Therapist

Rapid eye movement therapy ptsd

Eye movement desensitization and reprocessing (EMDR) is a fairly new, nontraditional type of psychotherapy. It’s growing in popularity, particularly for treating post-traumatic stress disorder (PTSD). PTSD often occurs after experiences such as military combat, physical assault, rape, or car accidents.

Although research continues, EMDR remains controversial among some health care professionals.

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.

What Can You Expect From EMDR?

An EMDR treatment session can last up to 90 minutes. Your therapist will move their fingers back and forth in front of your face and ask you to follow these hand motions with your eyes. At the same time, the EMDR therapist will have you recall a disturbing event. This will include the emotions and body sensations that go along with it.

Gradually, the therapist will guide you to shift your thoughts to more pleasant ones. Some therapists use alternatives to finger movements, such as hand or toe tapping or musical tones.

People who use the technique argue that EMDR can weaken the effect of negative emotions. Before and after each EMDR treatment, your therapist will ask you to rate your level of distress. The hope is that your disturbing memories will become less disabling.

Although most research into EMDR has examined its use in people with PTSD, EMDR is sometimes used experimentally to treat many other psychological problems. They include:

  • Panic attacks
  • Eating disorders
  • Addictions
  • Anxiety, such as discomfort with public speaking or dental procedures

How Effective Is EMDR?

More than 20,000 practitioners have been trained to use EMDR since psychologist Francine Shapiro developed the technique in 1989. While walking through the woods one day, Shapiro happened to notice that her own negative emotions lessened as her eyes darted from side to side. Then, she found the same positive effect in patients.

EMDR appears to be a safe therapy, with no negative side effects. Still, despite its increasing use, mental health practitioners debate EMDR’s effectiveness. Critics note that most EMDR studies have involved only small numbers of participants. Other researchers, though, have shown the treatment’s effectiveness in published reports that consolidated data from several studies.

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. It is widely assumed that severe emotional pain requires a long time to heal.  EMDR therapy shows that the mind can in fact heal from psychological trauma much as the body recovers from physical trauma.  When you cut your hand, your body works to close the wound.  If a foreign object or repeated injury irritates the wound, it festers and causes pain.  Once the block is removed, healing resumes.  EMDR therapy demonstrates that a similar sequence of events occurs with mental processes.  The brain’s information processing system naturally moves toward mental health.  If the system is blocked or imbalanced by the impact of a disturbing event, the emotional wound festers and can cause intense suffering.  Once the block is removed, healing resumes.  Using the detailed protocols and procedures learned in EMDR therapy training sessions, clinicians help clients activate their natural healing processes.

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.  Another study, funded by the HMO Kaiser Permanente, found that 100% of the single-trauma victims and 77% of multiple trauma victims no longer were diagnosed with PTSD after only six 50-minute sessions. In another study, 77% of combat veterans were free of PTSD in 12 sessions. There has been so much research on EMDR therapy that it is now recognized as an effective form of treatment for trauma and other disturbing experiences by organizations such as the American Psychiatric Association, the World Health Organization and the Department of Defense. Given the worldwide recognition as an effective treatment of trauma, you can easily see how EMDR therapy would be effective in treating the “everyday” memories that are the reason people have low self-esteem, feelings of powerlessness, and all the myriad problems that bring them in for therapy. Over 100,000 clinicians throughout the world use the therapy.  Millions of people have been treated successfully over the past 33 years.

EMDR therapy is an eight-phase treatment.  Eye movements (or other bilateral stimulation) are used during one part of the session.  After the clinician has determined which memory to target first, he asks the client to hold different aspects of that event or thought in mind and to use his eyes to track the therapist’s hand as it moves back and forth across the client’s field of vision.  As this happens, for reasons believed by a Harvard researcher to be connected with the biological mechanisms involved in Rapid Eye Movement (REM) sleep, internal associations arise and the clients begin to process the memory and disturbing feelings. In successful EMDR therapy, the meaning of painful events is transformed on an emotional level.  For instance, a rape victim shifts from feeling horror and self-disgust to holding the firm belief that, “I survived it and I am strong.”  Unlike talk therapy, the insights clients gain in EMDR therapy result not so much from clinician interpretation, but from the client’s own accelerated intellectual and emotional processes.  The net effect is that clients conclude EMDR therapy feeling empowered by the very experiences that once debased them.  Their wounds have not just closed, they have transformed. As a natural outcome of the EMDR therapeutic process, the clients’ thoughts, feelings and behavior are all robust indicators of emotional health and resolution—all without speaking in detail or doing homework used in other therapies.

