Updated 9/22/2021.
Eye movement desensitization and reprocessing (EMDR) is a form of interactive psychotherapy treatment. EMDR therapy was developed to offer relief from psychological stress related to traumatic events.
What is EMDR therapy, exactly? The EMDR therapy definition is best explained as a therapeutic approach used to address past traumatic experiences that are having a present effect on your thoughts, feelings, and emotions. It’s not uncommon for trauma to result in future triggers that cause someone to relive their most frightening moments. For example, a war veteran may struggle with fireworks on the Fourth of July, each blast can feel like a war flashback.
The American Psychiatric Association (APA) notes that EMDR can be an effective form of therapy for those who have post traumatic stress disorder (PTSD), especially if they have a difficult time vocalizing or reliving the trauma.
If you’re struggling with trauma or PTSD, you might want to consider EMDR therapy. It may help you learn to better navigate some of the common triggers that are keeping you from living a full, peaceful life. To learn more, including how EMDR works, continue reading. We’ll look in-depth at this effective treatment option that’s helped countless people to overcome their trauma.
How Does EMDR Therapy Work?
How EMDR works is a bit of a puzzle at this point. Even those who agree on its efficacy are somewhat conflicted about how and why this treatment option is so effective. To date, there are only theories about how it offers the help it does. Some have attributed the success to principles similar to prolonged exposure therapy.
EMDR therapy requires a series of visits that systematically cover 8 phases of treatment. Typically, it takes about 12 sessions to see the full effects of EMDR. Under a therapist’s guidance, you’ll learn to re-process a stressful past experience. Eventually, you’ll begin to bypass the anxiety and fear you once associated with the memory. Essentially, just like with physical wounds, you’ll build a protective barrier over your emotional pain.
EMDR uses dual attention stimulation, or bilateral stimulation, to help you begin to access and relive painful memories without being consumed by them. An EMDR therapist can guide you in remembering the traumatic event and then divert your attention, so you don’t begin to have your typical emotional response. Eye movements and alternating tapping can help you work through your distressing memories.
“When I work with clients experiencing PTSD, I like to learn the clients’ history to then provide them with activities that prepare them to deal with difficult emotions that may come up during the desensitization process.”
Talkspace therapist Cynthia Catchings, LCSW-S, LCSW-C, EMDR, CFTP
Stages of EMDR
There are 8 stages of EMDR that you’ll work through with a skilled therapist.
Phase 1: EMDR history
During the first phase of EMDR, you’ll review your history with a therapist to figure out exactly where you are in your treatment and healing process. You’ll be asked to discuss the traumatic event so your therapist can identify all potential past traumas that are haunting you.
Phase 2: Client preparation
Together, you’ll explore multiple ways that you can begin trying to cope with the stress you feel as a result of the trauma. Psychological stress can bear a heavy burden on your daily functioning, and specific stress management techniques can be extremely helpful. For example, a therapist can show you how to learn and practice mindfulness, meditation, and deep breathing— all of which have been found effective in EMDR therapy.
“When I work with clients experiencing trauma, as part of EMDR, I like to do resourcing exercises because it helps the client to relax and discuss their targets with less intensity.”
Talkspace therapist Catherine Richardson, MA, LPC, EMDR Trained Therapist
Phase 3: Assessment
The next phase, assessment, is when your EMDR therapist guides you in defining and targeting memories and other important components that may be contributing to your difficulties. Some of these might be physical sensations or sounds that stimulate a reaction as you relive an event. Once they’ve been identified, you can begin to target them in therapy. Some of the ways that your therapist will help you in the assessment phase can include:
- Identifying which specific incident the trauma surrounds – An accident? Sexual assault? Death of a loved one? Combat?
- Expressing the most common and consistent images that you connect to the memory.
- Defining whether or not the trauma is relevant to your current life and present circumstances. You’ll discuss the likelihood (or lack thereof) of the chance that the trauma might occur again.
The assessment phase is a common time for positive beliefs to be introduced and used regularly. So you may begin to tell yourself things like: I am in a safe place. I am safe now.
Phase 4: Desensitization
During the desensitization phase, you’ll attempt to rationally evaluate your trauma. The goal of this phase is to reprogram how your brain associates the actual trauma with the triggers you’re struggling with.
To help you achieve this, you’ll focus on the memory or image that you normally have a reaction to, while at the same time making eye movements using bilateral stimulation. Bilateral stimulation happens in 25-second-sets that repeat.
After each set, your therapist will ask you to take a deep breath, and then you’ll give feedback about the experience. Note the type of trauma you experienced, and your reaction to the stimulation may result in your therapist adjusting minor parts of the process. This can include how fast the stimulation goes, the type of stimulation that’s being used, and how long the sets are.
Phase 5: Installation
Phase 5, installation, involves your therapist helping you replace a traumatic memory with a positive belief that’s deeply rooted in your thought process. Eventually, this positive belief will become stronger than the negative one(s) you associate with your trauma. The longer you work on this, the more effective it’ll become. You’ll begin to have more (and much stronger) positive feelings than you do negative.
Phase 6: Body scan
The body scan phase involves bringing back and reevaluating the traumatic event. During this phase, somatic responses like raised blood pressure, muscle tension, or an increased pulse will help your therapist understand if you’re still experiencing residual trauma. If that’s the case, he or she will continue additional sessions of bilateral eye movement until you can complete the body scan without any responses.
