EMDR – Eye Movement Desensitization and Reprocessing

Here at Foundation Psychology a number of our psychologists in Melbourne are EMDR therapists working with people with trauma and other unresolved issues.

Emma Vaughan works with EMDR and has a special interest in first responders. Psychologists Dr Joanna Menger Leeman, Belinda Seymour-Wright, Jemima Koles and Clare McInnerney also use EMDR in their practice with trauma.

What is EMDR?

Eye Movement Desensitization and Reprocessing (EMDR) is a psychotherapy treatment that was developed in the late 1980s by psychologist Francine Shapiro. EMDR is a structured therapy that involves bilateral stimulation of the brain through eye movements, tapping, or other forms of sensory input. This process is thought to help the brain process and integrate traumatic experiences, reducing their emotional impact.

EMDR is primarily used to treat individuals who have experienced trauma, including post-traumatic stress disorder (PTSD), but it can also be used to address a range of other mental health conditions, such as anxiety, depression, and phobias. It is a unique form of therapy in that it is not talk-based; instead, clients are asked to recall the traumatic event while focusing on the therapist’s bilateral stimulation. Through this process, clients can reduce the intensity of their traumatic memories and move towards recovery. This process helps to desensitize the traumatic memory and reframe the individual’s beliefs about themselves and their experiences. EMDR therapy is culturally responsive and can be attuned with cultural resources and beliefs.

What to expect in EMDR treatment?

Because each person is different the exact EMDR protocol will differ from person to person. Below is a summary of a typical EMDR treatment protocol which can help you understand the process.

Initial Sessions

• History Taking and Assessment: The psychologist will start by taking a thorough history and assessing the client’s readiness for EMDR therapy. This includes discussing the client’s current symptoms, personal history, and identifying specific traumatic memories or current situations that are causing distress.
• Preparation: The therapist will explain the theory and process of EMDR, including what EMDR is, how it works, and what the client can expect during and after treatment. The therapist may also teach the client various coping techniques and stress-reduction strategies to help them manage emotional distress.

EMDR Therapy Phases

EMDR therapy is an eight-phase treatment that includes:

1. History and Treatment Planning: Identifying past events that have laid the groundwork for dysfunction, present situations causing distress, and developing future goals.
2. Preparation: Establishing trust and explaining the EMDR process. The psychologist may teach the client several stress management techniques.
3. Assessment: Identifying the specific memory to be targeted and all the components associated with that memory (image, negative belief, emotions, and body sensations).
4. Desensitization: This involves focusing on the memory while simultaneously experiencing bilateral stimulation (typically eye movements), which is believed to help the brain process the trauma.
5. Installation: Strengthening the positive beliefs the client wants to have replace their negative beliefs.
6. Body Scan: After the client focuses on the memory and the positive belief, they are asked to notice any residual tension in their body, which is then targeted for processing.
7. Closure: Ensuring the client leaves every session feeling better than when they arrived. The therapist might return to stress-reduction techniques taught in the preparation phase.
8. Reevaluation: At the beginning of future sessions, the therapist checks to ensure that the positive results have been maintained, and assesses if there are other memories to target.

Is EMDR effective?

Over 44 randomised controlled trials support the use of EMDR with a wide range of trauma presentations. There is a growing body of evidence that supports the use of EMDR as an effective treatment for PTSD and trauma-related disorders. Meta-analyses have shown that EMDR is as effective as trauma focused cognitive-behavioural therapy (CBT), a widely-used talk therapy approach, in treating PTSD.

In EMDR the therapist guides the individual through a series of eye movements or other forms of bilateral stimulation while they focus on the traumatic memory. While the exact mechanism by which EMDR works is still not fully understood, researchers have proposed several theories. One hypothesis is that the bilateral stimulation used in EMDR helps to activate the brain’s natural healing mechanisms, allowing the client to process and integrate traumatic experiences in a way that is less overwhelming. Another theory is that the eye movements used in EMDR stimulate both the right and left hemispheres of the brain, which may help to promote greater integration and communication between the two.

EMDR is typically recommended for individuals who have experienced trauma or PTSD, but it can also be helpful for those struggling with other mental health conditions. For example, EMDR has been shown to be effective in treating anxiety disorders, such as panic disorder and social anxiety disorder. It has also been used to treat depression, phobias, and addiction.

One of the benefits of EMDR is that it can be completed in a relatively short amount of time, with some clients experiencing significant improvement after just a few sessions. However, the length of treatment can vary depending on the severity of the trauma and the individual’s response to therapy.

Can I get EMDR?

It is important to note that EMDR is not a standalone treatment and should be used in conjunction with other therapeutic approaches as needed. EMDR (Eye Movement Desensitization and Reprocessing) therapy can be integrated with other therapies to create a more comprehensive and individualized treatment plan for clients. EMDR therapy is a versatile approach that can be adapted to the needs of the individual and the nature of their presenting problems. Here are some examples of how EMDR can be integrated with other therapies:

1. Cognitive Behavioural Therapy (CBT): CBT and EMDR share similar goals, including the reduction of negative thoughts and emotions related to trauma. Therefore, integrating CBT techniques such as cognitive restructuring and relaxation exercises with EMDR therapy can help individuals to cope better with trauma-related symptoms.
2. Mindfulness-Based Therapies: Mindfulness-based therapies, such as Mindfulness-Based Stress Reduction (MBSR) and Acceptance and Commitment Therapy (ACT), can help individuals increase their awareness and acceptance of their emotions and sensations. Integrating EMDR with these therapies can help individuals develop a more present-focused and non-judgmental perspective, which can enhance the effectiveness of EMDR therapy.

EMDR can be integrated with other therapies to create a more comprehensive and tailored treatment plan for individuals with trauma-related symptoms. The specific integration approach used will depend on the needs and preferences of the individual, and the expertise and training of the therapist.

In conclusion, EMDR is a psychotherapy treatment that has shown promise in treating trauma, PTSD, and other mental health conditions. If you or a loved one is struggling with trauma or PTSD, it may be worth considering EMDR.

References

Acarturk, C., Konuk, E., Cetinkaya, M., Senay, I., Sijbrandij, M., Cuijpers, P., & Aker, T. (2015). EMDR for Syrian refugees with posttraumatic stress disorder symptoms: Results of a pilot randomized controlled trial. European Journal of Psychotraumatology, 6(1), 27414.

de Jongh, A., Amann, B. L., Hofmann, A., Farrell, D., & Lee, C. W. (2019). The status of EMDR therapy in the treatment of posttraumatic stress disorder 30 years after its introduction. Journal of EMDR Practice and Research, 13(4), 261-269.

Scelles, C., & Bulnes, L. C. (2021). EMDR as treatment option for conditions other than PTSD: A systematic review. Frontiers in Psychology, 12, 644369.