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EMDR Therapy: Transforming Mental Health Treatment

Written by: Carol Miles, MSW, LCSW

Eye Movement Desensitization and Reprocessing (EMDR) therapy has become a transformative approach in the mental health space, offering hope and healing to individuals grappling with trauma and various psychological disorders. As mental health awareness grows, EMDR therapy stands out for its unique methodology and impressive outcomes, making it an essential tool for therapists and clients.

Understanding EMDR Therapy – EMDR therapy was developed by psychologist Dr. Francine Shapiro in the late 1980s. It is an integrative psychotherapy approach that has been extensively researched and proven effective for treating trauma. EMDR focuses on helping individuals process and integrate traumatic memories, reducing the lingering impact of these experiences on their daily lives. The core of EMDR therapy involves using bilateral stimulation, typically through guided eye movements, to facilitate the reprocessing of traumatic memories. During an EMDR session, the therapist will ask the client to recall distressing events while guiding their eye movements or providing other forms of bilateral stimulation, such as tapping or auditory tones. This process helps the brain reprocess the traumatic information, leading to reduced emotional distress and improved mental health.

Key Components of EMDR Therapy:

Phase 1: History Taking and Treatment Planning: The therapist gathers comprehensive information about the client’s history, particularly with an emphasis on trauma targets, and identifying specific memories and experiences that need processing.

Phase 2. Preparation: The client is prepared for EMDR  therapy by developing resources for emotional regulation.

Phase 3. Assessment: The therapist works with the client to  identify a  target memory for processing, including the associated emotions, beliefs, and physical sensations.

Phase 4. Desensitization: The client focuses on the selected target memory while engaging in alternating bilateral stimulation. This phase continues until the memory becomes less distressing.Once this is complete, the client moves to the Installation of Positive Beliefs phase.

Phase 5. Installation: Positive beliefs are developed to replace the negative beliefs associated with the traumatic memory.Once this phase is complete, the client moves to Phase 6.

Phase 6. Body Scan: The client is asked to observe their physical response to the memory, and any residual tension or discomfort is processed.If the client has completed Phases 4,5 & 6 successfully this is a complete session. If not, it is an incomplete session. 

Phase 7. Closure: Before ending the session, the therapist ensures that the client returns to a state of emotional equilibrium, particularly in the case of an incomplete target. 

Phase 8. Re-evaluation: Progress is assessed in subsequent sessions, and memories or issues are addressed as needed.

EMDR therapy uses a three-pronged approach to address past, present, and future issues that are contributing to a client’s distress. Here’s a breakdown of the 3 prongs:

  1. Past: This prong focuses on processing disturbing memories or experiences that are believed to be at the root of current problems. The therapist helps the client revisit the memory while using bilateral stimulation (eye movements, tapping, etc.) to facilitate emotional processing and reduce its negative impact.
  2. Present: This prong targets how past experiences influence present situations. The therapist helps the client identify triggers (people, places, situations) that evoke negative emotions linked to the past and then use EMDR to reprocess those triggers.
  3. Future: This prong focuses on developing positive outlooks and coping mechanisms for anticipated challenges. The therapist helps the client imagine future situations that cause anxiety and use EMDR to rehearse healthier responses, building emotional resilience.

Think of it like a three-legged stool. By addressing all three aspects, EMDR aims to create a more stable foundation for emotional well-being.

Benefits of EMDR Therapy

EMDR therapy is considered one of the most effective treatments for PTSD, backed by extensive research. Here’s a breakdown of its effectiveness:

PTSD:

  • Numerous studies demonstrate EMDR’s effectiveness in reducing PTSD symptoms over a course of about 3 months.
  • It has strong support from clinical practice guidelines for PTSD treatment from various organizations
  • Department of Veterans Affairs (VA) in the US https://www.ptsd.va.gov/understand_tx/emdr.asp.EMDR has garnered support from several prominent organizations within the scientific community. Here are some key examples:
  • International Society for Traumatic Stress Studies (ISTSS): This leading organization in trauma research issued strong recommendations for EMDR as an effective treatment for PTSD in their 2018 practice guidelines.
  • World Health Organization (WHO): The WHO’s 2023 guideline for mental, neurological and substance use disorders recommends EMDR with moderate evidence for adults and children in treating PTSD.
  • National Health Agencies: Many national health agencies recognize EMDR’s effectiveness. Examples include:
    • US Department of Veterans Affairs (VA): The VA includes EMDR as a first-line treatment for PTSD.
    • UK National Institute for Health and Care Excellence (NICE): NICE includes EMDR in their PTSD treatment recommendations.
    • Australian National Health and Medical Research Council (NHMRC): The NHMRC recognizes EMDR as an effective treatment for PTSD.
  • American Psychological Association (APA): While not a full endorsement, the APA included EMDR with a conditional recommendation in their 2017 Clinical Practice Guideline for PTSD treatment.

