What is EMDR Therapy?

Unlike other therapy approaches, EMDR therapy aims to help individuals face trauma memories with bilateral stimulation (usually rapid eye movements). The 8-phase therapy seeks to strengthen the healing process, provide closure, and reduce negative symptoms associated with thinking about past traumas.
Evidence Based
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EMDR stands for Eye Movement Desensitization and Reprocessing. Conceived and developed by American psychologist Dr Francine Shapiro, this line of psychotherapy approach aims to help individuals who have experienced traumatic events (like treatment of PTSD) or other upsetting life experiences. 

Both the EMDR Institute and EMDR International Association (EMDRIA) oversee the proper execution and training of EMDR therapy in the United States and around the world. 

EMDR therapy is unlike other treatment approaches. In different types of treatment, mental health professionals may require individuals to complete homework assignments after sessions and/or speak extensively about the preoccupying subject. 

Professional EMDR therapists, however, use a technique called bilateral stimulation. The purpose of the approach is to minimize the negative effects caused by adverse life experiences. 

Multiple meta-analyses of scientific publications have reported EMDR as being an effective treatment for PTSD.

Bilateral stimulation can consist of the following aspects:

  • Visual — this approach is the most common of the three in EMDR treatment. It gives rise to the name of EMDR or otherwise known as rapid eye movement therapy. Therapists may wave their fingers from left to right in a back-and-forth gesture and ask patients to follow the motion with their eyes. 
  • Audio — this approach includes an audio stimulus, in which patients wear headphones and listen to auditory tones in an alternating, rhythmic fashion. For example, patients may hear one sound in the left ear, then the next in the other ear, and so forth. 
  • Kinesthetic — this approach includes tapping or tactile stimulation. 

Bilateral stimulation is believed to help with information processing of traumatic flashbacks, Including replacing negative cognitions with those more positive. It also aims to guide patients as they engage with body sensations, thoughts, and feelings in a way similar to mindfulness and meditation. 

EMDR is an eight-phase treatment. Individuals can receive sessions twice per week on a consecutive basis. 

Various national and international health authorities and governmental bodies recognize the effectiveness of EMDR in the treatment of trauma. 

These reputable institutions include:

  • American Psychiatric Association (APA)
  • The Substance Abuse and Mental Health Services Administration (SAMHSA)
  • The U.S. Dept. of Veterans Affairs/Department of Defense
  • The World Health Organization (WHO)

What is Attachment-Focused EMDR?

Attachment-focused EMDR (AF-EMDR) builds upon the benefits of EMDR and bilateral stimulation to offer techniques for those less responsive to traditional EMDR approaches.  

These three primary techniques include:

  • Resource Tapping™  — this approach consists of two parts: the resource and tapping. The resource represents real or imagined people, locations, memories, etc. that evoke a sense of security in the patient’s mind and possess inherent elements like love or wisdom. The action of left-right tapping (on the legs, shoulders, or knees) is an example of bilateral stimulation. The combination of tapping while thinking deeper about the resource acts as a way to help rebalance the nervous system and strengthen patients before they undergo EMDR. 
  • EMDR  — this therapeutic component is much more emotionally intensive and aims to help patients face traumas more adequately. 
  • Talk therapy  — this follow-up line of treatment consolidates information from EMDR sessions and supports the healing process. 

AF-EMDR (Attachment-Focused Eye Movement Desensitization and Reprocessing) differs from EMDR, taking into account issues such as acute or chronic relational trauma and attachment deficits. The model intends to heal early attachment wounds.

The original developer of AF-EMDR Dr Laurel Parnell suggested that by placing EMDR within an attachment-repair framework, patients could experience a more resolute, positive response to past traumas. 

Who Benefits From EMDR Therapy?

Many individuals can benefit from EMDR therapy, including those with:

  • Post-traumatic stress disorder
  • Anxiety, depressions, or other negative thoughts
  • Personality disorders
  • Eating disorders
  • History of substance use and addiction
  • Traumatic experiences due to sexual assault or rape
  • Traumatic experiences due to violence and abuse

Other conditions that may make an individual a right candidate for EMDR therapy sessions include sleep disturbance, chronic illnesses, or dissociative disorders. 

Both children and adults can undergo EMDR therapy. 

How Does EMDR Work? 8 Phases of Treatment

EMDR therapy is composed of 8 phases, including:

  • History-taking and treatment planning (phase 1)  —  the therapist gathers the full history of the patient and works alongside the individual to define targets for therapy. These targets comprise memories, present triggers, and prospective goals. 
  • Preparation (phase 2)   —  the therapist provides an overview of the treatment and its procedures. The patient will practice eye movement and/or other bilateral stimulation techniques. The therapist will also review the Safe/Calm Place exercise (aimed at providing a temporary rest during sessions).   
  • Assessment (phase 3)  — the therapist activates the target memory via identification and evaluation of each aspect of that memory, including image, cognition, affect, and physical sensations. 
  • Processing memories to potential closure (phases 4 to 7)   —  processing memories may take one to three sessions depending on the patient. These phases comprise different components. In these sessions, the therapist will employ bilateral stimulation like rapid eye movement therapy while the patient focuses on the memory. This process continues until the patient no longer states feeling distraught by the memory. Then, in the “installation” phase, the therapist helps strengthen a positive cognition. Once the patient achieves this, the therapist will ask the individual to perform a body scan. Observing the physical sensations while thinking about the event and positive cognition help to determine and resolve any residual distress in the body. Finally, the therapist will bring the session to an end with closure of the process.
  • Evaluating treatment results (phase 8)  — the therapist will perform a re-evaluation of the patient to assess the individual’s current psychological state, lasting treatment effects, and any new memories since the prior session. The therapist will take the opportunity to work alongside the patient in defining new targets for the session. 

EMDR At Home: Is It Possible?

As with any type of mental health intervention, it is recommended to undergo EMDR sessions with a properly trained and licensed mental health professional. Self EMDR or Self therapy EMDR without medical guidance may cause further problems and worsen symptoms associated with the condition in question. 

In AD-EMDR, your therapist may show you how to use resource tappingoutside of sessions in moments of distress caused by specific memories. 

However, it is essential always to consult your nearest mental health professional if you are interested in pursuing any type of mental health treatment.


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Resources

“About EMDR Therapy.” EMDR International Association, 15 July 2020, www.emdria.org/about-emdr-therapy/.

Ehlers, Anke, et al. “Do All Psychological Treatments Really Work the Same in Posttraumatic Stress Disorder?” Clinical Psychology Review, Elsevier Science, Mar. 2010, www.ncbi.nlm.nih.gov/pmc/articles/PMC2852651/.

“EMDR Institute – EYE MOVEMENT DESENSITIZATION AND REPROCESSING THERAPY.” Emdr Institute Inc, www.emdr.com/.

“Eye Movement Desensitization and Reprocessing (EMDR) Therapy.” American Psychological Association, American Psychological Association, 31 July 2017, www.apa.org/ptsd-guideline/treatments/eye-movement-reprocessing.

“What Are EMDR and AF-EMDR.” Parnell Institute, 9 Aug. 2016, parnellemdr.com/emdr-and-af-emdr/.

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Updated on: August 25, 2020
Author
Anthony Armenta
About
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Medically Reviewed
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Annamarie Coy,
BA, CADACII/ICADC, ICPR, MATS
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