What is EMDR?
What is EMDR?
Eye Movement Desensitization and Reprocessing (commonly called EMDR) is a technique used by psychotherapists to help people recover from symptoms of trauma and emotional distress. With trauma, a painful moment can feel frozen in time, so much so that remembering the event may feel as bad as it did when it happened, with all the same sounds, smells, images and feelings.
Many people who go through a traumatic or painful experience carry that experience with them to one degree or another. This can result in anything from feeling afraid in certain situations to post traumatic stress disorder (PTSD). These lasting effects can change the way a person thinks about themselves, how they relate to the world around them, and how they relate to the people in their life.
We know that when a person is extremely upset, their brain cannot process information as clearly as it would normally; and that when something disturbing occurs in present life, it can trigger previous trauma, causing the brain to cloud or freeze often stimulating the same sensory experiences and emotions as before.
If you are struggling with after-effects of trauma, EMDR may be able to help you heal. The practice involves working with a psychotherapist who has been specially trained in EMDR. During an EMDR session, the therapist will guide you through a series of steps that help you, not so much let go of the trauma, as reprocess it, so you’re not reliving the trauma again and again. EMDR can often achieve noticeable results within a few sessions.
While first studied as a way of treating trauma and PTSD, EMDR may also help with other psychological disorders, such as anxiety or addiction. It may also be useful for people struggling with chronic pain, which may be aggravated by, or the result of unprocessed emotional pain. The practice is about 30 years old and has proved to be an extraordinary addition to the mental and emotional health toolkit of practices.
“I am personally a huge believer in EMDR,” says integrative psychotherapist, mind-body medicine expert, and EMDR practitioner Amy Shinal, MSW, LCSW. “Part of it is that beyond just the recovery from their trauma, people feel so much stronger. This is beautiful. The benefits of EMDR generalize out to many aspects of their life. If you’re working on not having a voice, dating back to childhood or in a current relationship, for example, you might find your voice grows stronger in every area of your life.”
How does EMDR work?
Past trauma, along with other emotional pain, may persist in your body and influence your physical, emotional and mental health without your being consciously aware of it. You may be tamping down feelings, hoping to gain control of your responses and behavior; but instead, painful feelings and memories may manifest in a range of symptoms, such as anxiety, panic, obsessive thinking, anger, and physical pain.
The EMDR Institute explains that the mind can heal from psychological trauma much as the body does from physical trauma. The body naturally works to heal a cut on your hand; but if a foreign object aggravates the wound, healing may progress only when the object is removed. Similarly, the brain naturally inclines toward mental health; but if the brain’s processing system is blocked by the impact of a disturbing event, the result may be intense suffering. EMDR can help in removing the block and allowing healing to resume.
“A lot of clients who come in say, ‘I’ve done therapy around my trauma,’" shares Amy Shinal. “They are referring to talk therapy. EMDR recognizes that trauma is not just stored in our thoughts but in our bodies and our nervous systems, and provides a powerful aid to healing.”
EMDR was created in the late 1980s by Dr. Francine Shapiro. In 1989, Dr. Shapiro published an initial study on her work, outlining a procedure she originally called eye movement desensitization (EMD). Her research found that EMD could help people struggling with PTSD to feel better after a single session and that five sessions were often enough to provide significant relief from many symptoms. In 1991, she changed the name of her therapy to EMDR, as the R (reprocessing) better reflected what people were actually experiencing in a session.
EMDR quickly took off. Dr. Shapiro founded the EMDR Institute to help train other therapists in the practice, which achieved mainstream acceptance by the mid-1990s as studies by other researchers confirmed Dr. Shapiro’s initial findings on EMDRs usefulness for treating trauma. Today, it is considered a frontline approach for working with trauma and is recommended as an effective treatment for trauma in the Practice Guidelines of the American Psychiatric Association, and those of the Departments of Defense and Veterans Affairs.