It’s important to note that some researchers and mental health professionals hold reservations about EMDR, particularly concerning the exact mechanisms by which it works. However, the weight of evidence from these reputable organizations suggests that EMDR is a well-supported and effective treatment for PTSD, with growing recognition for its potential in treating other conditions.

  • Compared to other treatments like medication or waitlist, EMDR shows moderate to strong positive effects in reducing PTSD symptoms and even eliminating the diagnosis altogether in some cases.

Beyond PTSD

While PTSD is a core area where EMDR shines, research suggests it can also be beneficial for other conditions:

  • Anxiety disorders
  • Depression
  • Phobias
  • Grief and bereavement
  • Addiction
  • Crisis Intervention
  • C-PTSD

How it Works:

EMDR’s success isn’t fully explained by one theory, but several compelling possibilities exist:

Mimicking Slow Wave Sleep: This theory suggests EMDR’s bilateral stimulation (eye movements, tapping) mimics brainwaves present during slow wave sleep, a stage crucial for emotional memory processing. By replicating this activity, EMDR might facilitate the brain’s natural ability to heal from trauma.

Dual Attention Hypothesis: This theory proposes that focusing on the bilateral stimulation while recalling a traumatic memory taxes the working memory.  Since attention is limited, the brain can’t fully engage with the distressing memory, potentially leading to a reduction in its emotional intensity.

Enhanced Memory Reconsolidation: This theory suggests EMDR helps reprocess traumatic memories. By revisiting them in a safe space with the therapist and the bilateral stimulation, the brain might integrate new, more positive information with the memory, weakening its negative impact.

It’s important to remember that these are just theories, and research into EMDR’s mechanisms continues.

The Adaptive Information Processing (AIP) model is the core theory underpinning EMDR therapy. Here’s a breakdown of its key concepts:

  • Information Processing System: The model posits that our brains have an in-built system for processing and storing experiences. This system forms interconnected memory networks that link thoughts, feelings, body sensations, and images related to those experiences.
  • Disturbing Events and Maladaptive Networks: When we experience highly stressful or traumatic events, the information processing system can become overwhelmed. These events may not be fully integrated into existing memory networks, leading to fragmented and maladaptive networks.
  • Negative Impacts: These maladaptive networks can cause problems in the present. Triggers associated with the trauma can activate the network, leading to distressing emotions, negative beliefs about oneself, and physical sensations.
  • EMDR as a Reprocessing Tool: EMDR therapy aims to reprocess these maladaptive networks. Through bilateral stimulation (eye movements, tapping, etc.) and guided recall, EMDR helps the brain revisit the traumatic memory in a safe and controlled environment.
  • Integration and Positive Change: By revisiting the memory while using bilateral stimulation, the brain is believed to be able to integrate new, more adaptive information with the memory. This can lead to a reduction in the negative emotions, beliefs, and physical sensations associated with the trauma.

The AIP model offers a framework for understanding how EMDR works and how it can facilitate healing from past traumas. It’s important to remember that the model is still evolving, but it provides a valuable foundation for understanding the potential benefits of EMDR therapy.

Important Considerations:

  • EMDR isn’t a one-size-fits-all solution. While effective for many, it might not be the best fit for everyone.
  • A qualified therapist trained in EMDR Therapy by an EMDRIA Approved Therapist  is crucial for its successful application.
  • EMDR can be emotionally challenging as it involves revisiting trauma.

Overall: EMDR is a well-studied and effective treatment for PTSD, with growing evidence for its use in other conditions. If you’re struggling with trauma or related issues, consulting a mental health professional to discuss EMDR as a potential treatment option can be helpful.

Why EMDR Matters

EMDR stands out as a beacon of hope in the fight against mental health struggles. Here’s why it’s so important:

  • Relief from Debilitating Symptoms: EMDR targets the root cause of many debilitating issues, offering a chance to break free from their hold on your life.
  • Effective Tool in a Growing Need: As mental health concerns rise, EMDR provides a readily available and powerful therapy backed by research.
  • Healing with Compassion: This approach combines scientific rigor with a deep understanding of the human experience, fostering a compassionate healing journey.
  • Empowerment Through Healing: EMDR empowers individuals to move beyond the shadows of past traumas and reclaim their full potential.
  • Groundbreaking and Transformative: EMDR represents a revolutionary approach in therapy, offering profound healing and renewed hope for a brighter future.

By wielding this powerful tool, mental health professionals can guide their clients on a path to lasting well-being.

Are you interested in taking the first step in becoming EMDR certified? Register for our upcoming Fall EMDR basic training led by Carol Miles, MSW, LCSW!

About the Author

Carol Miles, MSW, LCSW, EMDRIA-approved Basic Trainer and Consultant, is a clinical social worker specializing in individual psychotherapy and maintains a private practice with adolescent and adult clients. She also provides training and consultation for therapists developing skills in Eye Movement Desensitization and Reprocessing Therapy (EMDR Therapy) under her Three Rivers Training Center. Most of her training and therapy have been virtual since March 2020. She currently specializes in offering intensive EMDR Therapy to address trauma and healing.