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Eye-Movement Desensitization and Reprocessing Therapy is one of the gold-standard treatments for trauma, PTSD, and C-PTSD in the therapy field. But is it a good fit for you?
In the last 10-15 years, the world has become so much more aware of psychological trauma and its impact on the mind and body. That's great! Knowledge is power. After all, trauma and post-traumatic stress disorder (PTSD) can have a significant impact on a person's life, making it difficult to function in day-to-day activities or form meaningful relationships.
It's worth noting, however, that just being "aware" that we've been traumatized is not sufficient for change. Even engaging in talk therapy about trauma with a mental health professional often does not reduce some of the biggest and most intrusive symptoms: hyper-vigilance, nightmares, sleep disruptions, flashbacks, feelings of isolation.
So what will help? EMDR one of the best (though not the only) trauma treatments readily available in the field. So let's get into it –everything you need to know about EMDR.
The Key Points:
Trauma and PTSD are widespread issues that affect many individuals worldwide. According to the National Center for PTSD, approximately 60% of men and 50% of women experience at least one traumatic event in their lifetime. Furthermore, it is estimated that 7-8% of the US population will experience PTSD at some point in their lives. Among military veterans, the rates of PTSD are even higher, with some estimates suggesting that up to 20% of veterans who served in Iraq or Afghanistan may experience PTSD. These statistics highlight the importance of effective treatments like EMDR therapy for individuals who have experienced trauma or are suffering from PTSD.
EMDR therapy is a relatively new approach to therapy that has been proven to help trauma survivors of all kinds get plugged back into their life. In this blog post, we will explore what EMDR therapy is, how it works, and how it can be used to help individuals overcome trauma and PTSD. We will also discuss the EMDR therapy process and who may be a good candidate for this type of therapy. By the end of this post, we hop that you'll will have a better understanding of how EMDR therapy can be a valuable tool in the treatment of trauma and PTSD
Question #1: What The Heck is EMDR?
EMDR therapy, or Eye Movement Desensitization and Reprocessing therapy, is a type of psychotherapy that is used to treat trauma, post-traumatic stress disorder (PTSD), and complex post-traumatic stress disorder (CPTSD). EMDR has been recognized as an effective treatment for PTSD by numerous organizations, including the World Health Organization (WHO) and the American Psychological Association (APA). This "bottom-up" approach utilizes various forms of bilateral stimulation to help clients process traumatic memories and reduce symptoms of PTSD.
EMDR therapy was originally developed in the late 1980s by psychologist Dr. Francine Shapiro. Dr. Shapiro discovered the therapeutic benefits of eye movements by chance when she was out for a walk and noticed that her own distressing thoughts became less intense as she moved her eyes rapidly back and forth. She began experimenting with this process in her therapy sessions with clients and found that it could be an effective treatment for trauma.
Over time, Dr. Shapiro developed a structured approach to using bilateral stimulation to process traumatic memories. She initially called this approach "Eye Movement Desensitization" and later added "Reprocessing" to the name to reflect the fact that the therapy involves more than just eye movements.
During an EMDR therapy session, the therapist will guide the client to focus on a traumatic memory while also engaging in some form of "bilateral stimulation". This may involve following the therapist's fingers as they move back and forth, listening to alternating sounds in each ear, or feeling a vibrating device in each hand. The bilateral stimulation is thought to activate both sides of the brain while reducing activity in the "danger center" of the brain, which can help the client to process the traumatic memory and reduce its emotional impact.
Question #2: How Does EMDR Help Heal Trauma and PTSD?
The underlying theory of EMDR therapy is that traumatic experiences can become "stuck" in the brain and continue to cause distress and interfere with daily functioning. This is thought to occur because the brain is unable to process the traumatic experience in the same way that it processes other memories. Instead of being stored in an adaptive way, the traumatic memory remains fragmented and disconnected from other memories, which can make it difficult for the person to integrate the experience into their life story.
During an EMDR session, the client follows the therapist's fingers or a moving light back and forth, or alternatively feels a vibrating device in each hand, while also focusing on the traumatic memory. The exact mechanism by which bilateral stimulation works is still being studied, but it is thought to involve the stimulation of the brain's information processing system. The rapid back and forth eye movements or tapping may stimulate the same mechanisms in the brain that are activated during REM sleep, which is when the brain processes memories and emotions. It is also thought that bilateral stimulation may help to activate the brain's natural healing processes and reduce the intensity of negative emotions associated with traumatic memories.
