What is EMDR Therapy?

EMDR (eye movement desensitization and reprocessing) is a special psychotherapeutic technique that can be a very powerful treatment for people who have been emotionally traumatized. EMDR therapy uses eye movements or other alternate hemisphere stimulation to remove the emotional charges of traumatic memories.

As part of EMDR therapy sessions, a therapist may direct you to hold specific memories in mind while tracking the therapist’s hand as it moves back and forth across your field of vision. Diverting your attention in this way while you recall a traumatic event has been found to minimize the emotional response connected to the memory. Researchers believe the therapy activates mechanisms in the brain that help you process the memory and distressing emotions.

Processing Traumatic Memories in the Brain

The brain is naturally wired to help us recover from traumatic events and distressing memories. The healing process involves communication between a variety of brain regions, such as the hippocampus (memory-making center), amygdala (fear center), and prefrontal cortex (behavior center). In some people, however, events can be so traumatic it disrupts the normal flow of neural communication and memories get stuck, making you can feel like you are frozen in time. EMDR helps you get unstuck by restoring the communication process.

What Research Shows About EMDR

Numerous studies show that EMDR therapy offers benefits for emotional trauma and PTSD that typically take years to achieve in psychotherapy alone. A 2014 review of the existing research indicates that 24 randomized controlled studies point to benefits from EMDR treatment for emotional trauma and adverse life events. This review also showed that in some studies, 84% to 90% of people who have experienced a single trauma found relief from PTSD symptoms after just 3 EMDR sessions that lasted 90 minutes each.

In a controlled study by Kaiser Permanente, 67 individuals who had experienced trauma were assigned either to standard care treatment or EMDR. Compared to standard care, the EMDR group showed significantly more improvement on measures of anxiety, depression, and PTSD. In a subsequent study from the same team at Kaiser Permanente, follow-ups on the original study participants at 3 months and 6 months showed that improvements from EMDR had been maintained. The authors concluded that long-lasting benefits can be achieved with relatively few EMDR sessions.

Based on this growing body of research, the American Psychiatric Association and the Department of Veterans Affairs have recognized EMDR therapy as an effective treatment for PTSD. A growing body of research on EMDR therapy shows promising results in its effectiveness for other conditions, such as depression, addictions, and more.

Who Can Benefit from EMDR?

EMDR is primarily used to treat people suffering from emotional trauma, but it may also be beneficial for people struggling with other problems. According to the EMDR International Association, practitioners currently use EMDR therapy to address a wide array of issues, including but not limited to:

• PTSD

• Depression

• Bipolar disorder

• Anxiety

• Panic attacks

• Phobias

• Substance abuse

• Eating disorders

• Dissociative disorders

• Personality disorders

• Grief

What’s Involved in EMDR Therapy?

EMDR therapy involves 8 phases that incorporate a variety of elements. It includes looking at past memories, current triggers, and skills and behaviors that can help you in the future.

Phase 1:  History and Treatment Planning

A therapist will review your history, identify specific memories to target, and create a treatment plan.

Phase 2: Preparation

The therapist will share several techniques to help you cope with any emotional distress that may arise during treatment.

Phases 3: Assessment

During this portion of the treatment, you will be directed to identify 3 things associated with the targeted memory to be processed:

• a visual image related to the memory

• a negative belief about yourself

• any physical bodily sensations associated with the memory

Phase 4: Desensitization

As you hold these things in mind, the EMDR processing begins. After the therapist performs the hand movements or other stimulation, you will be asked to let your mind go blank. Then you may either return to continue processing that same memory or move on to process other memories.

Phase 5: Installation

Here you replace the negative belief you had about yourself with a positive belief. For example, a victim of assault may go from believing “I am powerless” to believing “I am in control.”

Phase 6: Body Scan

During this phase, your therapist will work with you to resolve any remaining physical tension or bodily sensations related to the memory.

Phase 7: Closure

The therapist will ensure that at the end of each session, you feel better than when it started. Your therapist will also provide you with strategies to help you handle any distressing emotions that come up in between sessions and will ask you to maintain a journal where you write down any issues that arise.

Phase 8: Reevaluation

At each session, you and your therapist will assess your progress so far and adjust your treatment plan as needed.

Steven’s EMDR Story

To help you understand how EMDR can work for emotional trauma like PTSD, take a look at Steven’s story.

Steven, a 33-year-old bicycle repair mechanic working in Santa Monica, California, took an early lunch on a summer day in 2003 and walked to the local farmer’s market. Within minutes, disaster struck when an 87-year-old man lost control of his car and barreled through the throngs of people at the market. The car was headed straight for Steven, who later said, “I thought he was going to run over my legs…I thought I would lose my legs.”

At the last possible moment, Steven was able to jump out of the way, but 10 people were killed and more than 50 were injured. Traumatized, Steven went back to work.  But for months, he couldn’t sleep, and he shook constantly. As in the case of most people who develop PTSD, the Santa Monica farmer’s market disaster was not Steven’s only trauma. He grew up in a severely abusive alcoholic home and also faced death as a tank commander during the Gulf War.

Steven decided to undergo an evaluation and EMDR therapy as a component of his treatment. As part of his assessment, Steven underwent 3 brain scans using brain SPECT imaging technology—before treatment, during his first EMDR session, and after 8 hours of EDMR treatments.

