What is EMDR? A closer look at trauma treatment

Author – Bailey Hall

Eye Movement Desensitization and Reprocessing (EMDR) is a therapeutic technique developed by Dr. Francine Shapiro that aims to relieve individuals of post-traumatic stress disorder (PTSD) symptoms (Gomez et al., 2017). EMDR is recognized as a highly effective treatment by numerous trauma organizations including the Department of Veterans Affairs and the International Society for Traumatic Stress Studies. The basic principle, tenant, and assumption of EMDR is the notion that individuals suffering from a post-traumatic stress disorder and comorbid symptoms/disorders can be returned to wellness or experience partial to full remission of symptoms by completing treatment involving saccadic eye movements while recounting the memory of their trauma with a therapist. Moreover, this treatment technique is assumed to “unstick” traumatic memories from working memory and instead, properly chronicle them in long-term memory. This allows the nervous system to deactivate and “turns off” the sympathetic “flight, fight, freeze, fawn” response(s). EMDR is effective in treating mental health issues triggered by shock trauma or developmental trauma (Hensely, 2015, p. 4). Recently, research suggests that EMDR may be useful in treating physical manifestations of trauma, such as chronic back pain and headaches (Tesarz et al., 2013).

EMDR is broken into eight phases, beginning with the therapist’s first contact with the client. Following this, the therapist gets to know the client, completing regular assessments and learning the client’s history. It is in this phase that the “clinician determines whether a client is able to tolerate reprocessing” (Hensely, 2015, p. 73). Then, the client is prepared for EMDR therapy. They must give informed consent and be aware of the potential risks and benefits. The third step is when the main components of the treatment are introduced: the traumatic memory is accessed, associated images are activated, and physical sensations are identified. Fourth, the dyad begins the desensitization portion in which the saccadic eye movements are utilized. The client will follow the therapist’s fingers, or sometimes an implement with lights is used to guide the eye movements. Fifth, the client pairs the traumatic memory with a positive cognition. Once this positive cognition is installed, a body scan is completed to determine if any remaining physical disturbances need reprocessing. The seventh step is to close the session by employing appropriate tools used to ground the client to the present moment and establish safety. Finally, the clinician must reevaluate to determine successful reprocessing of the traumatic memory and whether there are new troubling emergences since the last session. Before moving on to a new targeted traumatic memory, the clinician assesses whether the goal in reduction of symptom/severity has been reached using subjective units of disturbance (SUD) scale.

Originally, this method was designed to treat PTSD and similar disorders including depression. However, recent research supports the use of EMDR in treating “trauma-associated symptoms” of “comorbid disorders” such as “psychosis, bipolar disorder, unipolar depression, anxiety disorders, substance use disorders, and chronic back pain” (Gomez, 2017). EMDR is not designed for a specific demographic based on race, gender, ethnicity, socioeconomic status, or age. Given the ubiquitous nature of traumatic events, EMDR may be suitable for most individuals in western society. Research offers “60% of men and 51% of women in the general population report at least 1 traumatic event in their lives” (van der Kolk, 2007).

References

Hensley, B. (2017). An EMDR therapy primer from practicum to practice (Second edition.). Springer Publishing Company, LLC.

Kolk, B. A., Spinazzola, J., Blaustein, M. E., Hopper, J. W., Hopper, E. K., Korn, D. L., & Simpson, W. B. (2007). A Randomized Clinical Trial of Eye Movement Desensitization and Reprocessing (EMDR), Fluoxetine, and Pill Placebo in the Treatment of Posttraumatic Stress Disorder. The Journal of Clinical Psychiatry,68(01), 37-46. doi:10.4088/jcp.v68n0105

Tesarz, J., Gerhardt, A., Leisner, S., Janke, S., Hartmann, M., Seidler, G., & Eich, W. (2013). Effects of eye movement desensitization and reprocessing (EMDR) on non-specific chronic back pain: A randomized controlled trial with additional exploration of the underlying mechanisms. BMC Musculoskeletal Disorders, 14(1), 256–256. https://doi.org/10.1186/1471-2474-14-256

Valiente-Gómez, A., Moreno-Alcázar, A., Treen, D., Cedrón, C., Colom, F., Pérez, V., & Amann, B. (2017). EMDR beyond PTSD: A systematic literature review. Frontiers in Psychology, 8, 1668– 1668.https://doi.org/10.3389/fpsyg.2017.01668