EMDR Therapy: Healing From Trauma

Content Warning: Please be advised that this article mentions trauma and other potentially triggering subjects. Read with discretion. 

Eye movement desensitization reprocessing therapy (EMDR) is often used to help clients revisit trauma, adverse events, or other distressing life experiences by desensitizing them to the memory. Developed to treat post-traumatic stress disorder (PTSD), this type of psychotherapy can help clients process trauma. During sessions, a therapist uses bilateral stimulation techniques, stimulating both sides of the client's brain. These can include eye movements, hand buzzers, or bilateral movement. To find an EMDR therapist, you can search an online directory based on your location and access their profile listing to determine their services, availability, training, and education.

The History Of EMDR 

EMDR has been shown to positively affect the process of overcoming unwanted beliefs, memories, or emotions. It is now one of the first recommended treatments for PTSD by the American Psychiatric Association. 

Psychologist Francine Shapiro discovered EMDR as a Harvard researcher. She was investigating rapid eye movement and sleep (REM sleep). She noticed that sensations and disturbing memories would occur during REM. She hypothesized that recreating REM while clients are awake could allow them to discuss those memories in the part of the brain that processes them. 

After practicing this therapy, Dr. Shapiro noticed that clients could come in for an initial session with extreme fear over a traumatic event. After successful treatment, they learned to accept that the event happened and don't experience as many symptoms. They were able to process the event without retraumatizing themselves. She found that clients could work through traumatic events once the memories had less power over them. They could process their thoughts, sit with them, and move through them.

Francine Shapiro has become a worldwide speaker on EMDR processing and has co-authored many articles and books on the subject. She also founded the EMDR Institute. Dr. Shapiro has won awards for her development of EMDR, which include the following: 

• The International Sigmund Freud Award

• The American Psychological Association Trauma Division Award for Outstanding Contributions to Practice in Trauma Psychology

• The Distinguished Scientific Achievement in Psychology Award by the California Psychology Association

Shapiro was active in various organizations, facilitating and teaching the usage of EMDR and supporting further research for EMDR and effective treatments for PTSD. She completed workshops and consultation programs to assist clinicians in mastering the technique. Members of these organizations had access to resources that helped them determine appropriate criteria and points for EMDR application.

What Can EMDR Treat? 

EMDR therapy relies on the adaptive information processing model. Although commonly used to treat PTSD or adverse experiences, EMDR can also treat symptoms of anxiety, depression, stress, personality disorders, and other mental health conditions. EMDR can also be used for EMT emotional therapy when trauma is experienced. Anyone who has experienced traumatic events, whether accompanied by post-traumatic stress, may benefit from this rapid eye movement therapy. Acute stress disorder may also benefit from EMDR. 

EMDR therapy can also be described as a form of exposure therapy.  By having a client describe a traumatic event and imagine that event during an EMDR session, the client faces memories that may be distressing or challenging to address. However, due to how EMDR works, this therapy may reduce the emotional impact of exposing oneself to these memories. 

Eye movement desensitization is also considered to be a reprocessing therapy.  According to the International EMDR Institute, the therapy allows a client to reprocess thoughts without feeling retraumatized.  Afterward, the way they frame the event may change, and their reaction to triggering stimuli may be more manageable. 

What To Expect In An EMDR Session 

EMDR sessions often last from 60-90 minutes. A therapist moves their fingers in front of a client's eyes, and the client follows their movements visually as they recall a traumatic incident. Other forms of bilateral stimulation might include hand buzzers in both hands, throwing a ball back and forth between two hands, or watching lights move back and forth on a screen. 

During the practice, clients think about their physical sensations as they recall the memory. The EMDR therapist might also guide the client through meditation. Often, the session starts with the client remembering the traumatic event they came to discuss. They might move into other memories as they talk. 

The process of EMDR therapy has eight phases. Bilateral stimulation or eye movements are part of the first session, and after the first session, the clinician may decide which activity or technique to try next. 

What Are The Eight Phases Of EMDR? 

Often, EMDR is practiced in eight distinct phases, including the following. 

Phase One 

The first phase of EMDR involves treatment planning and determining a practice guideline. During the treatment planning phase, a certified EMDR therapist may request information about the client's history, diagnoses, and symptoms. They may create a map of goals for treatment. Trauma treatment may begin at varying levels, depending on the individual and the person's past experiences. The therapist and client might spend a few sessions discussing their goals for treatment or learning meditation strategies before starting the EMDR process. 

Phase Two

The second phase of EMDR involves preparation. The therapist teaches the client how to maintain stability in between and during sessions and specific signals for stopping the treatment if it feels too intense.  

Phase Three 

The third phase involves an assessment of the client's memories. They are guided to focus on details of the memory that stand out, imagining visuals and beliefs that have become associated with it. The therapist may ask the client to envision positive aspects of the incident, like the lessons they've learned from the experience or what made them feel safe during that time. During this phase, bilateral stimulation practices may be used. 

Phase Four 

In the fourth phase, a target event that was discussed in the third phase is explored on a more profound level. This phase is often called "desensitization." In this phase, the trauma-related sensations and sensory experiences may be discussed in detail and might be challenging for the client. Bilateral stimulation is often used in this stage. 

