EMDR

What is EMDR?

Eye Movement Desensitization and Reprocessing (EMDR) is a psychological method for treating emotional difficulties that are caused by disturbing life experiences, ranging from traumatic events such as accidents, assaults, illness, natural disasters to upsetting childhood experiences that have had a lasting effect on one's life. EMDR is a complex method that brings together elements from well-established theoretical orientations, including psychodynamic, cognitive, behavioral and client centered approaches. For many clients, EMDR provides more rapid relief than conventional therapies.

How Was EMDR Developed?

Psychologist Francine Shapiro made the chance observation in 1987 that eye movements reduced the intensity of her disturbing thoughts. Dr. Shapiro subsequently tested her discovery under a variety of clinical conditions and reported the results of her first study in 1989 in the Journal of Traumatic Stress.

What is it Used For?

While EMDR is best known for its treatment of post-traumatic stress reactions, it is also used to treat anxiety, depression, and other clinical presentations such as complicated grief reactions, phobias, and self-esteem issues. EMDR is also used to help alleviate performance anxiety and to enhance the functioning of people at work, on the playing field, and in the performing arts.

What Happens in EMDR?

During an EMDR Session, the clinician works with the client to identify a specific problem or issue that will become the focus of the treatment session. Utilizing a structured protocol, the practitioner helps the client identify an experience that relates to the problem, focusing on aspects of the experience that continue to be disturbing to the client in the present. As the client focuses their attention on the targeted event, the clinician initiates eye movements. Once the client is engaged in the experience, he or she is likely to experience various aspects of the initial memory or other memories that are associated with the targeted event. The clinician pauses with the eye movements at regular intervals to insure that the client is processing adequately on their own. The practitioner acts as a facilitator, making clinical decisions about the direction of the client's processing during EMDR, in an effort to reach an "adaptive resolution" to the problem that was initially identified.

Why Do So Many Clients Respond Well to EMDR?

EMDR is a client-centered approach that appears to activate an inherent healing mechanism in the brain that stimulates an information processing system. It allows the client to access a disturbing experience that has been a source of discomfort, and have the experience reprocessed in EMDR in a way that it is no longer a source of distress to the client. These experiences that were once stored in the brain in their original state are altered with EMDR. The clinician uses EMDR to activate that experience with all the thoughts, feelings and body sensations that are still associated with the experience. Through the adaptive information processing system in the brain, EMDR is able to stimulate a desensitization and a reprocessing of that initial experience, thereby bringing it to a more adaptive resolution.

What is the Mechanism That Makes EMDR So Effective?

While it is not clear how EMDR works, there are ongoing investigations of the possible mechanisms involved. What is clear is that present day occurrences can reactivate negative thoughts, emotions, and physical sensations that arise from earlier experiences that are disturbing. It appears that EMDR can change the association of those experiences, greatly decreasing the current distress about past and present events.  

Several hypotheses have been proposed to explain how EMDR works. The process of reciprocal inhibition, that is, pairing emotional distress with a "compelling relaxation response." Bessel van der Kilk, M.D. of Boston University School of Medicine, postulates that EMDR helps the client differentiate between exposure to a real traumatic event and an associated memory of an old traumatic event by increasing the activity of the anterior cingulate gyrus and the left front lobe of the brain. 

Another hypothesis proposed by Harvard researcher Robert Stickgold, Ph.D. is that EMDR turns on memory processing systems normally activated by REM sleep. The two systems involved in that process, the hippocampus and the neocortex are being stimulated to "communicate" with each other, and that the bilateral stimulation activates that communication. Dr. Stickgold is currently conducting research to test his hypothesis.

How Long Does EMDR Therapy Take?

Once the client and clinician have agreed that EMDR is the treatment of choice, the therapy can take anywhere from 1-3 sessions for a single event trauma to a year or more for more complex problems. A "typical" course of EMDR treatment is generally 3-15 sessions, performed at regular intervals. EMDR therapy can be applied as an adjunctive treatment for a client who is already in psychotherapy, or it can be a therapy unto itself. Ideally, most clients and clinicians prefer EMDR treatment as part of a comprehensive psychotherapeutic approach.

Are Eve Movements Needed to Make EMDR Effective?

Anecdotal evidence from clients and clinicians alike suggest that bilateral stimulation appears to activate an information processing system in the brain. The bilateral stimulation can be eye movements that are similar to the movements of the eyes in REM sleep, or tapping on one side of the body and then the other in an ongoing pattern, or tones that alternate in the left and right ears.

What is the Research That Supports EMDR?

Since 1989, several controlled studies have been conducted, and results demonstrate that EMDR is one of the most efficacious treatments available for post traumatic stress disorder, or PTSD. In 1995, Wilson, Decker and Tinker, in the Journal of Consulting and Clinical Psychology studied the effects of three 90-minute EMDR treatment sessions on traumatic memories of 80 participants. The results suggest that EMDR was effective in decreasing symptoms and anxiety associated with traumatic memory and in increasing positive cognition. Other studies indicate that EMDR may be effective in treating phobias, performance anxiety in the workplace, trauma in children, and the reduction of chronic pain.

Are There Any Precautions?

Yes. It is important that clients are thoroughly screened for EMDR treatment. There are many variables that are taken into account when considering EMDR treatment: the nature of the problem, the emotional stability of the client, the client's history, the medical as well as clinical situation. It is also important that the clinician administering EMDR has been formally trained by an EMDRIA-approved program, and is certified as a practitioner of EMDR by EMDRIA.

How Do You Get More Information on EMDR?

Further information can be obtained by calling the EMDR International Association at 512-451-5200 or by contacting the website at www.emdria.org. The EMDR International Association is a non-profit, professional organization whose mission is to establish, maintain and promote the highest standards of excellence and integrity in EMDR practice, research and education. EMDRIA provides information to mental health providers and to the public about EMDR. It has established guidelines for certification of EMDR practitioners, consultants and training programs. It supports further research on EMDR's efficacy, recent innovations of EMDR treatment, and applications of EMDR with different client populations and diagnoses. It maintains a register of certified clinicians, consultants, instructors and training programs.