One thing that research is indicating more and more strongly is that bilateral stimulation works to inhibit an area of the brain called the amygdala, which acts as the "fear center" of the brain. By activating these memories while inhibiting activity in the amygdala, other important regions in the brain are able to stay "online" long enough to reprocess and re-encode the traumatic memory, reducing overall distress from the memory and it's effect on the present.
While the use of eye movements or bilateral stimulation is a key aspect of EMDR therapy, it is important to note that the therapy also involves a structured approach to processing traumatic memories and developing coping skills. The goal of EMDR therapy is to help individuals process traumatic memories so that they no longer interfere with daily functioning, and the use of bilateral stimulation is just one component of this process.
Through this process, individuals are able to reduce the emotional intensity of traumatic memories and integrate them into their life story in a way that is less disruptive. They are also able to develop new beliefs and behaviors that are more adaptive and aligned with their current reality.
Question #3: Is It Effective?
Studies have found that EMDR therapy can be more effective than other therapies in treating PTSD. One meta-analysis, published in the Journal of Consulting and Clinical Psychology, analyzed 26 RCTs that compared EMDR therapy to control conditions or other active treatments for PTSD. The meta-analysis found that EMDR therapy was superior to control conditions and at least as effective as other active treatments in reducing symptoms of PTSD.
Another meta-analysis, published in the Journal of EMDR Practice and Research, analyzed 20 RCTs and found that EMDR therapy was associated with significant reductions in PTSD symptoms, depression, and anxiety.
There is also evidence that EMDR therapy is effective in treating a variety of populations, including children, adults, and military veterans. For example, a study published in the Journal of Child Psychology and Psychiatry found that EMDR therapy was effective in reducing PTSD symptoms in children who had experienced sexual abuse. Another study, published in the Journal of Traumatic Stress, found that EMDR therapy was effective in treating PTSD in military veterans.
A critical difference between EMDR and traditional talk therapies is that EMDR is a relatively short-term treatment. While traditional talk therapy may require months or even years of weekly sessions, EMDR therapy typically involves 6-12 sessions, depending on the severity of the trauma and the individual's response to treatment.
EMDR therapy also has the benefit of being a non-invasive treatment. Unlike medication, EMDR therapy does not have any side effects and does not require individuals to take medication on an ongoing basis. This can be particularly important for individuals who are sensitive to medication or who prefer to avoid medication for personal or cultural reasons.
Question #4: What Can I Expect?
An EMDR therapy session is broken into several different phases of treatment, including the initial assessment, preparation, desensitization, and reprocessing phases. The session typically lasts between 60 and 90 minutes. Below is a step-by-step explanation of the EMDR therapy process:
Phase 1: Initial Assessment
The first step in the EMDR therapy process is an initial assessment, during which your therapist will gather information about your history, trauma, symptoms, and goals for therapy. Your therapist will also assess your readiness for EMDR therapy and determine if it is an appropriate treatment based on your needs needs.
The initial assessment phase of EMDR therapy is a critical part of the treatment process. During this phase, the therapist gathers information about the individual's history, trauma, symptoms, and goals for therapy. This information helps your therapist develop a specific treatment plan that is customized to fit your specific needs and goals.
The assessment typically involves a combination of interviews, questionnaires, and other assessments. Your therapist will ask you about their trauma history, but don't worry. You don't have to get into every little detail at this point. Your therapist just needs a big picture overview. They may ask questions about the type of trauma, the severity of the trauma, and any related symptoms you may be experiencing. Your therapist may also ask about your current emotional state, any current stressors or triggers, and your social support system.
In addition to gathering information about your trauma history, your therapist will also assess your readiness for EMDR therapy. This may involve assessing your emotional stability, your ability to cope with emotional distress, and your overall mental health. If your therapist determines that you are not ready for EMDR therapy, they may recommend other forms of treatment or additional support.
The initial assessment phase is a critical part of the EMDR therapy process. It helps your therapist develop a deeper understanding of the your needs and goals and helps to ensure that the therapy is safe and effective.
