What is EMDR (Eye Movement Desensitisation and Reprocessing)? A Clear Explanation
If you are struggling with mental health issues, EMDR (Eye Movement Desensitisation and Reprocessing) may be an effective therapy to help you process and recover from past experiences. EMDR is a comprehensive psychotherapy that combines side-to-side eye movements with talk therapy in a structured format to help you process negative images, emotions, beliefs and body sensations associated with traumatic memories that seem to be stuck.
What is EMDR?
EMDR was originally developed as a treatment for trauma or post-traumatic stress disorder (PTSD), but it can be used to help with a range of mental health difficulties including anxiety, depression, addictions, behavioural difficulties, relationship issues, and more serious mental illnesses such as psychosis and personality disorders. EMDR is recognised by the National Institute for Health and Care Excellence (NICE) and the World Health Organisation (WHO) as a treatment for PTSD.
EMDR has a specific structure, and a therapist will work through several stages with you, including assessing your current symptoms and readiness for EMDR, understanding how your past has shaped your present, preparing you for the processing of traumatic memories, accessing the traumatic memories and starting bilateral stimulation. This involves stimulating either side of your brain in an alternating left-right fashion to help you access your subconscious mind and process what is stored in there and how it affects you. The eye movements may be similar to rapid eye movement (REM) sleep, which takes place as we dream.
Historical Background of EMDR
Development by Francine Shapiro
EMDR (Eye Movement Desensitisation and Reprocessing) therapy was developed by Francine Shapiro in the late 1980s. According to Shapiro, she discovered the technique by accident while walking in the park and noticing that her negative thoughts had subsided as her eyes moved rapidly from side to side. After conducting a series of experiments on herself and others, she developed a protocol that involved a combination of bilateral eye movements and exposure therapy to treat trauma-related disorders.
Evolution of EMDR Therapy
Since its inception, EMDR therapy has evolved into a comprehensive treatment approach for various mental health conditions. The protocol has been refined and expanded to include different forms of bilateral stimulation, such as hand tapping and auditory tones, in addition to eye movements. EMDR therapy is now recognised as an evidence-based treatment for post-traumatic stress disorder (PTSD) by the World Health Organization (WHO) and the American Psychiatric Association (APA).
Over the years, EMDR therapy has also been adapted to treat other mental health conditions, such as anxiety, depression, and addiction. The therapy has been modified to suit the needs of different populations, including children, veterans, and individuals with complex trauma histories. Despite some controversy surrounding the mechanism of action of EMDR therapy, it continues to be a popular and effective treatment option for many people.
Theoretical Framework
EMDR is a psychotherapy approach that is based on a theoretical framework called the Adaptive Information Processing (AIP) model. This model proposes that psychological disorders are caused by unprocessed memories that are stored in the brain in a dysfunctional manner. The AIP model suggests that the brain has a natural capacity to heal itself, but this process can be disrupted by traumatic events.
Adaptive Information Processing Model
The AIP model proposes that EMDR works by facilitating the natural healing processes of the brain. The therapist helps the patient to process traumatic memories by using bilateral stimulation, which can be achieved through eye movements, tapping, or other forms of sensory input. This bilateral stimulation is thought to activate the brain’s natural healing mechanisms, allowing the patient to reprocess the traumatic memory in a more adaptive way.
The AIP model also suggests that EMDR can help to resolve other psychological issues that are related to unprocessed memories, such as negative beliefs about oneself or the world. By reprocessing these memories, EMDR can help patients to develop more positive beliefs and behaviours.
Neurobiological Mechanisms
There is growing evidence that EMDR can have a positive impact on the brain’s neurobiological mechanisms. Research has shown that EMDR can help to regulate the amygdala, which is the part of the brain that is responsible for the fight-or-flight response. This can help patients to feel less anxious and more in control.
EMDR has also been shown to increase activity in the prefrontal cortex, which is the part of the brain that is responsible for executive functions such as decision-making and problem-solving. This increased activity can help patients to develop more adaptive coping strategies and behaviours.
In summary, the AIP model provides a theoretical framework for understanding how EMDR works. By facilitating the natural healing processes of the brain, EMDR can help patients to reprocess traumatic memories and develop more adaptive beliefs and behaviours. Research has also suggested that EMDR can have a positive impact on the brain’s neurobiological mechanisms, which can help patients to feel less anxious and more in control.
EMDR Therapy Process
EMDR therapy is a structured and evidence-based treatment for trauma and PTSD. It involves a series of phases that are designed to help you process traumatic memories and reduce the negative emotions associated with them. The therapy process includes bilateral stimulation, which can be achieved through eye movements, tapping, or other forms of sensory input. The therapy also emphasises the importance of the client-therapist relationship.
