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FAQs:
What is EMDR Therapy?
EMDR is a structured therapy that encourages the patient to focus briefly on the trauma memory while simultaneously experiencing bilateral stimulation (typically eye movements), which is associated with a reduction in the vividness and emotion associated with the trauma memories. Eye Movement Desensitization and Reprocessing (EMDR) therapy is an extensively researched, effective psychotherapy method proven to help people recover from trauma and PTSD symptoms. Ongoing research supports positive clinical outcomes showing EMDR therapy as a helpful treatment for disorders such as anxiety, depression, OCD, chronic pain, addictions, and other distressing life experiences (Maxfield, 2019). EMDR therapy has even been superior to Prozac in trauma treatment (Van der Kolk et al., 2007). Shapiro and Forrest (2016) share that more than 7 million people have been treated successfully by 110,000 therapists in 130 countries since 2016.
Who Benefits from EMDR Therapy?
Much of the research done on EMDR has been with patients suffering from PTSD, a disorder often caused by a traumatic event that leaves lingering stress, anxiety, and flashbacks of the event. Studies have found that EMDR therapy can, “significantly reduce the symptoms of PTSD, depression, anxiety and subjective distress in PTSD patients.” While not as robust as the research on EMDR’s effect on patients with PTSD, there is also significant research finding EMDR to be beneficial for people with anxiety disorders, panic disorder, depression, addiction, and eating disorders. It’s important to use EMDR, “when the client is stable enough (meaning no current drug or alcohol use or immediate safety needs) to be able to process their trauma, anxiety, and/or depression.
Does EMDR Work for Anxiety?
EMDR therapy for Post-Traumatic Stress Disorder (PTSD), depression, or panic disorder does not differ from EMDR for anxiety. Many mental health disorders require desensitization and EMDR for anxiety is no exception. Many individuals suffer anxiety as a result of their trauma. EMDR for anxiety can help as it aids you in feeling liberated from your memories.
Although EMDR therapy during anxiety treatment is widely practiced, it can be used to treat a variety of other mental health conditions. Other than EMDR for anxiety, small pilot studies have found this therapy to be especially effective for those who suffer forms of PTSD and psychotic symptoms that arise from trauma.
For those who want to consider a form of therapy, studies comparing the effectiveness of EMDR and Cognitive-Behavioral Therapy (CBT) have proven that EMDR is just as effective. Both forms of therapy help reduce the symptoms related to anxiety, such as PTSD or panic disorders. Some common mental health disorders or trauma-associated symptoms that can be treated through the use of EMDR or CBT include:
- Psychosis
- Unipolar depression
- Bipolar disorder
- Anxiety disorders
- Agoraphobia
- Chronic back pain
EMDR is particularly effective for agoraphobia when past traumatic experiences are contributing to your current symptoms. EMDR was created to help people deal with and heal from experiences that have caused emotional trauma. Furthermore, EMDR therapy can be especially beneficial to those who suffer from non-traumatic symptoms such as mood disorders or chronic pain. Those who suffer from chronic pain may also suffer from anxiety and depression which is easily treated in EMDR. EMDR for anxiety and other mental health disorders can improve the quality of life for any individual just as CBT would.
Can EMDR Help with Repressed Memories?
EMDR does not recover repressed memories. The brain is doing only what it is able to and feels comfortable doing. I know this sounds strange, but our brain is a fantastic protective tool. EMDR only assists the brain in reprocessing unstable processed memories. If the brain has locked away memory, it has done so for a reason. This therapy will not unlock something that it is not ready for. Only time will do that. I have never had a client randomly unlock repressed memories through reprocessing that they were not working to try to remember in the first place.
Is EMDR Evidence Based?
Eye Movement Desensitization and Reprocessing (EMDR) is an evidence-based treatment for post-traumatic stress disorder (PTSD). This means that it has been studied by many researchers and found to be effective in treating PTSD. Most people who complete 1-3 months of weekly 50-90 minute sessions of EMDR show a noticeable improvement in PTSD symptoms. Many people start to notice improvements after a few sessions. After trauma, people with PTSD often have trouble making sense of what happened to them. EMDR helps people process the trauma, which allows your loved one to start to heal. In EMDR, your loved one will pay attention to a back-and-forth movement or sound while calling to mind the upsetting memory until shifts occur in the way that memory is experienced and more information from the past is processed.
Can You Do EMDR on Yourself?
