What is EMDR?
What Is EMDR?
Eye movement desensitization and reprocessing (EMDR) therapy is a psychotherapy that uses rhythmic left-right (bilateral) stimulation to help people recover from trauma or other distressing life experiences.
Bilateral stimulation, along with focusing on the traumatic memory, is thought to reduce the memory's emotional impact. Then, you can begin to heal from the fear and pain associated with the trauma you experienced. Over time, exposure to these memories reduces or eliminates your negative response to them.
EMDR was initially developed in the late 1980s by psychologist Francine Shapiro to treat post-traumatic stress disorder (PTSD). As a therapeutic approach, EMDR is based on several theories of psychotherapy, including concepts of cognitive behavioral therapy (CBT).
"Unlike other forms of therapy that focus on changing the emotions, thoughts, and behaviors resulting from distressing experiences, EMDR therapy focuses directly on the specific memory to change the way it is stored in the brain."
What EMDR Can Help With
Originally designed to treat PTSD
EMDR is now used to treat a variety of mental health conditions, including:3
EMDR can be used on its own or in conjunction with other psychotherapy techniques (such as CBT) and medications.
Benefits of EMDR
The benefits of EMDR extend beyond PTSD and trauma resolution. Some potential benefits of this therapeutic approach include:
Changes negative thinking: EMDR can help you identify, challenge, and even change the negative thoughts cluttering your mind.
Decreases chronic pain: Research shows that bilateral stimulation activates the region of the brain associated with relaxation and comfortable feelings.4
Improves self-esteem: EMDR works by targeting distressing memories and negative thoughts associated with yourself. By identifying them, you learn how to process and heal from them.
Requires minimal talking: In EMDR, you don't have to divulge every detail of your painful experience like you would in talk therapy. This makes EMDR is particularly useful for people who have difficulty talking about their trauma.
Yields fast results: EMDR is classified as a brief-psychotherapy. While everyone's journey is different, 80% to 90% of people report positive results within their first three sessions.
According to the American Psychological Association (APA), EMDR therapy is effective for treating symptoms of PTSD.2 One small pilot study found that EMDR therapy was safe and effective in treating PTSD in people with a psychotic disorder.6 The treatment helped reduce symptoms of depression and anxiety as well as improving self-esteem.
A study published in 2017 compared the effectiveness of EMDR to CBT in treating the symptoms of panic disorder and improving patients' quality of life determined that EMDR is just as effective as CBT.7
In 2017, a review of published studies on the effectiveness of EMDR for treating trauma-associated symptoms in people with psychosis, unipolar depression, bipolar disorder, anxiety disorders, substance use disorders, and chronic back pain found that EMDR does improve symptoms.
The review also found evidence that EMDR may even help improve the other non-traumatic symptoms found in mood disorders and may be useful as an additional treatment for people who have chronic pain.
Treatment with EMDR can provide rapid relief. It even has the potential to help you begin to feel better after the first session. However, there is a great deal of variability in how individuals respond to EMDR.
EMDR is typically delivered one to two times a week for a total of six to 12 sessions by trained professionals who are qualified to deliver EMDR.
EMDR involves eight phases of treatment that focus on the past, the present, and the future. Each phase helps you work through emotional distress and trauma, then learn skills to cope with current and future stress.
Phase 1: History-Taking
The first phase involves getting your complete history. This could include discussing painful memories, events, or experiences from your past, as well as your current stresses. Based on your history, you and your therapist will develop a treatment plan that targets specific memories or incidents.
Phase 2: Preparation
During this phase, your therapist will help you learn some ways to deal with stress and anxiety, such as doing mental exercises.
Phase 3: Assessment
First, your therapist will have you select one of the targeted memories you selected in phase one. You'll identify several components of the targeted memory:
A vivid mental image related to the memory
A negative belief about yourself
Related emotions and body sensations
You'll also be asked to identify a positive belief about yourself related to the mental picture of the memory and rate this belief according to how true it is.
