Eye Movement Desensitization and Reprocessing, or EMDR, is a form of therapy that aims to help survivors of trauma process distressing emotions related to a traumatic event and learn how to view the event from a more positive viewpoint. Therapists must be specifically trained in the use of EMDR in order to effectively use it, so it is not a form of therapy that can be used by general therapists.
Originally developed in 1989 by Francine Shapiro, the core of EMDR revolves around the use of specific eye movements. Shapiro discovered that these eye movements could alleviate the intensity of the emotions related to a traumatic event. While EMDR has a variety of applications, it is primarily used in the treatment of post-traumatic stress disorder (PTSD). Since PTSD commonly co-occurs with substance abuse, EMDR may be used as part of a substance abuse treatment program that addresses co-occurring disorders.
How EMDR Works
In EMDR sessions, the client and the therapist identify a target event that will be addressed, and this is generally the underlying traumatic event. While discussing the trauma, the therapist leads the client through a series of saccadic eye movements, which are quick, jumpy movements with the eyes. The idea behind EMDR is that the person will be better able to process and reframe the trauma when confronting it while performing these eye movements. The focus is on the present – present feelings – versus the past. Next, the client and therapist work on viewing the event from a new perspective.
Once the client is able to view a formerly traumatic event from a new point of view, they will address the original traumatizing event once again and rate their physical reaction to the memory. If any negative reaction remains, additional reprocessing will take place.
Each EMDR sessions ends with a “closure” phase. This phase ensures that the client feels better than they did at the start of that session. Oftentimes, relaxation techniques are used during this phase.
EMDR is defined as an “integrative” therapeutic approach that is used to treat people who have experienced traumatic events, such as war, child abuse, sexual abuse, and terror events, according to the EMDR International Association. Qualified therapists learn a series of standardized practices that draw on elements from various treatment approaches, taking their clients through the traumatic events that have brought them into therapy.
According to Utah Valley University, trauma represents memories that have not been fully processed. When something happens to someone, such as a sudden, unexpected roadside explosion or a physical assault, the traumatic memory doesn’t allow the person to continue processing the memory of the event. Every time the person remembers the event, they experience feelings and effects that, over time and distance, may be irrational in light of the current circumstances. For example, a person may experience panic attacks on a daily basis, even though there is no present threat of harm.
EMDR comes in at the point where a person is mentally and emotionally “stuck” on that memory, unable to move forward to full healing and recovery.
When clients are taught to move both of their eyes back and forth horizontally, it is called bilateral stimulus. This movement assists the person in beginning to process that traumatic event through to the point where, eventually, it will no longer hold negative emotions, reactions, or even interest. Ultimately, clients learn to change their perception of the event. In addition, they learn how to change how they see themselves.
Is EMDR Suitable for Children Who Have Experienced Trauma
Yes, it can be. According to Social Work Today, children who have experienced a single traumatic event often “catch on” to the EMDR process more quickly than adults. Children who have experienced child abuse may respond more positively to sessions of EMDR than they do to traditional talk therapy. When a child has completed all EMDR sessions, they have ideally fully resolved the events that caused traumatic reactions.
One reason that children do better with EMDR is related to trust. Adults, especially those who have experienced sexual abuse as children, often have a difficult time trusting the motivations of others. While EMDR may, over time, work for them, it generally takes them longer to believe they can trust their therapist. Because of this distrust, adults may take much longer to decide to fully commit to the therapy.
Individuals Best Suited for EMDR Therapy
Anyone who has experienced a major trauma, or who has been diagnosed with PTSD, is suited for treatment with EMDR. If the person experiences flashbacks or intrusive memories of the event, avoids reminders of the trauma, suffers from outbursts of anger or sleep issues, has trouble concentrating, or startles easily, they may be a good candidate for EMDR, according to Psych Central. The decision on whether or not to use EMDR should be jointly made by the individual client and therapist in consultation with the client’s overall treatment team.
EMDR doesn’t take a long time to complete. Unlikely other forms of therapy, EMDR generally involves a set treatment timeline with a defined number of sessions, according to the University at Buffalo.
People generally think much more quickly than they can talk. In an EMDR session, the client is rarely required to say anything, especially about what they are experiencing mentally. Therefore, they will soon learn how to face and address traumatic events more rapidly than they would in traditional talk therapy. As a result, EMDR can be beneficial to those who haven’t found recovery with traditional therapy.
In addition, EMDR uses both sides of the person’s brain. As they revisit traumatic events, they are building new brain pathways and infusing their experiences with additional associations.
Individuals Who Should Not Receive EMDR Therapy
EMDR will not work for everyone. People who are emotionally shut down and who cannot (or will not) express how they are feeling are not well suited for EMDR. If the person is depressed, they aren’t a good candidate either, according to Social Work Today. The EMDR process requires the person to be in touch with their feelings, which helps them to measure if they are successfully addressing their negative reactions to the traumatic events that have affected their lives. If an individual is unable to address and recognize those feelings, another form of therapy may be preferable.
People suffering from a seizure disorder should not go through EMDR. In addition, a child diagnosed with autism shouldn’t be taken through the EMDR process because their reactions to traumatic events can be so highly physically distressing. If a person is taking psychotropic medications, this treatment also would not be appropriate for them. In addition, clients with dissociative disorders may not be suited to this therapy.
Qualifications to Practice EMDR
Mental health professionals who have been certified, licensed, or registered by their state licensing board are qualified to become certified in providing EMDR therapy, according to the Adelphi University School of Social Work. In addition, mental health interns, graduate students, and other mental health professionals can learn how to administer EMDR treatments.
Those who are thinking of undergoing EMDR treatments should ask questions and find out if their therapist is licensed and qualified in this form of mental health treatment, as recommended by the EMDR Institute. Questions clients should ask include:
- Have you received extensive EMDR training?
- Have you stayed current with the current treatment protocols and developments?
- Have you treated others with my condition with EMDR therapy? How effective was it?
- Do you use EMDR in conjunction with other treatments?
In some instances, EMDR can be an effective means of therapy for those with PTSD and other issues related to trauma. Generally, EMDR should be used as part of a comprehensive treatment programs that includes other treatment modalities to address all co-occurring issues.