Fieldwork Counselling

All about Eye Movement Desensitization and Reprocessing (EMDR)

Eye Movement Desensitization and Reprocessing (EMDR) is a psychotherapy that has gained popularity in recent years due to its effectiveness in treating a wide range of psychological conditions, particularly trauma-related disorders. EMDR utilizes bilateral stimulation — such as eye movements, audio tones, or tapping — to help clients process distressing memories and experiences.

Originally developed in the late 1980s by psychologist Francine Shapiro, it was initially used to treat post-traumatic stress disorder (PTSD), but it has since been found to be effective for various other conditions, such as anxiety, depression, panic disorder, phobias, and even substance use disorders.

EMDR has become popular in recent years due to its ability to rapidly improve clinical symptoms in individuals suffering from trauma. Research has shown that with EMDR, traumatic experiences are processed in a way that reduces their emotional impact, allowing the individual to heal from the distress and move forward. The use of bilateral stimulation during the therapy session helps to reprocess traumatic memories, thus reducing their intensity and associated symptoms.

Compared to other trauma-focused treatments like cognitive processing therapy, exposure therapy, and prolonged exposure therapy, EMDR differs in its approach. While these therapies aim to help individuals confront and process traumatic memories through cognitive restructuring or repeated exposure, EMDR utilizes bilateral stimulation to facilitate the processing of these memories. As a result, many people find EMDR to be a gentler, easier, and more effective way of treating trauma.

In the following sections, we will delve deeper into the process of EMDR therapy, explore the technique of bilateral stimulation, discuss its significance in treating trauma, and outline its effectiveness in improving clinical symptoms.

What is EMDR?

EMDR was developed in the late 1980s by psychologist Francine Shapiro. Initially, Shapiro discovered that moving her eyes from side to side seemed to reduce the intensity of her negative thoughts and emotions. Intrigued by this, she began exploring the therapeutic potential of eye movements for trauma-related conditions. Shapiro’s research led to the development of EMDR, which is now recognized as an evidence-based therapy for the treatment of various psychological disorders, particularly post-traumatic stress disorder (PTSD).

EMDR works by harnessing the brain’s natural ability to process information and integrate traumatic experiences. During an EMDR session, the client recalls distressing memories while simultaneously engaging in bilateral stimulation, typically achieved through eye movements, taps, or sounds. This bilateral stimulation is believed to activate the brain’s information processing system, allowing traumatic memories to be reprocessed and integrated into the client’s existing memory networks in an adaptive way.

The specific mechanisms underlying EMDR’s effectiveness are not fully understood, but it is believed that the bilateral stimulation facilitates the access of traumatic memories, their associated emotions, and negative beliefs, allowing for a reevaluation and restructuring of all these elements. This process eventually leads to a reduction in emotional distress and the development of new insights and perspectives on the trauma. EMDR is also thought to promote the formation of new neural connections, facilitating adaptive functioning and healing.

In contrast to other therapies that focus exclusively on the cognitive, emotional, or somatic (body-based) experiences of trauma, EMDR combines all of these to address traumatic memories and their associated symptoms in thinking, feeling, and in the body. Through a structured protocol, EMDR aims to transform distressing experiences into more adaptive memories, allowing people to move forward and lead healthier, more fulfilled lives.

History of EMDR

EMDR therapy was developed in the late 1980s by psychologist Dr. Francine Shapiro. Originally, Shapiro was studying the effectiveness of eye movements on reducing negative thoughts and emotions. However, serendipitously, she discovered that the therapy had a profound impact on alleviating the symptoms of post-traumatic stress disorder (PTSD).

Initially, EMDR therapy was designed to target the emotional distress associated with trauma. It aimed to provide a comprehensive treatment approach that could help individuals process traumatic memories and reduce the intensity of associated symptoms. PTSD, a condition prevalent among war veterans, accident survivors, and survivors of abuse, was the initial target for EMDR therapy.