Phase 4: Desensitization
While you focused on the targeted memory, your therapist will lead you through stimulation sets. These sets may include eye movements, tactile taps, or auditory tones.
After each stimulation set, your therapist will instruct you to clear your mind and discuss any insights, thoughts, memories, feelings, or images that came to mind. If you're still experiencing negative sensations, they will become the focus of the next set. This process continues until the target memory no longer distresses you.
EMDR is designed to break any associations you have between certain memories and negative symptoms.
Phase 5: Installation
The fifth phase of EMDR strengthens the positive belief you identified in phase three. If you want to change your positive belief to something else, this is the time to do so.
When you aren't experiencing distress related to the target memory any longer, your therapist will ask you to focus on your positive belief. While thinking of the target memory and positive belief, your therapist will take you through more stimulation sets.
Phase 6: Body Scan
After you have strengthened your positive belief, your therapist will ask you to note if you have any sort of physical response while thinking of the target memory and the positive belief. The purpose of this is to identify any residual distress.
If you're still experiencing tension, your therapist will take you through more stimulation sets until it's resolved.
Phase 7: Closure
Closure is used to end every session. During this phase, you and your therapist will discuss the positive steps you've made and how to keep them going on a daily basis.
Your therapist may assign homework to help maintain progress between sessions. Typical homework assignments include:
Daily journaling that tracks your progress and the relaxation techniques you learn.
You may be encouraged to use imagery that allows you to picture what it would be like to gradually face your fears.
Self-help techniques, such as visualization, where you use your imagination to envision a peaceful environment.
Phase 8: Reevaluation
Every new session begins with reevaluation. You and your therapist will discuss your current psychological state and whether the treatment and self-relaxation techniques are working.
They will ask if any targeted memories have arisen since the previous session. At this point, you'll also determine if you need to work through other targeted memories you identified in phase one.
Prince Harry Speaks Out About His Experience with EMDR Therapy
EMDRIA Board President Wendy Byrd, LPC, LMFT who explains EMDR therapy and how it helps:
“Byrd encourages anyone with a painful memory to consider EMDR. [She says] “People feel like sometimes what happened to them isn’t big enough. They should just be able to get over it. … And that just breaks my heart because I know that they can feel better and that they do deserve to feel better,” she said. “I just wish that people knew that they could come in, we could figure out some of the things that are happening that are causing them pain and that it would be not that long of a journey before they could get some relief.”
In a new mental health documentary series with Oprah Winfrey, Prince Harry is seen undergoing a form of therapy known as EMDR (eye movement desensitisation and reprocessing) to treat unresolved anxiety stemming from the death of his mother, Diana, Princess of Wales, when he was 12.
How to Get Started
If you think you are someone you love would benefit from EMDR, consider the following steps:
Determine your personal preferences. When choosing a therapist, it's important to find someone you think you’ll work well with. Are you more comfortable working with a therapist of a specific age or gender identity? Do you prefer in-person or online therapy?
Seek a trained professional. EMDR is a specialized therapy that requires specific training. To find a qualified EMDR therapist, consider searching the EMDR International Association's website.
Ask about their specialty. Not all EMDR therapists specialize in every mental health condition. Many specialize in working with people with PTSD, for example. Before committing to a therapist, ask them what experience they have using EMDR with your particular problem.
Know what to expect. Your initial session may be similar to a doctor's appointment. This means you may need to fill out a variety of medical forms about your personal information, health insurance, medical history, and family medical history.
Things to Consider
EMDR is considered safe with relatively few side effects.6 Though it can be effective, there are some possible pitfalls of this approach:
Heightened awareness: You might experience a high level of emotion or physical sensation that lasts beyond your therapy session. Some people report experiencing unpleasant dreams while they begin to reprocess traumatic events.
Potential for retraumatization: If EMDR is not used appropriately, it can leave people feeling retraumatized.
Requires multiple sessions: It may take a while to see positive effects. For some, this may become a financial barrier.
Thinking about traumatic events can be distressing, particularly at the outset of therapy. Work with your therapist to find ways to cope with your feelings as you go forward with therapy.