Treatments For Trauma EMDR Therapy

Content Warning: Please be advised the below article mentions trauma, abuse, and other potentially triggering subjects. Read with discretion. 

There are many types of treatments commonly used to treat symptoms of post-traumatic stress disorder (PTSD). One such treatment is eye movement desensitization and reprocessing therapy (EMDR). EMDR uses rapid eye movement and bilateral brain stimulation to help clients remember and relieve painful memories and experiences without feeling that they are reliving the situation. 

PTSD is a complex mental health condition that affects about 13 million Americans. For those experiencing symptoms, EMDR may reduce the impact of traumatic memories on emotions and the body. Understanding the structure and effectiveness of EMDR can help you make an informed decision on whether it suits your needs. 

What Is EMDR Therapy?

EMDR is a structured mental health therapy involving eye movement while focusing on traumatic memories, often referred to as bilateral stimulation (BLS). As clients perform this rapid eye movement therapy, they may experience a reduction in the vividness and impact of their memories over time. Depending on the therapist, clients might also use buzzers, tones, or taps on both sides of the body while thinking about a traumatic memory, which can similarly impact the brain.  

Compared to other trauma treatments, EMDR therapy instructs patients to focus directly on memory. Using BLS and guided instructions, EMDR alters how memories are stored in the brain, potentially minimizing trauma symptoms throughout treatment. 

What Conditions Does EMDR Treat?

EMDR is commonly used to treat PTSD. However, mental healthcare professionals may also recommend it to treat the following conditions:

• Anxiety disorders
• Depressive disorders 
• Substance use disorders
• Obsessive-compulsive disorder
• Chronic pain

If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources.

A Brief Overview Of PTSD

Some people may develop PTSD after experiencing a traumatic event, such as combat, crime, terrorism, an accident, or a natural disaster. The primary symptoms of PTSD can include: 

• Unwanted memories of a traumatic event, including flashbacks or nightmares
• Avoidance of activities, places, or people associated with the traumatic event
• Disinterest in former hobbies and feelings of detachment from others 
• A sensitive startle response
• Sleep disturbances
• Difficulties with concentration and memory

To treat these symptoms, EMDR guides the patient through their emotional, psychological, and behavioral responses to traumatic memories, helping them reduce the distress and disturbance associated with these recollections.

How Does EMDR Therapy Work?

This form of treatment may take several weeks to a few months before a client sees results, which can also be faster than other forms of therapy. If you’re a prospective client, you may engage in EMDR once or twice weekly and discuss with your therapist the number of sessions that works for you. Often, EMDR is divided into eight phases. 

Phase One: Taking History 

Like many forms of talk therapy, the client and therapist may identify their treatment targets during the first appointment. For people with PTSD, targets might include reducing the impact of memories, understanding current triggers, and outlining future goals.

Phase Two: Preparation

Many clients may be unfamiliar with EMDR, so the therapist will explain the therapy and its procedures, including eye movements and other forms of BLS. The therapist and client may brainstorm a list of positive memories or images to focus on during difficult moments in the session to help the client feel calm if they become dysregulated. Some clinicians might help clients craft a “safe space” where they can mentally envision themselves after processing traumatic memories. 

Phase Three: Identify The Target Memory

Phase three involves activating the traumatic memory, otherwise referred to as the “target” of the session. Using two psychological measures, the therapist may assess the following components of the patient’s memory:

• Image
• Cognition
• Affect (emotion)
• Body sensations

To assess these components, EMDR therapists often use the Subjective Units of Disturbance (SUD) scale and the Validity of Cognition (VOC) scale. The SUD measures the level of distress or “negative beliefs” before and after a client processes the target memory. Alternatively, the VOC asks the client to estimate the truthfulness of their positive beliefs. Often, the goal of EMDR is to reduce SUD scores and increase VOC scores. 

Phases Four To Seven: Processing And Resolving The Target Memory

Processing a traumatic memory may require desensitization. To achieve this, the therapist asks the client to focus on the traumatic memory while performing eye movements or other BLS. Afterward, the client reports any new thoughts that emerge in response to the memory. 

