What is EMDR?

EMDR stands for "Eye Movement Desensitization and Reprocessing" and was discovered between 1987 and 1989 by the American Psychologist Dr. Francine Shapiro developed for the treatment of trauma. She found out that rapid (horizontal) eye movement triggers the processing of memory in the brain. What sounds simple at first is a complex and comprehensive Psychotherapy method, which requires several years of training, and to which currently only recognized Psychotherapists are admitted.

When I first heard of the incredible healing effects of EMDR (example #1, #2) I became suspicious and thought it was unserious and unscientific. Meanwhile, I am convinced that EMDR is a very effective therapy method and a powerful tool to speed up Psychotherapeutic processes. It works with most people.

History

In 1987, Shapiro accidentally discovered the effects of eye movements. She had just received a difficult diagnosis herself and went for a walk in the hospital park to digest the news. She moved her eyes (randomly) quickly back and forth and ten minutes later, her distress suddenly had disappeared. Shapiro was so fascinated by this event, that she developed EMDR in the following years. Later, Shapiro and colleagues found that the effect can not be caused solely by eye movements, but rather by bilateral stimulation. But by that time, the name EMDR has already been established and so that they decided to keep it. When you do EMDR today, you have a choice to do it using eye movements, alternating sounds (with headphones) or with a vibrating device ("EMDR Buzzies"with alternating vibrations, see picture).

How does it work?

Interestingly, the efficacy is well documented, but it is not completely understood how and why EMDR works. There are, however, some hypotheses:

• The bilateral stimulation boosts the processing of memories, similar to REM sleep

• EMDR triggers an orientation reaction, leading directly to desensitization and processing of traumatic memory

• EMDR promotes bilateral data exchange between the two sides of the brain so that "stuck" memories can be processed.

• EMDR “deblocks” the Information processing system in the central nervous system (CNS). Due to the sensory overload during a traumatic situation, this system is thought to be partially blocked with PTSD patients.

Slow vs. fast stimulation

With slow stimulation, existing phenomena are intensified or anchored. Note that these effects are only temporary. This technique will be used during a first ‘trial session’ (so called absorption technique) or at the conclusion of a successful EMDR session. Fast stimulation, however, is used for the actual EMDR treatment. Memories are processd deeply and the effects are permanent.

Effectiveness

The EMDR method has been accepted as an effective and time-efficient treatment for post-traumatic stress disorder. By now, almost every civilized country has its own EMDR training center. Furthermore, EMDR is being adapted successfully for other Psychiatric disorders. In the 30 years of its existence, EMDR has become the therapeutic method with the most controlled and uncontrolled therapeutic trials for the treatment of PTSD. [Current state of EMDR research] The effects are persistent and stand out clearly from placebo effects. A person with a single trauma (and no other preconditions) might only need a few sessions (10 or so) of EMDR treatment until they feel significantly better. For a person suffering from early or repeated traumatization, it will take takes substantially longer. The period of stabilization (before you can confront any trauma at all) might take weeks to years.

 

Which problems can EMDR be used for?

• Monotrauma (single traumatic event) such as accidents, catastrophic events

• Complex trauma (early or repeated traumatization) such as physical, emotional and sexual abuse, war experiences, etc.

• Attachment issues / Developmental Trauma

• Depression

• Anxiety, panic attacks, phobia

• ADHD

• Asperger syndrome

• Obsessive-compulsive disorder

• Mourning processes

What does an EMDR treatment look like?

The treatement can be divided in 8 phases. In the best case scenario, you can start processing the difficult memories after a few sessions. These are the 8 phases which every EMDR treatment should contain:

1. Thorough medical history
- Especially stressful or traumatic events
- Diagnosis, possibly trauma assessment
- Indication und treatment plan

2. Preparation - this phase might take between a few sessions and years!
- In-depth information about the treatment
- Checking / acquiring strategies for emotion regulation
- Acquiring stabilizing techniques, getting in touch with
your body an feelings
- Trial session with positive memories (so called
Absorption-technique), with slow bilateral stmulation

3. Assessment of one chosen memory
- Image, thoughts, feelings, distress level, body sensations

4. Desensitization / Reprossessing
- with fast bilateral stimulation, until distress is gone

5. Installation of positive thoughts / body sensations with slow bilateral stimulation

6. Body scan

7. Closure The patient must be returned to a state of equilibrium at the end of each session, regardless of whether reprocessing is complete.

8. Reevaluation and treatment planning in the following session

The actual processing of the memories takes place in a 60-90 minute session (phases 3-7).

Note: Instead of the tiring eye movements, EMDR can be performed using a vibrating device (EMDR ”buzzies”, see picture above).

Preconditions for a EMDR treatment

• Patient should ideally be in a relatively stable phase of life, meaning: currently no profound life events such as change of residence, final exam, separation / divorce, pregnancy, child birth, withdrawal treatment, etc.

• Sufficient self-regulation mechanisms (since treatment is performed on an outpatient basis), also ability to allow stressful feelings

• No ongoing abuse relationship

• For ADHD patients, it is recommended to be on their medication that day

• Exclusion criteria: psychosis, epilepsy, acute suicidality, permanent drug use, permanent use of benzodiazepines

Links and literature

• Great animation by the National Center for PTSD - Video (2.54)

• Dr. Leeds explains how EMDR works Video (4.43)

• Interview with Francine Shapiro Video (8.20)

• Francine Shapiro explains EMDR Video (3.59)

• Historic document of Francine Shapiro talking about her discovery Old video (2.54)
  Old video (2.51)

• Good article pdf

• FAQ, more scientific Text

• FAQ, less scientific Text

• Overview current research

• Even Prince Harry is doing EMDR!