I Keep Hearing About EMDR. What Is It?

Eye Movement Desensitization and Reprocessing (EMDR) is a model of psychotherapy that was developed to decrease and eliminate distress caused by trauma. The original research was done with war veterans for PTSD. The research has since shown positive outcomes for symptoms related to depression, anxiety, and other trauma responses. 

Let me break down what to expect from EMDR therapy.

Just like traditional talk therapy, the counselor will take time to get to know you and your primary concerns. During this time, the EMDR therapist will also teach you coping skills and stress reduction. This is an important part of the process of EMDR. The more coping skills and resources you have, the better progress you will have in your treatment. Once you and your therapist feel confident that you have enough coping skills to use as needed, the counselor will prepare you for the phases of EMDR that focus on traumatic/distressing memories and/or symptom reduction. 

One of the tenets of EMDR is “the past is lived in the present.” What this means is that past experiences actively influence our current thoughts, actions and emotions. For instance, if a child was told they were “stupid” when they made mistakes, as an adult they will think, “I am stupid” when making mistakes, try to avoid making mistakes, and have low self-esteem. 

You will work with your counselor to establish one or more memories or current stressful situations that you would like to reprocess. After you have an identified memory, you will begin the “eye movement” part of EMDR. 

Eye Movement: The process of EMDR was discovered by Francine Shapiro when she was walking in a park while thinking of a distressing memory. Shapiro noticed that as her eyes darted back and forth at the trees while she was thinking about the memory, her negative emotions associated with the memory decreased. Shapiro used her experience to research how eye movements could be used to decrease distress in PTSD. 

The theory is that the eye movements in EMDR mimic how our eyes naturally move during REM sleep (dream sleep). If you’ve ever looked at someone sleeping while dreaming, you might have noticed that you can see their eyes move back and forth under their eye lids. Dreams are a way for our brains to process information from the day or past memories. EMDR uses these same eye movements, but while awake and alert. This way we can process past experiences in a similar manner as dreaming, but while conscious. 

Since Shapiro’s original research with eye movements, other “bilateral” movements have also been studied (Bilateral meaning activating both sides of your body). In EMDR we stimulate/activate both sides of the body in the following ways:

• Eye movements - either by following a small light on a light bar or following the therapist’s fingers

• Tapping your hands on your shoulders or thighs

• Holding “tappers,” which actually vibrate (not tap), the vibration moves from one hand to another 

• Using headphones and hearing a beep in each ear

• Other movements can also be used depending on your need and ability

Desensitization: During the stimulation phase of EMDR, you will likely notice a decrease in distress in a short period of time compared to traditional talk therapy. The EMDR therapist will check in to see what you are noticing during the bilateral movements. The goal is to get distress down to a 1 or 0 (on a 10-high scale). Most people notice that while they do not forget the memory, it no longer causes them negative emotional reactions. 

Reprocessing: Another pillar of EMDR therapy is changing thoughts about ourselves. Let’s use the example from earlier in which the person thinks, “I am stupid.” Through the EMDR process, the thought will likely change from “I am stupid” to something along the lines of “I am capable” or “I make mistakes because I am human.” This reprocessing allows you to think about a past memory and change the narrative from something negative to something neutral or positive. 

EMDR is gaining recognition in recent years and is seen as a sought-out treatment for PTSD, anxiety, depression, and stress. Recently, Prince Harry demonstrated how he uses EMDR with his therapist. Prince Harry and Oprah produced the series, The Me You Can’t See on AppleTV and he shows part of an EMDR session. There was also a piece on Good Morning America that shows a clip of Prince Harry’s EMDR session. 

EMDR therapy sessions can be in-person or online (aka telehealth), depending on your needs and what your EMDR therapist offers. More information about EMDR can be found at the EMDR Institute and EMDR International Association.