simultaneously making eye movements incorporating bilateral stimulation. The bilateral stimulation is conducted in a series of sets that usually last for about 25 seconds each. After each set, you will be instructed to take deep breaths and asked for your feedback on your experience during the preceding set.
Your therapist may adjust the type, length, and speed of stimulation used to direct your eye movement depending upon the intensity of your response to the trauma. (Korn, D.L., 2009)
Phase 5: Installation
Your therapist will guide you as to how to “install” a positive belief deep into your thought process and patterns, meaning they will help you strengthen the positive belief so that it replaces the negative one. For instance, if you were physically abused or assaulted as a child, you will be helped to realize that you are completely capable of resisting abuse as an adult.
This process will extend until your feelings of trauma reduce, and you experience more positive feelings after each set is completed.
Phase 6: Body Scan
Following the installation phase, your therapist will ask you to bring back the memory of the traumatic event to your mind to reevaluate it. The purpose of this is to help your therapist see whether the event elicits a somatic response such as raised pulse, blood pressure, or muscle tension; in other words, whether there is any residual trauma. If you continue to experience negative emotions related to the trauma, your therapist will extend the sessions of bilateral eye movements.
Phase 7: Closure
Closure is generally used to end the session. Suppose the targeted memory was not entirely processed in the session. In that case, your therapist will emphasize specific instructions and techniques, such as maintaining a record of any disturbances that occur between sessions and will also coach you on how to manage them effectively.
Phase 8: Evaluating Treatment Results
The next session begins with phase eight, that is, re-evaluation, during which your therapist will evaluate your current psychological state, whether treatment effects have been sustained, which memories may have emerged since the last session, and identify targets for the new session.
What Can You Expect Out Of EMDR Therapy Treatment?
EMDR is considered to be safe with fewer side effects as compared to those of prescription medication treatments.
However, there are certain side effects that you may experience, such as:
EMDR therapy can cause a heightened awareness of thinking which may not end immediately after a session ends. This can cause you to feel light-headed. It may also cause extremely vivid, realistic dreams.
It often takes several sessions of EMDR therapy to treat PTSD, meaning it doesn’t work overnight, and you will have to be patient, consistent, and committed.
Initially, the beginning of your treatment may be exceptionally triggering as you start to deal with traumatic events, especially as a result of the heightened focus caused by EMDR. While the treatment will likely be effective in the long run, it can be emotionally distressing to get through the course of treatment.
How Effective is it?
Since psychologist Francine Shapiro created EMDR in 1989, more than 20,000 practitioners have been trained to utilize it. Shapiro noticed that as her eyes wandered from side to side while wandering through the woods one day, her own unpleasant feelings faded. Then she discovered that patients had the same positive impact.
EMDR appears to be a risk-free treatment with no known adverse effects. Despite its growing popularity, mental health professionals continue to question EMDR's efficacy. Most EMDR studies have only had a tiny number of participants, according to critics. Other researchers, on the other hand, have published findings combining data from many trials to demonstrate the treatment's efficacy.
Just as psychotherapeutic approaches, the effectiveness of EMDR contradicts with the limited knowledge of its underlying mechanism of action. Due to its relatively short life as a psychotherapeutic option, EMDR has been a subject of controversy, particularly regarding the role of bilateral stimulation as the active component of the treatment.
People who use this approach argue that EMDR therapy can help weaken the effect and intensity of negative emotions.
Before and after each EMDR therapy session, your therapist may ask you to rate the level of distress you are experiencing. The goal is that your traumatic memories progressively become less disabling.
Although most research on EMDR treatment has examined its use on sufferers of PTSD, EMDR can sometimes be used experimentally to treat other psychological issues such as:
- Panic attacks
- Eating disorders
EMDR therapy has proven to be an effective approach in treating PTSD and trauma. It may also be able to help in the treatment of other mental conditions such as depression, anxiety, and panic disorders.
Some people may prefer this treatment compared to prescription medications, which can result in unexpected adverse effects. On the other hand, some may find that EMDR therapy boosts the effectiveness of their medications.
The efficacy of EMDR for PTSD is evaluated in "Eye movement desensitization and reprocessing (EMDR): Evaluation of controlled PTSD research." Journal of behavior therapy and experimental psychiatry (1996) by Shapiro and Francine.
A meta-analysis for EMDR is developed by Davidson, Paul R., and Kevin CH Parker in "Eye movement desensitization and reprocessing (EMDR): a meta-analysis." Journal of consulting and clinical psychology (2001).