EMDR Therapy: What It Is, How It Works, and When to Try It
Does it live up to the hype?
I was admittedly a bit skeptical when I began training to become an EMDR therapist. Though I had read studies and heard anecdotal reports touting the effectiveness of this popular treatment method for years, it seemed unlikely that the inclusion of eye movements and tapping could elicit such a rapid and dramatic resolution of trauma symptoms in a way that traditional talk therapy and classic exposure therapy could not.
Then I experienced it for myself. I received EMDR therapy as a part of my training and chose to target some residual PTSD symptoms I was having as a result of a car accident I was in many years ago. I was amazed by the visceral sensations and images brought about through this multi-phase technique and the quick manner in which the associated uncomfortable sensations began to dissipate. I experienced strange and intense dreams for days after, and by the next session, all remaining symptoms were completely gone.
My enthusiasm for EMDR increased further as I began to use it with clients and witnessed remarkable progress on issues that had been slow to respond to other treatment approaches. It is now a critical component of my toolbox for trauma and PTSD, and I often use it in the treatment of depression, anxiety, addiction, and OCD, among other conditions.
A Walk in the Park
Dr. Francine Shapiro tells the story of how she discovered EMDR:
“EMDR is based on a chance observation I made in May 1987. While walking through the park one day, I noticed that some disturbing thoughts I was having suddenly disappeared. I also noticed that when I brought these thoughts back to mind, they were not as upsetting or as valid as before. Previous experience had taught me that disturbing thoughts generally have a certain “loop” to them; that is, they tend to play themselves over and over until you consciously do something to stop or change them. What caught my attention that day was that my disturbing thoughts were disappearing and changing without any conscious effort. Fascinated, I started paying very close attention to what was going on. I noticed that when disturbing thoughts came into my mind, my eyes spontaneously started moving very rapidly back and forth in an upward diagonal. Again the thoughts disappeared, and when I brought them back to mind, their negative charge was greatly reduced. At that point I started making the eye movements deliberately while concentrating on a variety of disturbing thoughts and memories, and I found that these thoughts also disappeared and lost their charge. My excitement grew as I began to see the potential benefits of this effect” (Shapiro, 1995).
In the years since this discovery, despite initial criticism from the scientific community, Dr. Shapiro’s work developed from a hypothesis to a formal therapy process. EMDR therapy has been demonstrated to be effective for treating trauma in randomized clinical trials, case studies, and millions of clinical hours treating trauma and trauma-related disorders around the world. The American Psychiatric Association, the U.S. Department of Veterans Affairs (USVA) and Department of Defense (USDOD), the United Kingdom’s National Institute for Health Care and Excellence (NICE), the World Health Organization (WHO), and multiple global organizations now recognize the effectiveness of EMDR therapy.
So what exactly is EMDR therapy?
Eye Movement Desensitization and Reprocessing (EMDR) Therapy is a structured therapy that encourages the client to briefly focus on a trauma memory while simultaneously experiencing bilateral stimulation (BLS) (typically eye movements or tapping), which leads to a reduction in the vividness and emotion associated with the trauma memory. EMDR is an individual therapy typically delivered one to two times per week for a total of 6-12 sessions, although some people benefit from more or fewer sessions. It is guided by the Adaptive Information Processing model (Shapiro, 2007) which considers symptoms of PTSD and other disorders (unless physically or chemically based) to result from past disturbing experiences that continue to cause distress because the memory was not adequately processed. These unprocessed memories are understood to contain the emotions, thoughts, beliefs and physical sensations that occurred at the time of the event. When the memories are triggered by current events, the associated disturbing elements are experienced and cause the symptoms of PTSD and/or other disorders.
Unlike other treatments that focus on altering the emotions, thoughts and responses resulting from traumatic experiences, EMDR therapy focuses directly on the memory, and is intended to change the way that the memory is stored in the brain, thus reducing and eliminating the problematic symptoms. Processing of a specific memory is generally completed within one to three sessions. EMDR therapy differs from other trauma-focused treatments in that it does not include extended exposure to the distressing memory, detailed descriptions of the trauma, challenging of dysfunctional beliefs or homework assignments (APA, 2017).
EMDR therapy may be used within standard talk therapy, as an adjunctive therapy with a separate therapist, or as a treatment all by itself.
The 8 Phases of EMDR
History-taking and Treatment Planning
In addition to getting a full history and conducting appropriate assessments, the therapist and client work together to identify targets for treatment. Targets include past memories, current triggers, and future goals.
Preparation
The therapist offers an explanation for the treatment, and introduces the client to the procedures, practicing the eye movement and/or other BLS components. The therapist ensures that the client has adequate resources for affect management, leading the client through a Safe/Calm Place exercise and other breathing and grounding methods.
Assessment
This phase activates the memory that is being targeted in the session, by identifying and assessing each of the memory components: image, cognition, affect and body sensation.
Desensitization
During this phase, the client focuses on the memory while engaging in eye movements, tapping, or other bilateral stimulation (BLS). Then the client reports whatever new thoughts have emerged. The therapist determines the focus of each set of BLS; usually the associated material becomes the focus of the next set. This process continues until the client reports that the memory is no longer distressing.
Installation
The fifth phase of EMDR is installation, which strengthens the preferred positive cognition, or healthier belief about oneself.
Body Scan
During the body scan, clients are asked to observe their physical response while thinking of the incident and the positive cognition and identify any residual somatic distress. If the client reports any disturbance, standardized procedures involving the BLS are used to process it.
Closure
Closure is used to end the session. If the targeted memory was not fully processed in the session, specific instructions and techniques are used to provide containment and ensure safety until the next session.
Re-evaluation
The next session starts with phase eight, re-evaluation, during which the therapist evaluates the client's current psychological state, whether treatment effects have maintained, what memories may have emerged since the last session, and works with the client to identify targets for the current session.
Should you try EMDR?
Looking for an EMDR therapist in Los Angeles can be daunting. It is important to work with someone who has been properly trained by an EMDR International Association (EMDRIA) approved provider. My training exceeds the minimum requirements set forth by the EMDRIA, which was organized to promote, foster, and preserve education, science, and knowledge regarding EMDR therapy and trauma-informed care. As an EMDR trained therapist in Pasadena, I work with adults and children of all ages with a range of conditions in our beautiful bungalow offices. I also provide EMDR therapy virtually throughout California.
For me, the most rewarding part of being an EMDR therapist is getting to witness my clients become aware of how their unprocessed traumatic memories are tied to negative beliefs about themselves, and then having the opportunity to reprocess those memories and connect them to new, positive and adaptive beliefs about themselves. A common exclamation I hear from clients after they complete all 8 phases of EMDR is, “I feel so much lighter!”
As Dr. Francine Shapiro said, “Changing the memories that form the way we see ourselves also changes the way we view others. Therefore, our relationships, job performance, what we are willing to do or are able to resist, all move in a positive direction.”
Indeed, millions of people have been able to recover and move in a positive direction as a result of this extraordinary therapy.
If you are interested in trying this effective approach for relieving your symptoms of PTSD, depression, anxiety, or additional conditions that have not been adequately treated by other methods, please contact me to schedule a free phone consultation or book an appointment online. I would love to meet you and help you determine if EMDR is a good fit!