The therapeutic process of EMDR therapy is guided by the Adaptive Information Processing (AIP) model. Based on this model, trauma can interfere with the normal functioning of the brain, leading to the storage of unprocessed memories. Unprocessed memories can result in the emergence of distressing symptoms such negative beliefs, avoidance behaviours, and nightmares, amongst others. EMDR therapy facilitates the reprocessing and integration of these memories into the individual’s cognitive and emotional framework. Through bilateral stimulation, either through eye movements or other forms, individuals engage in a series of specific techniques that facilitate the processing of unprocessed memories.

Overview of how EMDR works

The process of EMDR involves eight distinct phases of treatment. The first phase is history-taking, where the therapist gathers information about the client’s traumatic experiences and identifies negative beliefs associated with them. The second phase focuses on preparing the client for the therapy by teaching various coping techniques and relaxation exercises.

The next phases involve targeting specific traumatic memories. The therapist helps the client select a specific memory and identifies strong negative beliefs related to it. The client then focuses on the memory while engaging in bilateral stimulation, which can be achieved through eye movements, tapping, or auditory stimulation.

Bilateral stimulation is used to bypass the brain’s processing area, leading to the reprocessing of traumatic memories. This bilateral stimulation helps to activate both the left and right hemispheres of the brain simultaneously, allowing the processing of traumatic events to occur.

As the client engages in bilateral stimulation, the therapist guides them through a series of sets, during which the negative beliefs associated with the trauma are challenged and replaced with more positive ones. This reprocessing of memories and beliefs continues until the client experiences a significant reduction in distress and a shift towards positive emotions and beliefs.

Through these eight phases, EMDR works by reprocessing traumatic memories and changing negative beliefs to positive ones.

Who can benefit from EMDR therapy?

EMDR can be immensely beneficial for individuals who have experienced traumatic events or suffer from various mental health conditions. This evidence-based psychotherapy approach aims to alleviate distress and promote healing by targeting and processing the effects of traumatic memories.

People who have been diagnosed with PTSD are among those who can greatly benefit from EMDR therapy. This includes individuals who have experienced traumas like physical, emotional or sexual assault or abuse, natural disasters, accidents, or work-related accidents. EMDR can help people process the distressing memories associated with these traumas and alleviate the symptoms of PTSD, such as flashbacks, nightmares, and anxiety.

Additionally, EMDR therapy can assist individuals experiencing anxiety disorders, panic disorders, depression, and phobias. It can be particularly effective for those who have undergone disturbing experiences in their past that contribute to their current symptoms. By targeting and desensitizing the disturbing memories, EMDR helps individuals reprocess and integrate the traumatic material, enabling them to experience relief and regain control over their lives.

Who Can EMDR Help?

Primarily, trauma survivors can greatly benefit from EMDR therapy. This includes individuals who have experienced a single traumatic event, such as a car accident or assault, as well as those who have endured prolonged or repeated traumas, such as abuse or combat. 

EMDR therapy is suitable for both children and adults of all ages. Children who have experienced trauma, such as witnessing violence or going through a natural disaster, can find relief and healing through the therapy. Additionally, individuals struggling with anxiety disorders, depression, or chronic illnesses can benefit from EMDR therapy. The therapy helps address the underlying trauma that may be contributing to these mental health conditions, leading to improved emotional well-being.

Understanding Traumatic Memories

Traumatic memories refer to the recollection of distressing experiences that have left a deep impact on an individual’s psychological well-being. These memories often stem from events that are perceived as life-threatening or emotionally overwhelming, such as physical or sexual abuse, natural disasters, or witnessing violent acts. The process of understanding traumatic memories involves gaining insight into how they are stored and retrieved by the brain, the impact they have on an individual’s daily functioning, and the various therapeutic approaches that can help individuals cope with and overcome the effects of these memories. Additionally, understanding traumatic memories requires recognizing the complex nature of trauma and its implications for both the individual and society as a whole. Through a deeper understanding of traumatic memories, we can strive to create a supportive and empathetic environment that fosters healing and growth for survivors.

