What exactly is EMDR? 
Exactly, EMDR therapy stands for Eye Movement Desensitization and Reprocessing. It was developed by psychologist Francine Shapiro, PhD, almost 40 years ago. Since then, several forms of EMDR have been developed to address many areas of mental health and chronic pain.
Has EMDR Therapy been clinically studied?
Yes. EMDR Therapy has been clinically studied for over 30 years, studied across the world, and for many different populations, ages, cultures, and areas of focus. Most of the studies focus on the treatment of trauma and Post Traumatic Stress Disorder. It continues to be studied today. Based on these studies, EMDR has been approved by several organizations, including:
· The World Health Organization: recommends EMDR Therapy as one of the “top” forms of treatment for Post Traumatic Stress Disorder (PTSD), along with Cognitive Behavioral Therapy with a Focus on Trauma.
· U.S. Department of Veterans Affairs.
· The American Psychological Association (APA): determined indifferent results for EMDR, but that the benefits outweigh the harm over no treatment.
· Several organizations around the world recommend EMDR over or along with other approaches to therapy, per the U.S. Veterans Affairs.
How does it work?
EMDR Therapy is based on the theory of the Adaptive Information Processing (AIP) Model. Specifically, that our brains process information in a naturally healthy, adaptive, and integrative way. Information we learn from our life experiences is stored and used as a guide to help us make decisions, respond to situations appropriately, and obtain our wants and needs.
However, when a traumatic and/or distressing experience occurs, this information process system gets interrupted, and instead, the memory of the experience becomes stuck. All the sights, sounds, smells, emotions, physical sensations, and negative beliefs developed in that moment (i.e., I’m not safe) are stuck and unprocessed. This leads to repeated activation when reminded of that experience (aka, a trauma trigger). The AIP theory concurs with other leading therapeutic approaches, such as Somatic Experiencing and Nervous System Regulation theories by Bessal Van De Kolk, M.D., Peter Levine, PhD, and Stephen Porges, PhD.
It’s in this disruption that symptoms and reactions of PTSD, anxiety, depression, or other mental, emotional, and/or physical ailments develop if it remains in this unprocessed state. Symptoms continue to be reinforced by present reminders of past experiences.
EMDR Therapy uses specific techniques to identify where present symptoms stem from and process those experiences to neutrality. The process reduces overwhelming, triggering reactions. For some, significantly. Sometimes, no longer meeting a mental health diagnosis.
The process is an 8-phase protocol with the use of Bilateral Stimulation. The 8-phase approach is applied to each memory or experience that you and your therapist deem needed to reach healing. Not all memories need to be processed to reach that goal.
What is Bilateral Stimulation?
Bilateral Stimulation (BLS) is where the EM in EMDR Therapy gets its name, Eye Movement. It is the technique of alternating eye movements from side to side while processing the memory of focus. It has a dual purpose.
1. It engages both sides of the brain’s hemispheres to help naturally process and desensitize the memory until it reaches a state of neutrality.
2. It provides the ability to sustain what is called dual attention. The ability to tolerate processing of the memory without feeling as if one is in the past reliving the experience. Instead, ability to process with awareness of being in the present and safe place. This allows for Nervous System Regulation.
Eye movement is not the only form of BLS. Alternating taps and/or sounds are also used as forms of BLS.
What can I expect in an EMDR Session?
EMDR is an 8-Phase protocol. The phases are usually linear at the start of therapy, but it’s common to revert back and forth between phases as you move and progress in therapy.
Phase 1:
Usually occurs within the first 2 sessions of therapy. Your therapist will obtain your present complaints and full history, including family, medical, and psychiatric history. This allows your therapist to guide you effectively in sessions.
Phase 2: Usually occurs in your second or third session. Phase 2 is to assess resources, support, and/or coping tools that have been successful for you and introduce additional tools if needed. It’s important to assess a client’s ability to tolerate and regulate reactions to difficult experiences. Also, to help you feel open, safe, and confident to begin deeper trauma work. How many sessions this takes will differ with each client.