Phase Five 

The fifth phase is the installation phase, where a therapist can bring in positive cognition, which is aimed at replacing or challenging unwanted thoughts or beliefs about the event. After processing a distressing memory and feeling no distress, the client is asked to identify a positive belief with which they'd like to replace unwanted beliefs. 

Phase Six

The sixth phase is the body scan phase. During the body scan phase, the client is asked if any physical sensations are left from the painful events in any part of their body. If there is, the therapist can target specific body sensations through guided relaxation and meditation with the client to help them soothe the symptoms.  

Phase Seven

The seventh phase includes closure. The closure state helps bring the client back into equilibrium. They may be guided through a meditation exercise to control their nervous system before ending the session. The therapist might also ask them to remember the positive thought or visualization they selected at the beginning of the session.

Phase Eight 

The eighth phase of EMDR is reevaluation. In this phase, the therapist can ask the client how effective the session was and if there are any remaining distressing symptoms or thoughts. Based on the evaluation, they can make a plan for future sessions. 

After Sessions 

After a session of EMDR, the therapist may ask the client to keep a record of what happens during their week at home and how often they can use the relaxation techniques they learned in therapy. Some clients may keep a journal to track their progress over time. 

What Imagery Is Used In EMDR? 

In EMDR therapy, clients often visualize traumatic memories and other distressing experiences. This focus may be in the form of visualization exercises, where the therapist asks the client to focus on what they saw during the event. They imagine those moments as the therapist takes their fingers and moves them back and forth in front of their eyes or uses another form of stimulation. 

Afterward, the client might be asked to close their eyes, empty their mind, and let the therapist know what memories or thoughts appear. The images they see might not make sense to them. However, discussing these images or acknowledging them can help clients reprocess memories. They do not necessarily have to explain or understand what the memories mean to heal them. 

How Imagery Works

Since trauma lives in parts of the brain that impact memory and emotions, it can be hard to process trauma without stimulating the mind. Discussing trauma while actively remembering it during EMDR can help clients imagine these events without feeling their impact. Note that no image is wrong, silly, or shameful to have. 

During the visualization process, the client may feel anxious, and their heart might race. If they become dysregulated, the therapist guides them to imagine a peaceful or relaxing image, such as a beach scene or a comforting person. They can imagine this until they feel their distressing symptoms reducing. 

Internal Family Systems And EMDR

Another type of therapy used to treat trauma is called internal family systems therapy (IFS therapy). This therapy type uses strategies similar to EMDR, such as visualization. It often involves envisioning one's younger self and imagining saving them from trauma. The client might talk to their child self in their head or out loud to ask them what they need. They can give the child their needs metaphorically through imagination or by giving themselves the need in their current adult life.  

IFS shows how individuals have separate parts that organize various aspects of their life. For example, many people might have a more social side, a scared and traumatized side, or a side that cares for others. Inner child work is done to help clients connect with themselves and feel like a complete system instead of a broken person. 

These strategies might be used in EMDR to help clients feel safe. However, not all EMDR therapists use IFS as well. Either way, these therapy modalities can be healing for those who have experienced an adverse childhood or adult experience. 

Is EMDR Effective? 

The United States Department of Veterans Affairs encourages and recommends EMDR to treat PTSD in combat veterans experiencing trauma from past events. In addition, a recent study of 30 veterans found eye movement desensitization and reprocessing 100% effective in treating PTSD. In this study, the test group's delusions, anxiety, and depression were improved after completing the sessions. 

EMDR client reports show the external stimulus of lateral eye movements is effective long-term in reframing unwanted beliefs to positive ones. Increasing evidence shows that this process can be as effective via online EMDR therapy as in person. The Veterans Health Administration offers resources for those looking to find eye movement desensitization and reprocessing therapy if you're considering trying this type of counseling. 

According to the World Health Organization, EMDR therapy is the first and most effective recommended treatment therapy for PTSD. If you're still looking for proof of effectiveness, the American Psychiatric Association has multiple case examples on its website.  

Counseling Options 

Trauma may feel insurmountable at times. However, there are several types of therapies available to treat symptoms. Eye movement desensitization and reprocessing therapy is one of the most effective forms of therapy for trauma and can provide lasting benefits. If you cannot afford this type of therapy in your area or cannot find a therapist practicing EMDR, you can also try online EMDR. 

Online counseling after traumatic event allows flexibility because you can schedule appointments at any time you need. In addition, therapists can offer clients accessible worksheets, journaling prompts, and unique resources. EMDR can be successfully done online, and the EMDR Institute has released a report for therapists looking to provide this treatment. Studies have also found statistically significant and clinically meaningful reductions in symptoms in clients using EMDR via an internet intervention. 

If you're interested in trying this type of counseling, consider reaching out to a therapist through a platform like BetterHelp, which offers over 30,000 therapists trained in various therapy modalities, including online EMDR. You can also schedule a consultation, utilize the location field feature to find a local provider, or explore other trauma-informed therapies, like internal family systems (IFS) or cognitive-behavioral therapy (CBT).