EMDR Therapy: Healing From Trauma

By Sarah Fader |Updated May 18, 2022
CheckedMedically Reviewed By Lauren Guilbeault, LMHC

What Is EMDR?

Eye movement desensitization reprocessing is a technique that can help people recover from trauma. It's incredibly useful in treating trauma and post-traumatic stress disorder (PTSD). During sessions, a therapist will help a client release traumatic experiences using eye movements. It will trigger the client in brief sessions, or “bites," as they recall traumatic events. Doing this through online therapy allows clients to alleviate emotional distress that they experienced before. It works because a client is distracted by a therapist using their hands to guide the patient's eyes in different directions. This method allows the patient to be exposed to traumatic memories without experiencing a strong reaction because they're distracted by their vision being drawn in different directions. As a result, it lessens the impact that the trauma has on an individual.

the EMDR approach is safe and measured

Therapy Can Be Healing And Teach You Coping Techniques

Eye movement desensitization was developed by American psychologist, Doctor Francine Shapiro

Francine Shapiro has become a worldwide speaker on EMDR and has co-authored many articles and books on this subject. She’s also won many outstanding awards for her development of EMDR, which include the International Sigmund Freud Award, the American Psychological Association Trauma Division Award for Outstanding Contributions to Practice in Trauma Psychology, and the Distinguished Scientific Achievement in Psychology Award by the California Psychology Association.  Francine Shapiro is still today very active in many organizations, facilitating and teaching usage of EMDR, as well as helping in further research for EMDR and treatment for PTSD.

EMDR has been researched thus far so well that it is being used as a very effective treatment for those who live with post traumatic stress disorder in particular.  However, anyone who has experienced traumatic events in their life, whether or not its accompanied by post traumatic stress, may benefit greatly from this form of trauma therapy, including those who have been diagnosed with acute stress disorder, a diagnosis that occurs within four weeks of a traumatic event.

Desensitization and reprocessing EMDR can also be described as a form of exposure therapy.  By having a client describe a traumatic event and even imagine that event during a therapy training sessions, the client is face-to-face with memories of his or her trauma, and may even be accompanied by physical sensations, brought on by his or her nervous system, that are related to the trauma. 

Eye movement desensitization is also considered to be reprocessing therapy.  According to the International EMDR Institute, it helps a client to reprocess thoughts around traumatic events.  Afterward, the way that he or she frames the event may have changed, and their reaction to triggering stimuli may lessen.

What To Expect

EMDR sessions can last anywhere from 60-90 minutes. A therapist moves their fingers in front of a client's face, and the client follows their movements visually as they recall a traumatic incident. They think about physical feelings that go along with this trauma as they follow their therapist's fingers. In an EMDR session, your therapist will guide you on a meditation of a certain kind. You'll start by thinking about the traumatic event , but it'll lead down to various memories or situations. Some therapists might use tapping as a technique in EMDR, and they might also use music as an alternative. This therapy exists in eight phases or activities. Bilateral stimulation or eye movements are part of the first session, and after that first session, the clinician decides what to target next.

Francine Shapiro discovered EMDR as a Harvard researcher. She was investigating rapid eye movement and sleep. She noticed that sensations and disturbing memories would occur during rapid eye movement. When EMDR works, painful memories become less and less as the patient works through them by following the therapist's fingers with their eyes. Someone could come in for an initial session entirely frightened of being assaulted and might feel extreme guilt, shame, and fear. After treatment, they learn to accept that an event happened and don't experience as many symptoms after becoming strengthened and empowered through EMDR therapy. Wounds of trauma never heal, but they get less and less over time. Clients can work through traumatic events once the memories have less power over them. They're able to process memories, sit with them, and move through them.

learning about the EDMR approach

Phases Of Eye Movement Desensitization Therapy

EMDR focuses on three different periods in time: past, present, and future.

Overview Of Phase One

The first part of treatment focuses on a client's past, and it helps him or her to bring up memories in treatment. In phase one, a therapist takes a patient's history and talks about memories. They emphasize one particular memory to work on. Sometimes, an EMDR therapist will focus on a client’s childhood first and after move into adulthood, depending on what trauma that the individual experienced.

