Eye Movement Desensitization and Reprocessing (EMDR) is a powerful psychotherapy approach that has helped an estimated two million people of all ages relieve many types of psychological distress.
WHAT IS EMDR?
In 1987, psychologist Dr. Francine Shapiro made the chance observation that eye movements can reduce the intensity of disturbing thoughts, under certain conditions. Dr. Shapiro studied this effect scientifically, and in a 1989 issue of the Journal of Traumatic Stress, she reported success using EMDR to treat victims of trauma. Since then, EMDR has developed and evolved through the contributions of therapists and researchers all over the world. Today, EMDR is a set of standardized protocols that incorporated elements from many different treatment approaches.
HOW DOES EMDR WORK?
No one knows how any form of psychotherapy works neurobiologically or in the brain. However, we do know that when a person is very upset, their brain cannot process information as it does ordinarily. One moment becomes “frozen in time,” and remembering trauma may feel as bad as going through it the first time because the images, sounds, smells, and feelings haven’t changed. Such memories have a lasting negative effect that interferes with the way a person sees the world and the way they relate to other people.
EMDR seems to have a direct effect on the way that the brain processes information. Normal information processing is resumed, so following a successful EMDR session, a person no longer relives the images, sounds, and feelings when the event is brought to mind. You still remember what happened, but it is less upsetting. Many types of therapy have similar goals. However, EMDR appears to be similar to what occurs naturally during dreaming or REM (rapid eye movement) sleep. Therefore, EMDR can be thought of as a physiologically based therapy that helps a person see disturbing material in a new and less distressing way.
WHAT IS THE ACTUAL EMDR SESSION LIKE?
During EMDR, the therapist works with the client to identify a specific problem as the focus of the treatment session. The client calls to mind the disturbing issue or event, what was seen, felt, heard, thought, etc., and what thoughts and beliefs are currently held about that event. The therapist facilitates the directional movement of the eyes or other dual attention stimulation of the brain, while the client focuses on the disturbing material, and the client just notices whatever comes to mind without making any effort to control direction or content. Each person will process information uniquely, based on personal experiences and values. Sets of eye movements are continued until the memory becomes less disturbing and is associated with positive thoughts and beliefs about one’s self; for example, “I did the best I could.” During EMDR, the client may experience intense emotions, but by the end of the session, most people report a great reduction in the level of disturbance.
HOW LONG DOES EMDR TAKE?
One or more sessions are required for the therapist to understand the nature of the problem and to decide whether EMDR is an appropriate treatment. The therapist will also discuss EMDR more fully and provide an opportunity to answer questions about the method. Once therapist and client have agreed that EMDR is appropriate for a specific problem, the actual EMDR therapy may begin.
A typical EMDR session lasts from 60-90 minutes. The type of problem, life circumstances, and the amount of previous trauma will determine how many treatment sessions are necessary. EMDR may be used within a standard “talking” therapy, as an adjunctive therapy with a separate therapist, or as a treatment all by itself.
BUT DOES EMDR REALLY WORK?
Approximately 20 controlled studies have investigated the effects of EMDR. These studies have consistently found that EMDR effectively decreases/eliminates the symptoms of post traumatic stress for the majority of clients. Clients often report improvement in other associated symptoms such as anxiety. The current treatment guidelines of the American Psychiatric Association and the International Society for Traumatic Stress Studies designate EMDR as an effective treatment for post traumatic stress. EMDR was also found effective by the U.S. Department of Defense, the United Kingdom Department of Health, the Israeli National Council for Mental Health, and many other international health and governmental agencies. The national registry (NREPP) of the Substance Abuse and Mental Health Services Administration (SAMHSA), an agency of the U.S. Department of Health and Human Services (HHS), cites EMDR as evidence based practice for the treatment of PTSD, anxiety and depression symptoms. Research has also shown that EMDR can be an efficient and rapid treatment. For further references, a bibliography of research may be found through EMDR International Association’s website, www.emdria.org.
WHAT KIND OF PROBLEMS CAN EMDR TREAT?
Scientific research has established EMDR as effective for post traumatic stress. However, clinicians also have reported success using EMDR in treatment of the following conditions: