Understanding EMDR Therapy: Definition and Effectiveness of Treatment
Eye Movement Desensitization and Reprocessing (EMDR) therapy is a new psychotherapy method used to treat people’s past traumas—or the painful symptoms caused by distressing experiences. But unlike regular psychotherapy treatment, the healing process with EMDR is much shorter. Also, you don’t have to talk at length or relive your traumatic experiences.
What is EMDR therapy and how does it work?
EMDR therapy is a guided process where you move your eyes to the therapist’s fingers (also known as lateral eye movement) while processing stressful memories. Some professionals use other sensory stimuli such as hands, arms, patting on the lap and sound stimulation.
Like ours the brain processes good and bad memories in different ways – stores bad memories in such a traumatic form that it usually prevents healthy healing – as you access and process the traumatic experience, you can repair emotional wounds that may still remain. In this process, you recreate new experiences and replace memories of bad experiences with positive ones. Ultimately, this “allows the brain to resume its natural healing process,” says The International EMDR Association.
Dr. Francine Shapiro developed EMDR therapy in 1989, initially intending to help trauma victims with post-traumatic stress disorder (PTSD). The treatment is based on the Adaptive Information Processing (AIP) model, also by Shapiro, which is a theory that explains how EMDR therapy helps the brain in accessing and processing stressful memories.
The pattern follows a three-step protocol:
- Processing past traumatic events in association with “adaptive information” or new memory.
- Targeting the current cause of distress while reducing triggers.
- Anticipating 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 scientific articles. For example, 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 helped 84 to 90 percent of single-trauma victims eliminate PTSD, and 12 sessions helped 77 percent of military veterans become PTSD-free.
While EMDR therapy was originally created to help victims of trauma (including PTSD), today practitioners use this method as treatment of multiple conditions. Anxietydepression, eating disordersobsessive-compulsive disorders, dissociative disorders, personality disorders, substance abuse, and sexual abuse are some of the most common examples.
But given its methodical process, how does EMDR therapy work?
EMDR Therapy Eight Phase Treatment
Each EMDR session lasts between 60 and 90 minutes, and each phase may take 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 reassessment. Here’s what happens in each phase.
Phase 1: History taking
In this first step, you meet with the therapist to discuss your history of the problem, including patterns and symptoms. The therapist then develops a detailed plan, focusing on targets (disturbing memories, past harmful incidents, etc.) that are at the root of the condition.
Phase 2: Preparation
The clinician prepares you for the session by explaining symptoms and providing self-management techniques to ensure a smooth treatment. Also, this is when they help you understand trauma processing and set reasonable expectations for the entire treatment.
Phase 3: Evaluation
In the third phase, you and your therapist choose a target memory to focus on during that particular session. The therapist guides you to find an image and negative beliefs that are strongly associated with this memory. The clinician also suggests positive thoughts if appropriate for the target memory. They used the Validity of Cognition (VOC) scale and the Subjective Units of Disturbance (SUD) scale as baseline measures. The goal is to understand the extent to which the statement about the 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
At this stage, the clinician instructs you to simultaneously focus on the target image and eye movement (bilateral stimulation) or other sensory stimulation. They then continue with each set of eyes (or other stimuli), after which they ask you to take a breath and forget what you just focused on. The clinician then helps you become aware of your feelings, thoughts, and sensations about your experience. Then, based on your response, the professional can redirect your focus or the length, speed, and type of stimulation.
Phase 5: Installation
This is when the therapist instructs you to focus on the positive image you plan to incorporate. At this point, the positive knowledge must outweigh the negative. In other words, the therapist works with you to raise your VOC score, which should be seven or higher.
Phase 6: Body Scan
The therapist asks you to scan your body to help you process the specific body sensation. Again, the idea is to identify and address any residual response caused by the stress of the traumatic event – in which case the symptoms should subside as you go through the sessions.
Phase 7: Closure
In this phase, the therapist incorporates the self-control techniques taught at the beginning of the session to stabilize you. They also prepare you for what to expect until the next session. Finally, they require you to keep a log of possible disasters as a potential target for future sessions. This also helps you remember the calming activities learned in phase two.
Phase 8: Reassess
In this final stage, the therapist and you evaluate the treatment to ensure effectiveness and identify other goals for continuing care if needed.
Why is EMDR so controversial?
Numerous organizations and agencies around the world use EMDR therapy, including the US, UK, Germany and Australia. The World Health Organization, the Department of Defense, the Department of Veterans Affairs, and the American Psychiatric Association are among the many that recognize the efficacy of EMDR in the treatment of trauma and distressing events.
However, EMDR is still controversial among some health professionals. Not necessarily because of its effectiveness; they know EMDR works. Some studies even show it works faster than most psychotherapies or other types of behavioral therapy. Yet there is still no comprehensive understanding of why the therapy works—the reason Shapiro created the AIP model. Everything up to this point is mostly hypothetical.
Also, compared to other forms of mental health treatment, EMDR is relatively new, which requires more research to understand its long-term efficacy.
So far, there are no studies proving the dangers of EMDR therapy. And no side effects are attributed to the treatment, other than possible dark thoughts between sessions, which your therapist will help you deal with. However, this treatment is only effective for conditions developed from some type of trauma – the reason it is so effective for PTSD. So, in other words, if your disorder is due to a family history rather than a traumatic experience, this therapy probably won’t be right for you.
Experts recommend that you seek the help of a trained and licensed mental health provider to assess your need for this type of treatment or what is best for your situation.
Read more: The Brave New World of DIY Shock Therapy.