By Elizabeth Lee, MEd, CPsych
Jun 22, 2021
Eye Movement Desensitization and Reprocessing (EMDR) is an evidence-based psychotherapy method that was developed by psychologist Dr. Francine Shapiro and has demonstrated success in helping some individuals heal from the emotional distress that stem from painful and traumatic life experiences.
Our brains have a natural system that digests ourexperiences and integrates them into memory networks, which enable us to makesense of new information (Shapiro, 2001). However, a distressing incident canoverwhelm healthy functioning of this system, preventing the traumaticinformation from being effectively processed by our brain and causing thetraumatic memories to get “stuck” (Shapiro 1995, 2001, 2006). When traumaticmemories get stuck, individuals may experience distress that, in turn, cantrigger the “fight-flight-freeze” responses well as a series of upsetting emotions,images, and bodily sensations (Shapiro, 2001). Additionally, individuals canstart having negative beliefs about themselves that are related to andmaintained by the unprocessed traumatic incidents, such as “I won’t survive”(Shapiro, 2001; Soloman & Shapiro, 2008).
The “fight-flight-freeze” response is a response weare biologically wired to produce when we feel threatened. This automatic responsewas helpful when our ancestors needed to spring to action (eg. A lion is aboutto attack and we need to flee or fight) or needed a moment to decide whichoption offered the best chance of survival (freeze when a lion is stalking usto decide the best course of action) (Roelofs, 2017). However, when thisresponse is activated by a threat in our mind- when we remember a traumaticmemory- the “fight-flight-freeze” response hinders us instead of helping ussince the threat is no longer real.
EMDR involves a series of experiential activities designedto help “unstuck” the brain’s system, allowing disturbing memories to be fully processedso that when negative incidents are remembered, although unpleasant, there’s nolonger an overwhelmingly distressing experience. EMDR also consists ofstrengthening positive beliefs to ultimately replace the negative beliefs thatare intertwined with and maintained by traumatic memories. For example, whenrecalling a painful memory, instead of believing “I’m unlovable” we believe andfeel “I’m loveable.”
What arethe eye movements about?
EMDR involves bilateral stimulation such as eyemovements, alternating hand-tapping, or alternating sounds as a way to helpclients effectively process their emotionally disturbing memories.
Dr. Shapiro noticed in 1989 that her emotionaldistress related to disturbing thoughts disappeared when she rapidly andspontaneously moved her eyes. She later conducted a controlled study and foundthat eye movements are associated to desensitizing traumatic memories (Shapiro,1989).
Several randomized research studies have found that sucheye movements have an effect on: emotional arousal, image vividness, retrieval,distancing, and memory association (Andrade et al, 1997; Barrowcliff et al.,2004; Christman et al., 2003). Lee et al. (2013)’s meta-analysis found that theeye movements reduced the vividness and emotion associated with unpleasantautobiographical memories.
What does EMDR consist of?
A trained EMDR therapist would first assess whether ornot EMDR would be an appropriate intervention for a client before introducingthis type of psychotherapy. After discussion and with clients’ agreeance, EMDRtrained therapists guide clients through the phases of EMDR therapy in a controlledand standardized way, called the Adaptive Information Processing Model(Shapiro, 2007). This includes:
- History and treatment planning: thetherapist collects some information about the client’s distressing memoriesthen works collaboratively with clients to create a treatment plan consistingof which specific incidents to work on as well as the associated negativebeliefs and the positive beliefs.
- Preparation: therapists teach clients skills to cope withemotional disturbance related to distressful memories that might be experiencedoutside of psychotherapy sessions.
- Assessing incident(s): thisinvolves a negative image, bodily sensations, and negative beliefs such as “I’mnot good enough”, “it’s my fault” as well as positive beliefs, which might be“I’m enough”, “I did my best”, etc.
- Processing the memory: clientsfocus on a traumatic memory while engaging in bilateral stimulation (eyemovement, alternating taps, listening to tones), to lessen the distress of thetrauma memory, and notice physical sensations in the body.
- Strengthening positive beliefs: clientsfocus on a memory while engaging in bilateral stimulation (eye movement,alternating taps, listening to tones), to strengthen the positive belief.
- Closure: when the targeted memory is not fully processed in asession, clients are encouraged to use specific techniques that have beentaught during the Preparation stage to develop safety between sessions.
- Evaluating treatment outcomes: therapistand client discuss the effects of EMDR and if there are other incidents ornegative beliefs to work on.
Is EMDR effective?
Several research studies found that EMDR was effectivein:
- Reducing post-traumatic stress disorder (PTSD),depressive and anxiety symptoms for survivors of life-threatening cardiacevents after a 4-week treatment (Arabia et al., 2011).
- Reducing PTSD, anxiety, and depressive symptoms for cancerpatients (Capezzani et al., 2013).
- Reducing distressing emotions for people whoexperienced disturbing life events and don’t meet the criteria for PTSD(Cvetek, 2008).
- Reducing clinical symptoms for adult female survivorsof childhood sexual abuse (Edmond et al., 1999).