Phase 3 to 8: A typical EMDR session,
o Phase 3: Assess and activate the memory or experience of focus
o Phase 4: Process using eye movement bilateral stimulation (or other form of BLS) to desensitize triggered reactions to neutral or positive
o Phase 5: Identify positive belief, identify the believability of this new belief, and strengthen
o Phase 6: Scan the body as you focus on the memory and positive belief to process any further lingering sensations related to the experience.
o Phase 7: If a session does not reach completion of Phase 6, interventions will be applied to reduce any remaining activation at the end of session. This provides you safety and stability until the work can resume in your following session.
o Phase 8: Reevaluate the work from your previous session to determine if further processing is needed. If the memory continues to feel neutral, Phase 3 through 7 begins again, focusing on a different memory/experience.
Do I need to talk about my trauma in detail?
No. Your therapist will ask just a few questions to activate the memory, and you will then process the experience quietly and concurrently with bilateral stimulation. Your therapist will pause the BLS and ask for just 1 to 2 sentences about what is arising to guide you safely and appropriately, then return to processing with BLS. EMDR is most effective when your focus is on your internal experience with minimal disruption.
However, you can choose how much and how little you want to share.
What does EMDR Therapy treat?
EMDR Therapy was originally developed to treat trauma, specifically PTSD. It is now applied to many areas of mental and physical symptoms:
· PTSD, Complex PTSD, other forms of trauma
· Anxiety, Panic Attacks, OCD, Performance Anxiety
· Eating Disorders
· Alcohol and Substance Use, including reduction in Cravings, Urges, or processing experiences that led to use
· Grief, loss, including loss of a relationship, job, and other forms of loss
· Chronic pain
It can be especially effective when combined with Somatic Experiencing Interventions, Internal Family Systems, or Ego State Parts Work. It can strengthen a state of Nervous System Regulation. It does not have to be a stand-alone intervention.
How long can I expect to be in therapy with an EMDR approach?
Studies determined approximately 3 to 6 months; however, this may be the case for someone who has a single traumatic event. In my experience of providing therapy for more than 20 years (EMDR Therapy, specifically, for 12 years), the length of time in therapy cannot be predicted. Length of time will vary based on one’s history, severity of symptoms, and current level of support and/or coping tools. For example, someone who experienced a car accident usually will need a few months. Someone who has Complex PTSD will often need significantly more time.
Is EMDR Therapy safe or does it have side effects?
The purpose of phase 2 of the 8-Phase protocol is to develop coping tools, resources, and support to make sure a client feels safe to begin processing and minimize discomfort of emotions, sensations, or negative beliefs. For example, does nervous system regulation need to be discussed, practiced, and strengthened before deeper work? An effective EMDR therapist will work in collaboration and ask for permission from a client before proceeding.
Once coping tools are established, processing can continue between sessions.
Side effects of EMDR therapy between sessions can include:
· Emotional and physical fatigue
· Recall of other memories
· Emotional discomfort
· A dream the night of a session with content that resembles a memory of focus
Side effects also include:
· Improved emotional, physical, and mental regulation
· Improved self-compassion, understanding, and/or shift in perspective
· Reduction in symptoms
· A more adaptive belief of self (i.e., I’m not safe to I’m safe now).
What certifications should an EMDR therapist have?
In a previous blog, I addressed 5 questions to ask an EMDR Therapist. Click here for more information.
Where can I get more information?
· EMDR International Association: https://www.emdria.org/
· To watch a video for more information on what bilateral eye movement stimulation looks like, click here.
Are you ready to begin?
If you’re ready to take the next step of starting EMDR therapy and would like to learn more about my focus and experience, please contact me for a 20-minute free phone consultation.
Resources:
World Health Organization (WHO): https://www.who.int/news-room/fact-sheets/detail/post-traumatic-stress-disorder
US Veterans Affairs:
https://www.ptsd.va.gov/understand_tx/emdr.asp
American Psychological Association (APA):