How Does EMDR Work?
EMDR stands for Eye Movement Desensitization and Reprocessing therapy. It is primarily used for treating post-traumatic stress disorder, or PTSD, including simple and complex traumas. EMDR is a relatively new treatment, developed in 1987. Many studies have found it to be effective in treating PTSD, significantly reducing symptoms in nearly 80 percent of patients.
EMDR is based on the idea that the brain can heal itself, given the opportunity. This is much different to other therapies. Cognitive behavioural therapy, or CBT, for example, might focus on changing your beliefs and emotions related to the trauma by bringing to light and systematically correcting cognitive distortions. CBT has been proven effective in treating PTSD and other conditions. However, as everyone is different, it’s good to have different treatment options, and CBT and EMDR are not mutually exclusive.
EMDR works differently to CBT in that it directly changes how the memory of the traumatic event is stored in your brain. Traumatic memories are painful and one common symptom of PTSD is that key features of the traumatic event are buried so you can’t remember them. This is meant to protect you from pain, but it also prevents you from processing the experience. Instead, the experience surfaces in other ways, such as anxiety, flashbacks, and nightmares. When you process the memories in a safe way, the symptoms subside.
EMDR is essentially a method of accelerated learning that facilitates productive insights about your trauma. These insights aren’t guided by a therapist but rather generated from within. Clients often find their beliefs about the traumatic event spontaneously change during therapy because EMDR is intended to not only reduce the painful symptoms of trauma, but to change negative beliefs into positive beliefs. Unlike CBT, EMDR does not require you to discuss the traumatic experience in detail, to directly challenge your beliefs about it, or to do homework between sessions.
EMDR involves a structured process that includes taking your history and planning your treatment, preparing you for treatment, assessing the target memory, processing the memory, installing positive thoughts, scanning your body, closing the session, and evaluating the results. In the history segment, you and your therapist discuss your memories, your current triggers, and future plans and decide how to proceed with treatment. In the preparation stage, the therapist explains how the treatment works and what the procedure is. You practice the movements and learn emotional regulation strategies to use between sessions. In the assessment stage, you activate the target memory and assess the components of the memory, which include image, cognition, affect, and body sensation.
The processing stage is where the eye movement, called bilateral stimulation, or BLS, comes in. You recall key features of the traumatic event while watching the therapist’s hand move side to side, watching a graphic move across a screen, tapping with opposite hands, or some other bilateral movement. This is thought to change how you engage with the traumatic memory. Before and after each session, the therapist will assess the strength of each memory, and the process is repeated each session until the memory has sufficiently diminished. Processing a memory typically takes one to three sessions. Often, new memories arise in the course of the session and these new memories also have to be targeted for desensitization. This process continues until no new painful memories emerge.
At the end of each session, you will install and strengthen a positive thought about the the traumatic experience. For example, if you see yourself as weak and helpless following an assault, you may realize instead that you’re a resilient survivor. After this, you try to notice any feelings in your body that arise while thinking of the traumatic experience and the new positive belief about it. If troubling sensations persist, your therapist will help you work through them. After this, the session is closed. If the memory has not yet been fully processed, your therapist will help you manage it until the next session, when you will continue to process the traumatic memory.
Finally, comes the assessment. This is when the therapist looks at whether the progress from previous sessions has been maintained and if any new memories have surfaced since the last session. These new memories may also need to be processed.
There is no set timeline for each of these phases. The preparation phase, for example, may take several sessions or just one. New memories may continue to emerge, or if the traumatic event was relatively simple, it may be worked through in relatively few sessions. Everyone is different and will proceed through treatment at a different rate. There is no hurry to finish, but EMDR is meant to finish at some point, rather than continue indefinitely. For many people, relatively few sessions will be enough to significantly reduce the symptoms of PTSD.
The key to EMDR is reprocessing traumatic memories in a safe way. It’s not exactly clear how the bilateral stimulation of eye movements or hand taps facilitates this. There are two hypotheses. One is that the eye movements mimic the eye movements of REM sleep, which is a phase of sleep involved in processing and consolidating memories. A second hypothesis is that the BLS taxes your working memory, making the traumatic memory less vivid, and therefore easier to process. Some studies suggest that BLS doesn’t actually affect the treatment one way or another. However, there is plenty of evidence that EMDR significantly reduces the symptoms of PTSD and that is might also be effective for other conditions such as anxiety disorders and panic disorders.
If you or someone you love is struggling with addiction, PTSD, or an anxiety disorder, The Dawn Medical Rehab and Wellness center can help. We are one of Thailand’s most respected addiction treatment and wellness centers. We use cutting-edge treatment modalities, including EMDR and CBT to provide personalized care to treat addiction, depression, anxiety, bipolar disorder, personality disorders, PTSD, and executive burnout. See our contact page to reach us by phone or email.