Everything you need to know about EMDR and more

Introduction

Understanding and recovering from traumatic experiences can be a challenging journey. One therapeutic approach that has shown significant promise is Eye Movement Desensitization and Reprocessing Therapy (EMDR). Developed in the late 1980s by Dr. Francine Shapiro, EMDR is a psychotherapy approach designed for working with distressing or traumatic memories.

The aim of EMDR therapy is to foster healing from emotional distress due to disturbing life experiences. It's been recognized for its effectiveness by numerous organizations, including the American Psychological Association (APA), World Health Organization (WHO), and the US Department of Defense (DoD).

This article will delve into EMDR therapy, exploring its protocols, effectiveness, applications, and what you can expect during an EMDR session. Whether you're a mental health professional looking to learn more about this therapeutic modality or someone interested in undergoing this therapy yourself, this comprehensive exploration will provide valuable insights.

The focus will be on why EMDR is considered an effective treatment for Post Traumatic Stress Disorder (PTSD) and other conditions. We'll investigate the role of bilateral stimulation in EMDR, discuss the eight phases of therapy with relevant examples, and even touch on some criticisms and controversies surrounding its practice.

By reading this article, you'll gain a thorough understanding of how EMDR works, allowing you to make informed decisions about whether it might be right for your own healing journey or helpful in your professional practice.

Understanding EMDR Therapy

At its core, EMDR therapy is about healing emotional distress stemming from disturbing life experiences. It's a psychotherapeutic approach that brings the brain's natural healing mechanisms to bear on the task of processing traumatic memories.

How EMDR Therapy Works

When you've experienced a traumatic event, the memories associated with that event can become "stuck" in your brain. These memories might include powerful and distressing images, emotions, physical sensations, and beliefs. They're stored in an unprocessed form that keeps them active and capable of being triggered by current events that remind you of the trauma.

EMDR therapy, however, offers a way to process these stuck memories effectively. It works by helping your brain to connect the unprocessed trauma memory with more adaptive information. This connection allows for a reprocessing of the memory, transforming it into a form that no longer triggers distressing reactions.

A key component of this process is what's known as bilateral stimulation. This technique involves creating a rhythmic, back-and-forth pattern of sensory stimulation.

Types of Bilateral Stimulation

This stimulation occurs in various forms:

Visual: You might follow a moving light or the therapist's finger with your eyes.
Auditory: You may listen to tones or clicks that alternate between your left and right ears using headphones.
Tactile: You could feel taps or buzzes alternating on different sides of your body.

The role of bilateral stimulation in EMDR therapy is still being researched, but it appears to have several effects:

It aids in accessing and activating traumatic memories.
It helps you to maintain a mindful state during processing.
It may stimulate communication between different parts of your brain, assisting in memory reprocessing.

Through these mechanisms, bilateral stimulation enhances your ability to fully process disturbing experiences and integrate them into your broader life narrative, lessening their emotional impact.

In essence, EMDR therapy supports your brain's natural healing processes, much like how the body heals from physical injuries. It provides a practical, evidence-based approach to dealing with the emotional distress that can follow in the wake of traumatic experiences.

The Nine Phases of EMDR Therapy

EMDR therapy is a structured approach to treating traumatic memories and emotional distress. It relies on an eight-phase treatment protocol, with each phase playing a crucial role in the healing process. Bilateral stimulation during memory processing is a key component throughout these phases. Here's what you need to know about each phase:

1. History Taking and Treatment Planning

During the initial phase, your therapist will gather your history and map out the specific memories that will be targeted in treatment. This might include distressing events from your past as well as current situations that cause emotional turmoil. Sometimes you don't know what the specific memories are that are causing you trauma - don't worry the EMDR process does reveal these to you in time

2. Preparation

Here, your therapist will explain the EMDR process and establish a trust-based relationship with you. Techniques for coping with emotional distress are introduced, such as mindfulness or relaxation exercises.The therapist will also identify a safe space - somewhere you can return too if things become to emotionally painful.

3. Assessment

In this phase, you identify the vivid visual image related to the memory, a negative belief about yourself, related emotions and body sensations. Additionally, you'll come up with a positive belief that would indicate resolution of the traumatic memory.

4. Desensitisation

This involves focusing on the memory while engaging in bilateral stimulation—such as side-to-side eye movements—which reduces the vividness and emotion associated with the memory. You can tell when desensitisation has completed because you can remember a painful memory but the power and influence it has over you is gone. Sometimes desensitisation takes several goes to completely change the feelings around the memory.

