Eye Movement Desensitization and Reprocessing (EMDR) is an evidence-based therapy modality: a way therapists provide trauma-informed care for clients who have previously experienced distressing events. By helping clients process their trauma — while maintaining a safe, contained environment — therapists give clients a way to move past those experiences and the upsetting emotions that come with them.
If you’re considering seeking EMDR, we’ve answered your questions so you can learn more about this excellent therapy treatment.
What is EMDR therapy?
In EMDR therapy, the therapist guides the client through a series of eye movements. These eye movements engage the brain’s systems that deal with information processing — they’re similar to when you’re in REM sleep and your eyes move back and forth. The client’s eyes will follow a stimulus while the therapist carefully guides the client through their memories of adverse experiences. This stimulus may be a flashing light on a handheld device especially made for EMDR therapy, an alternating audio stimulus, a tap on one knee and then the other — there are many ways to engage the brain with this modality. In a way, the therapist and client are hacking the brain’s functionality to show that bad experiences are in the past and nothing to be worried about in the present.
In EMDR therapy, clients don’t need to discuss every detail of their trauma. They won’t have to relive the experience or recount what happened to them. Much of the processing happens unconsciously, making this approach to trauma care helpful in keeping clients comfortable. For this reason and many more, EMDR is now a standard practice for certified therapists.
What is EMDR used to treat?
EMDR therapy is used to treat many mental health conditions. In its original form, it was used to treat post traumatic stress disorder (PTSD) and the symptoms that occur after a person has gone through a traumatic experience, now therapists use EMDR with their clients who suffer from anxiety, depression, eating disorders, and more.
EMDR is a treatment that helps individuals feel less “stuck,” so it could also be helpful for clients that find themselves feeling stuck in their work, relationships or sport. EMDR is also useful when clients feel stuck in negative thought patterns or emotional cycles. The use for EMDR is wide and far reaching, making it a versatile therapy option for many.
Who is a good candidate for EMDR?
Good candidates for EMDR therapy can be people of any identity or background. People of all genders benefit from EMDR therapy. EMDR therapy can be used with children and adolescents, though is most commonly used with adults. It’s necessary for clients to have a sense of safety and security in their lives before they engage with EMDR therapy.
Strong candidates for EMDR therapy include veterans, survivors of assault (including sexual assault), victims of natural disasters, those who are greiving the loss of a loved one, those who experienced traumatic medical conditions or treatments, and many more. Anyone whose mental health goal includes moving past a difficult past experience is a good candidate for EMDR therapy.
Can EMDR make you worse?
Many people wonder if EMDR therapy can make you feel worse, especially if you’re explicitly accessing painful and traumatic memories. Won’t it hurt to remember harmful memories? Isn’t it best to leave those memories alone?
When we leave painful memories alone, we don’t get the opportunity to process through them and move past them. As painful as it may be to uncover those memories, it’s even more painful to try and forget them without addressing them with an evidence-based approach like EMDR therapy.
When you do EMDR therapy, your therapist will be there to support you. This includes talking with you about your emotional reactions, validating how you feel, and reminding you of your innate strength. With this support, even if thinking back on painful memories makes you feel uncomfortable in the moment, your therapist will be there for you. The ultimate goal of EMDR therapy is to make it so these memories no longer bring about symptoms, leaving you to a more comfortable daily life.
When should you not use EMDR?
Because EMDR therapy requires that an individual have a strong sense of security in their daily lives, clients who suffer from substance abuse issues, current abusive relationships, housing insecurity, and other situations that negatively impact their foundation may not fully benefit from this therapy. It’s vital for clients to have strong coping skills ready to use, in case they do become overwhelmed by their traumatic memories.
Clients should also not use EMDR therapy when they don’t yet trust their therapist or there isn’t a strong therapeutic alliance, as it’s vital for the success of EMDR therapy to feel safe around your therapist. Finding a therapist that you feel connected to is an important step of accessing EMDR therapy and Zencare makes it easy for you to do so by viewing each therapist’s introductory video.
What are the dangers of EMDR?
Based on the current research around EMDR therapy, there are no dangers of completing EMDR therapy as a treatment for a relevant mental health condition. However, this is only true when you’re working with a trained, experienced EMDR therapist. EMDR therapists learn from experts how to facilitate EMDR therapy with their clients, including how to handle any emotions that become overwhelming during the session. They will also assess clients for readiness when it comes to beginning EMDR therapy — if you aren’t yet ready for EMDR therapy, you should not begin with it.
What is the success rate of EMDR?
There is a high success rate for a reduction in mental health symptoms after completing EMDR therapy. A 2014 study found that 77% of the study’s participants no longer met the criteria for PTSD after completing EMDR therapy. Other studies declare that EMDR therapy is an effective treatment for medical trauma as well as an effective treatment for those with acute mental illness.
