What Is EMDR Therapy?

On the surface of things, you seem to have it all together. You go about your days fairly well — going to work, socializing with friends, and fulfilling your adult responsibilities. Underneath, however, you feel a heaviness, a deep seated pain that weighs you down. You keep trying to push it away, maybe even attempting to numb it with alcohol, but nothing seems to offer any relief. You’ve even noticed tension throughout your body that just never seems to go away. Could you be suffering from unhealed trauma?

A treatment known as eye movement desensitization and reprocessing (EMDR) therapy can help us heal from trauma or painful life experiences. What is EMDR therapy? We’ll also explore who can most benefit from it, and what to expect if we decide to try it. Let’s get started!

What Is EMDR Therapy?

EMDR therapy is a relatively new psychotherapy or mental health technique that can help us heal from trauma and relieve psychological stress. It was initially developed in the late 1980s by psychologist Francine Shapiro, who randomly discovered that eye movements appeared to decrease the negative emotion associated with her own distressing memories.

Shapiro eventually developed a protocol that could be duplicated and studied, which is now known as EMDR therapy. It was first used to treat people suffering from post-traumatic stress disorder (PTSD), but it’s now used to treat a variety of mental health conditions, such as alcohol and drug misuse, anxiety, chronic pain, depression, eating disorders, panic attacks, and phobias.

The goal of EMDR is to reduce symptoms of trauma or other distressing life experiences by changing how our memories are stored in our brain. According to the theory behind this method, traumatic and painful memories can cause PTSD when we don’t fully process them, or when we process them effectively. When we experience certain sights, sounds, words, or smells that trigger unprocessed memories, we re-experience them, triggering the emotional distress and other symptoms associated with PTSD.

With EMDR therapy, a trained professional typically leads us through a series of rhythmic left-right (side-to-side) eye movements as we recall traumatic or triggering experiences in small segments. These bilateral eye movements, along with focusing on the traumatic memory, are thought to reduce the memory’s emotional impact. As a result, we begin to heal from the fear or pain associated with trauma.

Unlike other forms of therapy that focus on changing our emotions, thoughts, and behaviors, EMDR therapy focuses directly on the specific memory to change the way it’s stored in our brain.

Who Can Benefit From EMDR Therapy?

So, who can benefit from EMDR? According to research, a lot of us! While the most widespread use of EMDR is for treating PTSD, mental healthcare providers have also used it to treat anxiety disorders, depression, eating disorders, obsessive-compulsive disorder, and alcohol and drug misuse. In fact, since the discovery of EMDR, meaningful change has been achieved in many areas, making it one of the most recommended psychotherapeutic treatments of trauma.

As for its effectiveness, research has a lot to say on that, too. In fact, one review concluded that EMDR therapy was useful for relieving distress caused by trauma and that it may work more quickly and effectively than trauma-focused cognitive behavioral therapy (CBT). In fact, research findings have led the American Psychological Association (APA) to recommend EMDR for the treatment of PTSD.

Here’s a closer look at what the research says about who can benefit from EMDR therapy:

• Depression: Studies suggest that EMDR can be an effective treatment for those struggling with depression. One study noted that 70% of people treated with EMDR achieved complete remission from depression symptoms. After receiving treatment, people with depression report improvements in symptoms, and fewer relapses and depression-related concerns at follow-up over a year later.
• Panic disorder: One study of people with panic disorder suggested EMDR is just as effective at treating panic disorder symptoms as cognitive behavioral therapy (CBT). In fact, after going through EMDR therapy, participants reported a significant reduction in panic attacks and hyperarousal symptoms, such as heart palpitations, chest pain, sweating, trembling and shaking.
• Psychosis: According to a review of six studies, EMDR may help treat psychosis with no adverse effects. The studies noted that EMDR decreases delusions and negative symptoms, with some participants reporting fewer hallucinations and less paranoia. Other participants also reported reduced use of medication and mental health services. However, researchers have noted that more research needs to be done to determine its effectiveness.
• Trauma symptoms: A review of studies found that EMDR improves trauma-associated symptoms in people with psychosis, unipolar depression, bipolar disorder, anxiety disorders, substance use disorders, and chronic back pain. The review also found evidence that EMDR may help improve non-traumatic symptoms found in mood disorders and may be helpful as an additional treatment for people with chronic pain. While EMDR can be highly effective for many people, it might not be suitable for people with severe psychiatric conditions (such as schizophrenia), who require specialized treatment and support. Similarly, EMDR therapy may not be advisable for people who have recently experienced a traumatic event, as they may not be ready to process those emotions.

How Does EMDR Therapy Work?

So now that we know what EMDR therapy is and who it can benefit, let’s look at what we can expect if we try it. Keep in mind that EMDR can be used on its own or in conjunction with medications or other psychotherapy techniques, such as cognitive behavioral therapy (CBT).

EMDR therapy usually takes about 3 months of weekly sessions under the supervision of a trained EMDR therapy provider. Treatment typically involves eight phases that focus on the past, present, and future. Each phase is designed to help us work through emotional distress and learn coping skills to better handle future stress.