Traumatic memories can have a profound impact on mental health, affecting various aspects of a person’s life including relationships, job performance, and personal boundaries. One of the ways in which traumatic memories affect relationships is by causing trust issues and difficulty in forming close connections with others. Individuals may struggle with intimacy and struggle to establish healthy boundaries or maintain healthy relationships due to fear of potential harm or retraumatization. Additionally, the emotional distress caused by traumatic memories can lead to irritability, anger, and emotional detachment, further straining relationships.

In terms of job performance, traumatic memories may result in difficulties with concentration, memory impairment, and decreased productivity. The intrusive nature of traumatic memories can make it challenging to focus on tasks or engage fully in work-related activities. Additionally, the emotional distress caused by these memories may lead to decreased motivation, low self-esteem, and absenteeism.

Personal boundaries can also be significantly impacted by traumatic memories. People with a history of trauma may struggle with setting and enforcing boundaries, as they may fear rejection, abandonment, or further abuse. This can make it challenging to prioritize one’s own needs and engage in self-care practices.

The benefits of EMDR therapy span across various demographics, making it accessible for people of all ages, languages, and cultural backgrounds. Unlike other forms of therapy that heavily rely on verbal processing during sessions, EMDR utilizes bilateral stimulation techniques, such as eye movements or tapping, which do not require extensive verbal engagement. This makes it suitable for individuals who may prefer to keep particular aspects of the trauma private (for example, with sexual assault).

Symptoms of Post-Traumatic Stress Disorder (PTSD)

Post-traumatic stress disorder (PTSD) is a mental health condition triggered by a traumatic event. It can cause significant distress and disrupt various aspects of an individual’s life. The symptoms of PTSD can be categorized into four main groups: intrusive memories, avoidance, negative changes in thinking and mood, and changes in physical and emotional reactions.

Intrusive memories are one of the hallmark symptoms of PTSD. This can include distressing and recurrent memories, flashbacks, or nightmares about the traumatic event. Individuals may experience intense emotional and physical reactions when they are exposed to reminders of the event.

Avoidance is another common symptom of PTSD. This can involve avoiding thoughts, feelings, places, or people that remind the individual of the traumatic event. They may also experience a reduced interest in activities they previously enjoyed and have a sense of detachment from others.

Negative changes in thinking and mood can manifest in individuals with PTSD. They may have distorted thoughts about themselves, others, or the world. They may also experience feelings of guilt, shame, or fear. Individuals may struggle with memory problems, have difficulty concentrating, and experience a consistent negative mood.

Changes in physical and emotional reactions are also seen in PTSD. These can include being easily startled, feeling on edge or constantly on guard, or having difficulty sleeping. Individuals may experience outbursts of anger or irritability, and they may engage in risky or self-destructive behaviors.

Post-traumatic stress disorder symptoms can manifest differently in individuals who have experienced trauma, but these categories help identify and understand the wide range of symptoms that can occur. It is important to seek professional help if you or someone you know is experiencing these symptoms to ensure appropriate treatment and support.

Bilateral Stimulation in EMDR

Bilateral stimulation, specifically referred to as the eye movement component in EMDR, involves the use of rhythmic left-right stimulation to facilitate the processing and integration of distressing memories or traumatic events. Bilateral stimulation can be done with other methods besides eye movements, including with one’s own hands (e.g. “the butterfly hug”), with devices that sit in the hands (commonly called “buzzers”) or with tones played through headphones.

Bilateral stimulation refers to the use of sensory stimulation that alternates between the left and right sides of the body. The bilateral stimulation used in EMDR therapy works by engaging the left and right hemispheres of the brain. The alternating stimulation prompts communication and integration between the two hemispheres, facilitating the processing of traumatic memories or distressing experiences.

By engaging both hemispheres of the brain, bilateral stimulation promotes emotional regulation. Traumatic memories are typically stored in the right hemisphere, which is responsible for emotions and nonverbal experiences. The left hemisphere, responsible for language and logical processing, is often underactive during traumatic recall. Bilateral stimulation helps activate the left hemisphere, allowing the individual to access more adaptive processing and cognitive understanding of the traumatic event.