5. Installation

The positive belief identified earlier is then strengthened and 'installed'. Bilateral stimulation continues to be used to solidify this more adaptive belief alongside the targeted memory. Installation also includes resourcing. Resourcing ensures that a better more positive memory feeling is implemented to "fill the gap".

6. Body Scan

You're asked to think of the original traumatic event and notice if there are any residual physical sensations or tension in your body. If so, these are targeted with further bilateral stimulation until they dissipate.

7. Closure

At the end of each session, you're brought back to equilibrium regardless of where you are in the process of working through a particular memory. Techniques learned in Phase 2 might be used here for self-soothing after the session.

8. Reevaluation

Each new session begins with an assessment of your current psychological state and a review of progress made since the last session. The therapist determines if further reprocessing is needed for targeted memories or if new areas have emerged that need attention.

By progressing through these stages, EMDR therapy helps facilitate changes in emotional reactions, thoughts, and bodily sensations associated with traumatic memories using bilateral stimulation during memory processing. With each phase building upon the last, EMDR aims to reshape how traumatic memories are stored in the mind, leading to symptom reduction and improved mental health.

9. Brittain Co Regulation model.

Throughout the process a co regulation needs to occur throughout the process. The Brittain Co regulation model created by Tracey Brittain ensures the therapist meets the client in the current Polyvagal state, creating safety and trust. This allows for effective processing of traumatic memories and promotes a sense of resilience and empowerment in the client. The therapist's role is crucial in guiding the client through these stages, offering support, validation, and containment when needed. Without co regulation the client might not be able to engage with the process extensively enough.

The crux of EMDR therapy lies in its ability to activate the natural healing processes of the brain, which are often hindered by traumatic experiences. By reprocessing these experiences, you can eliminate their negative effects and replace them with positive beliefs and feelings.

Remember, everyone's experience with EMDR will be different, as the process is tailored to each individual's needs.

The Protocols and Procedures Used in EMDR Therapy

EMDR therapy follows specific protocols designed to activate the brain's natural healing processes. These protocols are carefully crafted to ensure consistent and effective delivery of therapy, maximizing its potential to bring about change.

Core Components of EMDR Protocols

The protocols used in EMDR therapy consist of several key components:

Target Memory Selection: Identifying the specific traumatic memory or incident to focus on.
Client Preparation: Building trust and explaining the EMDR process, ensuring the client is ready for exposure to the traumatic memory.
Desensitisation: Using bilateral stimulation to reduce the emotional impact of the memory.
Installation: Strengthening positive beliefs associated with the targeted memory.
Body Scan: Checking for any residual somatic response and addressing it through further bilateral stimulation if necessary.
Closure: Ensuring the client leaves the session feeling better than when they arrived.
Reevaluation: Assessing progress in subsequent sessions and adjusting the treatment plan as needed.

Adherence to Structure

Therapists receive training on following these protocols, which have a strong foundation in research. They also need to be skilled at making real-time adjustments based on each client's individual responses during sessions.

Important factors therapists monitor during EMDR therapy sessions include:

Emotional reactions
Somatic responses
Changes in insights or cognitions

By using these structured protocols, therapists can guide clients through their traumatic memories towards an adaptive resolution. External stimuli such as eye movements or auditory tones play a crucial role in facilitating this process, supporting clients as they reprocess distressing memories into neutral or positive ones.

EMDR protocols are not rigid scripts but frameworks that prioritize individual client needs while still following established therapeutic techniques. This balance allows therapists to provide personalized care grounded in proven practice.

Research Evidence and Recognition

Eye Movement Desensitization and Reprocessing (EMDR) therapy has been examined by a myriad of research studies. These studies validate its efficacy and have led to recognition by several major organizations.

Research Studies on EMDR

Numerous positive controlled outcome studies have examined EMDR's effectiveness, particularly in treating trauma. Over 30 such studies testify to the significant benefits it offers for those grappling with traumatic experiences. Each of these investigations contributes to a growing body of literature supporting EMDR as a powerful tool within the realm of psychotherapy.

One study published in the Journal of Clinical Psychology found that EMDR effectively reduces symptoms related to post-traumatic stress disorder (PTSD).
Another study in the Journal of Traumatic Stress reported that EMDR can be beneficial even for individuals who have experienced long-lasting psychological distress due to traumatic exposure.
Extensive research has allowed large organisations to adopt EMDR as the default trauma reduction treatment

Recognition by Major Organisations

The evidence base for EMDR extends beyond academic research. Esteemed organizations within the field of psychology and mental health have recognized its potency:

The American Psychological Association (APA) includes EMDR as an evidence-based practice for treating PTSD in adults.
The World Health Organisation (WHO) recommends EMDR for children, adolescents, and adults suffering from PTSD.
The NHS has the largest healthcare platform in the world. EMDR was approved through the NICE accreditation in 2017 ).
The Department of Defense (DoD) also acknowledges the value of EMDR in its Clinical Practice Guideline for Management of Post-Traumatic Stress Disorder and Acute Stress Disorder.