The short answer is partially. It is possible to learn how to cope with the anxiety and distress that comes up from experiencing a traumatic memory. Being able to handle these moments effectively can help in your recovery process. However, obtaining the full benefits of EMDR requires being able to talk with a therapist to process the memories and resolve them. His or her support can be helpful for stretching yourself to face memories that you may be more tempted to avoid. The result is a more in-depth process than what you would get along.
EMDR is a safe and effective technique for those who struggle with traumatic memories and want help. Clients can incorporate EMDR into their everyday lives for periods when these images come up. A therapist though can help you get the full benefit of this technique by guiding you through the process. Also, it helps that therapists can be a sounding board, aid your navigation through tough memories, and help you resolve the past.
Is EMDR Dangerous?
EMDR is a safe technique for processing trauma. There may be times when very difficult memories come to the surface. These can be processed to better understand them. You can always stop until you feel better. The EMDR Institute notes that there isn’t any evidence that EMDR will cause seizures. Only three people have had seizures using EMDR, and they already had seizures prior to treatment.
Does EMDR Therapy Actually Work?
According to the EMDR Institute, Inc., some of the studies on this type of therapy show that 84-90% of single-trauma victims no longer have post-traumatic stress disorder after only three 90-minute sessions.
Another study, funded by the HMO Kaiser Permanente, found that 100% of the single-trauma victims and 77% of multiple trauma victims no longer were diagnosed with PTSD after only six 50-minute sessions. In another study, 77% of combat veterans were free of PTSD in 12 sessions.
What is also different about this type of therapeutic intervention is that the therapist does not conversationally converse with the client while going through the process.
Following an EMDR session, it's not unusual for sleep to be impacted. Vivid dreams are common as well as feeling more sensitive to interactions with others and to external stimuli.
EMDR Therapy is not the only form of therapy appropriate for people dealing with anxiety, PTSD, panic, and/or trauma. EMDR therapy is often conducted in conjunction with other forms of therapy.
Speak with your therapist about combinations of therapy or other therapeutic techniques that might be effective for you.
Cognitive behavioral therapy (CBT), and rational emotional behavioral therapy (REBT) can also be effective for anxiety and trauma.
What Does Research Say About EMDR?
Since the introduction of EMDR in 1987, a number of studies have found support for its effectiveness. A 2014 review of 24 studies suggested EMDR:
- can help relieve emotional distress after adverse experiences
- may work more quickly and effectively than trauma-focused cognitive behavioral therapy (CBT)
- may help ease somatic symptoms, like pain or muscle tension
Research findings have led the American Psychological Association to conditionally recommend EMDR for the treatment of PTSD. A conditional recommendation means that, while research suggests positive treatment outcomes, there’s not yet enough evidence to recommend it to everyone across the board.
The Department of Veterans Affairs also recommends EMDR as one primary option for treating PTSD.
Here’s a closer look at what research has to say about EMDR’s effectiveness:
1. For depression. A 2015 study of 32 people receiving inpatient care for depression found that EMDR therapy showed promise as a treatment: 68 percent of those receiving EMDR showed full remission after treatment. After EMDR, they noted more improvements in depression symptoms overall, plus fewer relapses and depression-related concerns at follow-up over a year later.
2. For children. A 2012 summary of research studies suggested EMDR may have benefits for treating a single instance of trauma in children. While EMDR also shows promise as a treatment for repeated trauma, like abuse, experts agree on the need for more research.
3. For panic disorder. A 2017 study involving 84 people with panic disorder suggested EMDR is just as effective at treating panic disorder symptoms as CBT.
After a stressful event requiring ER treatment. A 2018 study found that a single 1-hour session of EMDR appeared to help prevent post-concussion-like symptoms in patients who received emergency room care after a stressful event.
For refugees with PTSD. A small 2018 study explored the benefits of EMDR for Syrian refugees with PTSD. Of the 18 participants who received EMDR in a group therapy intervention, just over 61 percent no longer met the criteria for a PTSD diagnosis afterward. Those who received EMDR also reported fewer symptoms of depression.
For psychosis. According to a 2020 review of six studies, EMDR may help treat psychosis with no adverse effects. In all six studies, EMDR helped decrease delusions and negative symptoms, and participants reported less use of medication and mental health services. Some participants also noticed a decrease in hallucinations and paranoia. The review authors noted the need for larger trials to support these benefits.
How Much is EMDR Therapy?
The cost of EMDR (Eye Movement Desensitization and Reprocessing) therapy can vary depending on several factors such as the therapist's location, qualifications, experience, and practice setting.
The cost for a single EMDR therapy session in the United States can range from approximately $75 to $250 per session. However, some therapists may charge more or less depending on their location and practice.
