What Is EMDR Therapy?
Eye Movement Desensitization and Reprocessing (EMDR) therapy, developed by Dr Francine Shapiro in the late 1980s, is a scientifically validated, effective psychotherapy technique proven to help people recover from trauma symptoms and other mental health disorders.
EMDR is a structured therapy that incorporates elements of cognitive therapy, exposure therapy, and bilateral stimulation to facilitate both processing and integration of traumatic memories.
How Does EMDR Therapy Work?
The Adaptive Information Processing model was developed to explain how EMDR works. The model proposes that symptoms of PTSD and other mental health disorders result from traumatic memories or distressing experiences that continue to cause disturbances because the memory was not adequately processed. That is, the distress or trauma memory is stuck in the brains processing system. These unprocessed or stuck memories are hypothesised to hold the emotions, thoughts, and physical sensations that occurred at the time of the traumatic event. When the traumatic memory is triggered, the stored disturbing emotions, thoughts, and physical sensations are again experienced which causes the symptoms of PTSD and other mental health disorders.
The main element of EMDR is the use of bilateral stimulation. This is typically eye movements however can also be body movements to stimulate the brain’s natural healing mechanisms and facilitate the reprocessing of traumatic memories. The bilateral stimulation combined with other therapeutic processes helps memory access and reprocessing. Reprocessing helps the brains healing or repair process reducing or eliminating the problematic symptoms.
How does EMDR Therapy Affect the Brain?
Stress responses are part of our natural survival (fight, flight, freeze) instincts. However, when distress from a disturbing or traumatic event remains, images, thoughts, and emotions can create the feeling of reliving the event or being back in that every moment. EMDR therapy supports the brain to process the memories and facilitates the natural healing.
The natural healing process involves communication between the amygdala (which detects threats, activates our fear based responses, and processes threats), the hippocampus (which consolidates information from short to long term memory, and assists learning), and the prefrontal cortex (which modulates executive functions such as self-control, planning, decision making, and problem solving).
How is EMDR Different from Other Psychological Therapies?
Other psychological therapies such as Cognitive Behaviour Therapy and Psychodynamic Therapy involve (a) talking about the traumatic event or distressing issue or retelling the trauma story, (b) changing emotions, thoughts, and behaviours resulting from the trauma, and (c) completing homework between sessions. EMDR therapy is different in that it does not require talking in detail about the traumatic event nor does it involve completing homework. Additionally, EMDR therapy does not work to change emotions, thoughts, or behaviours however allows the brain to continue its natural healing process.
The Eight Phases of EMDR Therapy
EMDR therapy is a structured approach encompassing eight distinct phases. These phases include history-taking and planning, preparation, assessment, desensitization, installation, body scanning, closure, and reevaluation.
Phase 1: History and Treatment Planning
History-taking and treatment planning typically takes two sessions at the beginning of therapy, and at times can continue throughout the therapy if new issues are revealed. While this phase includes a discussion of the specific problem that has brought the client into therapy, there is no need to discuss in detail the traumatic or disturbing memories. A general picture or outline is sufficient.
Phase 2: Preparation
Preparation can take between two and four sessions for most clients, however for others this phase can take a longer time. It is important that trust is established which can take some clients longer than others. During this phase, the psychologist will explain EMDR and teach the client emotional regulation techniques.
Phase 3: Assessment
In the Assessment phase, the client first selects a mental image from the target event that best represents the traumatic memory. The client then expresses a negative self-belief associated with the traumatic event along with a positive self-belief they would rather believe. A rating of how true the belief is will also be taken. The client will also be asked about the emotions and physical sensations associated with the target and asked to rate the level of disturbance.
Phase 4: Desensitisation
The Desensitisation phase focuses on the disturbing emotions and physical sensations with the use of bilateral stimulation until the level of distress is clinically reduced. Sessions can typically last 90 minutes with on average two to three sessions required per target. Most clients attend one to three sessions per week.
Phase 5: Installation
During the Installation phase, the positive self-belief is strengthened and installed. The level of believability of the positive self-belief is rated with the goal of the client accepting their positive self-belief as true.
Phase 6: Body Scan
The Body Scan phase involves the psychologist asking the client to recall the target to check if any trauma associated physical sensations are noticed in the body. If so, these physical sensations are then targeted for reprocessing. In this way, the information about the traumatic event that has been stored in the body (motoric memory), rather than just the narrative is processed.
Phase 7: Closure
The Closure phase occurs at the end of the treatment sessions. If processing of the traumatic memory has not been completed in the session time, the therapist and client will use self-regulating or calming techniques to support the client regain a stability.
Phase 8: Reevaluation
Opens every new session. The Reevaluation phase occurs at the start of the treatment sessions acting as a guide for that the client is needing.
The Benefits of EMDR Therapy
Resolution of Trauma: EMDR has been widely recognized for its effectiveness in treating trauma-related disorders, including PTSD. The therapy helps individuals process traumatic memories, reduce distressing symptoms, and develop more adaptive coping mechanisms.
Targeting Other Mental Health Conditions: EMDR has also shown promise in treating other mental health conditions such as anxiety disorders, depression, phobias, and grief.
Enhanced Self-awareness and Growth: EMDR therapy can lead to increased self-awareness, improved self-esteem, and enhanced personal growth. By reprocessing past traumas, individuals can develop a more positive and empowered outlook on life.
Who Can Benefit from EMDR Therapy?
EMDR therapy is suitable for individuals who have experienced various forms of trauma or distressing life events. It can be effective for both single-incident traumas (e.g., accidents, assaults) and complex traumas (e.g., childhood abuse, combat-related trauma). EMDR therapy has also been found to be an effective treatment for mental health disorders such as addictions, anxiety, psychosis, and depression. Additionally, EMDR can be used to help with performance anxiety experienced by athletes and professionals seeking to overcome blocks or self-limiting beliefs.
The World Health Organisation, Australian Psychological Association, Cochrane, Australian Government Department of Veteran Affairs, and US Department of Veteran Affairs among organisations recognize EMDR therapy as an effective treatment. Additionally, EMDR is listed on Medicare Australia’s list of approved Focussed Psychological Strategies
Experiencing EMDR Therapy
EMDR is an individual therapy typically delivered one to three times per week. Sessions can be conducted on consecutive days. Once the client and psychologist deem EMDR therapy is an appropriate treatment, EMDR therapy can commence proceeding through the eight phases. Each EMDR therapy session can last from 60-90 minutes and at times can be longer. During Desensitisation, the client will be focus on the target and engage in bilateral stimulation. The client will be guided to notice what comes to mind and as therapy continues may experience changes in images, physical sensations, emotions, and beliefs regarding the traumatic event. During each session, and importantly during bilateral stimulation, the client has complete control and can stop at any point.
Between sessions, some processing may continue and new information may arise. This is a normal part of the EMDR therapy experience. The client can record these experiences and use their calming or regulation techniques.
The Role of the EMDR Therapist
EMDR therapy can only be administered by those who have the appropriate training. Psychologists are AHPRA registered professionals and have rigorous standards and ethics to uphold.
A psychologist or EMDR therapist typically creates a safe and supportive therapeutic environment, assists the client through the therapy process, and facilitates recovery from trauma and other mental health disorders.
EMDR therapy offers a powerful and effective approach to address various forms of trauma, distress, and psychological difficulties. By leveraging the brain’s natural healing abilities, EMDR enables individuals to process traumatic memories and achieve lasting emotional and psychological healing. If you are struggling with the effects of trauma or other distressing experiences, EMDR therapy may provide a path towards healing, growth, and a renewed sense of wellbeing.