Overall, there is much empirical evidence that supports EMDR’s efficacy in treating mental illness.
Why does EMDR work so well?
Many researchers and therapists believe that the dual-activation of both sides of the brain (also called bilateral stimulation) allows clients’ minds to make connections across the whole brain, which may be beneficial for the processing of painful memories — think of a road detour past an intersection blocked with cars. Others believe that EMDR changes the brain’s processing capabilities and therefore decreases the intense anxiety, fear, or overwhelming emotion previously present. Another theory is that EMDR replicates the dream state achieved through REM sleep, which promotes access to traumatic memories and gives your brain a better chance of processing them.
While the mechanism behind the treatment is still under investigation, EMDR is an effective treatment and is becoming a standard of practice in the field of trauma.
How do I prepare for EMDR?
If you’re getting ready to start EMDR therapy, there are a few ways to prepare. The first way to ensure success in EMDR is to build strong rapport with your therapist or find a therapist with whom you feel close. You’ll lean on your relationship with your therapist if EMDR therapy evokes painful emotions or if you find yourself feeling overwhelmed with insight, so finding the right one is paramount to your outcomes. You might also want to consider who else is a part of your support system and who you will turn to when you need to talk with someone.
Another great way of preparing for EMDR therapy is to start a feelings journal where you record how you’re feeling throughout the day and week. This journal will give you a way to track the results of EMDR therapy, as well as another resource for processing through what comes up during therapy.
Mindfulness practices may also be helpful to incorporate into your routine as a way of destressing or relaxing before or after EMDR sessions. Mindfulness routines can be a form of self care that gives you time to breathe without the pressure of making your emotions make sense.
Do you talk during EMDR?
There may be some elements of talking during EMDR therapy sessions, but mostly it will be on the part of your therapist. Your therapist will guide your thoughts by prompting you to think about certain aspects of your past, and whether you want to verbally respond or not is up to you.
That being said, there will be a lot of conversation leading up to EMDR therapy sessions as you build rapport with your therapist. Before you begin EMDR treatment, you and your therapist may discuss your background, your presenting issues, or anything else that’s on your mind as you grow your trust with one another. Immediately before beginning EMDR, your therapist may ask you about your history surrounding the painful memory or memories. You can tell them as much or as little as possible, however the therapist will need a basic understanding of the trauma so they can facilitate the treatment.
What does a therapist do during EMDR?
The therapist acts as facilitator during EMDR therapy sessions. They will guide you verbally while you engage with the stimulus. Your therapist will ask you a series of questions, many of which do not need verbal answers but are meant to take you back through your memories.
Your therapist will ask you how you’re feeling physically and if anything comes into your mind as you go through the session. They may ask you to consider how you felt during the traumatic experience, including questions like:
- What do you see?
- What do you smell?
- What do you hear?
- How are you feeling in this moment?
- What words come to mind as you’re in this situation?
Your therapist may also stay quiet as you continue to reflect on the experience and attend to the stimulus. After the session, your therapist will check in on you and ask how you feel — you may feel a stroke of insight, emotional fatigue, or other emotions, all of which you can discuss with your therapist.
What happens after an EMDR session?
After an EMDR therapy session, you might feel light-headed physically and emotionally. You might feel a sense of heightened thought but not be able to put a finger on exactly what those thoughts are. If you think of EMDR as a hack into REM sleep, no wonder you end the session a little disoriented — it’s as if you wake up after a long nap!
What you do after an EMDR session is up to you. However, it’s best to relax after an EMDR therapy session, whatever that looks like for you. Your brain will still be thinking about the experience long after you leave your therapist’s office, so giving it a quiet, calm environment allows it to keep going without interruption.
You might find yourself a bit overwhelmed with emotion after a session, so be sure to take care of yourself. If you aren’t sure how to do that, bring it up with your therapist.
How quickly does EMDR work?
While there are 8 phases in traditional EMDR therapy, the amount of time that it takes for EMDR therapy to take effect varies by person. Some people feel results after only 4 sessions, others take months of work to feel a reduction in their mental health symptoms. More complex trauma takes more time to process through. If your trauma is the result of one event, it will change the amount of time it takes with EMDR therapy than if your trauma was spread out over years.
However long it takes you to feel the effects of EMDR therapy, remind yourself that you’re taking a brave step towards improving your daily life — sometimes, it takes time for this to come about!
EMDR therapy is a tried-and-true method of overcoming the impact of trauma. Many therapists find that using EMDR therapy with their clients helps them feel better in the day-to-day and that EMDR therapy helps get their stuck clients unstuck.