Phase 7: Closure
During the closure phase, stress reduction techniques will be strongly emphasized. Your therapist will likely ask you to keep a record of any incidents you have before your next session. And, you’ll get detailed instruction on how to manage and handle additional occurrences should they occur.
Phase 8: Reevaluation
The final phase of EMDR therapy is known as the reevaluation phase. Here, you and your therapist will assess how effective the treatment has been and discuss whether or not future sessions are a good idea. You may also plan at least one final additional follow-up session, if needed.
What is EMDR Therapy Used to Treat?
EMDR therapy is used to treat post traumatic stress disorder (PTSD) and other related disorders that are a result of traumatic experience. It can help you cope with mental and physical symptoms stemming from trauma-related mental health conditions.
“If you have been struggling and feeling overwhelmed with negative thoughts and feelings as a result of going through a traumatic event, EMDR is going to help you heal,” says Bisma Anwar, LMHC.
“When I work with clients that have experienced severe trauma, EMDR is one of my preferred types of therapy since I can start seeing results within the first session; it typically allows clients to process and heal faster than other therapeutic modalities.”
Talkspace therapist Cynthia Catchings, LCSW-S, LCSW-C, EMDR, CFTP
How Effective is EMDR Therapy?
EMDR has been shown in numerous studies to be an effective treatment for PTSD. A look at some findings confirms the efficacy.
- One randomized pilot study reported that after eight sessions of treatment, EMDR therapy was superior to a variety of CBT techniques. “Almost all the patients (20 out of 21, 95.2%) did not have PTSD after the EMDR treatment.”
- Department of Veterans Affairs & Department of Defense (2010): EMDR was one of four therapies given the highest level of evidence and recommended for treatment of PTSD.
- American Psychiatric Association (2004): EMDR has given the same status as CBT as an effective treatment for reducing symptoms for both acute and chronic PTSD.
- SAMHSA’s National Registry of Evidence-based Programs and Practices (2011): Cites EMDR as an evidence-based practice for the treatment of PTSD, anxiety, and depression symptoms.
- World Health Organization (2013): Trauma-focused CBT and EMDR are the only psychotherapies recommended for children, adolescents, and adults with PTSD. Unlike CBT with a trauma focus, EMDR does not involve:
- detailed descriptions of the event
- direct challenging of beliefs
- extended exposure
- homework
“EMDR can help people who are struggling with traumatic events, even years later because their body still remembers the pain they went through. Through the tapping and eye movements, the mind and body can work towards healing the trauma,” Bisma Anwar, LMHC, said.
What to know before starting EMDR
You might be nervous before starting EMDR therapy, and that’s okay! Starting work with a new counselor or therapist — especially one using such a unique method — can be a little unnerving. But there’s no need to be anxious about what will happen during your appointment. You already know the process, and phases of the technique, and here is some more information about what the EMDR therapy meaning actually is.
EMDR might trigger strong emotions
Remembering and reliving traumatic situations can invoke a lot of powerful emotions, from fear to stress, to panic. All of this is normal, and your therapist won’t be surprised if you are emotional during your sessions. In fact, they’ll expect you to have some sort of reaction. Accept your feelings as they come, and don’t pass judgment on your experience. Healing takes time.
Dual attention stimulation can feel strange at first
Whether your therapist uses lights, hand-held buzzers, or some other method to induce bilateral stimulation, there’s no denying it can feel a little odd. You may be wondering how casting your eyes back and forth can be therapy. But it is. Taking some time to get accustomed to EMDR is perfectly normal.
Your mind might wander
You may go into therapy thinking you’ll talk exclusively about one traumatic event. But if you suddenly start to remember everything unusual or uncomfortable that’s ever happened to you, don’t be alarmed. If you begin talking about experiences from childhood, or high school, or college, your therapist isn’t going to think anything is wrong. Know that your mind might wander, and feel free to follow where it goes.
Is EMDR Right For You?
Have you been struggling with unresolved trauma? If you’ve tried other solutions with limited success, EMDR might be a great, effective alternative. A certified EMDR counselor can help you process difficult memories so you can start living your life sooner. Reach out to a therapist today to learn more.
If you feel that you have unresolved trauma and may be experiencing PTSD, consider taking our PTSD test as a first step.
Sources Cited:
- Eye Movement Desensitization and Reprocessing (EMDR) Therapy. https://www.apa.org. https://www.apa.org/ptsd-guideline/treatments/eye-movement-reprocessing/ Published 2017. Accessed September 2, 2021.
- Capezzani L, Ostacoli L, Cavallo M et al. EMDR and CBT for Cancer Patients: Comparative Study of Effects on PTSD, Anxiety, and Depression. Journal of EMDR Practice and Research. 2013;7(3):134-143. doi:10.1891/1933-3196.7.3.134.
- Lewey J, Smith C, Burcham B, Saunders N, Elfallal D, O’Toole S. Comparing the Effectiveness of EMDR and TF-CBT for Children and Adolescents: a Meta-Analysis. J Child Adolesc Trauma. 2018;11(4):457-472. doi:10.1007/s40653-018-0212-1.
- What is EMDR? – EMDR Institute – EYE MOVEMENT DESENSITIZATION AND REPROCESSING THERAPY. EMDR Institute – EYE MOVEMENT DESENSITIZATION AND REPROCESSING THERAPY. https://www.emdr.com/what-is-emdr/ Published 2020. Accessed September 1, 2021.
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