Eye Movement Desensitization and Reprocessing (EMDR)

EMDR is a type of psychotherapy that was designed to help people overcome the distress that comes with traumatic memories. For this reason, it is usually used to treat post-traumatic stress disorder, but it can be used to treat other conditions like depression, anxiety, obsessive-compulsive disorder, and dissociative disorders.

During EMDR, a client will recall disturbing scenarios while focusing on an outward stimulus. Usually, this stimulus takes the form of lateral (side-to-side) eye movements that are directed by a therapist.

The idea behind the eye movements is that these kinds of movements mimic Rapid Eye Movement (REM) sleep. As the client recalls the event and moves their eyes, internal emotions and associations arise, and the client is then able to replace unwelcome or intrusive thoughts or beliefs with new, more empowering ones.

Adaptive Information Processing

EMDR is based on the theory of Adaptive Information Processing (AIP), which was developed by Dr. Francine Shapiro. Shapiro is also the founder of EMDR.[10]

Adaptive Information Processing posits that a person’s brain stores and processes normal and traumatic memories differently.[1] Normally, a person’s brain processes events by coding them into some sort of language and moving them into short-term and then long-term memory if the event is deemed worthy of recalling.

When a person experiences something traumatic, the brain responds differently, bypassing the normal processes and linking the memory with the specific sensory input (sights, smells, sounds, etc.) the person is experiencing at the time.

The traumatic memory is then not moved into memory the way normal events are, which allows the possibility of flashbacks; when triggered, the person is not able to simply remember or recall the event but instead feels like the past is the present.

Injury Analogy

The analogy of getting injured is often used to explain what happens when a person experiences trauma and why AIP happens.[2] In this analogy, psychological trauma is likened to a physical injury.

When a person gets injured physically, the body immediately begins trying to repair the wound. If the person cleans the wound out thoroughly and makes sure the setting is right for healing (perhaps by covering the wound with a bandage or allowing it to rest), the body is able to repair itself, and soon all that is left (if anything) is a scar.

However, if the person does not or is not able to clean out the wound or the wound is not kept dry, it can begin to fester and get infected. The body is stuck trying to heal itself, but is not able to.

In the same way, when a person experiences trauma, the mind tries to heal itself, but it is not able to. The psychological wound festers and prevents healing until a person re-opens the wound, cleans it out, and allows the natural healing process to take place as the brain attaches new thoughts and emotions to the old memory, which can now be coded and stored as a memory rather than a present event.

EMDR is extremely effective at treating patients who have PTSD, and it can be applied to other disorders as well.

The EMDR International Association says that “EMDR therapy is recommended as a first-line treatment for PTSD and other trauma-related disorders in the treatment guidelines of top health organizations, including International Society for Traumatic Stress Studies (ISTSS), World Health Organization (WHO), American Psychological Association (APA), and Department of Veterans Affairs/Department of Defense VA/DoD.”[3,4]

According to the EMDR Institute, “Some…studies show that 84%-90% of single-trauma victims no longer have post-traumatic stress disorder after only three 90-minute sessions.” Other studies show that “100% of the single-trauma victims and 77% of multiple trauma victims no longer were diagnosed with PTSD after only six 50-minute sessions.”[5]

Although there is some mystery about how exactly this kind of therapy re-codes traumatic memories in the brain, it is clear that EMDR works quickly and effectively for most people who engage in this type of therapy.

EMDR treatment includes eight phases, described below. Sometimes clients and therapists will move between phases in a single session, but phases 1 and 2 usually take place only during early sessions. 

• Patient History and Information 
  • The first step the therapist takes is to ask about the patient’s history, the events they want to cover, and the goals they have for the sessions. This helps the therapist know if EMDR is a fit for the client. 
• Preparation and Education 
  • During this phase, the therapist explains what will happen during EMDR and makes sure the client has coping strategies for the possible emotional distress they will encounter. 
• Assessment 
  • In this phase, the client will recall the specific traumatic memories they want to process. The client will be asked to specify the negative thoughts the trauma created and new, positive thoughts they want to believe instead. 
• Desensitization and Reprocessing 
  • In this step, the patient recalls the traumatic event and identifies specific images and feelings. The therapist will ask the patient to notice how they feel and any new thoughts or insights they have. 
• Installation 
  • The therapist will then ask the patient to imprint the new, positive thought into the old memory. 
• Body scan 
  • The therapist will ask the client to survey how they feel in their body, especially as they think about the negative memory. Negative feelings should lessen throughout the EMDR therapy. 
• Closure 
• • This phase allows a patient to return to a calm, secure state before ending the session. The therapist may ask the patient to keep a log of any related material that comes up between sessions. 
• Reevaluation 
  • In the final step, the client and therapist discuss the progress thus far and plans for the next session, and any other plans for the future.