What is EMDR Therapy?

History of EMDR therapy or eye movement desensitization and reprocessing therapy

EMDR therapy, EMDR, or eye movement desensitization and reprocessing therapy, was developed by Francine Shapiro. EMDR therapy modality was founded in 1987 and has since become a popular form of mental health treatment and trauma therapy. EMDR can help people who have experienced severe trauma and related mental health conditions. Traumatic and painful events sometimes have a way of sticking with people and can make it difficult to function when you consistently experience flashbacks to your trauma.

Another way that EMDR therapy is conducted is through hand tapping. An EMDR therapist guides their client to tap places on their body that stimulate brain activity while discussing traumatic experiences. EMDR therapy aims to help the person recall different memories surrounding trauma to desensitize themselves to these distressing memories. Other forms of rapid eye movement and desensitization may be used during treatment, but the key to eye movement desensitization and reprocessing (EMDR) is bilateral stimulation.

What is EMDR Therapy?: EMDR therapy as a mental health treatment

During EMDR therapy, the client is asked to recall distressing events. A trusted EMDR therapist asks their client to tap their body or move their eyes while recalling said traumatic memories. EMDR therapy can help both the mind and body with a natural healing process to work through psychological trauma and associated symptoms such as anxiety, depression, panic attacks, and more. 

Traumatic stress studies and statistics show that it works for post-traumatic stress disorder (PTSD) and other instances of trauma. According to Kaiser Permanente (a healthcare company), in one study, 100% of trauma victims and 77% of people who had experienced complex trauma benefited from EMDR therapy. EMDR therapy is a structured therapy that may also be a helpful tool in aiding multiple trauma victims, such as war veterans and soldiers at large.

When you read about EMDR therapy, you will likely see bilateral stimulation, which is a core component of how EMDR therapy works. That means an EMDR therapist helps a client stimulate both parts of their brain through eye movements or other forms of desensitization and reprocessing. This is accomplished through the client tracking different stimuli with their eyes. For example, an EMDR therapist or professional may move their finger back and forth while a client follows it to stimulate different parts of their brain. As mentioned above, tapping is another example of bilateral stimulation. Alternatively, some EMDR professionals use light sources as another external stimulus to help their clients engage in bilateral stimulation. The individual in treatment follows a light back-and-forth with their eyes to engage different brain hemispheres. Bilateral stimulation is a significant part of EMDR therapy.

There are eight phases of EMDR treatment. EMDR therapy can be an intense process, as it involves confronting trauma. An EMDR therapist may first spend a long time gaining background information on their client's traumatic experience before using bilateral stimulation and confronting trauma. Below are the eight stages of eye movement desensitization and reprocessing (EMDR).

Phase one of EMDR treatment can take one to two talk therapy sessions and involves the client stating past trauma and developing a treatment plan. EMDR therapists discuss situations that caused them to experience emotional distress or flashbacks. The individual may also identify coping skills they need to learn to begin to feel better. During this phase of EMDR therapy, the person tends to identify problems and traumatic memories and begins to work towards reducing feelings of immediate danger related to trauma and/or triggers.

Phase two of EMDR therapy can take anywhere from one to four sessions and can be a more involved process for people who have severe or complex trauma. During phase two, a counselor prepares their client to engage in talk therapy while simultaneously experiencing bilateral stimulation, such that they don't have to talk about disturbing memories in detail. However, they may talk about experiences generally and how they feel about it now. During this phase, the client tends to discuss how trauma made them feel in order for the therapist to identify critical factors.

During the third phase, the client selects a specific trauma memory or mental picture to target during EMDR therapy treatment. The client is asked to choose a statement or a negative connotation that they have about their trauma and emotional distress. For example, one negative belief, mantra, or association could be, "It was my fault," or "I'm a bad person." After, the client chooses a set of positive beliefs or statements to replace or reframe these negative beliefs and statements, such as, "I don't have control over what happened to me, but I can heal," or "I did the best that I could." During phase three, a therapist may ask their client on a scale of 1-7 how much they believe the statement. One means that the statement seems false, and seven means it feels entirely true. In this way, they identify how much they believe the negative statement. During this EMDR assessment, the client may also talk about negative emotions that accompany trauma and their belief systems.

Additionally, they rate their beliefs using subjective units of disturbance (or SUD) from 0-10. Zero means it doesn't disturb them at all, and 10 means it's the worst thing they have ever experienced. During this phase, they are working on reprocessing and changing the negative cognition they’re experiencing. If they experience a single traumatic event, it may take around three sessions of EMDR practice with a therapist to make progress. However, it can take longer with a complex traumatic situation.

During this phase, the client tends to focus on their distressing emotion and how they feel, and the counselor measures SUD. The counselor aims to help their client by using different eye movements or tapping techniques, starting with the target traumatic memory and moving forward afterward.

The installation phase aims to do away with the negative sentiment toward the targeted memory and replace it with an affirmative one. The counselor aims to instill the validity of cognition, or VOC in their client. Their goal is to help this person get to a certain level of truth on a scale of 0-7 (0 = I don't believe it at all, and 7 = I believe it is entirely true). One thing to note about EMDR therapy is that one session may not be able to take away negative thoughts and memories completely. Still, it may help you feel better, and you may begin to change your relationship to specific ideas or memories.

After the therapist helps their client understand a positive way of thinking, they may focus on how the disturbing event(s) affects the body. PTSD and trauma can embed themselves in a person's physical being sometimes without that person being consciously aware of their presence. Through this body scan, the counselor aims to help their client understand where in the body they are feeling trauma and how to work through those physical sensations.

Following this scanning of body sensations, the EMDR therapist helps the client get back to a state of grounding. The therapist usually continues to use bilateral stimulation, i.e., back and forth eye movements, and ends this session by taking the client out of their memory and helping them come back to a sense of stasis.

During the reevaluation step of EMDR therapy, the client is usually asked to reassess how traumatic this memory is to them after having used bilateral stimulation or hand tapping. They are asked to reevaluate how much their thoughts have changed about it.