EMDR is an evidence-based approach to psychotherapy and a useful treatment for trauma and PTSD. When compared with cognitive-behavioral therapy (CBT)—the most common form of psychotherapy used to help people recover from trauma—research shows that EMDR can be equally (and perhaps even more) effective. Studies have also found EMDR to work better than antidepressants for treating PTSD.
Why does EMDR work? The exact mechanisms of how it affects the brain are unknown. However, Dr. Shapiro suggests that EMDR allows you to do what scientists call memory reconsolidation—to change your relationship with old memories.
EMDR effects the way the brain processes information; so that following successful EMDR treatment, when the past painful memories are brought to mind, the person no longer “relives” the sounds, images, and feelings associated with that event, and negative beliefs about oneself in relation to the event are reformulated.
EMDR sessions follow a standard approach designed by Dr. Shapiro, in which the therapist and client work together to identify the specific problem or memory to address.
The client is asked to call to mind the memory or issue, along with what they saw, heard, felt, and thought or believed. Then the therapist uses tapping, eye movements or auditory stimulation while the client focuses on the memory, including its sensory associations. The client then simply notices what comes to mind without making any attempt to control or direct their thoughts as the therapist facilitates the processing until the memory becomes less disturbing and is associated with more positive self-referencing beliefs.
Generally, a single incident trauma that occurred during adulthood can be resolved in a few sessions, while people who have experienced multiple traumas (or multiple incidents of the same trauma) will require more treatment time. In the more complex cases, the therapist will often need one or more sessions to understand the nature of the problem and to assess whether or not EMDR is an appropriate treatment. Sessions are typically 60-90 minutes, and before the session ends the therapist will help make sure you’re feeling grounded enough to leave.
What are the benefits of EMDR?
EMDR is primarily used as a treatment for trauma and PTSD, for which it is considered one of the best interventions available. However, EMDR is also been reported to be successful in treating other mental and emotional health conditions, including anxiety, panic attacks, phobias, stress, addiction, and long-term grief. It may also be helpful in dealing with emotional factors that can cause chronic pain, or for recovering from trauma related to surgery or illness. In other words, if you are suffering because of ongoing painful emotions, EMDR may be worth trying.
Amy Shinal says, “Even though people think of EMDR as a trauma treatment—which it is—it’s also really effective at removing all kinds of blocks standing in the way of where you are now and where you want to be—even if you don’t know what those blocks are.
“If you think about what you want to do, and you feel anxious….If inwardly you really don’t believe in yourself... EMDR could be very helpful. Most of us fall into this category. We all have sticking points; but instead of trying, often unsuccessfully, to talk yourself out of or into something, EMDR can clear the way to feel stronger, and having your body in agreement with that feeling, instead of battling with doubt or anxiety.”
Safety and side effects
When performed by a qualified professional, EMDR is safe and has no side effects. However, working with trauma can often feel daunting. That’s okay—psychotherapists who practice EMDR are trained to help you navigate any scary, painful feelings that come up during a session, and to help you get grounded again before you finish.
During EMDR, a client may experience intense emotions, but by the end of the session, most people report a significant reduction in the intensity of disturbance and a more positive view of themselves and their own capacity.
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The following expert reviewed and contributed to this article:
Amy Shinal, MSW, LCSW, Integrative Psychotherapist & Clinical Director of The Center for Mind-Body Medicine.
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The Role of Eye Movement Desensitization and Reprocessing (EMDR) Therapy in Medicine: Addressing the Psychological and Physical Symptoms Stemming from Adverse Life Experiences
Francine Shapiro, PhD
The Permanente Journal, 2014
A randomized clinical trial of eye movement desensitization and reprocessing (EMDR), fluoxetine, and pill placebo in the treatment of posttraumatic stress disorder: treatment effects and long-term maintenance.
van der Kolk BA, Spinazzola J, Blaustein ME, Hopper JW, Hopper EK, Korn DL, & Simpson WB
Journal of Clinical Psychiatry, 2007
EMDR in the treatment of chronic pain.
Grant, M & Threlfo, C
Journal of Clinical Psychiatry, 2004