Notably, these endorsements signify an important step towards acknowledging alternative psychotherapy methods that can be instrumental in healing emotional distress caused by disturbing life experiences.

These recognitions from well-respected organizations coupled with solid research findings provide compelling evidence for the effectiveness of EMDR therapy.

Applications of EMDR Therapy

Undoubtedly, the primary application of EMDR therapy is in trauma/PTSD treatment. A traumatic event can disrupt an individual's ability to process emotions and memories, leaving them stuck in a loop of distress. EMDR therapy breaks this cycle, allowing the individual to process their traumatic experiences and move forward.

The process involves bilateral stimulation - usually through eye movements, but also through sounds or tapping - which helps accelerate the brain's natural healing capabilities. This bilateral stimulation aids in accessing and processing traumatic memories, replacing negative beliefs with positive ones. It's transformative changes at a gut level that make EMDR therapy so effective.

EMDR Therapy for Trauma and PTSD

The efficacy of EMDR for trauma and PTSD is well-documented. Over 30 positive controlled outcome studies have demonstrated its effectiveness, resulting in its recognition by major organizations such as the APA, WHO, and DoD.

Additional Benefits of EMDR Therapy

But that's not all. EMDR therapy has additional benefits beyond PTSD treatment. Many mental health professionals use it to treat:

Anxiety disorders
Depression
Obsessive-compulsive disorder (OCD)
Chronic pain
Addictions

The treatment phases of EMDR help not only with processing traumatic memories but also with understanding and managing symptoms associated with these conditions. By focusing on both past influences and current symptoms, EMDR can bring about substantial improvements in a patient’s mental well-being.

Exploring New Possibilities

In addition to the aforementioned conditions, there's growing interest in exploring how EMDR might be used for other mental health conditions. For instance, some therapists are examining its potential benefits for individuals suffering from personality disorders or psychosis.

With over 100k clinicians worldwide using EMDR therapy for over three decades, millions have been treated successfully. Its applications continue to grow as we further our understanding of the brain's capacity for healing and resilience.

Remembering Individuality

While EMDR has proven to be a powerful tool in the arsenal of mental health professionals, it's important to remember that each case is unique. Hence, the effectiveness and applicability of EMDR may vary from person to person. It should be used as part of a comprehensive care plan under the guidance of a qualified therapist.

Training and Qualifications for EMDR Therapists

EMDR Therapy is not a technique that can be applied casually or without the necessary professional expertise. It requires trained and specialist therapists who are well versed in the protocols, procedures, and philosophies underpinning this therapeutic approach.

To practice EMDR therapy effectively, a mental health professional needs to undergo rigorous training. This training involves learning about the eight-phase treatment model, mastering the use of bilateral stimulation, understanding how to identify and process target memories, and gaining knowledge about how to manage any potential risks or complications that might arise during therapy.

Key Points on EMDR Therapist Training

Consider these key points regarding EMDR therapist training:

The process includes both theoretical education and practical workshops. Therapists learn the foundational concepts behind EMDR therapy and get to apply these theories in supervised practice sessions.
To reinforce their skills, therapists also need to complete a certain number of clinical hours where they apply EMDR therapy under supervision.
After completing their training, therapists must pass an assessment before they can be certified as EMDR practitioners.

On top of this formalised training pathway, ongoing professional development is also essential for EMDR therapists. This field is continually evolving as new research findings emerge and methodologies are refined. Hence, therapists need to stay updated on the latest advancements in order to provide the best care possible for their clients.

Qualifications for EMDR Therapists

In terms of qualifications, an EMDR therapist in the UK should:

Have practised in psychotherapy for over four years with a set number of client sessions signed off by the therapist supervisor.
Ideally be accredited by reputable organizations such as the EMDR International Association(https://emdrassociation.org.uk/map-member/tracey-brittain/) or equivalent bodies in their respective countries.

It's worth noting that successful EMDR treatment doesn't necessarily require extended periods - even just "6 sessions can make a difference". However, more complex cases may require longer treatment durations.

The rigorous training and qualifications required for EMDR therapists underscore the depth and complexity of this therapeutic approach. They also highlight the need for individuals seeking EMDR therapy to ensure they are working with a competent, well-trained professional.

