EMDR FAQs

What many people ask about EMDR

Here are some common questions about EMDR that many people might have. For a refresher, EMDR stands for Eye Movement Desensitization and Reprocessing. This type of therapy began in 1987 after a graduate student named Francine Shapiro became interested in exploring how distressing thoughts abated when she moved her eyes back and forth. Although that is the history, it is good to note that EMDR is more than eye movement and reprocessing, it is a trauma-informed treatment approach (Shapiro, 2018).

Do you have to have PTSD to do EMDR?

Although EMDR is a first-line therapy, evidence-based therapy for treating trauma, you don’t need to have survived a traumatic event to engage in EMDR therapy. You may have faced a loss, or you may have “stuck” moments, or memories and experiences that were painful enough to be pushed away from memory. Many research studies have found that successful clinical trials using EMDR have been conducted in treating PTSD from wars, anxiety and panic disorders, victims of crime, those facing grief, children who were survivors of assault and natural disasters, sexual assault, people with personality disorders, people with chronic pain, and those addicted to substances (Shapiro, 2018).

Is eye-movement the same as hypnosis?

In EMDR, the client is completely conscious and in control, it is not a form of hypnosis. Including in the preparation stages, the client and therapist will work collaboratively to form a good connection and trust, establish goals, and determine the best place to start with the memories. A client can stop the treatment if they are uncomfortable. A good therapist will make sure the client has worked on coping skills, identified a goal, found social support, and has found a way to calm down after engaging in the memory.

Can I do EMDR by myself?

Certainly, bilateral taps or butterfly taps can be calming and helpful when feeling stressed, and anyone can do this at any time on their own. However, to reprocess or digest (integrate) a traumatic memory into one’s current state, it is important to entrust this work with someone who is trained and certified, and the eye movement processing is the more effective form of bilateral stimulation. We are in a current age where people can become certified by taking a one or two-day online training, which can be helpful, but it’s best to receive extensive training to engage in trauma reprocessing because it is not only a skill, it is a trauma-informed framework. 

Many people can read an EMDR book, see a YouTube video, even take a really good PESI course on EMDR and “do EMDR,” but the bilateral stimulation, the reprocessing part, isn't the only part of the treatment. A therapist must know how to help select a memory that a client is ready to reprocess. It is not only a matter of technique, it’s a matter of having a systematic approach to prepare a client so as not to become overwhelmed. 

The worst thing to happen, which I have heard, is that people say, “I tried EMDR, and it made things worse.” It’s not that the EMDR made things worse, it could be that the therapist did not know how to prepare the client to engage properly in memory integration. 

Shapiro (2001) says that we have a natural healing process that needs to be reactivated. This is a useful perspective because a clinician helps to remove obstacles, and facilitates the client to heal on their own. The client is following their own mental images, thoughts, and feelings during EMDR, the client is just a facilitator, the client is the true healer. 

How long does EMDR take?

The time depends on many factors. Some people can reprocess a trauma, or access it mentally with little distress. Some people can move from denial, anger, sadness, and acceptance of the trauma memory in a matter of a few sessions, or it can take months. In some cases, a client will leave a session and another memory will resurface that needs to be addressed. One strength of EMDR is efficiency. Studies have found that people can process their trauma memories without being overwhelmed after a few 90-minute sessions. Again, this also depends on the individual working with the client to prepare and strengthen the client for the reprocessing phase of treatment.

How does EMDR work?

EMDR activates the emotional aspects of a trauma memory while thinking ‘contradictory information,’ in other words, a new way of thinking about something. For example, someone could be facing a memory and thinking, “I am powerless,” and then by letting the mind wander, they might end up with a new perception, “Well, I was a child, I didn’t know what to do. Any child would have been just as frozen,” or move from, “I can never be safe in the world,” to “That was in the past, it was horrible, but it’s over now.” This second example shows a type of acceptance, rather than a negative untruth or belief that came from the trauma or loss. Shapiro writes, “The client learns what is necessary and useful from the disturbing past experience, and the event is restored into memory in an adaptive, healthy, and non-distressing form” (Shapiro, 2018).

 One of the reasons that EMDR works so quickly is that it helps restructure early patterns of perceptions about the world, feelings, and behaviors at the time of experiencing trauma, and through adaptive information processing, this information is “accessed and transformed” (Shapiro, 2018, p. 17). 

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Reference

EMDR Institute, Inc. (n.d.). What is EMDR? https://www.emdr.com/what-is-emdr/

(Shapiro, F.) (2018). Eye movement desensitization and reprocessing (EMDR) therapy: Basic principals, protocols and procedures (3rd ed.). Gilford Press.New York. 

What Is EMDR?

EMDR stands for Eye Movement Desensitization and Reprocessing. This type of therapy began in 1987 after a graduate student named Francine Shapiro became interested in exploring how distressing thoughts abated when she moved her eyes back and forth. Although that is the history, it is good to note that EMDR is more than eye movement and reprocessing, it is a trauma-informed treatment approach (Shapiro, 2018). 

To boil it down to the basics, when someone engages in EMDR, they are guided by a trained therapist to focus on a highly distressing memory while following the therapist’s fingers move across the visual field, or sometimes by tapping the shoulders or hearing a sound on either side. After this, the client will talk about thoughts, images, and sensations that were elicited by the bilateral stimulation. This reprocessing component or the digestion of a traumatic memory,  (focusing on the difficult memory) will come towards the end of building the groundwork of trust, emotional skills, and developing a treatment plan collaboratively between the client and therapist.

Benefits of EMDR

EMDR allows us to process a traumatic moment in small doses. In addition, the eye movement helps form new associations allowing the body and mind to reintegrate the trauma and adapt. The EMDR Institute, Inc. writes,

“These new associations [resulting from EMDR] are thought to result in complete information processing, new learning, elimination of emotional distress, and development of cognitive insights” (n.d.).

Another advantage of this method is that the client does not need to concentrate on the traumatic memory for long periods of time. Some therapists have found that clients have a higher tolerance for EMDR than other exposure therapies, and is therefore seen by many clients as more secure and without negative outcomes. It is important to practice EMDR with a trained professional because the best results come from systematically preparing the client to engage in reprocessing a traumatic memory. 

EMDR therapy often follows three stages. In a snapshot, they are:

1. Take a history of the trauma and map out a treatment plan

2. Learn a way to cope with stress. 

3. Throughout stages 3-6, the client will think about a negative thought or belief, locate bodily sensations, and explore a memory associated with the trauma.

   7. Client keeps a log and revisits coping techniques from stage 2. 

8. The therapist and client will review the progress made up to that point.

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Reference

EMDR Institute, Inc. (n.d.). What is EMDR? https://www.emdr.com/what-is-emdr/

(Shapiro, F.) (2018). Eye movement desensitization and reprocessing (EMDR) therapy: Basic principals, protocols and procedures (3rd ed.). Gilford Press.New York.