Eye Movement Desensitization & Reprocessing (EMDR)

EMDR (Eye Movement Desensitization and Reprocessing) is a psychotherapy that enables people to heal from the symptoms and emotional distress that are the result of disturbing life experiences. 

Repeated studies show that by using EMDR therapy people can experience the benefits of psychotherapy that once took years to make a difference.

EMDR has been demonstrated as an effective therapy for trauma and post-traumatic stress disorder (PTSD) by helping the brain reprocess past traumas differently and relieving debilitating symptoms such as heightened anxiety, flashbacks, nightmares, insomnia, and panic attacks.

Print Friendly, PDF & Email
EMDR

WHAT IS EMDR?

EMDR (Eye Movement Desensitization and Reprocessing) is a psychotherapy that enables people to heal from the symptoms and emotional distress that are the result of disturbing life experiences. 

At first glance, EMDR appears to approach psychological issues in an unusual way. It does not rely on talk therapy or medications. Instead, EMDR uses a patient’s own rapid, rhythmic eye movements. These eye movements dampen the power of emotionally charged memories of past traumatic events.

Repeated studies show that by using EMDR therapy people can experience the benefits of psychotherapy that once took years to make a difference.

HOW DOES EMDR THERAPY WORK?

EMDR therapy is broken down into eight different phases, so you’ll need to attend multiple sessions. Treatment usually takes about 12 sessions and last between 60 to 90 minutes.

Session & Topic
Description
Phase 1:
History & treatment planning
Your therapist will first review your history and decide where you are in the treatment process. This evaluation phase also includes talking about your trauma and identifying potential traumatic memories to treat specifically.
Phase 2: Preparation
Your therapist will then help you learn several different ways to cope with the emotional or psychological stress you’re experiencing. Stress management techniques such as deep breathing and mindfulness may be used.
Phase 3: Assessment
During the third phase of EMDR treatment, your therapist will identify the specific memories that will be targeted and all the associated components (such as the physical sensations that are stimulated when you concentrate on an event) for each target memory.
Phases 4-7: Treatment
Your therapist will then begin using EMDR therapy techniques to treat your targeted memories. During these sessions, you will be asked to focus on a negative thought, memory, or image. Your therapist will simultaneously have you do specific eye movements. The bilateral stimulation may also include taps or other movements mixed in, depending on your case. After the bilateral stimulation, your therapist will ask you to let your mind go blank and notice the thoughts and feelings you’re having spontaneously. After you identify these thoughts, your therapist may have you refocus on that traumatic memory, or move on to another. If you become distressed, your therapist will help bring you back to the present before moving on to another traumatic memory. Over time, the distress over particular thoughts, images, or memories should start to fade.
Phase 8: Evaluation
In the final phase, you’ll be asked to evaluate your progress after these sessions. Your therapist will do the same.

 

HOW MANY SESSIONS DOES EMDR TAKE?

The number of sessions depends upon the specific problem and client history. However, repeated controlled studies have shown that a single trauma can be processed within 3 sessions in 80-90% of the participants. While every disturbing event need not be processed, the amount of therapy will depend upon the complexity of the history. In a controlled study, 80% of multiple civilian trauma victims no longer had PTSD after approximately 6 hours of treatment. A study of combat veterans reported that after 12 sessions 77% no longer had post-traumatic stress disorder.

WHAT IS THE EVIDENCE FOR EMDR?

More than 30 positive controlled outcome studies have been done on EMDR therapy.  Some of the studies show that 84%-90% of single-trauma victims no longer have post-traumatic stress disorder after only three 90-minute sessions. 

A 2012 study of 22 people found that EMDR therapy helped 77 percent of the individuals with psychotic disorder and PTSD. It found that their hallucinations, delusions, anxiety, and depression symptoms were significantly improved after treatment. The study also found that symptoms were not exacerbated during treatment.

An older study that compared EMDR therapy to typical prolonged exposure therapy, found that EMDR therapy was more effective in treating symptoms. The study also found that EMDR therapy had a lower dropout rate from participants. Both, however, offered a reduction in the symptoms of traumatic stress, including both anxiety and depression.

Several small studies have also found evidence that EMDR therapy is not only effective in the short term, but that its effects can be maintained long term. One 2004 study evaluated people several months after they were given either “standard care” (SC) treatment for PTSD or EMDR therapy.

During and immediately after treatment, they noticed that EMDR was significantly more efficient in reducing symptoms of PTSD. During the three- and six-month follow-ups, they also recognised that participants maintained these benefits long after the treatment had ended. Overall, the study found that EMDR therapy gave people a longer-lasting reduction in symptoms than SC.

In another study, 77% of combat veterans were free of PTSD in 12 sessions.