It's important to note that many insurance companies cover EMDR therapy for individuals who have been diagnosed with post-traumatic stress disorder (PTSD) or other mental health conditions. However, the coverage and out-of-pocket costs can vary depending on the specific insurance plan.
If you're interested in EMDR therapy, it's recommended that you check with your insurance provider to determine if EMDR therapy is covered and what the associated costs may be. Additionally, you can check with local EMDR therapists to get an idea of their fees and any potential insurance coverage. Some therapists may also offer a sliding scale fee based on income, so it's worth asking about this as well.
Is EMDR Basically Hypnosis?
EMDR and hypnotherapy are two very different and distinct modalities. Both can be effective and often, this may depend on a variety of factors unique to each therapist and patient. Generally, there are several key differences between hypnosis and EMDR:
During hypnosis, a state of mental relaxation is employed to tap into the conscious mind. EMDR, on the other hand, attempts to gently connect with an anxious mental state.
Hypnosis assists you in maintaining one highly focused state where you can receive and accept new ideas. EMDR allows you to maintain a dual focus by addressing your beliefs in a more positive manner while dealing with problematic memories.
The most fundamental difference is that EMDR does not induce the trance-like state attributed to hypnosis. EMDR continually grounds you by honing in on emotions and sensations as a way of remaining connected to reality.
How Did EMDR Therapy Start?
In the late 1980s, Francine Shapiro, Ph.D., discovered a connection between eye movement and persistent upsetting memories. With this personal insight, she began what became a lifelong study and development of Eye Movement Desensitization and Reprocessing (EMDR) therapy.
Over the years, and in the face of initial skepticism, 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 across the globe. 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), and the World Health Organization (WHO), multiple global organizations now recognize the effectiveness of EMDR therapy that Dr. Shapiro developed.
Conditions that EMDR Can Treat
EMDR is generally recommended for people living with overwhelming traumatic memories and symptoms of PTSD. You may find it particularly helpful if you have a hard time sharing the trauma you’ve experienced with others, including therapists.
To date, limited evidence supports the effectiveness of EMDR for other mental health conditions, but some mental health professionals may also recommend it for treatment:
- depression
- anxiety
- panic attacks
- eating disorders
- substance use disorders
A 2017 systematic review of existing research suggested EMDR could potentially have benefits for people who have a history of trauma along with certain conditions, including:
- bipolar disorder
- depression
- psychosis
- anxiety disorders
- substance use disorders
- low back pain
For the most part, EMDR appears to be a safe intervention for a range of mental health symptoms, but future research may offer more conclusive support for its effectiveness.
The Advantages and Disadvantages of EMDR
- It works. Dozens of studies have found that EMDR is effective.
- It tends to work faster than other forms of therapy. People receiving EMDR typically start seeing results much sooner than with other forms of therapy.
- It involves less homework. Other forms of therapy typically involve journaling or other types of homework outside of your sessions. EMDR usually involves only writing down any thoughts or ideas you want to bring up at your next session (if and when those thoughts happen).
- It’s usually less stressful. EMDR focuses on processing and moving past your trauma. Other methods involve having you describe and even relive negative events.
Disadvantages
EMDR does have some drawbacks compared to other forms of therapy.
- It only works with conditions related to traumatic experiences. If you have a mental health condition because of an inherited condition, an injury, or other physical effects on your brain, EMDR is unlikely to help.
- Why it works is still theoretical. EMDR was an accidental discovery. Experts still can't fully explain why it works, despite the evidence that it works.
- It’s a new method. EMDR’s creation happened in 1989, while other forms of therapy have been in use for much longer. More research is necessary before experts know if EMDR is a long-term solution or if people need additional therapy years or decades later.
The 8 Phases of EMDR
EMDR therapy consists of eight phases. These phases occur over multiple sessions, with one session sometimes using parts of several phases. An example of this would be how phases 1 and 2 typically happen only in early sessions, while phases 3 through 8 are part of multiple sessions later.
For a single disturbing event or memory, it usually takes between three and six sessions. More complex or longer-term traumas may take eight to 12 sessions (or sometimes more). Sessions usually last between an hour and 90 minutes. The eight phases are:
1. Patient history and information gathering. This part of the process involves your healthcare provider gathering information about you and your past. This helps them determine if EMDR is likely to help you. It also includes asking about upsetting or disturbing events and memories that you want your therapy to focus on, as well as your goals for this therapy.
2. Preparation and education. During this phase, your healthcare provider will talk to you about what will happen during EMDR sessions and what you can expect. They’ll also talk to you about things to focus on to help you feel more stable and safe during sessions. They’ll provide you with tools to help you manage your emotions.