Criticism and Controversies Surrounding EMDR Therapy

Despite the widespread adoption of Eye Movement Desensitisation and Reprocessing (EMDR) therapy in clinical settings, certain aspects of its practice have sparked debate within the mental health community. Critics often highlight controversial aspects of EMDR, questioning both the mechanism behind its effectiveness and the robustness of research evidence.

Mechanism of Action

Critics point out that the theory behind EMDR's eye movements mimicking REM sleep and thereby facilitating information processing is not conclusively proven. Some argue that the eye movement component of EMDR is unnecessary, suggesting that its therapeutic effects may be derived from more traditional elements like exposure to distressing memories and the therapeutic relationship. Research contrary to this objection is vastly stronger Criticism and Controversies Surrounding EMDR Therapy

The Role of Marketing

The proprietary nature of EMDR therapy highlights the need for individuals seeking EMDR therapy to ensure they are working with a competent, well-trained EMDR therapist. This can easily be addressed by looking up the directory in the EMDR association. Therapist normally also attend yearly conferences to keep up to date on the latest research.

Research Evidence

While many studies support EMDR's efficacy, skeptics express concerns about methodological weaknesses in some research, including small sample sizes, lack of control groups, and issues with researcher bias. There is an ongoing debate regarding whether EMDR can be distinctly separated from other forms of psychotherapy in terms of its results, leading some to question if it offers unique benefits beyond established treatments for PTSD.

Future Directions and Ongoing Research

The future of EMDR therapy is poised on the cusp of innovation as researchers continue to explore its efficacy and applications. With a growing body of evidence supporting its use, the horizon looks promising for this therapeutic approach.

Emerging Areas of Research

Technological Integration

The integration of technology in EMDR therapy, such as virtual reality (VR), holds potential for creating more immersive and controlled environments for patients. Studies are underway to determine the effectiveness of VR-assisted EMDR in treating conditions like PTSD.

Neurobiological Underpinnings

Advancements in neuroscience provide opportunities to better understand how EMDR affects the brain's processing mechanisms. Ongoing research aims to map out neural changes before and after EMDR sessions using modalities like fMRI and EEG.

Expanding Scope

Initially recognised for treating PTSD, current research is expanding EMDR's scope to address a variety of mental health conditions such as anxiety disorders, depression, substance abuse, and eating disorders.

Pediatric Application

There is an increased focus on tailoring EMDR therapy for children and adolescents. Investigating age-specific protocols can enhance the treatment's efficacy among younger populations with developmental considerations.

Cultural Adaptations

As EMDR therapy becomes more global, studies are examining how cultural differences impact treatment outcomes. This research will inform culturally sensitive adaptations of EMDR protocols.

Comparative Effectiveness

Researchers continue to evaluate how EMDR stands up against other therapeutic methods across varied conditions. Such comparisons will help refine treatment guidelines and identify candidates most likely to benefit from EMDR.

By investigating these areas, professionals aim not only to refine the practice but also to make it more accessible and effective for diverse patient populations. The ongoing research will likely yield transformative insights that could further cement EMDR therapy’s role in mental health treatment.

Conclusion

EMDR therapy stands as an effective treatment for PTSD, with a wide recognition in the realm of psychotherapy for its ability to foster profound change. This transformative approach aims not only at symptom relief but at the very heart of the traumatic experience, offering a path to recovery that many have found effective.

Consider EMDR therapy as a valuable tool in your healing arsenal, especially if traditional approaches have been less effective.
Seek guidance from therapists who are credentialed in EMDR to ensure you receive the highest standard of care.
Remember the potential that EMDR therapy holds for transforming painful events into sources of strength.

The impact of EMDR on individuals who have endured traumatic experiences is remarkable. By effectively processing and integrating traumatic memories, clients can achieve emotional freedom and empowerment. The legacy of EMDR therapy is a testament to its pivotal role in advancing mental health treatment, and it continues to evolve with ongoing research.

For those on a journey toward healing, embracing EMDR therapy under the direction of a qualified therapist may illuminate the path to recovery. The significance of this therapeutic approach lies in its unique capacity to aid individuals in rewriting their narrative from one of adversity to one of resilience and hope.

Fun Fact: EMDR can be used on animals too

Many animal therapists are now using EMDR to help animals overcome trauma and anxiety, further demonstrating its versatility and effectiveness. Our therapy dog Rocket fell awkwardly on the stairs when he was a young puppy. This meant Rocket would not go near any stairs. Tracy performed EMDR on him, and he has never looked back. So, whether you're seeking relief for yourself or your furry friend, consider exploring the transformative potential of EMDR therapy.