Phase 2: The Preparation Phase
Once you and your therapist have agreed to proceed with EMDR therapy, your therapist will begin the preparation phase. This phase begins with you and your therapist working to establish a sense of safety and trust in the therapeutic relationship. This may involve helping you to develop relaxation and grounding techniques, such as deep breathing, progressive muscle relaxation, or visualization exercises. These techniques can be helpful in managing any emotional distress that may arise during the EMDR sessions.
Your therapist may also provide education about trauma and its effects on the brain and body, as well as information about how EMDR therapy works. This can help you understand the process and feel more comfortable and prepared for the actual sessions.
In addition, the preparation phase may involve setting specific treatment goals and developing a plan for how to achieve those goals. You and your therapist will work together to identify specific memories or events related to the trauma that will be targeted during the desensitization phase of EMDR.
The preparation phase is critical for two big reasons. First, you're getting ready to unpack and work through some of the worst events of your life. We don't (and shouldn't) take on that level of vulnerability with a total stranger. Building trust and having your trauma seen and recognized is a key piece of healing.
Second, these traumatic events have often been buried or pushed to the side for years by the time people come in to therapy. Working through trauma via EMDR means that you'll be digging up some very old, painful things. Opening this can of worms is painful at first. For this reason, you need to have some effective and well-practiced tools in your tool kit to get you past the initial "band-aide" rip as the wound begins to close.
Phase 3: Desensitization Phase
The desensitization phase is the heart of EMDR therapy! During this phase, your therapist will ask you to focus on a traumatic memory while simultaneously engaging in a form of bilateral stimulation (such as eye movements, taps, or sounds). This pairing of stimuli helps the brain re-process the memory and reduce its emotional intensity, allowing you to integrate the experience into your overall life story without being overwhelmed by intense negative emotions.
Your therapist will guide the individual through the desensitization process, using techniques such as guided imagery or cognitive restructuring to help you reframe your thoughts and beliefs about the traumatic event. Your therapist will also monitor your emotional state and help you manage any distress that may arise during the process.
As the desensitization process progresses, you should begin to experience a reduction in the emotional intensity associated with the traumatic memory or event. This can help you feel more in control of their emotions and reduce symptoms of PTSD.
Phase 4: Reprocessing Phase
Once you have achieved significant desensitization of the traumatic memory, your therapist will move into the reprocessing phase. During this phase, your therapist will guide you in connecting the desensitized memory to more adaptive, positive beliefs about yourself and your future.
The reprocessing phase involves asking you to recall the traumatic memory or event, while engaging in bilateral stimulation. This time, the focus is on reinforcing positive beliefs and emotions that were identified during the desensitization phase. Your therapist may use techniques such as positive self-talk, imagery, or other cognitive restructuring methods to help you solidify your new positive beliefs and emotions.
The goal of the reprocessing phase is to help you integrate your new beliefs and emotions into your overall sense of self, and to reduce the likelihood of relapse or recurrence of symptoms. By reinforcing positive beliefs and emotions, you can feel more confident and resilient in the face of future stressors or triggers.
Throughout the reprocessing phase, your therapist will continue to monitor your emotional state and provide support and guidance as needed. Your therapist may also work with you to develop strategies for maintaining the gains made during therapy and continuing to build on them in the future.
Phase 5: The Closing Phase
The final phase of EMDR therapy is the closing phase. During this phase, your therapist will check in with you to ensure that you are feeling safe and grounded, and will provide any additional support or resources that may be needed. You and your therapist will also discuss the progress made during the therapy and identify any next steps or future goals for treatment.
Overall, the EMDR therapy process is designed to help individuals process traumatic memories in a safe and effective way, and to facilitate the development of more adaptive beliefs and behaviors. While the therapy may be challenging and emotionally intense at times, many individuals find that it provides significant relief from the symptoms of trauma and PTSD.
Question #5: How Do I Know If It's A Good Fit For Me?
We know what you're thinking. "Sure, all that psychobabble sounds great, but how do I know if EMDR will work for me"?
That's a great question! Below are some important considerations you might want to take into account before you reach out to a therapist for a consultation.