In regard to depression, one study of 32 people conducted in an inpatient setting found that EMDR therapy shows promise in treating the disorder. The study found that 68 percent of the people in the EMDR group showed full remission after treatment. The EMDR group also showed a stronger decrease in depressive symptoms overall. Because of the small sample size, more research is needed.

There has been so much research on EMDR therapy that it is now recognised as an effective form of treatment for trauma and other disturbing experiences by organisations such as the American Psychiatric Association (APA), the World Health Organization (WHO) and the Department of Defense. It has become one of the Department of Veterans Affairs’ strongly recommended options to treat PTSD.

REFERENCES

  • Bisson, J., Roberts, N.P., Andrew, M., Cooper, R. & Lewis, C. (2013).  Psychological therapies for chronic post-traumatic stress disorder (PTSD) in adults (Review). Cochrane Database of Systematic Reviews 2013, DOI: 10.1002/14651858.CD003388.pub4
    Research indicates that CBT and EMDR therapy are superior to all other treatments.
  • Bradley, R., Greene, J., Russ, E., Dutra, L., & Westen, D. (2005). A multidimensional meta-analysis of psychotherapy for PTSD.  American Journal of Psychiatry, 162, 214-227.
    EMDR is equivalent to exposure and other cognitive behavioral treatments and all “are highly efficacious in reducing PTSD symptoms.
  • Chen, Y. R., Hung, K. W., Tsai, J. C., Chu, H., Chung, M. H., Chen, S. R., … & Chou, K. R. (2014). Efficacy of eye-movement desensitization and reprocessing for patients with posttraumatic-stress disorder: a meta-analysis of randomized controlled trials. PloS one9(8), e103676.
    [A] quantitative meta-analysis on the findings of 26 randomized controlled trials of EMDR therapy for PTSD published between 1991 and 2013 . . . confirmed that EMDR therapy significantly reduces the symptoms of PTSD, depression, anxiety, and subjective distress in PTSD patients.
  • Davidson, P.R., & Parker, K.C.H. (2001). Eye movement desensitization and reprocessing (EMDR): A meta-analysis. Journal of Consulting and Clinical Psychology, 69, 305-316.
    EMDR is equivalent to exposure and other cognitive behavioral treatments.  It should be noted that exposure therapy uses one to two hours of daily homework and EMDR uses none.
  • Ho, M. S. K., & Lee, C. W. (2012). Cognitive behaviour therapy versus eye movement desensitization and reprocessing for post-traumatic disorder–is it all in the homework then?. Revue Européenne de Psychologie Appliquée/European Review of Applied Psychology, 62(4), 253-260.
    There were no differences between EMDR and TFCBT on measures of PTSD. However, there was a significant advantage for EMDR over TFCBT in reducing depression . .  The analysis also indicated a difference in the prescribed homework between the treatments. . . EMDR is efficacious for PTSD and trauma patients with or without co-morbid depression and requires little to no between session tasks to ensure positive outcomes.
  • Lee, C.W., & Cuijpers, P. (2013).  A meta-analysis of the contribution of eye movements in processing emotional memories. Journal of Behavior Therapy & Experimental Psychiatry, 44, 231-239.
    The effect size for the additive effect of eye movements in EMDR treatment studies was moderate and significant (Cohen’s d = 0.41). For the second group of laboratory studies the effect size was large and significant (d = 0.74).
  • Maxfield, L., & Hyer, L.A. (2002). The relationship between efficacy and methodology in studies investigating EMDR treatment of PTSD. Journal of Clinical Psychology, 58, 23-41
    A comprehensive meta-analysis reported the more rigorous the study, the larger the effect.
  • Rodenburg, R., Benjamin, A., de Roos, C, Meijer, A.M., & Stams, G.J. (2009). Efficacy of EMDR in children: A meta – analysis. Clinical Psychology Review, 29, 599-606.
    Results indicate efficacy of EMDR when effect sizes are based on comparisons between EMDR and non-established trauma treatment or no-treatment control groups, and incremental efficacy when effect sizes are based on comparisons between EMDR and established (CBT) trauma treatment.
  • Seidler, G.H., & Wagner, F.E. (2006). Comparing the efficacy of EMDR and trauma-focused cognitive-behavioral therapy in the treatment of PTSD: a meta-analytic study. Psychological Medicine, 36,1515-1522.
    Results suggest that in the treatment of PTSD, both therapy methods tend to be equally efficacious.
  • Watts, B.V. et al. (2013).  Meta-analysis of the efficacy of treatments for posttraumatic stress disorder. Journal of Clinical Psychiatry, 74, e541-550. doi: 10.4088/JCP.12r08225
    CBT and eye movement desensitization and reprocessing were the most often-studied types of psychotherapy. Both were effective.