What is EMDR and How Does it Work?

Jake Newby

| 4 min read

Eye movement desensitization and reprocessing (EMDR) therapy is becoming an increasingly common method of treatment for posttraumatic stress disorder (PTSD). It is an information processing technique that encourages the client to access their traumatic memories and briefly focus on them.
There are typically two objectives of EMDR therapy: To help the client face their trauma head, so they can resolve negative experiences or at least make memories a little less disturbing. The other objective is to equip the client with the cognitive and emotional tools necessary to help enable them to practice healthy behaviors in the future. In addition to PTSD, EMDR has been known to treat panic attacks, eating disorders, addictions and anxiety. 

What happens during an EMDR session?

During an EMDR session, you should expect you therapist to move their fingers back and forth in front of your face and ask you to follow their hand motions with your eyes as you simultaneously recall a disturbing event. This includes focusing on the emotions and body sensations associated with the trauma.
What separates EMDR from other forms of PTSD treatment is that it utilizes bilateral stimulation of the brain, like eye movement or other forms of rhythmical stimulation, such as sound and touch. This is done to stimulate the brain's information processing system. So, while some therapists use finger movements, others use alternatives like tapping sounds or musical tones.
Gradually, the therapist will guide you to shift your focus to more pleasant thoughts. Before and after each EMDR treatment, your therapist will ask you to rate your level of distress to gauge the therapy’s effectiveness. EMDR therapy is normally delivered one to two times per week for a total of six to 12 sessions. They last about 90 minutes per session and should take place in a warm, comforting therapeutic space.

What are the 8 steps of EMDR?

Though a typical EMDR therapy session is explained above, it can help to break down the process into eight steps or “phases.” The first three help identify the issues that need to be addressed during therapy. The next three involve the bilateral stimulation performed by your therapist. The seventh and eighth are meant to return you to a calmer state and evaluate the process.
  • Step 1: History gathering and treatment planning. You will speak with your therapist about why you’ve elected to undergo EMDR therapy.
  • Step 2: Preparation. This phase involves your therapist explaining the process and guiding you on how to manage the upsetting emotions you may experience.
  • Step 3: Assessment. The active part of the session begins. You are asked to identify and assess memory components like image, cognition, affect and body sensation.
  • Step 4: Desensitization. Your therapist leads you through the bilateral and/or rhythmical stimulations as you focus on the memory.
  • Step 5: Installation. This key part of the process is when you are asked to attach positive thoughts and feelings to a memory that you most often view as unpleasant or disturbing.
  • Step 6: The body scan. This phase is a time to pay close attention to your physical response to the therapy and assess your emotions.
  • Step 7: Closure. Now is the time to find a state of calm and sense of security. Discuss the target memories with your therapy, how they’ve been processed and how you feel about them now.
  • Step 8: Reevaluation. You and your therapist will discuss your current psychological state, the previous process of target and which new memories – if any – have emerged since the last session. You also use this phase to make any changes you see fit to your treatment plan. 

Who is EMDR not suitable for?

Some clients who use EMDR say it weakens the effect of negative emotions. It’s a treatment method that has been proven effective in many studies. However, it does have some disadvantages, in that finding therapists trained in EMDR can be challenging.
If you have an inherent or genetic condition, or you are dealing complications from a brain injury, EMDR may not be appropriate or helpful for you.
Also, recent survivors of trauma may not be ready to process their experiences through EMDR. For this reason, EMDR is not recommended for children who have recently gone through abuse or neglect. In general, children may not possess the brain development to face their trauma, process it and put it behind them in a way that promotes healing, as is the crux of EMDR therapy.
Photo credit: Getty Images
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