EMDR therapy is the leading evidence based treatment for Post-Traumatic Stress Disorder. It is important to have some basis understanding of EMDR prior to starting therapy, finding a trauma/EMDR therapist or helping someone you love to find help. This post outlines some EMDR basics.
What is EMDR therapy?
EMDR is an acronym for Eye Movement Desensitisation & Reprocessing Therapy. It was designed to alleviate distress associated with traumatic memories. EMDR therapy helps to access traumatic memories and facilitates the processing of these memories to bring them to an adaptive resolution. Successful EMDR treatment is characterised by the relief of distress, the reformulation of negative beliefs and a reduction in physiological arousal.
What evidence is there to suggest that it works?
There have been over thirty studies of EMDR therapy which have had a positive outcome. Under this umbrella of controlled studies over 84% of single event trauma victims reported no post-traumatic stress after three ninety-minute sessions. An HMO study found that 100% of single event trauma victims and 77% of multiple trauma victims were free from Post-Traumatic Stress Disorder, (PTSD) after six, fifty-minute sessions. In a similar study reports indicated 77% of combat veterans were free from PTSD in twelve sessions.
EMDR is recognised alongside Trauma Focused CBT as the treatment of choice for PTSD by the:
- American Psychiatric Association
- The World Health Organisation
- The Department of Defence
The US Department of Veterans Affairs & Department of Defence placed EMDR into category A for most effective PTSD psychotherapies.
The United Kingdom Department of Health reported the best evidence for the efficacy of EMDR.
What would an EMDR therapy session involve?
EMDR treatment would usually begin with several sessions which might involve stabilisation, grounding and psycho-education. The standard EMDR therapy protocol follows eight-phases which includes resourcing, processing and installation. This may vary depending on if you are having treatment for anxiety, PTSD, phobias or tinnitus. Processing is carried out using bilateral stimulation. This is facilitated by eye movements, auditory clicks, tapping or tactile vibration buzzers.
Can I be cured in one session?
Having EMDR therapy as an adjunct therapy can be completed in one session. However, EMDR therapy is usually used in the wider context of therapy which includes a stabilisation and history taking phase so it is likely you will have a few therapy sessions which may or may not use EMDR specifically. Length of therapy also depends on how much trauma you might be processing and the nature of that trauma. Most clients have more than one trauma to process.
In addition, PTSD is designed to desensitise anxiety related to traumatic memories not necessarily eliminate all PTSD symptoms. Therefore, EMDR is sometimes used in order to pave the way to regaining homeostasis as part of a wider treatment strategy.
Will my symptoms come back over time?
Follow up assessments of people suffering from PTSD were carried out over varied follow up times. These were three, four, nine, fifteen and five years after treatment. Benefits of treatment were maintained in eight out of nine studies carried out. Other studies carried out found a deterioration of treatment benefits at follow up which correlated with incomplete EMDR treatment. It is clear that if treatment is completed benefits are maintained but if treatment is not completed benefits can deteriorate.
Why is EMDR treatment so effective?
EMDR is quicker than more traditional forms of therapy and does not prolong trauma recall exposure which can sometimes be the case with other therapies. It also incorporates a number of elements from traditional therapeutic approaches. These include Cognitive Behavioural Therapy (CBT), experiential and interactional therapies. The EMDR approach integrates strands of imagery, cognition, affect, related memories and somatic sensation.
What is bilateral stimulation?
Bilateral stimulation is stimuli which occur in a rhythmic left to right pattern. For example, visual bilateral stimulation might involve watching a finger or hand moving from left to right. Tactile stimulation would involve holding buzzers which vibrate alternately in each hand. Auditory bilateral stimulation involves hearing alternate sounds in each ear via headphones.
You might go to an EMDR session expecting to move your eye left to right following a light bar or therapist finger. When EMDR was first invented eye movement was the only bilateral stimulation used hence the name eye movement desensitisation and reprocessing therapy. Bilateral stimulation has now broadened out to include taps and auditory beats.
What are the side effects of EMDR therapy?
EMDR usually has a positive effect on a client’s experience of life by helping to reduce anxiety sand PTSD symptoms.
There are however some side effects which can manifest as a result of treatment. These might include new, unresolved memories that come into consciousness. Reactions can also occur in treatment which might include a high level of physical sensation and high level of emotions. Processing can also continue after a session ends. This can affect dreams, feelings and memories on a temporary basis. It just means you might feel very emotional during emdr therapy and in-between emdr therapy sessions.
How many EMDR sessions will it take?
The number of sessions it takes to desensitise and reprocess trauma depends on the client. If you have experienced a particularly severe trauma and you have a long history of trauma therapy will take longer.
If you have experienced a single event trauma with a limited trauma history emdr is likely to last for a shorter period of time.
EMDR is also used in an adjunct way as part of a more comprehensive, holistic, integrative approach to trauma. It might therefore only make up part of your treatment programme which would go on for longer.
On the whole EMDR in itself is not a long term therapy.
Will I have to re-live the trauma I went through?
Processing trauma requires a brief history of your traumas so that the therapist knows what you require help with. This is a brief history where you are not expected to go into detail.
Processing will require you to recall the traumatic incident to the front of your mind and feel what you felt at the time. EMDR therapy helps with trauma because we go straight through the middle of it in a controlled way with the support of a qualified therapist.
This will enable you to desensitise yourself to the trauma incident and reprocess it. When you do this trauma and PTSD symptoms decrease.
Will I experience immediate benefits following treatment?
Some people experience immediate benefits following EMDR therapy. They experience and immediate cessation of symptoms relating to the traumatic event.
For others it takes longer especially with multiple traumas to process. A positive outcome usually manifesting once the right cognitions and trauma are worked through.
