Eye Movement Desensitization & Reprocessing Therapy (EMDR)
What is EMDR Therapy?
Eye Movement Desensitization & Reprocessing Therapy or EMDR has been adapted to treat a wide range of psychiatric problems, but its most scientifically-validated application is in the treatment of PTSD.
In EMDR therapy, the goal is to activate the Adaptive Information Processing (AIP) system to finish the job of processing and storing the trauma memory in a more adaptive way.
EMDR is based on the theory that the human brain has an innate AIP system that takes in new information and experiences, “digests” them, and integrates them into existing memory networks. This enables a person to make sense of their experiences, learn from them, and include them coherently in their own life narrative and understanding of the world.
According to EMDR theory, a traumatic event (or series of events) can disrupt the functioning of the AIP system, preventing the experience(s) from being fully “metabolized.” The dysfunctionally-stored trauma memory is at the heart of PTSD, generating symptoms such as nightmares and flashbacks, emotional agitation, hyper-alertness, physical tension or discomfort, and negative beliefs about oneself (e.g.,“I’m in danger,” “I’m weak,” “I deserved it”).
How Does EMDR Work?
The patient is prompted to recall the most distressing elements of the memory, such as images, thoughts, emotions, physical sensations, etc.
Then the AIP system is “kick-started” via bilateral stimulation (BLS). BLS stimulates the left and right hemispheres of the brain in alternation, through side-to-side eye movements, tactile stimulation, or auditory tones.
The patient is asked to mindfully observe real-time changes in their emotions, thoughts, physical sensations, or to the memory itself. The therapist serves as a support and guide, helping the patient sort through the cognitive, emotional, and physical experiences that emerge.
After multiple “sets” of BLS, negative experiences begin to shift, allowing more adaptive and positive feelings, memories, and insights to arise.
Reprocessing of the memory is complete when it no longer evokes strong emotion, physical tension or discomfort abates, and the patient’s self-beliefs related to the trauma are more helpful (e.g. “I’m safe now,” “I’m a survivor,” “I deserve to heal and move forward”). Patients frequently express that the traumatic event finally feels like it is “in the past.”
Successful reprocessing of a single memory or symptom may take one or multiple sessions. Patients are asked to practice mindfulness exercises or other distress management strategies between sessions, and to keep a log of any emotional disturbances or intrusive symptoms that occur. The total number of EMDR sessions can vary significantly based on the patient’s symptom severity, complexity of trauma history, and capacity for managing distress.
EMDR For PTSD
EMDR has been demonstrated effective by many high-quality research studies, and it is recognized by the Departments of Defense and Veteran Affairs, as well as other authoritative professional organizations, as a first-line intervention and best practice for treating PTSD.