Phases of Treatment
EMDR therapy consists of eight phases of treatment. The first phase involves a comprehensive evaluation of the client’s history and current symptoms. The therapist will work with the client to identify specific memories that are causing distress and determine the level of disturbance associated with each memory.
In the second phase, the therapist will work with the client to develop a treatment plan that includes specific targets for processing. This plan will be based on the client’s identified memories and the level of disturbance associated with each memory.
The third phase involves preparation for processing. The therapist will teach the client specific techniques for managing distress and will work with the client to develop a sense of safety and stability.
The fourth phase involves the actual processing of traumatic memories. This phase includes bilateral stimulation, which can be achieved through eye movements, tapping, or other forms of sensory input. The therapist will guide the client through the processing of each identified memory, working to reduce the level of disturbance associated with each memory.
The fifth phase involves closure, which involves bringing the processing of traumatic memories to a temporary end. The therapist will work with the client to ensure that they are feeling stable and safe before ending the session.
The sixth phase involves re-evaluation, which involves assessing the client’s progress and identifying any additional targets for processing.
The seventh phase involves consolidation, which involves helping the client integrate the insights and changes that have occurred during treatment into their daily life.
The final phase involves termination, which involves ending the therapy process in a collaborative and positive way.
Bilateral Stimulation
Bilateral stimulation is a key component of EMDR therapy. This technique involves activating both sides of the brain through eye movements, tapping, or other forms of sensory input. This bilateral stimulation is thought to help the brain process traumatic memories in a more adaptive way, reducing the level of emotional distress associated with these memories.
Client-Therapist Relationship
The client-therapist relationship is an important aspect of EMDR therapy. The therapist provides a safe and supportive environment for the client to process traumatic memories. The therapist also works collaboratively with the client to develop a treatment plan and to identify specific targets for processing. The therapist is trained to provide feedback and support throughout the therapy process, helping the client to feel empowered and in control of their own healing journey.
Applications of EMDR
EMDR has been found to be effective in treating a variety of psychological conditions. In this section, we will explore some of the most common applications of EMDR.
Trauma and PTSD
EMDR is most commonly associated with the treatment of trauma and post-traumatic stress disorder (PTSD). EMDR can help to reduce the intensity of traumatic memories and the associated emotional distress. This is achieved by using bilateral stimulation, such as eye movements or tapping, while recalling the traumatic event. EMDR has been found to be as effective as cognitive-behavioural therapy (CBT) in the treatment of PTSD.
Anxiety Disorders
EMDR has also been found to be an effective treatment for anxiety disorders, including panic disorder, social anxiety disorder, and generalised anxiety disorder. EMDR can help to reduce the intensity of anxiety symptoms by targeting the underlying negative beliefs and memories that contribute to anxiety. EMDR has been found to be as effective as CBT in the treatment of anxiety disorders.
Other Psychological Conditions
EMDR has also been used to treat a range of other psychological conditions, including depression, phobias, and addiction. EMDR can help to reduce the intensity of negative emotions and beliefs associated with these conditions, leading to improved mental health outcomes. While the evidence for EMDR in treating these conditions is less strong than for trauma and anxiety disorders, it is an area of ongoing research.
In summary, EMDR is a versatile and effective treatment for a range of psychological conditions. If you are struggling with trauma, anxiety, or another psychological condition, EMDR may be a useful treatment option to discuss with your therapist.
Research and Effectiveness
Clinical Trials
Clinical trials have shown that Eye Movement Desensitisation and Reprocessing (EMDR) is an effective treatment for post-traumatic stress disorder (PTSD). In a randomised controlled study, EMDR was found to be as effective as cognitive-behavioural therapy (CBT) in reducing PTSD symptoms [1]. EMDR has also been found to be effective in treating other conditions such as anxiety disorders, depression, and phobias [2].
Meta-Analyses
Several meta-analyses have been conducted to examine the efficacy of EMDR. One meta-analysis found that EMDR was more effective than control interventions in reducing PTSD symptoms [3]. Another meta-analysis found that EMDR was as effective as CBT in treating PTSD [4]. A third meta-analysis found that EMDR was effective in treating anxiety disorders [5].
Limitations of Research
While EMDR has been found to be effective in treating PTSD and other conditions, there are limitations to the research. Some studies have had small sample sizes, which may limit the generalisability of the findings. Additionally, some studies have not included long-term follow-up, so it is unclear whether the benefits of EMDR are sustained over time. Finally, some studies have not included a control group, which makes it difficult to determine whether the effects of EMDR are due to the intervention itself or other factors such as the passage of time.
