EMDR: PTSD Treatment For Everyone

Post-traumatic stress disorder (PTSD) doesn't discriminate. It can affect anyone. A complex mental health condition, post-traumatic stress disorder causes changes in the brain that can lead to cognitive and emotional impairment. Traditional therapies such as cognitive behavioral therapy (CBT) can work, but characteristically, may take a long time before symptoms begin to improve. Eye movement desensitization and reprocessing therapy (EMDR) is a specialized type of psychotherapy that works more quickly than other types of therapies to heal people from symptoms of emotional distress that were caused by traumatic events.

Researchers have discovered that our minds can heal from psychological trauma as much as our physical bodies recover from sickness or injuries. While eye movement desensitization and reprocessing is effective for people experiencing PTSD and traumatic life experiences, it also works well for people who experience other mental health-related concerns like low self-esteem, feelings of powerlessness, and everyday memory problems.

What is PTSD? Who can get it? 

According to the American Psychiatric Association (APA), post-traumatic stress disorder (PTSD) is a psychiatric disorder that can develop in people who have either experienced or witnessed a traumatic event. Natural disasters, serious accidents, rapes, assaults, chronic abuse, terrorist acts, and combat are some of the types of situations that may cause PTSD.

In past decades, PTSD was better known by other names. After World War I, people referred to it as "shell shock." As veterans returned from World War II, people called it “combat fatigue,” according to the U.S. Department of Veterans Affairs.

While PTSD is often most commonly associated with combat veterans, it can and does occur in people of any ethnicity, culture, or age, including children. About 3.5% of U.S. adults are afflicted with PTSD, and approximately one in 11 people will receive a PTSD diagnosis within their lifetimes. Women are twice as likely to get PTSD as men. People who’ve experienced minority stress and stigma, such as people experiencing gender dysphoria, are at a greater risk of developing complex trauma.

What are the symptoms of PTSD?

Post-traumatic stress disorder (PTSD) can cause intense, disturbing thoughts and feelings that can last long after the traumatic event is over. The emotions are, in some way, tied to the event. Many people with PTSD experience flashbacks or nightmares, causing them to relive the event.

The symptoms of PTSD can cause people to feel extremely sad, fearful, or angry. Others may feel detached and estranged from people. It's also common for people to become hypervigilant and be easily startled by loud or unexpected noises or movements. The severity of symptoms varies between people. Symptoms can cause significant stress to the degree that individuals have trouble functioning.

PTSD is always a result of a past traumatic event. The event can be an indirect event, such as learning about a loved one who went through a traumatic event. Post-traumatic stress disorder also occurs in people who have repeated exposure to trauma, such as in cases of domestic abuse. Symptoms can last for months or even years.

The APA categorizes symptoms into the following four categories:

1. Intrusive thoughts – involuntary upsetting memories of the event that repeat, waking due to nightmares, having vivid flashbacks, feeling like they're reliving the event.

2. Avoiding reminders of the traumatic event – staying away from people, places, and activities that trigger memories of the event, casting memories out of mind, and refusing to talk about the traumatic event.

3. Negative thoughts and feelings – experiencing feelings and beliefs about self that are distorted; experiencing constant fear, anguish, anger, guilt, or shame; losing interest in activities; feeling detached in relationships.

4. Feeling hyper-aroused or hypervigilant – being easily startled, having trouble concentrating or sleeping, having angry outbursts, acting in self-destructive ways, and having irritability.

A PTSD diagnosis may be made when a client reports that symptoms have caused significant distress or disruption to daily life, and they’ve lasted for at least one month.

How does EMDR therapy work?

In 1987, Dr. Francine Shapiro began conducting studies exploring the effects of eye movements on feelings associated with trauma. She found that these eye movements, combined with cognitive processing of traumatic events, could alleviate trauma-related mental health challenges. Shapiro’s research led her to develop a new modality, which she called eye movement desensitization and reprocessing (EMDR). 

The EMDR Institute explains the effectiveness of EMDR treatment by drawing an analogy between how our bodies heal physical wounds and how they heal emotional wounds. If you have an open wound, antibodies form and work to repair the skin, fight infection, and close the wound. If we re-injure the wound, it may fester, cause pain, and take longer to heal.

Eye movement desensitization and reprocessing (EMDR) therapy for PTSD works in a similar way to the body's natural healing process. When someone has gone through a traumatic experience, the brain tries to heal itself. The brain naturally and instinctively moves towards good mental health. When the signals from the brain get blocked, the emotional wound festers, causing intense emotional pain. As posited by the adaptive information processing theory, when used for treating PTSD, EMDR helps to unblock signals going to and from the brain, which allows emotional healing to occur.

