Eye Movement Desensitization and Reprocessing

When people are upset or distressed, they’re often encouraged to get up and take a walk. Moving the muscles seems to allow feelings of nervousness and anxiety to dissipate, and often, new solutions seem to bubble up from deep inside the mind when the muscles are contracting and relaxing. While the benefits of this kind of movement are well documented, there may be other exercises that could also help people to deal with trauma and distress. Specifically, moving the eyes during targeted therapy sessions might help people to process their memories and come to a deeper sense of healing and peace. This kind of therapy, known as eye movement desensitization and reprocessing (EMDR), could be just the sort of therapy people need in order to deal with the past and focus on the future.

EMDR Theory

During the course of a typical day, a person has a series of experiences that move from the forefront of consciousness into deep storage. As these experiences are processed, the physical feelings associated with the event fade in importance, and the person develops a sort of summary statement regarding the event. Sleep, particularly rapid eye movement sleep, can play a key role in this memory formation, allowing people to come to deeper understanding about the events that have taken place. Sometimes, however, the event is so traumatic and so upsetting that the brain’s processes seem to shut down. The memory doesn’t move into deep storage, and all of the physical sensations and negative thoughts about that event remain just below the surface.

The idea behind EMDR is to expose the person to that negative event in a controlled and safe environment, all while mimicking the movement of the eyes that takes place during rapid eye movement sleep. According to Janet Shapiro, PhD, who is primarily responsible for developing the treatment, the eye movement portion of treatment lasts only about 30 seconds or so, but those movements allow people to deal with their memories and discard all of the negative beliefs and physical pain that they may associate with the event. In short, they keep what’s helpful and toss the rest, all with the help of therapy.

Building Trust

The Substance Abuse and Mental Health Services Administration reports that EMDR sessions typically last for 60 to 90 minutes. It’s a personalized therapy that involves only a client and a therapist. While other therapies often lean on the power of groups, EMDR is focused and intimate, so it’s not the sort of work that can be done with other people hovering nearby. Since there are only two people involved in the sessions, their contact must be close and honest. Clients are expected to share every thought they have, and be honest about their experiences. Pleasing the therapist by feigning healing or hiding significant reactions could make the therapy less effective, so it’s important for clients to feel safe and secure, so they can stay open and honest about everything that happens to them.

These feelings of security are fostered by the slow pace of early EMDR sessions. Here, therapists ask clients to detail:

  • The specifics of the problem that prompted the person’s entry into therapy
  • The behaviors that might be linked to that memory
  • People, places and things that cause distress
  • Techniques the person has used in the past in order to deal with the memory

With this information, therapists can develop a detailed plan in which the hurtful events are explored and the memories are processed. Clients might be reminded, at this point, that they are in charge of the speed and progression of the therapy, and they might be provided with a hand signal they can use if they feel overwhelmed during treatment and need to take a break.

Learning to Relax

Before memory processing begins, therapists provide their clients with information about relaxation and self-soothing. Some clients benefit from learning how to control their breath. For these clients, feelings of nervousness or anxiety are accompanied by quick, shallow breaths that might make them feel yet more weak and upset. By learning how to take in deep breaths when nervousness hits, these clients might be able to stop a vicious circle of anxiety before it starts. Other clients might benefit from learning how to focus on a happy place or a safe place when they feel nervous, distracting their minds from destructive thoughts before they can take over. Some clients may also learn how to tense and relax their muscles, starting with their heads and moving down their bodies until they reach their toes. This distracting technique may also reduce the sensation of nervousness and despair.

These relaxation techniques are key to the success of EMDR, according to the EMDR International Association. People who live happy lives know how to deal with the tensions that commonly crop up during the course of the day. By teaching people these skills, therapists might make EMDR sessions easier for people to tolerate, but they might also provide people with the tools they can use to reduce their chances of problems in the future.