While the exact mechanism of how bilateral stimulation works remains uncertain, research suggests that it may mimic the natural process of REM sleep, where the brain is known to process and integrate memories. Another theory posits that bilateral stimulation works by keeping people grounded in the present as they recall past trauma, allowing them to not be overwhelmed by the traumatic memories.

How bilateral stimulation aids in processing traumatic memories

According to the AIP model of trauma, traumatic memories become separated and unprocessed in the brain’s various networks, leading to distressing symptoms such as intrusive thoughts, flashbacks, and emotional distress. The presence of these symptoms suggest that integration of the traumatic events has not occurred. Bilateral stimulation is thus thought to work by stimulating both hemispheres of the brain simultaneously, which promotes the connection between the logical, rational side of the brain and the emotional, sensory side.

During bilateral stimulation, side-to-side eye movements or hand tapping enhances the communication between the right and left brain hemispheres, facilitating the storage of traumatic memories into long-term memory. This process allows individuals to reprocess the traumatic memories in a more adaptive way, reducing the distress associated with those memories.

Studies have shown that bilateral stimulation promotes the desensitization of traumatic memories by decreasing the physiological arousal linked to those memories. It also facilitates the integration of memories into the overall neural network, enabling individuals to gain a new perspective on the traumatic event.

The 8 Phases of EMDR

EMDR consists of 8 distinct phases, which provide a structured framework to guide both the therapist and the client through the treatment process, with the goal of reprocessing the traumatic memories and replacing them with more adaptive beliefs and emotions.

Phase 1

Phase 1 involves essential steps such as history-taking, discussing past traumatic experiences, identifying current stresses, and developing a targeted treatment plan. The purpose of this phase is to establish a therapeutic alliance with the client, gather comprehensive information about their background, and lay the foundation for subsequent phases.

During history-taking, the therapist collects detailed information about the client’s personal history, trauma history, and relevant background information. This helps create a contextual understanding of the client’s experiences and provides important insights into their presenting concerns. The therapist also assesses the client’s current functioning and identifies any specific symptoms, triggers, or concerns that are affecting their daily life.

Phase 1 also includes exploring current stresses and challenges the client is facing. These current stressors may be related to past traumatic incidents or may be unrelated but impact the client’s overall well-being. Understanding the current stresses helps the therapist prioritize treatment focus and establish a sense of safety and stabilization.

Based on the information gathered in Phase 1, a targeted treatment plan is developed. This plan includes identifying specific memories or incidents that will be the focus of subsequent reprocessing sessions. The treatment plan outlines the goals for therapy, which may involve reducing distress around traumatic memories, addressing current stressors, or improving overall mental health and functioning.

Phase 2

Phase 2 focuses on establishing a therapeutic relationship with the client and teaching self-regulation techniques. These techniques aim to help the client manage any distressing emotions that may arise during the therapy process. By learning self-control techniques, the client gains a sense of autonomy and empowerment. These techniques commonly include paced breathing exercises and grounding techniques, as well as other coping strategies that the client can utilize to regulate both inside and outside of therapy sessions.

Phase 3

In Phase 3, the therapist assists the client in identifying traumatic memories and selecting an image to represent each memory. This phase is crucial as it allows the client to establish a focused target for processing and helps them gain a deeper understanding of their traumatic experiences.

During this phase, the client is encouraged to recall and acknowledge the negative beliefs associated with each memory. These negative beliefs often arise from the trauma and can significantly impact one’s self-perception and worldview. The therapist helps the client recognize these negative beliefs, such as “I am helpless,” “I am unworthy,” or “I am not safe.”

Furthermore, the client is also encouraged to identify any physical sensations that are present when recalling the traumatic memories. These physical sensations can manifest as tension, pain, or discomfort in various areas of the body. By bringing awareness to these sensations, the client can develop a greater understanding of the physiological impact of their trauma.

Once the negative beliefs and physical sensations have been identified, the client is guided to identify a positive thought that can replace the negative beliefs. This positive thought should challenge the negative beliefs and provide a healthier and more adaptive perspective. 

