Eye Movement Desensitization and Reprocessing (EMDR)
by Amy Scholten, MPH and Rebecca J. Stahl, MA
Proponents of eye movement desensitization and reprocessing (EMDR) claim it is a breakthrough treatment for those plagued with traumatic memories and other psychological problems. Let's learn more about it.
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 those suffering from traumatic memories.
EMDR is often used to treat people who have trauma resulting from:
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 8 phases of treatment. The number of sessions and phases within each session varies from person to person; however, the 8 phases of treatment are essential. They include:
Phase 1: Personal 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 2: 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 3: 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 4: 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 5: 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 6: 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 7: 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 8: 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 8-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 6 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 2 of 5 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, such as the EMDR International Association and the EMDR Institute. The therapist that you work with should have:
After you find an EMDR therapist, ask questions to help you determine if the person is someone that you feel comfortable with:
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.
EMDR International Association
Canadian Mental Health Association
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Last reviewed May 2021 by Michael Woods, MD, FAAP
Last Updated: 5/29/2021
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