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Eye Movement Desensitization and Reprocessing (EMDR)

IMAGE Proponents of eye movement desensitization and reprocessing (EMDR) claim it is a breakthrough treatment for those plagued with traumatic memories and other psychological problems. But does it actually work?

Who Developed EMDR?

EMDR was developed by psychologist Francine Shapiro, PhD, in 1987 when she discovered, by chance, that she could ease her own disturbing thoughts by moving her eyes rapidly from left to right. From there, Dr. Shapiro studied the effectiveness of EMDR on people with post-traumatic stress disorder (PTSD). Her research showed that EMDR held promise in reducing flashbacks, nightmares, negative thoughts, and avoidant behaviors. Since then, mental health professionals have received training in EMDR and use it regularly with patients suffering from traumatic memories.

According to the EMDR International Association, EMDR is often used to treat patients with trauma resulting from:

  • Sexual assaults
  • Other violent crimes
  • Combat
  • Airline and train crashes
  • Automobile and industrial accidents

In adults, these events often lead to symptoms such as nightmares, panic attacks, phobias , insomnia , and drug abuse . In children, symptoms such as oppositional behavior, sleep disturbances, and bed wetting may be present.

What Can You Expect?

If you are seeking EMDR treatment, the EMDR International Association recommends that you find an EMDR-trained mental health professional who will guide you through eight phases of treatment. The number of sessions and phases within each session varies from patient to patient; however, the eight phases of treatment are essential. They include:

Phase One: Patient History

The therapist will ask questions about your mental health history to evaluate your suitability for treatment. You will be asked about the level of your distress, current life stressors, and medical conditions. The therapist will then set up a treatment plan.

Phase Two: Preparation Phase

The therapist will introduce you to EMDR, explain how it works, and let you know what you can expect. You will be informed about the possibility of increased symptoms between sessions. You may be given relaxation exercises to use before and between EMDR sessions.

Phase Three: Assessment

You will be asked to identify the traumatic memory or an image from that memory. Then, you will be asked to think about a negative thought you have about yourself in relation to the traumatic event, such as “I am a bad person.” Next, the therapist will ask you to come up with a positive thought about yourself, such as “I am a lovable person” and to rate how much you believe that thought. Lastly, you will focus on the traumatic image and the negative thought you have about yourself and rate your level of emotional upset using a rating scale.

Phase Four: Desensitization

You will be asked to focus on your disturbing feelings while letting your eyes follow the therapist’s fingers as they move rapidly back and forth across a span of about 12 inches. This procedure is repeated in sets, each of which last from 10 seconds to more than 1 minute. This will continue until your emotional distress is greatly reduced.

In some cases, instead of eye movement, the therapist may ask you to tap alternate hands on a chair rest, or may use alternating sounds in your ears. Other more advanced strategies may also be used.

Phase Five: Cognitive Restructuring

In this phase, the positive belief will be strengthened in an effort to replace the negative belief associated with the traumatic memory. You will be asked to concentrate on the positive belief during the eye movement sets. This will continue until you reach a specific rate on the scale that the therapist is using. When evoking the traumatic memory, this should help you believe the positive thought about yourself.

Phase Six: Awareness of Bodily Sensation

As you hold the traumatic image and positive belief in your mind, you will focus on any tension that arises in your body. During the following sets of eye movements, or other desensitization techniques, the therapist will help you reduce bodily tension.

Phase Seven: Closure

Your therapist will talk to you about disturbing thoughts, images, or emotions that may occur between sessions and may ask you to keep a log or journal. While these symptoms may be uncomfortable, they are interpreted as a positive sign.

Phase Eight: Reevaluation

Before each new session, you will be reevaluated to see if the treatment effects have been maintained. The therapist will continue to work with you on additional traumatic memories and images, following the same eight-phase procedure.

Does EMDR Work?

Researchers have done controlled studies to investigate the potential effects of EMDR in people with PTSD. A review based on six studies concluded that eye movement desensitization and reprocessing was more effective than usual care or no care. However, it did not appear to be any better than cognitive-behavioral therapy or stress management in other trials. In another review, only two out of five trials that were evaluated showed that EMDR with eye movements was more effective than the treatment without eye movements.

How Do You Find an EMDR Therapist?

If you are interested in trying this type of therapy, you can begin your search with professional organizations, like the EMDR International Association and the EMDR Institute, that offer training programs. The therapist that you work with should have:

  • Earned a license to practice mental health or social work in your state
  • Completed a training program in EMDR and earned a certificate

After you find an EMDR therapist, ask questions to help you determine if the person is someone that you feel comfortable with:

  • What kind of training have you had?
  • Have you stayed current with your training?
  • How much experience do you have?
  • How can EMDR be helpful for me and my specific issues?

While EMDR is still evolving, it does carry the promise of reducing the intensity of traumatic memories, which can help you to live a more productive life.

  • EMDR Institute, Inc.

    http://www.emdr.com

  • EMDR International Association

    http://www.emdria.org

  • Canadian Mental Health Association

    http://www.cmha.ca

  • Health Canada

    http://www.hc-sc.gc.ca

  • Bison J, Andrew M. Psychological treatment for post-traumatic stress disorder (PTSD). Cochrane Library. 2007 Issue 3:CD003388.

  • Davidson P, Parker K. Eye movement desensitization and reprocessing (EMDR): A meta-analysis. J of Consulting & Clin Psychol.. 2001;69(2):305-316

  • Lansing K, Amen DG, Hanks C, Rudy L. High-resolution brain SPECT imaging and eye movement desensitization and reprocessing in police officers with PTSD. J Neuropsychiatry Clin Neurosci. 2005;17(4):526-532.

  • Posttraumatic stress disorder: other management. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/ . Updated June 13, 2011. Accessed June 20, 2011.

  • Seidler GH, Wagner FE. Comparing the efficacy of EMDR and trauma-focused cognitive-behavioral therapy in the treatment of PTSD: a meta-analytic study. Psychol Med. 2006;36(11):1515-1522.

  • Shepherd J, Stein K, Milne R. Eye movement desensitization and reprocessing in the treatment of post-traumatic stress disorder: a review of an emerging therapy. Psychol Med. 2000;30(4):863-871.

  • Stapleton JA, Taylor S, Asmundson GJ. Effects of three PTSD treatments on anger and guilt: exposure therapy, eye movement desensitization and reprocessing, and relaxation training. J Trauma Stress. 2006;19(1):19-28.

  • Vaughan K, Armstrong MS, Gold R, O'Connor N, Jenneke W, Tarrier N. A trial of eye movement desensitization compared to image habituation training and applied muscle relaxation in post-traumatic stress disorder. J Behav Ther Exp Psychiatry. 1994;25(4):283-291.

  • What is EMDR? EMDR Institute, Inc. website. Available at: http://www.emdr.com/general-information/what-is-emdr.html. Accessed October 10, 2013.