Phase 4

Phase 4 focuses on desensitization. During this phase, the therapist guides the client in reprocessing the traumatic material and reducing the emotional intensity associated with it.

The therapist facilitates desensitization by directing the client’s bilateral stimulation while they concentrate on the traumatic material. The bilateral stimulation create a dual attention state, allowing the client to access and process the traumatic memories in a safer and more controlled manner.

As the client focuses on the traumatic material and engages in bilateral stimulation, various physical sensations can arise. These sensations can range from mild to intense and may include feelings of lightheadedness, dizziness, or tingling in different parts of the body. Additionally, clients may experience changes in their breathing patterns or muscle tension. These physical sensations are considered normal and part of the reprocessing experience.

Phase 5

Phase 5 is known as the “installation” phase. During this phase, the therapist helps the client reinforce the positive thoughts identified in Phase 3. The purpose of this phase is to ensure that the positive thoughts become integrated into the client’s belief system, promoting healing and empowerment.

To assist the client in installing positive thoughts, the therapist uses sets of bilateral stimulation, which can be eye movements, taps, or sounds. The client is instructed to focus on the chosen positive thought while simultaneously engaging in bilateral stimulation. This process aids in the integration of positive thoughts with the client’s emotional and cognitive systems.

The client is also encouraged to pay attention to the associated image, negative thoughts, and body sensations related to the distressing event. By directing their focus to these elements, the client can deepen their understanding of the negative beliefs underlying their distress.

The therapist guides the client in exploring any resistance or lingering negative emotions related to the distressing events. Through this exploration and adjustment process, the client can achieve a more deeply held and authentic positive belief statement. This adjustment is significant because it allows the client to address the root causes of their distress and set the foundation for healing. By integrating the positive belief, the client can experience a reduction in distress and the transformation of their subjective experience of the distressing events.

Phase 6

Phase 6 focuses on integrating any residual distress that may still be present after the reprocessing of the target memory. The purpose of this phase is to ensure that any negative body sensations or residual distress related to the trauma are addressed and resolved.

During Phase 6, the therapist utilizes the body scan technique to help the client explore and identify any physical sensations or discomfort that may be linked to the original traumatic event. This technique involves guiding the client to scan their body, paying careful attention to any areas of tension, discomfort, or body sensations that arise.

As the client identifies these physical sensations, the therapist targets them for further processing. This involves utilizing EMDR techniques, such as bilateral stimulation, to help the client process and release any residual distress associated with these sensations. The therapist works with the client to guide them in reprocessing the physical sensations, allowing them to release any remaining negative emotions or distress that may be stored in the body.

Phase 7

Phase 7 involves the therapist instructing the client to keep a log throughout the week. The therapist will guide the client on how to maintain this log, which typically includes noting any distressing experiences, thoughts, or emotions that arise outside of the therapy sessions.

The purpose of this log is to help the client become more aware of any residual or triggering issues that may still be present. It allows the client to track their progress and provides valuable information for the therapist to assist in further processing and desensitizing these distressing experiences. By keeping a log, the client gains insight into their triggers and symptoms, helping them to better understand themselves.

This log has a strong connection to the self-calming activities mastered in Phase 2. The log serves as a tool for the client to identify situations that may require the use of these self-calming activities. By recognizing triggers and promptly employing self-soothing techniques, clients can develop healthier coping mechanisms for dealing with distressing emotions or thoughts between therapy sessions.

Phase 8

Phase 8 involves reevaluating the effectiveness of the treatment. This phase is crucial as it allows the therapist to assess whether the treatment has been successful, and if not, to make any necessary adjustments or modifications to ensure continued progress. Additionally, Phase 8 aims to identify any additional traumatic effects that may have been previously overlooked or that have emerged during the treatment process.

The first step of Phase 8 is to conduct a thorough evaluation of the treatment’s effectiveness. This involves analyzing the progress made by the client and determining whether the identified goals and objectives have been achieved. Assessment tools and measurements are utilized to gather data and evidence-based evaluations to determine the overall effectiveness of the treatment approach.

