What Is EMDR Therapy, And What Should You Expect?

Eye Movement Desensitization and Reprocessing, or EMDR, is often viewed as a rather new, unconventional type of psychotherapy. It can be popular for the treatment of post-traumatic stress disorder (PTSD) and often involves a therapist triggering eye movements that can be similar to the eye movements that typically take place during REM (rapid eye movement) sleep. During EMDR treatment, you may go through the eight typical phases of this type of treatment, which generally include talking about a traumatic experience while a therapist guides your eyes to reprocess your brain’s response to the disturbing event. If you’re interested in trying EMDR, you may find a suitable therapist in person or online.

What is EMDR?

Eye Movement Desensitization and Reprocessing is a type of therapy that can help individuals heal from symptoms and distressing feelings stemming from a traumatic experience. It was developed by Dr. Francine Shapiro in 1987 to help patients process trauma, and it is still used today. EMDR is often recommended for people with post-traumatic stress disorder (PTSD), particularly those who are military veterans or survivors of assault. According to the American Psychological Association, EMDR is both highly effective and supported by scientific evidence. This type of therapy can have the same benefits as traditional psychotherapy, but it’s often completed in a shorter timeframe. On average, people with PTSD can expect to attend around 6-12 EMDR sessions, each lasting 60-90 minutes. Though EMDR is not considered a quick fix, many people experience significant improvement in their symptoms.

The eight stages of EMDR

Eye movement desensitization and reprocessing (EMDR) therapy is generally an eight-stage treatment, according to the American Psychological Association (APA).

During EMDR, attention is given to the past, present, and future. The focus on the past can include any unsettling occurrences or events that have taken place. The focus on the present may include any unsettling occurrences or events that are currently happening. The focus on the future often involves coming up with skills and coping strategies to cope with unsettling occurrences.

Stage 1: History and treatment plan (1-2 sessions)

This stage usually involves a discussion with a therapist about unsettling, distressing occurrences that have happened in the past. The first meetings are usually focused on childhood incidents but can include adult experiences as well. Individuals with one specific adult traumatic event can usually be treated in less than five hours, but those with multiple traumas will generally need more time.

Stage 2: Preparation (1-4 sessions)

The therapist may offer the individual ways to cope with and overcome their emotional anguish. These techniques are generally to be used outside the office in between appointments. The hope is usually that these techniques help the individual replace their distressing thoughts with positive coping strategies. This can be a time for the individual to become comfortable and trusting of the therapist. Building this relationship can help the individual process their thoughts more freely during EMDR therapy.

Stage 3: Assessment

A specific distressing event or memory may be chosen for treatment using the EMDR technique. This stage can include one specific event or multiple traumatic incidences. This stage often includes the individual recognizing three things: visual images related to the target memory, negative beliefs about the self related to the memory, and trauma-related emotions and bodily sensations. The individual may then be asked to recognize a positive belief.

A rating system is typically used to describe the traumatic events during this stage, with the number 10 being the worst you've ever felt, and the number zero being no distress. The goal is generally to get the individual to respond with a zero when thinking about the traumatic event. The positive belief may be given a rating between one (completely false) and seven (completely true).

Stage 4: Desensitization

When most people think of EMDR therapy, they think of stage four.

During this stage, the therapist usually has the individual focus on one of the three things they came up with: the image, the negative belief, or the bodily sensations. While focusing on one of these things, the individual may also be led by the EMDR eye movements, taps, or tones. Taps and tones allow for bilateral stimulation of the brain, which can help calm the nervous system as the person recounts a traumatic experience. After each stimulus set, the individual may be told to empty their mind and notice what idea, impression, memory, or feeling arises. If the individual becomes uncomfortable, the therapist can help them refocus.

Stage 5: Installation

In this stage, the goal is generally to replace negative beliefs with positive beliefs. The therapist usually wants the individual to rate their positive belief as a seven by the end of this stage.

Stage 6: Body scan

Once the individual has internalized the positive beliefs, the eye movement desensitization and reprocessing therapist may bring up the original traumatic event that was targeted. They may ask the individual if there are any physical symptoms, such as tension. If the individual responds affirmatively, reprocessing of that traumatic event can occur. EMDR therapy is usually considered successful when no physical symptoms are felt.

Stage 7: Closure

This is normally the final step of every appointment. The therapist may check in to make sure that the individual feels better than they did when they started the appointment. If the answer is no, the therapist may give the individual some techniques to calm them and use them outside the office until the next appointment. The individual may be told to keep a journal during the week and write down anything that may arise. This can be a reminder of the techniques learned during EMDR therapy.

Stage 8: Reevaluation

This is generally the first step of each appointment. The therapist may verify that the positive beliefs have been upheld and discuss any new events or memories that may need to be processed. Many individuals may feel improvement instantaneously, but the eight stages usually need to be completed.

What to expect from EMDR therapy

• Some memories may come up that you didn't realize were there. An EMDR therapist can help you work through them.
• Some individuals may feel immediate improvement, but not everyone may have the same results. 
• The event you thought needed processing may bring about other memories that need more immediate processing.
• It can be helpful to go into the process with an open mind and trust in your therapist to help the thoughts and memories flow more smoothly.

How to find an EMDR therapist

Not all therapists may be trained in EMDR therapy. It can be important to find a practitioner who has specialized training and experience with this therapy. Most insurance plans cover this type of therapy because it is usually included in standard psychotherapy. 

If you cannot find a local EMDR therapist or would prefer to get help from the comfort of your home, online therapy can be a valid alternative to traditional therapy. Online therapy can empower you to receive professional support and guidance from the location where you feel most comfortable, and it can allow you to schedule sessions outside of typical office hours.

As this study explains, online EMDR can be an effective treatment for clients living with various mental health issues. If you believe you’d benefit from EMDR or any other type of therapy, please don’t hesitate to reach out and get the help you deserve.

Takeaway

Eye movement desensitization and reprocessing (EMDR) therapy usually involves working through trauma by talking about traumatic memories while a therapist guides your eye movements in a way that is similar to the eye movements of REM sleep. This can reprogram your brain to respond differently to memories of trauma. EMDR can be an effective method of treating post-traumatic stress disorder (PTSD) and other mental health disorders. The World Health Organization (WHO) recommends that people with a PTSD diagnosis should consider trying EMDR and/or cognitive behavioral therapy (CBT). If you’d like to try EMDR, you may find a therapist online or in your local area.