The theory behind eye movement desensitization and reprocessing (EMDR) is further explained by the Cleveland Clinic, where they explain that it’s not quite clear how EMDR works, though studies show it’s effective for many trauma survivors. EMDR therapy for PTSD can be conducted in a few different ways, but primarily utilizes eight distinct phases of treatment. In the first phase of EMDR for PTSD treatment, the therapist stimulates eye movements, or some other form of bilateral stimulation. Bilateral stimulation refers to techniques that activate both sides of the brain (e.g., alternating tapping on either side of the body; alternating sounds played in either ear).

During this first part of an EMDR session, the therapist and the client are sitting comfortably in a quiet room. The therapist moves one finger back and forth, about a span of 12 inches or so, or they may utilize a light or a dot moving back and forth on a screen. The therapist then asks the client to follow the movement with their eyes as it moves back and forth. As the eyes are moving back and forth, they're stimulating the back-and-forth motion that our eyes do automatically during REM (rapid eye movement), or deep sleep.

While this therapy is going on, the clinician asks the client to target the memory of the traumatic event. The clinician then asks the client to hold onto different aspects of that event, such as sights, sounds, tactile feelings, tastes, or smells that trigger the event.

Therapists may choose to use various other manipulatives such as rolling LED lights on a bar, sounds of waves emitting from two different speakers, and gentle hand buzzers that buzz first in one hand and then the other. The idea is to get a smooth, rhythmic back-and-forth motion going while the clinician leads the client in processing the memory and any disturbing feelings.

In taking a slightly deeper look at eye movement desensitization and reprocessing (EMDR) therapy, the clinician takes their clients on a mental journey back to the traumatic event. Once there, the clinician may help the client change the way they think about and process extremely painful events.

For example, if a person is a survivor of a violent crime, the therapist may transport them mentally and emotionally back to the event and help them transform their feelings of horror or self-disgust to new feelings that send an internal message of survival. Instead of feeling like a “victim,” for example, the therapist may lead them to believe new thoughts and feelings associated with the message: "I am a survivor."

Through this process, the client can remove some of the blockages to the brain and reprocess thoughts and feelings on a different and healthier intellectual and emotional level. If we go back to our original example of healing a physical wound, the EMDR process can help wounds change and transform rather than close. It's sort of like having a big scar over the wound. There are signs that the injury occurred and there are also signs that it healed. It’s something that’s a part of you, but is no longer an open wound.

By the time the clinician helps the patient work through all eight phases of EMDR, the client starts to change the way they look at the situation. They may begin to feel empowered by it rather than traumatized.

The clinician will be able to tell that the client is healing from the traumatic event by listening to how the client thinks, feels, and behaves. There should be clear indications of healthier thoughts and behavioral actions.

Is EMDR an evidence-based therapy for PTSD?

Eye movement desensitization and reprocessing (EMDR) therapy is recognized as evidence-based or strongly supported by evidence as an effective form of treatment for trauma and other disturbing events by at least 14 health organizations, including the American Psychiatric Association, the World Health Organization, and the Department of Defense.

Researchers have conducted numerous studies on the treatment effects of eye movement desensitization and reprocessing therapy. Over 30 controlled outcome studies on EMDR therapy have had positive results. In an HMO Kaiser Permanente study (one of the previously mentioned controlled outcome studies), 100% of the survivors of single traumas and 77% of survivors with multiple traumas no longer had PTSD symptoms after six 50-minute sessions. The study also showed that 77% of combat veterans were no longer diagnosed with PTSD after 12 sessions of EMDR therapy. The studies and meta-analyses show that over 100,000 clinicians around the world have successfully treated millions of people of all demographics over the last 25 years. Though it’s proven to be effective, other researchers call EMDR “controversial” because it’s unclear how exactly the therapy works.

It's true that PTSD is common among combat veterans. It's within this capacity that researchers learned that other survivors of traumatic events could also acquire PTSD. For example, virtually every geographic location is subject to some kind of natural disaster—hurricanes, tornadoes, snowstorms, floods, fires, earthquakes, and other natural events can occur unexpectedly at any time, leaving a wake of physical and emotional destruction in their path. 

Online therapy for PTSD

Research shows that online therapy can be effective for EMDR practices. In one study, researchers evaluated the efficacy of an online treatment plan that included both EMDR and cognitive-behavioral therapy (CBT) when providing help to those experiencing symptoms of PTSD. After treatment, 55% of participants no longer met the criteria for PTSD, with symptoms of other disorders, like depression and anxiety, being significantly reduced. 

You can participate in online therapy from the comfort of your own home, which may be particularly beneficial for people with PTSD who may be more susceptible to triggers in public environments, who struggle driving a car due to an experience with a vehicular accident, or simply people who lack time or transportation. There are online EMDR practitioners ready to help you move forward with your life after trauma.