7 Questions Answered about EMDR

With the vast number of people who have experienced at least one traumatic event in their life (which is estimated to be 60% of the population) it is important to have several effective trauma-focused treatments. In 2015, the Administration for Community Living (ACL) coined the term “person-centered, trauma-informed” or PCTI. One important principle from PCTI is that person-centered supportive service delivery considers everyone’s experience, needs, strengths, preferences, and goals. It honors that there isn’t a one size fits all treatment for trauma. According to the American Psychological Association (APA), there are four strongly recommended treatment options which include: Cognitive Behavioral Therapy (CBT), Cognitive Processing Therapy (CPT), Cognitive Therapy, and Prolonged Exposure. In addition, there are three conditionally recommended treatment options which include: Brief Eclectic Psychotherapy, Eye Movement Desensitization Reprocessing (EMDR) Therapy, and Narrative Exposure Therapy (NET). One that we’ll explore today is EMDR.

Which organizations recognize the effectiveness of EMDR?

EMDR is a widely recognized as an effective treatment for posttraumatic stress disorder (PTSD). In addition to the APA, this psychotherapy technique is recognized by the American Psychiatric Association, the International Society for Traumatic Stress Studies, National Alliance on Mental Illness (NAMI), the Substance Abuse and Mental Health Services Administration (SAMHSA), as well as the Departments of Defense (DOD) and Veterans Affairs (VA) as an effective treatment for trauma. It has been proven to be effective for children, adolescents, and adults.

What is EMDR?

EMDR was originally developed by Dr. Francine Shapiro in the late 1980’s. It is a form of exposure therapy where the client will focus on emotionally charged memories. The client is guided to visualize the representative image, noticing body sensation and emotions while going through short periods of bilateral stimulation (which is either eye movement, sound, or touch).  The clinician guides them through the memory and sensations until the emotionally charged feeling has dissipated as much as possible. It is a structured process with a standard Eight Phase protocol. This method helps the brain to reprocess and integrate the event within the client’s standard biographical memories.

What is the theory behind EMDR?

EMDR is based on the Adaptive Information Processing (AIP) model. This concept outlines how normal and traumatic memories are stored differently in the brain. During a traumatic event the hippocampus and amygdala take over and are activated while in survival mode. After the event the prefrontal cortex is left sorting out “the pieces” of what’s remembered and is unable to categorize/process the events leaving the event unprocessed. During re-processing with EMDR, the belief is that your “logical” modern brain can evaluate through re-experiencing the event, which will then process it objectively. Dr. Shapiro who developed this model explains, “most psychological disorders are forged by earlier experiences that contain affects of helplessness, hopelessness or any of the full spectrum of emotions that constitute a sense of self-denigration and lack of personal efficacy.” The AIP model highlights how all people have an inherent information processing system that moves naturally towards health, growth, and learning. However, during a traumatic experience these memories are maladaptively stored. EMDR therapy helps the brain to access adaptive information from the event or events, which in time can lead to transformation and resolution.

How is it different from other treatments?

According to the EMDR International Association (EMDRIA), EMDR is different from other trauma-based therapies, in a few important ways. The first is that it doesn’t require talking in detail about the traumatic event. Secondly, it is time efficient. It usually takes somewhere between 3 – 12 sessions depending on the complexity of the trauma. Sessions are typically between 60 – 90 minutes. Thirdly, EMDR helps to heal the brain’s reaction to the traumatic event. If the brain gets stuck in fight, flight, freeze after a disturbing event EMDR helps the brain to reprocess the memory. After treatment is completed, the experience is still remembered but the stress response isn’t repeatedly activated.

What is the process?

The eight phases of EMDR occur over multiple sessions, and sometimes include several of the phases in one session. According to Susanna Kaufman, an EMDRIA staff member, the eight phases are a framework that outline the treatment process, and act as a map for the therapist to follow. The eight phases include 1) history taking and treatment planning, 2) preparation, 3) assessment, 4) desensitization, 5) installation, 6) body scan, 7) closure, and 8) reevaluation. Here is a helpful infographic that outlines the eight phases.

Is it effective for anything other than the treatment of trauma?

There are more than 44 randomized controlled trials that have investigated EMDR treatment for posttraumatic stress disorder (PTSD), and early traumatic stress. In addition, there are 28 randomized controlled trials that evaluated the effects of EMDR on other psychological disorders which include major depressive disorder, bipolar disorder, dissociative disorders, eating disorders, psychosis, anxiety disorders, obsessive compulsive disorder, substance use disorder, and pain. The efficacy of EMDR on other psychological disorders is considered to be preliminary and further investigation is still required (Maxfield, 2019).

Interested in becoming certified as an EMDR practitioner?

The EMDR International Association has created a helpful video outlining the steps to become a certified practitioner. In addition, you can find more specific information on treatment guidelines here.

Ready to Learn More:

melissa petersonListen to Season 4 of CASAT Conversations. Season 4 delves into the topic of secondary and vicarious trauma experienced by people who work in the field of human services. In episode 8, you’ll hear from Melissa Petersen a practicing marriage and family therapist and former Wildland Firefighter. In this episode, she shares why she loves EMDR.

References

Administration for Community Living. (2022). Person-centered, trauma-informed service. ACL. Retrieved January 23, 2023, from https://acl.gov/programs/strengthening-aging-and-disability-networks/advancing-care-holocaust-survivors-older 

Cleveland Clinic. (2022). EMDR therapy: What it is, Procedure & Effectiveness. Cleveland Clinic. Retrieved January 22, 2023, from https://my.clevelandclinic.org/health/treatments/22641-emdr-therapy 

EMDR International Association. (2023, January 9). About EMDR therapy. EMDR International Association. Retrieved January 22, 2023, from https://www.emdria.org/about-emdr-therapy/ 

Kaufman, S. (2022, October 7). The eight phases of EMDR therapy. EMDR International Association. Retrieved January 23, 2023, from https://www.emdria.org/public-resources/the-eight-phases-of-emdr-therapy/ 

Maxfield, L. (2019). A clinician’s guide to the efficacy of EMDR therapy. Journal of EMDR Practice and Research, 13(4), 239–246. https://doi.org/10.1891/1933-3196.13.4.239 

Valiente-Gómez, Moreno-Alcázar, A., Treen, D., Cedrón, C., Colom, F., Pérez, V., & Amann, B. L. (2017). EMDR beyond PTSD: A Systematic Literature Review. Frontiers in Psychology8, 1668–1668. https://doi.org/10.3389/fpsyg.2017.01668

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