Let’s take a closer look at each of the 8 phases.

1. History and Information Gathering

This first phase involves providing our therapist with a complete history and overview of our life. This includes discussing our early childhood, family of origin and upbringing, and significant trauma or negative life experiences which cause distress or pain. These can range from general unpleasant life events and hardship, such as humiliation, bullying, rejection, or divorce, to extreme trauma like sexual abuse or near-death experiences.

The main goal is to identify past experiences which have led us to have negative beliefs about ourselves or the world. Based on our history, our therapist will work with us to develop a treatment plan that targets specific memories or incidents. While painful memories and emotions can be difficult to discuss, this is an essential component of EMDR and contributes to the healing process.

2. Preparation and education

In the preparation phase, our therapist prepares us for the EMDR process by walking us through what to expect. It’s not uncommon for unpleasant emotions or memories to arise from the EMDR process, but it’s important to remain present and allow the processing to take place. Our therapist equips us with tools to cope with distressing feelings, such as mindfulness, deep breathing, guided imagery, and progressive muscle relaxation.

3. Assessment

During the assessment phase, the therapist works with us to select a targeted memory or event from phase one, along with images, beliefs, feelings, and sensations about the event. For instance, if you were persistently bullied as a child, you might be asked to recollect a vivid mental image related to that, a negative belief about yourself that resulted from that (i.e. “I’m not worthy”), and any related emotions and body sensations. We’re also asked to rate the memory on a scale of 1-10 of how distressing it is. Furthermore, the therapist helps us identify positive beliefs that we would like to have about ourselves going forward.

4. Desensitization and reprocessing

This is when the actual EMDR processing of the memory and negative beliefs actually occurs. While focusing on the targeted memory or event, our therapist leads us through multiple bilateral stimulation sets to stimulate our brain to process whatever trauma is currently in our mind. These sets may include eye movements, tactile taps, or auditory tones.

After each set, our therapist will instruct us to clear our mind and discuss any thoughts, feelings, images, or sensations that arose. We’ll also be asked to rescale the intensity of our experience of the memory on a scale from 1-10 after each set. Whatever negative sensations we’re still feeling will become the focus of the next set, and this process will continue until we reach a lower level of intensity — or until the target memory no longer causes distress.

5. Installation

In the installation phase, our therapist works with us to strengthen the positive beliefs we came up with in step 3. The goal is for these new, more adaptive and positive beliefs to replace the negative views that we formerly held as a result of the unprocessed memory. For instance, we might focus on beliefs such as “I am safe,” “I am loveable,” and “I am worthy.” While thinking of the target memory and positive belief, our therapist guides us through more simulation sets to help embed it in our psyche. This is what we might call the “letting go” phase, when we’re making peace with the original unpleasant incident and any negativity associated with it.

6. Body Scan

During this phase, the therapist encourages us to attentively scan our body and notice any lingering physical sensations related to the distressing memory or incident. Trauma tends to be physiologically stored in the body, often manifesting in various physical sensations, such as tension, numbness, tingling, heat rashes, etc. If we have any lingering physiological disturbances, our therapist will perform more stimulation sets until it's fully resolved.

7. Closure and stabilization 

Closure comes at the end of the EMDR session to help return us to a calm state whether the reprocessing is complete or not. As it can take several sessions just to fully process one memory, it’s important not to leave the session in a more distressed state. In these cases, our therapist will use a series of calming exercises — such as guided imagery or meditations — so we can peacefully re-enter our normal life. We’ll then return to processing the memory in the next session. Our therapist also might assign homework to help maintain progress between sessions. For instance, they might ask us to journal, practice relaxation techniques, or use imagery that allows us to picture what it would be like to gradually face our fears.

8. Reevaluation and continuing care

Every new EMDR therapy session begins with reevaluation, in which we discuss our current psychological state and whether we feel the treatment and techniques are working. Our therapist might ask if any targeted memories have arisen since the previous session, and help us determine if we need to work through other distressing experiences.

Keep in mind that if any negative emotions and views of self have returned or are still present in our memory of the incident, that’s usually a sign that more stimulation sets are needed. Our therapist will help guide us through the steps above to ensure that healthier, more adaptive beliefs become fully installed on a more permanent level.

What To Keep in Mind Before Practicing EMDR Therapy

If we decide to try EMDR, it’s important to keep a few things in mind. First and foremost, be sure to find a trained professional, as EMDR is a specialized therapy that requires specific training. Consider browsing the EMDR International Association’s website to find a qualified EMDR therapist. Also inquire about the therapist’s specific experience with EMDR, as not all EMDR therapists specialize in every mental health condition.

Furthermore, although EMDR is considered safe, it’s important to remember that thinking about traumatic events can be distressing, particularly as we start therapy. However, our therapist can work with us to find healthy ways to cope with our feelings.

Finally, EMDR is not a quick fix. While it can provide rapid relief, results often take multiple sessions. But sticking with it is worthwhile, as a sense of freedom comes from fully confronting and healing from trauma.

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