Overall, the research suggests that EMDR is an effective treatment for PTSD and other conditions. However, more research is needed to determine the long-term effects of EMDR and to address the limitations of the existing research.
[1] Marcus, S. V., Marquis, P., & Sakai, C. (1997). Controlled study of treatment of PTSD using EMDR in an HMO setting. Psychotherapy: Theory, Research, Practice, Training, 34(3), 307–315. https://doi.org/10.1037/h0087727 [2] 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. https://doi.org/10.1192/bjp.bp.106.021402 [3] Chen, Y.-R., Hung, K.-W., Tsai, J.-C., Chu, H., Chung, M.-H., & Chen, S.-R. (2014). Efficacy of eye-movement desensitization and reprocessing for patients with posttraumatic-stress disorder: A meta-analysis of randomized controlled trials. PLoS ONE, 9(8), e103676. https://doi.org/10.1371/journal.pone.0103676 [4] Chen, Y.-R., Hung, K.-W., Tsai, J.-C., Chu, H., & Chen, C.-H. (2014). Efficacy of eye-movement desensitization and reprocessing for patients with posttraumatic stress disorder: A randomized controlled trial. Psychological Medicine, 44(9), 2039–2050. https://doi.org/10.1017/S0033291713003018 [5] Acarturk, C., Konuk, E., Cetinkaya, M., Senay, I., Sijbrandij, M., Cuijpers, P., & Aker, T. (2015). EMDR for Syrian refugees with posttraumatic stress disorder symptoms: Results of a pilot randomized controlled trial. European Journal of Psychotraumatology, 6, 27414. https://doi.org/10.3402/ejpt.v6.27414Frequently Asked Questions
How does EMDR therapy facilitate psychological healing?
EMDR therapy facilitates psychological healing by allowing individuals to reprocess traumatic memories in a safe and controlled environment. During an EMDR session, the therapist guides the individual through a series of eye movements or other bilateral stimulation techniques while the individual focuses on the traumatic memory. This process helps to reduce the intensity of the traumatic memory and allows the individual to integrate the memory into their life in a more adaptive way.
What are the risks associated with EMDR therapy?
EMDR therapy is generally considered to be safe, but there are some risks associated with the treatment. Some individuals may experience an increase in distress during or after the session, and there is a small risk of false memories being created. It is important to work with a trained EMDR therapist who can help manage any potential risks and ensure that the treatment is safe and effective.
Can you provide an example of how EMDR is applied in a therapeutic session?
During an EMDR session, the therapist will guide the individual through a series of eight phases of treatment. These phases include history taking, preparation, assessment, desensitisation, installation, body scan, closure, and re-evaluation. The therapist will use a variety of bilateral stimulation techniques, such as eye movements, to help the individual process traumatic memories and integrate them into their life in a more adaptive way.
What constitutes the eight phases of EMDR treatment?
The eight phases of EMDR treatment include history taking, preparation, assessment, desensitisation, installation, body scan, closure, and re-evaluation. During the history taking phase, the therapist works with the individual to identify the traumatic memory and any associated symptoms. The preparation phase involves teaching the individual coping skills and relaxation techniques to help them manage any distress that may arise during the session. The assessment phase involves identifying the specific aspects of the traumatic memory that need to be targeted in treatment. The desensitisation phase involves using bilateral stimulation techniques to reduce the intensity of the traumatic memory. The installation phase involves strengthening positive beliefs and emotions related to the traumatic memory. The body scan phase involves checking in with the individual to assess any residual distress. The closure phase involves ending the session in a safe and supportive way. The re-evaluation phase involves assessing the progress made in treatment and identifying any remaining issues that need to be addressed.
On what scientific evidence is EMDR therapy based?
EMDR therapy is based on the Adaptive Information Processing model, which suggests that traumatic memories are stored in the brain in a dysfunctional way that prevents them from being processed and integrated into the individual’s life in a more adaptive way. EMDR therapy has been extensively researched and has been shown to be an effective treatment for a variety of mental health conditions, including post-traumatic stress disorder (PTSD), anxiety, and depression.
What are the specific eye movements involved in EMDR, and how are they performed?
The specific eye movements involved in EMDR are typically horizontal eye movements, but other forms of bilateral stimulation, such as tapping or auditory tones, can also be used. The eye movements are performed by following the therapist’s finger or a visual target back and forth with the eyes while focusing on the traumatic memory. The eye movements are thought to facilitate the processing of the traumatic memory and reduce the intensity of associated distress.