How does EMDR psychotherapy work?

(Getty Images/Lucy Lambriex) What to Expect During a Session of EMDR Therapy

The popularity of talk therapy is well-founded. According to therapist Kandace Ledergerber, LMHC, cognitive behavioral therapy (CBT) is one of the most well-liked types of talk therapy. It focuses on dissecting your thoughts, feelings, and behaviors “to find fresh perspectives and improve [your] thought patterns.” However, not everyone benefits from this treatment approach. Eye Movement Desensitization and Reprocessing, often known as EMDR treatment, is a technique you should be aware of if talk therapy has failed to help you.

Because it doesn’t actually entail any talking, EMDR treatment differs greatly from CBT. It’s a process, according to Ledergerber, an EMDR practitioner “bottom-up strategy that utilizes bilateral stimulation to assist clients process trauma and build on internal resources they already have. ” Get accustomed to the term “bilateral stimulation”; we’ll explain what it means in more detail later. In other words, EMDR is a novel therapy strategy that actively makes use of your brain’s biology to aid in the processing of trauma. Read on to learn how it functions, why it’s beneficial, and whether you should think about attempting EMDR therapy yourself.

EMDR Therapy: What Is It?

According to EMDR-trained psychotherapist Elizabeth Fedrick, PhD, LPC, EMDR therapy is “a sort of trauma therapy that takes place by stimulating bilateral stimulations of the brain.” A recurrent, continuous pattern of bilateral stimulation involves turning on one side of your brain before switching to the other. This can be achieved by thinking about the traumatic incident you’re trying to process while following your clinician’s finger horizontally from side to side, for example – the original style of EMDR. Dr. Fedrick notes that the strategy has now changed and “may now be facilitated through visual, aural, or tactile stimulations,” such tapping or blinking lights.

A little background: REM (rapid eye movement) sleep is where the concept for EMDR truly originates. In this phase of sleep, according to Dr. Fedrick, you digest life events, dream, and store memories in long-term memory. Your eyes naturally travel back and forth throughout REM sleep to produce bilateral stimulation. The same physical technique is used in EMDR, but it is tailored to certain traumatic occurrences. In order to work to desensitize the distressing emotions and reprocess the negative beliefs connected to it, Dr. Fedrick explains that when using EMDR, you choose which incident you wish to target and then consciously focus on this event.

What is the EMDR therapy used for?

According to Ledergerber, EMDR therapy “may help restructure the brain and process unresolved trauma.” According to Dr. Fedrick, it can actually “accelerate the therapeutic process,” noting that in certain circumstances, progress can be shown after just one session. Another advantage of EMDR therapy is that clients are not required to discuss their traumatic events with their therapist in detail. Because trauma can feel shame-inducing and be challenging (or even impossible) to communicate, Ledergerber argues that this can be useful to trauma survivors.

EMDR Therapy: How Effective Is It?

EMDR therapy has been shown in studies to be useful for a variety of mental health conditions. A 2014 review found that 24 studies supported EMDR’s effectiveness for treating “emotional trauma and other adverse life experiences,” with some of the studies finding EMDR to be “rapid and/or more effective than trauma-focused cognitive behavioral therapy.” It is primarily used for and advised to treat PTSD.

EMDR is beneficial in treating depression, according to additional study. A tiny 2015 study reported that after completing EMDR therapy, 68 percent of a sample of 16 patients getting inpatient care for depression demonstrated “complete remission” (an average of between four and five EMDR sessions over an average of nearly 46 days in treatment). They also reported fewer issues and relapses related to depression a year later. A 2017 study found that EMDR was just as effective as cognitive behavioral therapy, suggesting that it may be useful for treating conditions like panic disorder.

What Takes Place Throughout EMDR Therapy?

What exactly can you anticipate from an EMDR session now that we’ve demonstrated that EMDR therapy differs significantly from some of our preexisting ideas of therapy? Actually, there are eight stages of EMDR therapy. Some of the steps will only need to be completed once, while others will need to be completed multiple times.

Getting your medical history and making treatment plans: To find out more about your background and the reasons you’re seeking treatment, your therapist will quiz you and offer you forms to complete. You’ll decide on your therapy objectives and look into the potential advantages of EMDR. To make sure they both understand and concur on the treatment goals, Dr. Fedrick states that “[t]reatment planning is conducted jointly between the client and therapist.”

Preparation: During the preparation stage, your therapist will offer you the chance to discuss any questions or concerns you may have, create coping skills in case there are any negative side effects (more on that below), and gain an understanding of the EMDR procedure. According to Dr. Fedrick, “the preparation phase is necessary so that the client and therapist may start to create rapport and trust within the therapeutic alliance.”

Evaluation: At this point, you’ll discuss the “target memory” you want to reprocess. Although it is occasionally preferable for clients “to process lesser-charged situations first,” Ledergerber argues that this is typically either your first traumatic memory or the worst traumatic memory you have. Your therapist will establish a “baseline measurement of the distress of this experience,” according to Dr. Fedrick, and you and your clinician will discuss important parts of the trauma, such as imagery, core beliefs, feelings, and sensations. Additionally, you’ll decide which optimistic belief you’d choose to link with the recollection.