If the treatment has yielded positive results and the client has made significant progress, the therapist may proceed to the next phase of therapy, with the understanding that ongoing support may still be necessary to maintain the gains made.

However, if the treatment has not been effective or if additional traumatic effects have emerged, further adjustments or modifications to the treatment plan are made. This could involve revisiting certain therapeutic techniques, exploring different interventions, or addressing any unresolved issues or traumas that have surfaced.

Efficacy of EMDR

EMDR has been shown to be highly effective in treating various mental health conditions, including PTSD, depression, and certain

In treating PTSD, EMDR has consistently demonstrated its effectiveness. Numerous studies have found that EMDR therapy significantly reduces PTSD symptoms, such as intrusive thoughts, nightmares, and flashbacks. One study involving combat veterans showed that EMDR therapy resulted in a 77% reduction in PTSD symptoms compared to a 42% reduction in those receiving other forms of therapy.

EMDR therapy has also been found to be effective in treating panic disorder. A study published in the Journal of Consulting and Clinical Psychology found that EMDR significantly reduced panic disorder symptoms and improved overall functioning in individuals with panic disorder.

Depression is another mental health condition that EMDR therapy has shown promising results in. A meta-analysis of multiple studies found that EMDR therapy was effective in reducing depressive symptoms in both adults and children.

It is important to note that EMDR therapy doesn’t just target specific mental health conditions, but also addresses trauma symptoms more broadly. EMDR works by helping individuals process and integrate traumatic memories, leading to symptom reduction and improved overall mental health.

Pros and Cons of EMDR

EMDR has gained popularity in recent years as a highly effective treatment for trauma and PTSD. It has several notable advantages, making it an appealing option for many individuals. Firstly, extensive research has shown that EMDR is effective in reducing the symptoms of trauma and PTSD. Studies have consistently demonstrated positive outcomes, making it a trusted therapy option.

Another advantage of EMDR is its ability to produce faster results compared to traditional talk therapy. While the exact duration varies depending on the individual, many clients report significant improvement in a shorter period. This can be particularly beneficial for those who are seeking relief from distressing symptoms.

Moreover, EMDR requires minimal homework between sessions, which can be helpful for individuals with limited time or resources. Unlike other therapies that often require substantial practice outside of sessions, EMDR therapy primarily focuses on processing memories during the therapy session, reducing the need for additional exercises.

However, there are also some disadvantages to consider when opting for EMDR. Despite its effectiveness, the underlying mechanisms of EMDR therapy are not entirely understood. While the eye movements or other bilateral stimulation used in EMDR are believed to facilitate processing, exactly how this occurs remains unclear. This lack of understanding may make some individuals hesitant or skeptical about trying this treatment.

Additionally, EMDR can initially be emotionally challenging as it involves revisiting traumatic memories. This may be uncomfortable or distressing for individuals, and the therapy process can be emotionally intense. However, this discomfort is often a necessary part of the healing process, and is usually only briefly encountered.

Conclusion

In conclusion, while EMDR has shown promising results in treating various psychological disorders, further research is needed to fully understand its potential applications and benefits. Although this therapy has shown promise in treating conditions such as PTSD, phobias, and anxiety, more research is required to investigate its effectiveness in other mental health conditions.

EMDR therapy is highly effective for individuals who have experienced trauma, whether it be due to a past event or ongoing experiences. It is particularly beneficial for those who suffer from post-traumatic stress disorder (PTSD), anxiety, depression, or other issues related to trauma. EMDR therapy helps individuals process traumatic memories in a safe and controlled environment, allowing them to reprocess these memories in a healthier way.

If you are considering EMDR therapy, it is recommended to speak with a registered counsellor who is trained in EMDR. They will be able to assess whether EMDR therapy is the right approach for you and provide guidance on what to expect during the therapy sessions. Additionally, talking to your primary care physician or a mental health professional can help you determine if EMDR therapy is a suitable treatment option for your specific needs. Seeking professional guidance and support is crucial in ensuring that you receive the most effective and appropriate care, and helping you realize your hope for inner peace and calm.