Commonly Reported Symptoms
Here are some examples of situations or symptoms that may indicate a client might benefit from EMDR therapy:
Flashbacks or intrusive memories: If a client is experiencing vivid and distressing memories of a traumatic event, EMDR therapy may be helpful in reducing the intensity and frequency of these flashbacks.
Avoidance behaviors: If a client is actively avoiding certain people, places, or situations that remind them of the traumatic event, EMDR therapy may help them to feel more comfortable and confident in these situations.
Difficulty managing emotions: If a client is experiencing intense emotions such as anxiety, fear, anger, or shame related to the traumatic event, EMDR therapy may help them to process and reduce the intensity of these emotions.
Negative beliefs or self-talk: If a client is experiencing negative beliefs or self-talk related to the traumatic event, such as feelings of guilt, shame, or self-blame, EMDR therapy can help to identify and reprocess these beliefs.
Chronic pain or physical symptoms: If a client is experiencing chronic pain or physical symptoms that are related to the traumatic event, EMDR therapy may help to reduce the intensity and frequency of these symptoms.
Complicating Variables
While EMDR therapy can be an effective treatment option for many individuals, there are certain factors that may affect a client's suitability for this type of therapy. These factors can include:
Level of emotional stability: Clients with severe emotional instability or ongoing mental health issues may not be good candidates for EMDR therapy. In some cases, it may be necessary to address these underlying issues before starting EMDR therapy.
Ability to tolerate distress: EMDR therapy can involve recalling and processing traumatic memories, which can be difficult and emotionally distressing. Clients who struggle to tolerate distress may not be good candidates for this type of therapy.
Support system: Clients with limited social support or who lack a stable living situation may not be good candidates for EMDR therapy. It's important for clients to have a support system in place to help them cope with the emotional and psychological challenges that may arise during therapy.
Current or Recent substance abuse: Clients with ongoing or recently abated substance abuse may not be good candidates for EMDR therapy, as the therapy can be emotionally intense and may trigger substance use.
Other health conditions: Clients with other health conditions, such as epilepsy or a history of seizures, may not be good candidates for EMDR therapy due to the use of bilateral stimulation, which can trigger seizures in some individuals.
It's important to discuss any concerns or questions about suitability for EMDR therapy with a qualified mental health professional, who can help determine the best course of treatment based on an individual's unique needs and circumstances.
The "Ideal" Candidate
EMDR therapy has been found to be an effective treatment option for many individuals who have experienced trauma, including those who have been diagnosed with PTSD. However, not everyone is a good candidate for this type of therapy because not everything works for everyone.
Ideal candidates (meaning those most likely to benefit) for EMDR therapy typically:
Have experienced a traumatic event or series of events that are negatively impacting their daily life.
Have difficulty managing their emotions and thoughts related to the trauma.
Are motivated to work through their trauma and improve their overall well-being.
Are willing and able to engage in the therapy process and follow through with any homework assignments or coping strategies recommended by the therapist.
Have a stable support system in place, such as family, friends, or a mental health professional.
It's important to note that EMDR therapy may not be appropriate for individuals who are currently experiencing severe mental health symptoms, such as active psychosis or suicidal thoughts. In these cases, a mental health professional may recommend alternative treatments or suggest stabilizing the individual's mental health symptoms before beginning EMDR therapy.
TLDR: EMDR Works. Quickly, Effectively, Humanely.
In conclusion, EMDR therapy is an effective and evidence-based treatment option for individuals who have experienced trauma and are struggling with PTSD. The therapy works by targeting and processing traumatic memories, ultimately leading to a reduction in PTSD symptoms and an improvement in overall mental health. The step-by-step process of EMDR therapy ensures that clients feel safe and supported throughout the treatment, with a qualified mental health professional guiding them through each stage.
It's important to note that EMDR therapy may not be appropriate for everyone who has experienced trauma or has PTSD. As mentioned earlier, it's important to consult with a trained mental health professional to determine if EMDR therapy is the right treatment option for your individual needs and circumstances.
While EMDR therapy may not be suitable for everyone, it can be a transformative treatment for those who are good candidates. If you or someone you know is struggling with trauma and PTSD, consider seeking out a qualified EMDR therapist to explore this treatment option. EMDR therapy offers a path to healing and recovery, providing hope for a brighter future.