As you begin to reprocess and desensitize your target memory, your therapist will begin bilateral stimulations with you. You can explore whatever EMDR technique seems the most comfortable for you with your therapist after asking them which technique(s) they typically utilize (such as tactile, auditory, or visual). The target memory “will be active in your mind once you start reprocessing,” according to Dr. Fedrick. She continues, “but expect them to intervene very little during this time.” Your clinician should remain aware of your emotional state to advise you and assist you in regulating any overwhelming feelings.

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Installation: After the emotional distress associated with the traumatic event has subsided, you and your therapist will work to reinforce the constructive belief (the one you identified during the assessment phase) through bilateral stimulation until it resonates with you.

Body scan: According to Dr. Fedrick, your therapist will urge you to keep the target memory and your empowering belief in your mind while mentally scanning your body to see if the target memory is still causing any disturbances. Bilateral stimulation will be used by your therapist if you do discover any unfavorable emotions or disturbances to assist you in processing them.

Closure: According to Dr. Fedrick, “the closure phase is crucial because it marks the client’s return to a state of emotional regulation and tranquillity.” Even if the target memory hasn’t been fully reprocessed, this stage happens just before each session ends. Through grounding tactics, such as remembering a safe environment you and your therapist may have planned and set up before the reprocessing, your therapist will assist you in “contain[ing]” the experiences you processed. (Your safe spot is a location, actual or imagined, that gives you a sense of serenity and peace. Your therapist will install this resource using gentle bilateral stimulations after you define the sensory elements of the environment, such as what you see, hear, and feel. It is intended that you can use this space if you experience stress, overwhelm, or triggers during or in between sessions.)

Re-evaluation: According to Dr. Fedrick, the final stage occurs at the start of your subsequent EMDR session. Your therapist will check in with you at this point, inquire about your feelings over your previous session, and determine the degree of disruption surrounding your target memory and how true the new, empowering ideas seem to you.

Tips for EMDR Therapy

It could be intimidating to try EMDR therapy for the first time even if you have a concept of what it would be like. The following details are crucial to keep in mind:

Being anxious is common. According to Dr. Fedrick, “many clients have anxiety about the thoughts or sensations that may surface during this time.” Be honest with your therapist about your concerns so they can offer you resources and assist you in creating coping mechanisms to handle any possible feelings.

During EMDR, you are fully conscious, aware, and in command. You will remain awake and conscious throughout your reprocessing because EMDR is not hypnosis. If you decide to stop while the reprocessing is going on, you should definitely let your clinician know, according to Dr. Fedrick.

There is no correct or incorrect way to react to EMDR. According to Dr. Fedrick, “I frequently counsel my patients to maintain an open mind throughout this process and to try not to control where their mind wanders during the reprocessing.” “They don’t have to accomplish anything ‘right’ at this moment,”

Dangers and Risks of EMDR Therapy

Even while EMDR therapy has a lot of potential benefits for your mental health, there are some potential negative effects that are worth noting. Dr. Fedrick lists the following as examples:

more distressing thoughts or feelings

More eerie dreams lately

increased sensitivity to emotion

fatigue that might persist for days after EMDR therapy

experiencing a wave of emotion throughout the EMDR procedure

According to Dr. Fedrick, “all clients have diverse experiences when it comes to their reactions during and after the EMDR procedure.” Your therapist should confirm that you have resources and support outside of therapy before beginning EMDR to assist you deal with these possible adverse effects.

What Issues Would EMDR Therapy Help?

Trauma therapy, such as EMDR therapy, can be beneficial “for those who have suffered a wide variety of trauma,” including both “big T trauma” (events like abuse, combat, or natural catastrophes) and “little t trauma,” according to Ledergerber (the accumulated effect of “smaller,” less pronounced events).

However, EMDR therapy isn’t just used to treat trauma. The original purpose of this method was to treat post-traumatic stress disorder (PTSD), but now, according to Dr. Fedrick, it’s also used to address problems like “anxiety and panic attacks, depression, phobias, sleep troubles, complicated grief, addictions, and more.” Additionally, it can be applied to all age groups.

But EMDR isn’t right for everyone, just like any other kind of therapy. In order to make sure this process is appropriate for their current needs, Dr. Fedrick advises people who have a history of dissociation, are pregnant, have pre-existing medical conditions, are involved in legal proceedings, or don’t have a strong support system at home to let their clinician (and medical provider, if necessary) know before beginning.

For context, Dr. Fedrick notes that some studies indicates that EMDR may “affect or damage” the veracity of your recall of the incident you are reconstructing. Therefore, you might not be able to clearly recall the memory for potential testimony if you’re involved in a court process that involves the target memory. If you plan to use EMDR while going through legal processes, be sure to discuss your options with your therapist and lawyer, if you have one.

Know that EMDR therapy may provoke some “heated and distressing emotions, triggers, and thoughts” before you decide to try it, according to Ledergerber. Before processing that trauma, it is crucial to establish a trusting rapport with the therapist and feel safe. Before beginning your EMDR adventure, take your time and choose the best therapist for your requirements.