What is EMDR therapy?
Eye movement desensitization and reprocessing (EMDR) therapy is an effective and widely researched method of psychotherapy. It has been shown to help people recover from trauma and other stressful life experiences associated with mental health issues such as post-traumatic stress disorder (PTSD), anxiety, depression, and many other conditions.
The World Health Organization has been recommending EMDR since 2013 as one of the recommended treatments for trauma-related disorders. The Cochrane Database of Systematic Reviews indicates that trauma-oriented therapies such as EMDR are more effective in post-traumatic conditions. The International Society for Traumatic Stress Studies (ISTSS) picks it up as one of the treatments of choice for PTSD. In many other clinical guidelines and international organizations, EMDR appears among the recommended therapies.
How is EMDR different from other recommended therapies?
Both EMDR and cognitive-behavioral therapies (CBT) have shown high levels of evidence for the treatment of traumatic memories. Unlike these psychotherapies, EMDR does not require the patient to talk in detail about the problem or to do homework between sessions. For example, in exposure therapy (a type of CBT) the aim is for the person to be in contact with the emotions that the memory generates without avoiding it, until a habituation process progressively occurs, reducing the discomfort.
In EMDR therapy, the person will contact the memory very briefly, to give way to an associative process with other memories, sensations or thoughts. There is therefore a decrease in discomfort (desensitization), but a process of multiple associations (reprocessing) is also set in motion.Both therapies are effective but operate through different mechanisms. In more cognitive type therapies, work is done on the beliefs that the patient has about the event so that they change to a healthier perspective. In EMDR, although the subject’s beliefs are collected, no specific work is done on them, rather they change as a result of memory processing.
For EMDR work, it is important, therefore, not only to address the specific memory that is blocked, but the connections between this experience and previous situations, which may share the same associated thoughts or sensations. An EMDR therapist will work with the patient to understand the roots of traumatic experiences, and to develop a comprehensive work plan to eliminate their influence in the present.
The central idea of the EMDR model, called the Adaptive Information Processing Model (PAI), is that the nervous system has mechanisms to process and integrate everything that happens to us, including difficult or stressful experiences. Sometimes, when these experiences are more intense or complex for the person, the system is blocked and the memory remains stored without elaboration, with the same perceptions, thoughts, emotions and sensations. These unprocessed memories are not a source of learning, but can lead to problems and symptoms in the present, when something that happens is connected to those experiences. EMDR therapy has defined procedures to access and unlock these memories, allowing the nervous system to finally integrate them. Within these procedures, one of the elements used is eye movement or other forms of bilateral brain stimulation (tactile, auditory). Although eye movements have given the therapy its name, it is important to note that this element by itself does not constitute a therapeutic approach, and its isolated use is not recommended.
What happens in the brain when we do EMDR?
Our brains have a natural way of recovering from traumatic memories and events. This process involves communication between the amygdala (a brain nucleus that functions as an alarm signal for stressful events), the hippocampus (an area that helps with learning, including memories about safety and danger), and the prefrontal cortex (which analyzes and controls behavior and emotion). While traumatic experiences can often be managed and resolved on their own, in many cases they may not process without help.
Stress responses are part of our natural fight, flight, or freeze instincts. These responses are activated by something that we experience as threatening and are deactivated when we feel that the danger has passed. However, when something happens that exceeds the brain’s ability to process it, these responses are still active, and disturbing images, thoughts, and emotions can create an overwhelming feeling of being back in the moment, or that time has stood still. that moment, that we cannot overcome. EMDR therapy helps the brain process these memories and allows the interrupted natural healing process to resume. The experience is still remembered, but the fight, flight, or freeze response associated with the past situation is resolved.
Who can benefit from EMDR therapy?
EMDR therapy helps children and adults of all ages. Therapists use EMDR therapy to address a wide range of issues:
- PTSD and other issues related to trauma and stress
- Anxiety, panic attacks, and phobias
- Chronic diseases and medical problems
- Bipolar and psychotic disorders
- dissociative disorders
- Eating Disorders
- duels and losses
- performance anxiety
- Personality disorders
- Violence and physical, sexual and emotional abuse
- Sleep disorders
- Substance abuse and addiction
- violence and abuse
In all these problems there is research showing favorable effects, with very different levels of evidence so far. The EMDR approach, in any case, is not focused on the diagnosis but on the basis of each disorder, which, to a greater or lesser extent, is influenced by the environment in which the person has developed and has been related. Although some pathologies have important genetic, sociocultural or toxic components, EMDR works on the unprocessed life circumstances that contribute to current problems.
Can EMDR therapy be done without a trained EMDR therapist?
EMDR therapy is a mental health intervention. As such, it should only be offered by properly trained and licensed professionals. The EMDR Spain Association does not approve or support the indiscriminate use of EMDR therapy, or any isolated element of it (such as eye movements, bilateral sounds or tapping) as a “do it yourself” virtual therapy. Although these elements are sometimes sold as harmless relaxation exercises or integrated into meditative practices, unguided use can be counterproductive.
One of the central objectives of the EMDR Spain Association and of the international entities of which it is a part is to guarantee the quality training of therapists who decide to start in this therapeutic orientation. Only psychologists and doctors can access accredited training, and the Association only recognizes courses and trainers that have gone through an independent accreditation process by the EMDR Europe Association. In the Association‘s therapist search engine, you can access a list of professionals who provide training with these guarantees.
How did EMDR therapy start?
In the late 1980s, Francine Shapiro discovered a connection between eye movement and persistent disturbing memories. From this personal observation, she began to study this phenomenon and develop what became eye movement desensitization and reprocessing (EMDR) therapy.
Over the years, and in the face of initial skepticism, Dr. Shapiro’s work evolved from a hypothesis to a structured process of psychotherapy. What today is EMDR therapy is the result of many research studies analyzing the changes during the sessions, the effectiveness in different pathologies, and the effects at the level of the nervous system.
Francine Shapiro encouraged the founding of the EMDR International Association, a membership of more than 11,000 mental health professionals who use EMDR therapy in their clinical practice to treat a wide range of issues. Until her death in 2019, Shapiro spearheaded EMDR research and the constant review of EMDR procedures based on empirical data.
What is the process of doing EMDR therapy like for the patient?
An experienced EMDR therapist must know the case in depth and understand with the patient the potential connections between the problem that brings him to the consultation and his previous history. Based on this initial map, it must be assessed whether the person needs a prior preparation process to better understand their difficulties and their resources, acquire some stability, manage their emotions and feel safe to deal with their difficult experiences.
Once the topics to work on have been agreed, each relevant memory will be accessed, paying attention to a negative image, belief, emotion and bodily sensation related to this event, and then to a positive belief that implies a change of perspective regarding the experience. .
A typical EMDR therapy session lasts 60 to 90 minutes. EMDR therapy can be used as a targeted intervention integrated into more verbal psychotherapy, as an add-on therapy with a different therapist, or as a treatment on its own.