3. Assessment. This part of the process is where your healthcare provider helps you identify themes and specific memories that you may want to work on during reprocessing. They’ll help you identify both negative beliefs about how the trauma has made you feel, as well as positive beliefs that you would like to believe about yourself going forward.
4. Desensitization and reprocessing. During this phase, your healthcare provider activates your memory by helping you identify one or more specific negative images, thoughts, feelings, and body sensations. Throughout the reprocessing, they’ll help you notice how you feel and any new thoughts or insight you have about what you’re experiencing.
5. Installation. During this phase, your healthcare provider will have you focus on the positive belief you want to build in as you process a memory. This positive belief can be what you said in phase 3 or something new you think of during phase 4.
6. Body scan. Your healthcare provider will have you focus on how you feel in your body, especially any of the symptoms you feel when you think about or experience the negative memory. This phase helps identify your progress through EMDR therapy overall. As you go through sessions, your symptoms should decrease until you don’t have any (or as close to none as possible). Once your symptoms are gone, your reprocessing is complete.
7. Closure and stabilization. This phase forms a bridge between later sessions. During this phase, your healthcare provider will talk to you about what you should expect between sessions. They’ll also talk to you about how to stabilize yourself, especially if you have negative thoughts or feelings during the time between sessions. They won’t end a session until you feel calmer and safe. They might also ask you to write down any new thoughts you have about the disturbing event(s), so you can bring them up at your next session.
8. Reevaluation and continuing care. The final phase of EMDR therapy involves your healthcare provider going over your progress and how you’re doing now. This can help determine if you need additional sessions or how to adjust your goals and expectations for your therapy. They’ll also help you explore what you might experience in the future — how you would like to handle things at that time, knowing what you know now, about yourself and your past trauma.
What to Expect from EMDR
An EMDR therapy session has eight phases. The first phase is discovering the client’s history and planning treatment. The second phase involves preparing treatment methods. Next, a traumatic memory assessment must take place. After that, desensitization to upsetting memories through eye movement is the fourth phase.
Installing positive thoughts that the client has previously identified represents the fifth phase. A client’s self-body scan and closure through self-control and stabilization are the sixth and seventh phases. Reevaluation is the eighth and final phase.
During the sessions, you may experience some unpleasant reactions to the surfacing of painful memories. Typical reactions include rapid heartbeat, sweating, or nausea. You can expect your therapist to try to minimize these reactions by directing your eye movement.
During the assessment phase, the therapist will ask you to choose a positive thought to replace negative images related to the traumatic memory.
What to Look for in an EMDR Therapist
EMDR is a highly specialized therapy that should be conducted by a licensed mental health professional who has specific training in this complex approach. Some therapists are EMDR trained, meaning they have completed EMDR basic training. Others are EMDR certified, meaning they have conducted at least 50 EMDR sessions with patients and continue to further their education.
In addition to ensuring a therapist is certified to provide EMDR therapy, there are specific questions you may want to ask a potential therapist.
Questions to ask a potential EMDR therapist:
1. What is your training and experience with EMDR?
2. Have you kept up to date about the latest protocols and developments?
3. How many people with my particular problem have you successfully treated?
4. Are there other therapies that you use besides EMDR for times when EMDR is not the best fit for a client?
4. What will we do if I become overwhelmed and don’t want to keep going in a session?
As well as having the right experience to help you, look for an EMDR therapist you feel you can trust and who makes you feel understood and cared for.
What to Know Before Trying EMDR Therapy
While experts generally recognize EMDR as a safe and effective approach with few unwanted effects, you could potentially experience a few side effects, including:
- vivid, realistic dreams
- heightened sensitivity to physical sensations or emotions
- lightheadedness
EMDR can also take several sessions to work, though you could notice some improvement after your first session.
You might find the beginning of therapy triggers some emotional distress and discomfort, especially if you’re just starting to deal with traumatic events.
But since EMDR doesn’t require you to talk about the trauma at length or spend extensive time thinking about it, it may feel less overwhelming than other approaches used to treat trauma.
If you do become distressed during treatment, your therapist will help you return to the present before shifting to another traumatic memory. Remember, too, that you’ll also learn relaxation and mindfulness strategies before you get started, and these techniques can help you manage those unwanted emotions.
Sources:
April Lyons Psychotherapy Group
The content herein is provided for general informational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Medical information changes constantly, and therefore the content on this website should not be assumed to be current, complete or exhaustive. Always seek the advice of your doctor before starting or changing treatment. If you think you may have a medical emergency, please call your doctor or 9-1-1 (in the United States) immediately.