Overview Of Phase Two

In phase two of EMDR treatment, a therapist helps a client deal with handling emotional distress that they feel during memories. The client will experience uncomfortable imagery and will work on staying grounded as they sit with imagery and thoughts that arise. In phases 3-6, there's a target that a client and therapist agree on, and three things happen: there's a visual image that relates to memory, a negative image of the person's self, and the body of that image that corresponds to that belief. After that, a therapist asks a client to relay a positive belief or feeling about themselves to override negative thinking, but the client will first focus on negative thoughts that they have about themselves.

Analyzing Your Results

As they focus on these thoughts, they also have bilateral stimulation, meaning that they're watching the therapist's fingers move back and forth. After stimulus happens, a client tells a therapist what they saw and what came up for them during that stimulation. The therapist will interpret those images that came up for a client and what that imagery or those memories mean. In phase seven of EMDR, the therapist asks a client to keep track of what happens during a typical week and express how or if they're able to use exercises to calm themselves down. In phase eight, therapist and client examine the events that have happened in the past that causes distress and how client can respond in the future. In terms of how long a treatment takes, it depends on the individual and how distressed they are by their memories when they enter treatment as well as their trajectory as they progress. Like most other forms of mental health treatment, the overall length of treatment will vary from person to person.

The Eight Phases Of EMDR

There are many phases of EMDR therapy. 

First phase of EMDR is the phase that involves treatment planning.  During the treatment planning phase, a certified EMDR therapist will request information about the client’s history and potential mental health illness. The client can also bring any concerns to their attention. This helps the therapist to develop a treatment plan for that client and understand where to begin. Trauma treatment may begin at varying levels, depending on the individual and the person’s past experiences. 

Second phase is the preparation phase. This is where client and therapist begin their therapeutic relationship and set expectations for treatment. The therapist teaches the client how to maintain stability in between and during sessions, as well as certain signals for stopping the treatment if it gets too intense. 

Third phase is the assessment phase, where therapist and client focus on a first targeted memory. The client is guided to focus on details of this memory that stand out, imagining visuals and beliefs that have become associated with it. The therapist will ask the client to envision positive things about the incident too, such as what they have learned, etc.

In fourth phase, a target event that was brought up in the third phase is evaluated and looked at deeper. This phase is called "desensitization" phase. In this phase, the trauma-related sensations and sensory experiences begin to transform, and the client may begin to experience a brighter sense of self efficacy, insight and behavior. This is the phase where the client will focus on the event and the eye movement simultaneously.

Fifth phase is the installation phase, where a therapist will bring in positive cognition, which is aimed at replacing the negative cognition.  EMDR therapists measures the progress of this phase through the VOC, which is labeled successful if it reaches 7.  Until then, both experiences, the positive and negative, are paired together.  The goal is to get the positive to reach a higher score.

Sixth phase is the body scan phase. During the body scan phase, the client is asked if there is any physical sensation left from the trauma, felt anywhere in the body still. If there is, the therapist will target specific body sensations and help to calm the nervous system. 

Seventh phase is closure. The closure state helps bring the person back into equilibrium, and anything that has not been reprocessed can be helped with the control techniques taught earlier on.  The therapist explains to the client what to expect in between sessions and and to keep track of any disturbances that happen. 

Eighth phase is reevaluation.  This phase is for review and to see how the treatment plan has worked.  Reevaluation also helps the therapist and client develop a further treatment plan if needed.  The therapist will check back in with the client about additional targets. 

Imagery To Heal Trauma

When a person is in EMDR therapy, they will be visualizing traumatic events. The therapist will tell them to focus on particular traumatic events and zero in on one moment that impacted them. They will imagine those moments as the therapist takes their two fingers and move them back-and-forth. Then they will close their eyes and report to the therapist what they see. The images that they envision may not make sense to them. They may seem strange or unrelated to the trauma. But they are related because the person is articulating what is in their memory bank. They are following the traumatic events and everything related to it.

How Imagery Works

Their unconscious forces at work, and that's why trauma is so sneaky. It lives inside a person's brain and makes a home for itself. So the person will talk to their therapist about what they see with their eyes closed and try to stay in the moment. No image is wrong. During the visualization process, the person may feel anxious, and their heart might race. That's when their therapist will tell them to go to a place of safety in their mind. They might imagine their partner holding them, or being with one of their children.

A safe place can bring a person back from feeling in a state of fight-or-flight to a state of grounding.