The installation subphase may happen next. Once the client has preprocessed trauma during the desensitization step, the therapist helps them develop positive beliefs. The goal may include reminding clients that they have control over their responses to traumatic memories.

Afterward, the therapist might employ a body scan to check for residual physical tension and unresolved thoughts. If the client reports any continued distress, the therapist may use BLS to help them process those feelings.

Over several sessions, the client continues to practice desensitization, installation, and body scans. The therapist adjusts the BLS throughout the treatment until the client no longer experiences distress in response to the target memory. They may do this for several memories if a person has more than one traumatic memory. 

Phase Eight: Evaluating The Treatment

After reprocessing, a therapist may assess a client’s emotional state. If the client is still experiencing distress, the therapist might offer guided instructions and coping techniques, ensuring the client’s safety and well-being until the next session.

The final phase of your first EMDR session may be a “bridge” to later sessions. After subsequent sessions, your therapist can continue to perform evaluations and adjust your goals and expectations if appropriate. 

The Benefits Of EMDR Therapy

EMDR may offer advantages for clients and therapists, including the following.  

Client-Driven 

EMDR does not necessarily require talking, which some clients might prefer. For many people, it can be challenging to dive into the details of their trauma during every therapy session. EMDR may be effective even if you do not tell your therapist about your trauma. You can think about it silently while undergoing the bilateral stimulation exercises.  

Efficient 

Clients often engage in EMDR for a few months before experiencing significant results. EMDR may also require less homework than other forms of therapy, although your therapist may ask you to write down any unresolved thoughts or ideas to bring up at your next session.

Research-Based 

EMDR is established as an effective treatment for PTSD. A growing body of supporting evidence indicates that EMDR is effective for other mental health conditions. Additionally, it is a safe treatment.

Low-Stress 

EMDR may provide a safe, low-stress space for people to engage with traumatic memories under the guidance of a professional. Many clients might feel safer and less stressed when focusing on traumatic memories instead of explaining them in detail.

Disadvantages Of EMDR Therapy

Due to several factors, some individuals may experience less success with EMDR. A couple of drawbacks may include the following. 

Lesser Research 

There can be controversy around the effectiveness of EMDR, and not all psychologists believe in its effectiveness. However, even if EMDR doesn’t work for you, other evidence-based therapies are available to treat your symptoms. Research continues to be made each year, and it is more positive with time.

EMDR May Be Newer Than Other Forms Of Therapy 

EMDR was introduced in 1987 for the treatment of PTSD. While newer treatments are not necessarily faulty, more research may be necessary to verify their effectiveness and psychological mechanisms. 

EMDR Counseling Options 

In modern psychology, EMDR can be practiced in many ways. After the Covid-19 pandemic, researchers started studying whether EMDR might adapt to telehealth settings. Based on discussions facilitated by the EMDR International Association and recent research, many experts agree that it’s possible to ethically and effectively perform EMDR online. 

Online therapy can be a more practical option for many due to its accessibility, cost-effectiveness, and growth opportunities. When choosing an online therapy provider, you may also be able to choose between phone, video, and live chat sessions and pay a significantly lower fee per session than you might pay out-of-pocket for traditional in-person therapy.  

Additionally, the EMDR International Association cites several recent studies as evidence of EMDR’s efficacy online, including a 2021 paper that assessed the delivery of EMDR during the beginning of the Covid-19 pandemic. In their study of 33 therapists and 93 patients, the researchers noted significant improvements in patients’ mental health questionnaires, which included a PTSD checklist and the “General Anxiety Disorder Scale.” Based on the results, the study concluded that EMDR could be delivered effectively via the Internet.

As the research and tools for EMDR develop, more therapists may offer this therapy online to reach a broader population. Using an online platform like BetterHelp, a licensed therapist can guide you through the BLS and other techniques, using the EDMR framework to help you recover from traumatic events or distressing symptoms.