EMDR Therapy

What is EMDR Therapy?

EDMR is a psychotherapy treatment meant to address and lessen any distress associated with traumatic experiences.¹ EDMR accesses and processes traumatic memories with the intent of bringing adaptive solutions by reformulating negative beliefs and reducing physiological arousal.

What does EMDR Stand for and How Does it Work?

EDMR stands for Eye Movement Desensitization and Reprocessing. EMDR therapy consists of the client attending to emotionally disturbing material in small doses while also being exposed to external stimulus.

Psychologist Francine Shapiro developed EDMR in the 1980s after realizing that, while moving her eyes from side to side, she reduced the distress of her reoccurring negative memories.² Shapiro later theorized that "trauma causes negative emotions to be stored within the same memory network as a troubling event." The essential purpose of EDMR is to rewire the connections of the negative emotions towards the memory.

Bilateral stimulation

Bilateral stimulation is an element of EDMR. Bilateral stimuli are practiced in different receptive methods and the benefits from this stimulation include:³

1. A relaxation effect including decreased physiological arousal
2. Increased attentional flexibility (where thoughts become less 'stuck' on negative aspects)
3. Distancing effect (the problem seems smaller and further away)
4. Decreased worry

Visual bilateral stimulation

Visual bilateral stimuli occur in a rhythmic left-right pattern. This practice can involve watching a hand or a moving light go from left to right repeatedly.³

Auditory bilateral stimulation

Auditory bilateral stimuli involve paying close auditory attention to sounds which alternate between the left and the right side of the head.³

Working memory

Working memory is a critical element in the practice of EMDR. Once an individual has a negative experience, that memory, and its emotions are stored in the long-term memory. While held in the long-term memory, the individual recalls the negative experience(s) and feels the emotions tied to the memory. During EMDR therapy, clients activate the experience in the long-term memory, bringing the experience into the short-term memory or the \"working memory.\"

In the therapy session, while the experience is stored in the working memory, the client focuses on the therapist's back and forth hand motions while simultaneously recalling the memory. This process allows the working memory to process a sum of information, which causes the negative memory to blur due to processing both the memory and the visual experience.

EMDR tappers

EMDR tappers are therapy devices designed to provide the individual in therapy the bilateral stimulation required for EMDR therapy.⁴ EMDR tappers were invented in the '80s to make EMDR therapy sessions simple for therapists to provide bilateral stimulation. EMDR tappers commonly provide tactile and audio bilateral stimulation.

Tappers consist of a control box and two pods, and headphones will be included for audio stimulation. The therapy client will hold the pods while they vibrate in the left hand and the right hand, back and forth. The vibration varies from low intensity to high intensity. The therapist changes the intensity during different points in the therapy session to either increase or decrease the stimulation based on the different moments in the memory experience.

The Eight Stages of EMDR Therapy⁵

Phase 1: History and Treatment Planning

The first phase of EMDR treatment is for the therapist to look through the history of the client and develop a treatment plan. The client and therapist will discuss the client\'s problem as well as the symptoms arising from it. The therapist will develop a treatment plan to address EMDR targets including:

• the event(s) from the past that the problem arises from
• which present situations cause distress
• the key skills that can increase the client\'s well-being

Phase 2: Preparation

During phase two, the therapist teaches the client-specific techniques to quickly handle any emotional disturbances or triggers.

Phase 3: Assessment

The therapist will prompt the client\'s memories of trauma in a controlled way so the experiences can be effectively processed.

Phase 4: Desensitization

In this phase, the client\'s emotions will be measured with a SUD rating (Subjective Units of Disturbance scale rating). The fourth phase \"deals with all of the person's responses (including other memories, insights, and associations that may arise) as the targeted event changes and its disturbing elements are resolved."

Phase 5: Installation

This stage will concentrate on increasing the client\'s positive belief system to replace his/her negative beliefs. The previous stage allows the client to reprocess the trauma and realize that he or she has the strength to handle these emotions.

Phase 6: Body Scan

During the body scan stage, the therapist will ask the client to bring forward the traumatic memory to observe if the body holds any residual tension. If tension and negativity still stem from the memory, the physical sensations are targeted to be reprocessed.

Studies with EMDR sessions show that there is a physical response to unresolved thoughts and that, when one is negatively affected by trauma, information about that event is stored in motoric memory. This will trigger both the negative emotions and the physical sensations of the event. Through EMDR therapy, the experience can be moved to narrative or verbalizable memory so that the body sensations and negative feelings are reduced.

Phase 7: Closure

The closure phase ensures that the client leaves each session feeling better than they did at the beginning of the session.

Phase 8: Reevaluation

During the reevaluation phase, the therapist guides the client through their treatment plan. The reevaluation phase will help determine how much effect the treatment has over time.

Who performs EMDR?

EMDR is a mental health intervention performed by licensed and trained mental health professionals. The study fields consist of psychology, psychiatry, social work, and other degrees within the mental health field.

How do they get EMDR training?

Professionals interested in EMDR certification receive EMDR training in the following steps:⁶

• Supervised small group practice on each training day
• Physiological overview of the information processing system
• Specialized history-taking to identify dysfunctional patterns and causes
• Treatment planning to address past events, current triggers, and future needs
• Stabilization techniques across the attachment spectrum
• Reduction of overt symptoms and achieving comprehensive mental health
• Addressing the full range of trauma and other disturbing life events
• Applications to combat trauma and first responders
• Applications to addictions, grief, anxiety, depression, and somatic disorders
• Applications to natural and man-made disasters
• Applications to family and couples therapy
• Personal use for a therapist to process vicarious traumatization

EMDR training prepares professionals to understand the components of memory and processing to effectively treat individuals suffering from traumatic experience recalls.

What Are the Side Effects of EMDR?

EMDR is generally considered a safe practice and alternative to medication-assisted treatment for depression and trauma. Despite its effectiveness, EMDR side effects exist. Dangerous side effects could include:⁷

• an increase in distressing memories
• heightened emotions or physical sensations during sessions
• light-headedness
• vivid dreams
• the surfacing of new traumatic memories

EMDR for Depression

Traumatic experiences can often lead to depression. Because EMDR is trauma-focused therapy, its elements target the negative emotions and memories that stem from that traumatic experience. EMDR centers on stopping the negative thoughts and feelings that contribute to the depressive state. However, depression that is due to hormonal imbalances or nutritional issues would not benefit from EMDR treatment.

EMDR for Addiction Treatment

EMDR is a cognitive-behavioral form of treatment that addresses negative emotions associated with traumatic events. According to cognitive-behavioral therapy research, addictions are tied to negative thoughts and feelings.⁸ The U.S. National Library of Medicine states, "From a psychological and neurological perspective, addiction is a disorder of altered cognition. The brain regions and processes that underlie addiction overlap extensively with those that are involved in essential cognitive functions, including learning, memory, attention, reasoning, and impulse control."

EDMR for PTSD

Experts believe eye movements help shuffle the memories to reduce their traumatic power when restoring them in the brain.² A 2011 study found that PTSD patients who moved their eyes during EMDR therapy found that their eye movement better reduced their distress and unease than those PTSD patients who kept their eyes closed and still.

How Fast does EMDR Work?

The effectiveness and duration of EMDR therapy sessions depend on everyone's case-by-case basis. EMDR sessions typically last 60-90 minutes. Although EMDR does not work overnight, progressing through the eight EMDR phases is an effective way to treat victims' traumatic experiences.