- Reducing PTSD symptoms for individuals who sufferedsexual assault (Rothbaum, 1997).
EMDR has been compared to other psychotherapyapproaches and meta-analysis research studies found:
- EMDR therapy is as effective as trauma-focusedCognitive Behavioral Therapy (CBT) for adults with chronic PTSD (Bisson et al.,2013).
- EMDR therapy isequally effective to exposure and other cognitive behavioral treatments forreducing PTSD symptoms (Bradley et al., 2005).
EMDR has been endorsed as an evidence-basedpsychotherapy model by various organizations, including: The InternationalSociety for Traumatic Stress Studies, The Cochrane Database of SystemicReviews, and the World Health Organization.
Can my therapist provide me EMDR psychotherapy?
EMDR is a specific psychotherapy method and shouldonly be provided by mental health clinicians who have been properly trained toprovide EMDR to their clients. The EMDR International Association (EMDRIA)provides EMDR training to individuals who are required to meet certaineligibility requirements.
Where can I learn more about EMDR?
For a more in-depth outline of the EMDR experience,please visit: emdria.org
To learn more about the theory and research on EMDR, pleasevisit emdr.com
EMDR Trained Psychologists
Elizabeth Lee, C.Psych, has obtained training in EMDR. Click here to learn more about her and visit our intake page to inquire about booking an appointment with her
References:
Andrade, J., Kavanagh, D., & Baddeley, A. (1997).Eye-movements and visual imagery: A working memory approach to the treatment ofpost-traumatic stress disorder. BritishJournal of Clinical Psychology, 36, 209-223.
Arabia, E., Manca, M.L., & Solomon, R.M. (2011).EMDR for survivors of life-threatening cardiac events: Results of a pilotstudy. Journal of EMDR Practice andResearch, 5, 2-13.
Barrowcliff, A.L., Gray, N.S., Freeman, T.C.A.,MacCulloch, & M.J.(2004). Eye-movements reduce the vividness, emotionalvalence and electrodermal arousal associated with negative autobiographicalmemories. Journal of Forensic Psychiatryand Psychology, 15, 325-345.
Bisson, J., Roberts, N.P., Andrew, M., Cooper, R.& Lewis, C. (2013). Psychological therapies for chronic post-traumaticstress disorder (PTSD) in adults. CochraneDatabase of Systematic Reviews, 2013, DOI: 10. 1002/14651858.CD003388.pub4
Bradley, R., Green, J., Russ, E., Dutra, L., &Westen, D. (2005). A multidimenstional meta-analysis of psychotherapy for PTSD.American Journal of Psychiatry, 162, 214-227.
Capezzani, L., Ostacoli, L., Cavallo, M., Carletto, S.,Fernandez, I., Solomon, R., Pagani, M., & Cantelmi, T. (2013). EMDR and CBTfor cancer patients: Comparative study of effects on PTSD, anxiety, anddepression. Journal of EMDR Practice andResearch, 7, 134-143.
Christman, S.D., Garvey, K.J., Propper, R.E., &Phaneuf, K.A. (2003). Bilateral eye movements enhance the retrieval of episodicmemories. Neuropsychology. 17,221-229.
Cvetek, R. (2008). EMDR treatment of distressfulexperiences that fail to meet the criteria for PTSD. Journal of EMDR practice and Research, 2, 2-14.
Edmond, T., Rubin, A., & Wambach, K. (1999). Theeffectiveness of EMDR with adult female survivors of childhood sexual abuse. Social Work Research, 23, 103-116.
Lee, C.W., & Cuijpers, P. (2013). A meta-analysisof the contribution of eye movements in processing emotional memories. Journal of Behavior Therapy &Experimental Psychiatry, 44, 231-239.
Roelofs, K. (2017). Freeze for action: Neurobiologicalmechanisms in animal and human freezing. Phil.Trans.R. Soc. B.372:20160206. http://dx.doi.org/10.1098/rstb.2016.0206
Rothbaum, B. (1997). A controlled study of eye movementdesensitization and reprocessing in the treatment of post-traumatic stressdisordered sexual assault victims. Bulletinof the Menninger Clinic, 61, 317-334.
Shapiro, F. (1989). Efficacy of the eye movementdesensitization procedure in the treatment of traumatic memories. Journal of Traumatic Stress Studies, 2, 199-223.
Shapiro, F.(1995). Eyemovement desensitization and reprocessing: Basic principles, protocols, andprocedures. New York: Guilford Press.
Shapiro, F. (2001). Eye movement desensitization and reprocessing: Basic principles,protocols, and procedures (2nd ed.). New York: Guilford Press.
Shapiro, F. (2006). New notes on adaptive information processing. Hamden, CT: EMDRHumanitarian Assistance Programs.
Shapiro F. (2007). EMDR, adaptive informationprocessing, and case conceptualization.Journal of EMDR Practice and Research, 1, 68-87.
Solomon, R.M. & Shapiro, F. (2008) EMDR and theadaptive information processing model: Potential mechanisms of change. Journal of EMDR Practice and Research, 2,315-325