Overview

What is EMDR therapy?

Eye movement desensitization and reprocessing (EMDR) therapy is a mental health treatment technique. This method involves moving your eyes a specific way while you process traumatic memories. EMDR’s goal is to help you heal from trauma or other distressing life experiences. Compared to other therapy methods, EMDR is relatively new. The first clinical trial investigating EMDR was in 1989. Dozens of clinical trials since EMDR’s development show this technique is effective and can help a person faster than many other methods.

Who needs to have EMDR therapy?

EMDR can help people with a wide range of mental health conditions. Adolescents, teenagers and adults of all ages can benefit from this treatment. Some healthcare providers also specialize in EMDR for children.

Why is this treatment used?

EMDR therapy doesn’t require talking in detail about a distressing issue. EMDR instead focuses on changing the emotions, thoughts or behaviors that result from a distressing experience (trauma). This allows your brain to resume a natural healing process. While many people use the words “mind” and “brain” when referring to the same thing, they’re actually different. Your brain is an organ of your body. Your mind is the collection of thoughts, memories, beliefs and experiences that make you who you are.

The way your mind works relies on the structure of your brain. That structure involves networks of communicating brain cells across many different areas. That’s especially the case with sections that involve your memories and senses. That networking makes it faster and easier for those areas to work together. That’s why your senses — sights, sounds, smells, tastes and feels — can bring back strong memories.

Adaptive Information Processing

EMDR relies on the Adaptive Information Processing (AIP) model, a theory about how your brain stores memories. This theory, developed by Francine Shapiro, PhD, who also developed EMDR, recognizes that your brain stores normal and traumatic memories differently.

During normal events, your brain stores memories smoothly. It also networks them, so they connect to other things you remember. During disturbing or upsetting events, that networking doesn’t happen correctly. The brain can go “offline” and there’s a disconnect between what you experience (feel, hear, see) and what your brain stores in memory through language.

Often, your brain stores trauma memories in a way that doesn’t allow for healthy healing. Trauma is like a wound that your brain hasn’t been allowed to heal. Because it didn’t have the chance to heal, your brain didn’t receive the message that the danger is over.

Newer experiences can link up to earlier trauma experiences and reinforce a negative experience over and over again. That disrupts the links between your senses and memories. It also acts as an injury to your mind. And just like your body is sensitive to pain from an injury, your mind has a higher sensitivity to things you saw, heard, smelled or felt during a trauma-related event.

This happens not only with events you can remember, but also with suppressed memories. Much like how you learn not to touch a hot stove because it burns your hand, your mind tries to suppress memories to avoid accessing them because they’re painful or upsetting. However, the suppression isn’t perfect, meaning the “injury” can still cause negative symptoms, emotions and behaviors.

Triggers

Sights, sounds and smells with a connection or similarity to a trauma event will “trigger” those improperly stored memories. Unlike other memories, these can cause overwhelming feelings of fear, anxiety, anger or panic.

An example of this is a post-traumatic stress disorder, or PTSD, flashback, where improper storage and networking causes your mind to access those memories in a way that’s uncontrolled, distorted and overpowering. That’s why people with a history of flashbacks describe feeling as if they were reliving a disturbing event. The past becomes the present.

Reprocessing and repair

When you undergo EMDR, you access memories of a trauma event in very specific ways. Combined with eye movements and guided instructions, accessing those memories helps you reprocess what you remember from the negative event.

That reprocessing helps “repair” the mental injury from that memory. Remembering what happened to you will no longer feel like reliving it, and the related feelings will be much more manageable.

What conditions and problems does EMDR treat?

The most widespread use of EMDR is for treating post-traumatic stress disorder (PTSD). Mental healthcare providers also use it in the treatment of the following conditions:

How common is EMDR therapy?

EMDR therapy is very common around the world. In the United States, the Department of Veterans Affairs and Department of Defense list EMDR as a “best practice” in treating veterans experiencing PTSD. Research on EMDR includes dozens of clinical trials, research studies and academic papers. It has official approval from the World Health Organization (WHO) and government organizations and agencies in the United Kingdom, Australia and Germany, among others.

Is EMDR controversial?

There’s some controversy surrounding why EMDR works. The creator of EMDR, Dr. Francine Shapiro, later developed a working theory about how your brain stores memories after accidentally discovering the eye movement technique she later used to create this therapy technique.

However, that controversy doesn’t extend to whether or not EMDR does work. Dozens of controlled trials and research studies have analyzed EMDR and shown that it’s effective.

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