Internal Family Systems And EMDR

There is an exercise in internal family systems therapy that is related to EMDR. It involves the therapist telling the client to imagine themselves as a child. They envision sitting with the younger version of themselves and talking to them. The client will ask the child what they need from them. It's the client's turn to give the younger version of themselves what they need emotionally. We are all broken in some way inside, and during EMDR therapy you have the chance to address the pieces of yourself that need healing. And the inner child work is a powerful way to connect with yourself and be reunited with that part. Healing does come from within, and it's important to remember that there are times during this exercise that will be painful. As you begin to address your pain, you will start to feel less sadness or anxiety due to the trauma you experienced. Eventually, you'll feel more whole and one with yourself, recovering from something like an anxiety disorder.

How Effective Is It?

Many people have said that EMDR is effective in treating PTSD. The Department of Veterans Affairs strongly encourages and recommends this form of treatment for PTSD. For example, a recent study of 30 veterans found EMDR was 100% effective in treating PTSD. In that study, the test group’s delusions, anxiety, and depression all improved after moving through EMDR therapy. EMDR is shown to be effective long-term, and it has been looked at in numerous studies. What’s more, increasing evidence shows that it is just as effective via online therapy. As a result, it is becoming more and more accessible.

Therapy Can Be Healing And Teach You Coping Techniques

Seeking Help For Trauma

Trauma has a way of holding people back. But you don't have to let that happen. EMDR is one of the most effective forms of therapy for trauma with a variety of lasting, positive benefits. Via online counseling, it is available whenever it works for you. It's time to seek the help of mental health professionals who can help you through these painful memories, a painful situation or loss. You can work with a therapist online here at BetterHelp for many types of mental health challenges. BetterHelp has therapists specializing in a variety of therapies who can offer advice and help tailored to your life. Read what others have to say about their experiences getting support below.

“Tasha has been extremely helpful to me! She listens to my concerns, and has given me a variety of tools to work with to make progress. I am particularly pleased with the EMDR therapy.”

https://www.betterhelp.com/tasha-young/

“Scott Van Camp is an amazing listener, and I mean he takes time to really understand what you are going through, and asks questions to allow you to think for yourself. His skill in EMDR therapy has transformed my life, and has led to so much inner healing. I highly recommend Scott!”

FAQs

What is EMDR therapy and how does it work?

This type of psychotherapy can help people recover from a traumatic memory and stands for eye movement desensitization and reprocessing. The sessions usually run between 60 and 90 minutes and works by connecting the person who has experienced the trauma to images and negative emotions associated with the past, allowing the mind to move toward something called "adaptive resolution." EDMR is different than traditional talk therapy and can be used for both adults and teens.

Why is EMDR so controversial?

Researchers often disagree on interpretations of the available evidence, especially as it relates to patients who have experienced posttraumatic stress disorder treatments. Because of this, it's usually not considered a core part of mental health services. 

What are the 8 phases of EMDR?

  • Phase 1: History And Treatment Planning
  • Phase 2: Preparation
  • Phase 3: Assessment
  • Phases 4-7: Processing the memory to adaptive resolution
  • Phase 8: Reevaluation

What are the side effects of EMDR therapy?

EMDR therapy procedures could result in an increase in distressing memories, heightened emotions or physical sensations during sessions, lightheadedness, vivid dreams, and the surfacing of new traumatic memories. 

Who should not do EMDR?

It's not advised to begin EDMR therapy training sessions if you are actively abusing alcohol, drugs, or a different substance to affect a person's thinking. It's important to take note of any potential substance abuse. Additionally, Successful EMDR therapy cannot be performed for a person who has yet to experience safe and trusting relationships, unlike talk therapy.

Who is not a good candidate for EMDR?

EMDR treatment processes are best suited for people who do not shut down when they feel an emotion, as the treatment relies on your ability to process thoughts and feelings and can be at a higher intensity compared to talk therapy. EMDR works to unpack psychological trauma within a person during the eight-phase treatment, peeling back layers of distressing events through the course of treatment. 

Is EMDR only for trauma?

While it is traditionally thought of in the context of PTSD, clients can generally cain insight through EMDR for mental health challenges such as anxiety, depression, worry, self-esteem, etc. The opportunity to make positive change in anxiety disorders is especially encouraging in the field of mental health, as so many are affected by this.

Is EMDR a hypnosis?

Unlike hypnosis, the difference with an EMDR session is that the person never goes into a trance-type of state of consciousness.

Do you talk during EDMR?

Sessions usually involve a little bit of talking, but much less than conventional talk therapy sessions that you might picture when considering therapy.

How quickly does EMDR work? 

Progress is usually accomplished within three sessions for a person reprocessing a single trauma.

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