Eye Movement Desensitisation and Reprocessing (EMDR) is a form of psychotherapy, introduced in the late 20th century by Francine Shapiro. EMDR stands as an innovative psychotherapy technique that uses eye movements or other forms of bilateral stimulation techniques in order to help the individual to process traumatic memories or experiences.
EMDR therapy is based on the idea that traumatic experiences can cause disruptions in the normal memory processing, leading to the development of symptoms of mental illness, such as PTSD.
What Conditions Can be Treated with EMDR Therapy?
Although EMDR therapy is most frequently used to treat post-traumatic stress disorder (PTSD), its application has also proven successful for treating other conditions such as:
- Anxiety disorders
- Panic attacks
- Phobias
- Obsessive-compulsive disorder (OCD)
- Depression
- Unresolved grief
- Chronic stress
- Performance anxiety
- Dissociative disorders
- Substance use disorder
- Personality disorders
How EMDR Therapy Works?
EMDR has proven to be an effective method to treat those exposed to traumatic events. It often reduces trauma symptoms as it allows the brain to reprocess painful memories without experiencing unpleasant symptoms when they are recalled. This therapy is based on the idea that it mimics the natural process of memory consolidation that occurs during REM (rapid eye movement) sleep, which is thought to facilitate the brain’s processing of traumatic memories without causing harm to the individual.
EMDR therapy works by targeting both emotional and cognitive aspects of traumatic memories. It is based on the Adaptive Information Processing (AIP) model, which suggests that psychological traumas can heal themselves much like physical injuries do. Here’s a step-by-step breakdown of the EMDR therapy process:
The Eight Phases of EMDR Therapy
EMDR therapy uses a structured eight-phase approach:
Phase 1: History and Treatment Planning:
In this phase, the therapist gathers information about the client’s history and identifies potential target memories for EMDR therapy. They then create a personalized treatment plan based on individual client needs.
Phase 2: Preparation:
The therapist helps the client develop coping mechanisms and self-soothing techniques to manage the emotional distress that may arise during the EMDR sessions.
Phase 3: Assessment:
Both therapist and client identify specific aspects of the target memory, such as images, emotions, and physical sensations. The client also identifies a positive belief they would like to hold about themselves in relation to the memory.
Phase 4: Desensitisation:
The client focuses on the target memory while engaging in bilateral stimulation. The therapist guides the client through several sets of stimulation until the emotional distress associated with the memory is reduced.
Phase 5: Installation:
The therapist helps the client strengthen the positive belief identified in the assessment phase and reinforce them by using bilateral stimulation techniques.
Phase 6: Body Scan:
The client scans their body for any residual physical sensations related to the target memory. If any discomfort remains, the therapist uses bilateral stimulation in order to address these sensations.
Phase 7: Closure:
The session ends with the client using the self-soothing techniques developed in the preparation phase to ensure they leave the session feeling calm and safe.
Phase 8: Re-evaluation:
At the beginning of each subsequent session, both therapist and client review the progress made in previous sessions and determine if additional EMDR sessions are needed.
EMDR and PTSD
EMDR therapy has proven highly successful at treating PTSD, a condition that develops following exposure to traumatic events, such as natural disasters, accidents, or violence. EMDR helps with PTSD by:
- Targeting the specific memories and emotions associated with the trauma
- Aiding the brain in processing and integrating these memories
- Reducing distressing emotions and physical sensations associated with the traumatic memories
The science behind EMDR therapy as a treatment for PTSD is not fully understood, but it is believed that the bilateral stimulation used in the therapy helps to activate the brain’s natural healing processes. This can lead to a reduction in the intensity of traumatic memories and improvement of mental health symptoms.
How EMDR Works for PTSD?
EMDR is an effective treatment for PTSD because it addresses various aspects of the disorder.
(1) Desensitising Traumatic Memories: EMDR helps the brain in processing traumatic memories more efficiently, lessening their emotional impact. As a result, clients experience less intense fight, flight, freeze or fawn responses.
(2) Accurate Time and Place Orientation: EMDR therapy helps clients to recognize that traumatic events have already passed; with improved time-place orientation, the brain can distinguish between past and present events more readily, reducing anxiety and distress.