Initially, his brain scan showed a diamond pattern that is often seen in PTSD, with an overactive limbic area, basal ganglia, and anterior cingulate. Then with the help of a trained EMDR therapist, Steven began clearing out the traumas—one by one. His brain actually showed benefit during the first treatment and was markedly improved after only 8 hours of treatment. Steven’s shaking had subsided, and he felt significantly better. With EMDR, Steven was able to change his brain and change his life for the better.

— Amen Clinics

What is EMDR (Eye Movement Desensitization and Reprocessing)?

One of the most researched and successful methods for healing trauma memory might sound like an idea that some mad scientist thought up. But to the mental health community’s surprise, it works! Eye movement desensitization and reprocessing (see why we shorten it to EMDR?) works very well with a qualified therapist who is well trained and experienced in using it.

EMDR is a form of psychotherapy, pioneered by Francine Shapiro, PhD, that has proven to help people who struggle with PTSD symptoms. EMDR uses bilateral stimulation of the brain through the movement of the eyes, sound, or touch to help process trauma. By alternately stimulating both sides of the body, this therapy works to help process trauma that is stored in neural networks of the brain and the body. It literally helps to release the “charge” that keeps a memory of past wounds impacting the present. But what does that mean to you? Here’s a simplified model that works for most.

We all have regular, weekly (if not daily) fears or upsets – a driver who cuts you off, a rude co-worker, a stubbed toe – that are like little chunks of ice that flow through our emotional brain and eventually get processed and dealt with in a healthy way. The ice chips we can usually handle (especially if our brain is fairly balanced). These ice-chip-sized memories work their way through our brain’s system, where they get melted, chewed, dissolved, or redistributed, and life returns to normal fairly quickly. This is our brain’s way of helping our mind to move on.

When we are hit with a tragedy or trauma, it’s like being hit with a heavy block of ice rather than the little ice chips. We can handle and process the chips because, after all, since we were about two years old, we’ve learned that life isn’t exactly fair or perfect. So, a healthy brain deals with it or shrugs it off. Not so with big chucks of pain. Not only does the big chunk of ice stay put, but sometimes it sticks to other ice chunks and turns into an iceberg, especially if there are multiple traumas, a prolonged trauma, or a very severe trauma (soldiers in war; losing multiple friends or family members; a long, frightening bout with cancer; a shocking or painful divorce; 9/11 survivors). This is an oversimplification, but it is a picture of post-traumatic stress disorder. I should mention here that one person’s ice chip could be someone else’s chunk of ice and, depending on a number of factors, can be just as stubborn to melt.

This much pain and shock literally changes your brain, and most people who’ve been there would wholeheartedly agree with that assessment. Then you have an iceberg of collective memories that get stuck in the Basement of Giant Fears and refuse to budge, melt, or go anywhere – even though you’d love nothing more than to have it disappear or, at least, be able to minimize the painful memory to a normal size so your brain can deal with it.

Not all people who suffer get PTSD (though most do experience some form of PTSD for a little while after a trauma, even a relatively minor car accident; however, the trauma might just linger a day, a week, or a month). Some soldiers return from war and, after a reasonable period of time, are able to move forward. Others are not so fortunate, such as the soldiers returning from Iraq (particularly the ones who were in the National Guard, who weren’t prepared for the horrors of war). Some of the ability to rebound faster has to do with genetic predisposition, and some of it involves the amount of trauma and the amount of attachment to the person who was killed or who died. Also, the amount of emotional and relational support that was given during and just after the crisis can play a role in our ability to recover.

Those who probably suffer the most are adults who were abused as children when their brains really didn’t have the resources to deal with such pain, especially if their parents, clergy, or teachers, when told, didn’t respond in soothing and proactive ways. This is often called a sanctuary trauma when a child looked for safety after a traumatizing experience and was turned away. This has a way of driving the original hurt deeper into the soul.

When the iceberg gets lodged, we are hit with unwanted thoughts and memories that may interrupt us at any moment. We’re triggered easily by anything that reminds us of the day that chunk of ice landed in our lives. We have nightmares about every aspect of that iceberg, almost as if our Basement of Giant Fears doesn’t even take a break to sleep. Oh, our brain continues to work around it as best it can, but it’s not the same . . . our brain stays on hyper-alert even when we don’t want to, or mean to be.

Ultimately, EMDR works a bit like a high-powered blender. It breaks up traumatic memories into manageable pieces using a variety of blender blades; recalling painful memories and replacing them with new, improved thoughts (with a trained counselor); slowing down or interrupting the story you’ve been telling yourself (which helps remove some of its power to your brain), and using alternating eye movement, tapping, or sounds (to break up and disrupt thought patterns). Using these methods and more, we sort of whirl, if you will, that big immovable hunk of ice into smaller pieces that can then be distributed through your brain and processed like other normal-sized memories until they melt into the place where typical memories (without major stress reactions attached) are stored. To simplify even more: we help monster memories turn into medium-sized memories, so they can go through the normal brain-drain system.

1. Dr. Earl Henslin, “EMDR Therapy,” THIS IS YOUR BRAIN ON JOY (2008):232-234

*Dr. Gray is a certified EMDR practitioner

— Dr. Brent Gray, Clinical Director, Ph.D., L.M.F.T., L.M.H.C., C.A.P.