Processing and Healing

When clients have a set of memories to focus on, and they know of techniques they can use to deal with distress, the real work of therapy can begin. Here, clients are asked to think of one scene from the difficult memory along with one statement that seems true and one that might be a better replacement. Someone struggling with a memory involving a car crash might focus on the moment of impact, attempting to replace the thought, “I will die” with the thought, “I am safe now.” Physical sensations regarding the incident are described, as the person focuses on finger movements and side-to-side eye motions. Then, the original image is brought back to mind, and the person attempts to discern if the replacement thought now seems yet more reasonable and true when compared to the original negative thought.

These sessions can be intense, as they require people to examine memories in great detail, but the therapist is always on hand to assist and provide encouragement. New memories might come to the surface, and nervousness might appear, but the therapist can always help and give guidance when needed.

Often, people who participate in EMDR feel much better in a hurry. For example, in a study in the Journal of Clinical Psychology, researchers found that 70 percent of participants had a reduction in symptoms after just three sessions. Some might feel as though their memories just lose power under such close scrutiny, while others might feel as though the soothing techniques allow them to deal with their distress, instead of suppressing it with denial or drugs.

Efficacy Rates

While EMDR can sound unusual and even a little bit strange, this is a therapy that has the capacity to help people who are dealing with profound suffering due to their memories. Those who have post-traumatic stress disorder (PTSD), for example, might feel as though their memories are so damaging and dangerous that they simply can’t be examined, and as a result, they might be left with troubling symptoms that include:

  • Disturbing dreams
  • Ongoing anxiety
  • Flashbacks
  • Substance abuse

By processing their memories in EMDR, people with PTSD might feel as though their memories no longer have the power to control their lives. Their disturbing feelings regarding the event have a place to go, and their healing might be profound as a result. In a study of the efficacy of EMDR, published in the Journal of Consulting and Clinical Psychology, researchers found that the benefits of therapy persisted when researchers contacted clients 90 days later. Studies like this seem to suggest that the therapy allows people to make longstanding changes in their thoughts and behavior, and this could be remarkable help for people who haven’t experienced healing with any other treatment they’ve tried.

EMDR isn’t right for everyone, however, as some people seem to do better with other forms of therapy. For example, in a study in the Journal of Consulting and Clinical Psychology, researchers found that exposure therapy was more efficacious for some people with PTSD. In this therapy, people are asked to slowly deal with the situations that once provoked their symptoms. It’s a bit like EMDR, without the eye movements. For some, this might be a better choice. People heal differently, and they all have different needs, so encouraging people to participate in the therapy that’s right for them should always be a part of an effective treatment program.

Other Issues

typical day in rehabWhile EMDR can be effective, it should always be provided by a trained professional. There are some self-help books, computer programs and cell phone apps that claim to provide the benefits of EMDR without the need for professional assistance, but these programs just don’t allow people to really benefit from all of the aspects of this very complicated form of treatment. In fact, for people with very serious difficulties with memory and stress, examining these issues alone without help could lead to very serious bouts of nervousness and anxiety that don’t seem to fade away with time. In general, it’s best for people to consult with an expert if they think this therapy might be right for them.

In addition, not all insurance programs consider EMDR a medically necessary treatment for all mental illnesses. They may feel as though the treatment works well for PTSD, for example, but they may think that people with depression could benefit from other therapies that have a longer history of medical research or a more straightforward healing method. As a result, some insurance programs won’t pay for this particular therapy, meaning that clients might be asked to pick up the tab for their care. This is an issue that’s best discussed with the insurance program directly, long before therapy begins, so there are no surprises down the line.

EMDR and Addiction

People with addictions may benefit from EMDR, if their substance use and abuse can be directly tied to memories that cause them pain and sorrow. For some, this is an easy connection to make, and they’re aware of how their abuse began and why they continued to use in later years. For others, this is a link that remains hidden through decades of substance use and abuse, and they may not be aware of the trauma that lies beneath their choices until they’re a little further along in the healing process. That’s why, at Axis, we provide our clients with customized treatment programs that change as our clients change. Some need EMDR right away, as their memories are clearly part of the spectrum of dysfunction they experience. Others don’t recognize their need until much later, but they may benefit from care all the same. If you’d like to know more about how we might incorporate EMDR into your treatment plan, please call us.