What is EMDR?  How this therapy is used in PTSD

What is EMDR? How this therapy is used in PTSD

What is EMDR?  How this therapy is used in PTSD

Living with PTSD

Post-Traumatic Stress Disorder (PTSD) can strike when someone least expects it. Perhaps an aggressive driver makes a person feel endangered, or a noise or smell triggers a traumatic memory and causes an oversized reaction that is difficult to control.

Trauma changes your brain — but there are treatments that help. One intriguing option is EMDR, an evidence-based therapy that helps you process traumatic memories and learn to deal with them in healthy ways.

What is PTSD?

PTSD affects nearly 7 percent of the US population, according to the National Institute of Mental Health. From flashbacks and hypervigilance to trouble concentrating and sleeping, the symptoms of this surprisingly common condition can dramatically change your daily life.

And while the condition itself isn’t always permanent, researchers suspect it can change the way your brain works forever.

PTSD is “a type of anxiety disorder that develops after a person experiences or witnesses an event that is intense and causes anxiety,” explains Janet Civitelli, PhD, a licensed psychologist and certified careers counselor in Austin, Texas.

Although PTSD is often associated with struggles, Civitelli explains that many experiences can trigger this “fight-or-flight” response to trauma, including bullying, abuse, medical treatments, and natural disasters.

People can also develop PTSD from recurring minor trauma. “We now have evidence that repeated exposure to minor trauma can cause more emotional damage than exposure to a single major trauma,” says clinical social worker Annie Miller, who specializes in trauma and sleep disorder therapy.

Whether you experience a cluster of non-life-threatening incidents or a single tragic event, you experience trauma and develop the potential for PTSD when your stress exceeds your brain’s processing limits, says board-certified and EMDR-trained therapist and practitioner Kevin Faust at Akahai Emotional Wellness in Hawaii.

What is EMDR?

Eye Movement Desensitization and Reprocessing (EMDR) is a highly complex, structured form of therapy offered by trained psychiatrists.

EMDR uses rhythmic bilateral actions (using both sides of the body) to help people reprocess trapped memories, according to Indiana-based licensed counselor Brittany A. Johnson, who is certified in EMDR and currently training to be an EMDR educator.

Research on therapy is promising, and it’s one of the approaches the American Psychological Association (APA) is proposing to treat PTSD. (Here’s the APA’s full list of PTSD therapies.)

EMDR therapy sessions involve focusing on a past traumatic event while performing back-and-forth actions aimed at activating both sides of the brain and keeping you “safe and grounded in the present,” according to Miller. For example, you could track your therapist’s hands back and forth across your field of view while thinking about a traumatic event.

Although lateral eye movements are a hallmark of EMDR, she says, the bilateral stimulations can be visual, auditory, or tactile. The idea is that focusing on the stimulation of reliving an event can help you reprocess the memory without getting lost in a barrage of negative emotions.

How EMDR works

The therapy is credited to research first begun by psychologist Francine Shapiro in the late 1980s; Remarkably, the idea came to her during a walk in the woods, where she found that moving her eyes back and forth in the trees helped ease the anxiety she was feeling at the time. After successfully trying it on patients, she developed the theory behind EMDR. The approach took time to gain acceptance, but in 2018 a comprehensive review of research on EMDR was published in the journal Boundaries in Psychology—found that EMDR can not only help diagnose PTSD, but also reduce symptoms such as anxiety and stress.

EMDR is based on a theory called adaptive information processing (AIP), which theorizes that mental disorders can occur when a traumatizing experience is insufficiently or incorrectly processed by the brain, according to another report published in frontiers in psychology.

“DR. Shapiro’s research led her to work with ‘bilateral stimulation,’ or rhythmic stimulation of both sides of the body,” Faust says Trauma is moved from the emotional part of the brain to the logical part, where it is processed and properly stored.”

Miller says stress and trauma can overwhelm your brain’s ability to heal. EMDR could help by allowing you to reprocess these events and complete them at a later time.

Rewinding the clock and releasing what Johnson describes as “trapped memories” through quick eye movements and hand slapping might sound a little fantastic. But research appears to support practitioners’ claims.

Numerous studies have shown that EMDR therapy is particularly useful for reducing PTSD symptoms. Research published in International Journal of Stress Management also suggested that the effects of EMDR persist for several months after therapy is stopped.

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The 8 phases of EMDR therapy

If you are interested in EMDR therapy, it is important to have clear expectations. A single session will not be enough to relieve PTSD symptoms or teach you all the regulation methods you need.

“EMDR is performed in eight phases, and while some patients and clinicians can complete the phases quickly, there are some things that require multiple sessions for each phase,” explains Johnson. She says an EMDR-trained therapist will tell you how many sessions you need to begin the process.

According to Johnson, the basic focus of each EMDR therapy phase is broken down as follows:

  • Phases 1 and 2: Reviewing your mental health history and creating a target treatment plan.
  • Phases 3 and 4: Identify, reprocess, and desensitize specific memories through bilateral stimulation.
  • Phases 5 and 6: “Installation” (introducing or reinforcing positive thoughts) and “Body Scan” (observing your thoughts, feelings, and actions, then identifying any remaining negative responses).
  • Phases 7 and 8: Complete, evaluate progress and identify future goals.

What it’s like to go to an EMDR therapy session

An EMDR session usually lasts between 60 and 90 minutes. Your session will vary depending on how far you have progressed through the EMDR phases.

Once you’ve reviewed your mental health history and created a treatment goal and plan with your therapist, “expect that your therapist will only allow you a few seconds between sentences to speak [of bilateral stimulation]’ says Johnson. The goal is to maintain a continuous flow through the recall and processing.

EMDR-trained therapists emphasize that you can expect warm-up activities and careful management of your traumatic memories and negative emotions.

Traumatic experiences are relived in 20- to 30-second lads while simultaneously performing bilateral stimulation. You may be asked to quickly follow your therapist’s hand back and forth with your eyes, or listen for taps, vibrating buzzers, or audible tones. Your therapist will guide you through the entire process.

“The goal of an EMDR therapy session is to allow you to reflect on the memory or event without feeling stuck in it,” says Miller. “You can learn to let go of painful emotions more easily.”

How to find an EMDR-trained therapist

To find an EMDR-trained therapist, visit the EMDR International Association or ask your doctor or local clinic for a referral.

“If you plan to use health insurance to pay for EMDR therapy, I recommend calling the phone number on the back of your insurance card and asking which mental health therapists are “in the network” in your area,” says Faust. Once you have a list, you can visit their websites to look for EMDR certification.

Can EMDR treat other problems?

Although research on EMDR’s success in treating other mental illnesses isn’t as clear, researchers are investigating the potential of EMDR in treating:

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