(3) Engaging the Upper Cortex: By activating the upper cortex, the rational part of the brain, EMDR allows clients to think more accurately about their experiences. This process helps to unlink irrational thoughts and cognitive distortions associated with PTSD, such as feelings of guilt or worthlessness.
(4) Reducing Vividness and Intensity: EMDR therapy can reduce the vividness and intensity of visual or other stimuli related to traumatic memories. This decrease in sensory stimulation can provide a relief from anxiety and distress associated with PTSD.
(5) Activating the Parasympathetic Nervous System: EMDR helps activate the parasympathetic nervous system, which is responsible for the “rest and digest” state. This activation helps the body return to a more balanced state, leading to physical healing and emotional wellbeing.
Is EMDR Effective for Treating PTSD?
Numerous studies have demonstrated the efficacy of EMDR therapy for treating trauma-related mental illnesses, specifically PTSD. According to the American Psychological Association (APA), EMDR is considered an evidence-based treatment for PTSD. The World Health Organization (WHO) also recommends EMDR as a first-line treatment for trauma-related disorders.
How EMDR Differs from Traditional Therapy?
EMDR therapy stands out among other therapies in various ways.
(1) Dual Attention Stimuli (DAS): EMDR uses dual attention stimuli, which involves focusing on an external stimulus while simultaneously recalling distressing memories. This process helps desensitize traumatic content, reducing the severity of PTSD symptoms like flashbacks, nightmares, and hypervigilance.
(2) Short-Term Treatment: Unlike traditional talk therapies, EMDR does not require clients to share detailed accounts of their traumatic experiences. As a result, the treatment is often short-term, with many clients experiencing positive effects after just a few sessions.
Potential Challenges of EMDR Therapy
(1) Emotional Discomfort and Distress: When engaging in EMDR therapy, clients are required to confront and focus on painful memories and beliefs, which can cause emotional discomfort and distress. Although these feelings are generally short-lived and improve as therapy progresses, it’s vital for individuals to brace themselves for potential emotional turbulence during treatment.
(2) Flashbacks and Nightmares: EMDR therapy may temporarily increase the frequency of flashbacks and nightmares in some cases. However, this usually indicates that the therapy is effective and helping the individual process their traumatic memories.
(3) False Memories: As EMDR therapy involves recalling and processing traumatic events, it may occasionally lead to the formation of false memories. This is a rare occurrence, and working with a skilled and experienced EMDR therapist can significantly minimize the risk.
(4) Physical Reactions: Individuals participating in EMDR therapy may experience temporary discomforts such as such as headaches, dizziness, or nausea. These side effects are typically short-lived and subside as therapy progresses.
Advantages of EMDR Therapy
Despite the potential challenges, EMDR therapy offers several benefits that often outweigh the risks.
(1) Effective Treatment for Mental Health Disorders: EMDR therapy has proven highly effective in reducing symptoms associated with mental health disorders, especially PTSD. Many individuals have experienced relief through this therapy approach, making it a desirable choice for those seeking treatment.
(2) Comparing EMDR to Other Therapies: Research shows that EMDR therapy is as effective as other therapeutic methods, such as cognitive-behavioural therapy (CBT). In some instances, EMDR therapy may even be more effective, depending on the individual and their specific needs.
(3) Personalized Treatment Approach: EMDR therapy is highly adaptable that allows therapists to customise treatment to the client’s unique experiences and requirements. This personalized approach can lead to more successful results and long-term improvements in mental health.
What to Expect in EMDR Therapy?
An EMDR therapy session typically lasts for up to 90 minutes, during which the therapist uses specific techniques to help clients address and overcome distressing memories. One such method involves the therapist waving their fingers from side to side in front of the client’s face, while the client’s eyes follow the movement. Simultaneously, the client is asked to recall a distressing event, including any related emotions and physical sensations.
As the session progresses, the therapist will gradually guide the client towards more uplifting and positive thoughts. Some EMDR therapists may uses an alternative approach as opposed to finger movements, such as tapping hands or feet, or EMDR specific audio tones.
