Eye Movement Desensitization and Reprocessing (EMDR) therapy is a new psychotherapy method used to treat people’s past trauma — or the painful symptoms caused by distressing experiences. But unlike a regular psychotherapy treatment, the healing process with EMDR is much shorter. Plus, you don’t have to talk extensively about or relive your traumatic experiences.
What Is EMDR Therapy and How Does It Work?
EMDR therapy is a guided process in which you move your eyes toward the therapist's fingers (also known as lateral eye movement) while processing stressful memories. Some professionals use other sensory stimuli like hand, arms, lap-tapping and sound stimulation.
As our brain processes good and bad memories in distinct ways – it saves bad memories in such a traumatic form that it usually hinders healthy healing – while accessing and reprocessing the traumatic experience, you can repair mental wounds that may still linger. In this process, you recreate new experiences and replace the reminiscence of bad experiences with positive ones. In the end, this “allows the brain to resume its natural healing process,” says the EMDR International Association.
Dr. Francine Shapiro developed EMDR therapy in 1989, initially intending to help trauma victims with post-traumatic stress disorder (PTSD). The treatment leans on the Adaptive Information Processing (AIP) model, also by Shapiro, which is a theory that explains how EMDR therapy assists the brain in accessing and processing stressful memories.
The model follows a three-step protocol:
Processing of past traumatic events while connecting with “adaptive information” or new memory.
Targeting the present cause of distress while lessening triggers.
Envisioning future (positive) events to support the patient with adaptive skills.
Therapists have proven the benefits of EMDR therapy in over two dozen control studies, clinical trials and research papers. For instance, a study by HMO Kaiser Permanente showed that six 50-minute sessions helped 100 percent of single-trauma victims and 77 percent of multiple-trauma victims get rid of PTSD. Other studies have shown that three 90-minute sessions aided 84 to 90 percent of single-trauma victims to do away with PTSD, and 12 sessions helped 77 percent of military veterans become PTSD-free.
While EMDR therapy was initially created to support victims of trauma (including PTSD), nowadays, professionals use this method as a treatment for multiple conditions. Anxiety, depression, eating disorders, obsessive-compulsive disorders, dissociative disorders, personality disorders, substance abuse and sexual abuse are some of the most common examples.
But considering its methodic process, how does EMDR therapy work?
EMDR Therapy Eight-Phase Treatment
Each session of EMDR lasts between 60 to 90 minutes, and each phase may take up several sessions, depending on the severity of the trauma or distressing memories, for a total of 6 to 12 sessions. As a systematic approach, the therapist guides patients through eight stages of treatment: history taking, preparation, assessment, desensitization, installation, body scan, closure and reevaluation. Here is what happens in each phase.
Phase 1: History Taking
In this first step, you meet with the therapist to discuss your history with the issue, including patterns and symptoms. The therapist then develops a detailed plan, focusing on targets (disturbing memories, past harmful incidents, etc.) that are the condition's root.
Phase 2: Preparation
The clinician prepares you for the session by explaining symptoms and providing self-control techniques to ensure a smooth treatment session. Also, this is when they help you understand the trauma processing and set reasonable expectations for the entire treatment.
Phase 3: Assessment
In the third phase, you and your therapist choose a target memory to focus on during the specific session. The therapist directs you to find an image and negative beliefs that strongly connect with that memory. The clinician also suggests positive thoughts if appropriate to the target memory. They use the Validity of Cognition scale (VOC) and Subjective Units of Disturbance (SUD) scale as baseline measures. The goal is to comprehend to what degree a statement about target memory is true for you and the level of distress the stored memory causes — including physical sensations and emotions that lead to the traumatic memory.
Phase 4: Desensitization and Reprocessing
In this stage, the clinician instructs you to focus simultaneously on the target image and eye movement (bilateral stimulation) or other sensory stimulation. Next, they proceed with each set of eyes (or other stimuli), then ask you to take a breather and forget what you had just focused on. The clinician then helps you realize your feelings, thoughts and sensations about your experience. Then, based on your response, the professional may re-direct your focus or stimulation length, speed and type.
Phase 5: Installation
This is when the therapist instructs you to focus on the positive image you plan to incorporate. At this point, positive cognition should surpass negative one. In other words, the therapist works with you to raise your VOC score, which should be seven or above.
Phase 6: Body scan
The therapist asks you to scan your body to assist you with processing the particular body sensation. Again, the idea is to identify and address any leftover response caused by the tension of the traumatic event — in this case, the symptoms should subside as you go through the sessions.
Phase 7: Closure
In this phase, the therapist enlists the self-control techniques taught at the beginning of the session to stabilize yourself. They also prepare you on what to expect until the next session. Finally, they request that you maintain a log of possible distress as a potential target for future sessions. This also aids you in remembering the soothing activities learned in phase two.
Phase 8: Reevaluation
In this final stage, the therapist and you evaluate the treatment to ensure effectiveness and identify other targets for continued care, if necessary.
Why Is EMDR So Controversial?
Multiple organizations and agencies worldwide have been using EMDR therapy, including the U.S., U.K., Germany and Australia. The World Health Organization, the Department of Defense, the Department of Veteran Affairs, and the American Psychiatric Association are a few of many acknowledging EMDR's efficacy in treating trauma and distressing events.
Nevertheless, EMDR is still controversial among some healthcare professionals. Not necessarily because of its effectiveness; they know that EMDR works. Some studies even show that it works faster than most psychotherapy or other behavioral therapy types. Yet, there is still no comprehensive information on why the therapy works — the reason Shapiro devised the AIP model. Everything so far is primarily hypothetical.
Also, compared to other forms of mental health treatment, EMDR is relatively new, urging more research to understand its long-term efficacy.
So far, no studies have proven the dangers of EMDR therapy. And no side effect is attributed to the treatment, except for possible gloomy thoughts between sessions, which your therapist will help you deal with. Still, this treatment is only effective for conditions developed by some type of trauma — the reason it’s so effective for PTSD. So, in other words, if your disorder is due to a family history instead of a traumatic experience, it’s likely that this therapy won’t be a good fit for you.
Specialists recommend that you seek the help of a trained and licensed mental health provider to assess your need for this type of treatment or the one that best fits your situation.
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