To assess progress, therapists will ask clients to evaluate their levels of distress both before and after each session. The primary objective is to lessen the disabling effects of these distressing memories on the client’s life.
During EMDR therapy, clients can expect:
- A supportive and non-judgmental therapeutic environment
- An initial assessment to determine the appropriateness of EMDR therapy
- A structured treatment approach that follows the eight phases of EMDR therapy
- Bilateral stimulation in the form of eye movements, tapping, or audio tones
- Regular progress evaluations to ensure the effectiveness of the treatment
FAQs:
Is EMDR therapy suitable for everyone?
EMDR therapy is not suitable for everyone. Individuals with certain medical conditions, such as epilepsy or severe dissociative disorders, may not be suitable candidates. A trained EMDR therapist will assess your suitability for treatment during the initial consultation.
Is EMDR therapy safe?
Yes, EMDR therapy is considered safe and has been extensively researched. It is a non-invasive treatment that does not require the use of medication.
How long does EMDR therapy take?
The length of EMDR therapy varies depending on the individual’s needs and the complexity of their trauma. Some clients may experience significant improvement in just a few sessions, while others may require more extended treatment.
Is EMDR therapy only for PTSD?
No, EMDR therapy has been found to be effective in treating a variety of mental health conditions, including anxiety disorders, depression, phobias, and more.
Can EMDR therapy be used alongside other treatments?
Yes, EMDR therapy can be used in conjunction with other evidence-based treatments, such as cognitive-behavioural therapy or medication, to address a client’s specific needs.
If you feel that you would benefit from EMDR treatment, please contact Cause Effect Psychology and request an appointment with Mr Umesh Shah via 07 3207 1851 or info@cepsychology.com.au
Author: Cause Effect Psychologist
References:
American Psychological Association. (2017). Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder (PTSD) in Adults. Retrieved from https://www.apa.org/ptsd-guideline/ptsd.pdf
Bisson, J. I., Ehlers, A., Matthews, R., Pilling, S., Richards, D., & Turner, S. (2007). Psychological treatments for chronic post-traumatic stress disorder: systematic review and meta-analysis. The British Journal of Psychiatry, 190(2), 97-104.
Lee, C. W., & Cuijpers, P. (2013). A meta-analysis of the contribution of eye movements in processing emotional memories. Journal of Behavior Therapy and Experimental Psychiatry, 44(2), 231-239.
National Institute for Health and Care Excellence. (2018). Post-traumatic stress disorder. Retrieved from https://www.nice.org.uk/guidance/ng116/chapter/Recommendations#eye-movement-desensitisation-and-reprocessing-emdr-for-post-traumatic-stress-disorder-ptsd
Seidler, G. H., & Wagner, F. E. (2006). Comparing the efficacy of EMDR and trauma-focused cognitive-behavioral therapy in the treatment of PTSD: a meta-analytic study. Psychological Medicine, 36(11), 1515-1522.
Shapiro, F. (2001). Eye Movement Desensitization and Reprocessing (EMDR): Basic Principles, Protocols, and Procedures (2nd ed.). Guilford Press.
Shapiro, F. (2014). The role of eye movement desensitization and reprocessing (EMDR) therapy in medicine: addressing the psychological and physical symptoms stemming from adverse life experiences. The Permanente Journal, 18(1), 71-77.
U.S. Department of Veterans Affairs. (2021, April 13). Eye Movement Desensitization and Reprocessing (EMDR) for PTSD. Retrieved from https://www.ptsd.va.gov/understand_tx/emdr.asp
van der Kolk, B. A., Spinazzola, J., Blaustein, M. E., Hopper, J. W., Hopper, E. K., Korn, D. L., & Simpson, W. B. (2007). A randomized clinical trial of eye movement desensitization and reprocessing (EMDR), fluoxetine, and pill placebo in the treatment of posttraumatic stress disorder: treatment effects and long-term maintenance. Journal of Clinical Psychiatry, 68(1), 37-46.
World Health Organization. (2013). Guidelines for the management of conditions specifically related to stress. Retrieved from https://apps.who.int/iris/bitstream/handle/10665/85119/9789241505406_eng.pdf