What is EMDR therapy?

EMDR therapy involves the therapist guiding the client to focus on a distressing memory or emotion while engaging in rapid back-and-forth eye movements. The eye movements result in alternating stimulation of the brain's right and left hemispheres. These movements mimic those occurring during REM sleep and appear to expedite the healing process.

In EMDR, desensitisation involves diminishing the emotional disturbance linked to a traumatic memory, while reprocessing entails replacing unhealthy, negative beliefs associated with traumatic memories with more positive ones.

When is EMDR therapy appropriate?

EMDR therapy addresses two categories of trauma: "big T" trauma, such as combat or rape, and "little t" trauma, which encompasses everyday chronic stressors like childhood experiences leading to low self-esteem. EMDR therapy can effectively treat both types of trauma, but it's crucial to note that the therapy can evoke intense emotions temporarily. Therefore, it may not be suitable for individuals unable or unwilling to confront distressing emotions. A thorough assessment by an EMDR therapist is necessary to determine its suitability within an overall treatment plan.

What is EMDR therapy helpful for?

EMDR (Eye Movement Desensitisation and Reprocessing) is a versatile therapy that can effectively treat a wide range of psychological conditions and issues, including:

1. Post-Traumatic Stress Disorder (PTSD): EMDR is widely recognised for its effectiveness in treating PTSD, helping individuals process and integrate traumatic memories.

2. Anxiety Disorders: Generalised anxiety, panic attacks, and specific phobias can be alleviated through EMDR by addressing underlying traumatic or distressing memories.

3. Depression: EMDR can assist in reducing symptoms of depression, particularly when it's related to past traumatic experiences.

4. Chronic Pain: Psychological factors contributing to chronic pain can be addressed with EMDR, often leading to reduced pain perception.

5. Grief and Loss: EMDR can help individuals process intense emotions related to loss, facilitating healthier coping mechanisms.

6. Addictions: By targeting trauma or distressing memories that may contribute to addictive behaviours, EMDR can be an effective component of addiction treatment.

7. Problem Eating Behaviours & Eating Disorders: EMDR can assist in uncovering and processing traumatic experiences and distressing memories that contribute to unhealthy eating behaviours.

8. Performance Anxiety: Issues related to performance, such as stage fright or sports anxiety, can be mitigated with EMDR by addressing underlying psychological factors.

9. Obsessive-Compulsive Disorder (OCD): EMDR can help reduce the intensity of intrusive thoughts and compulsive behaviours by processing related distressing memories.

10. Stress Management: Individuals dealing with high levels of stress can benefit from EMDR to process and manage their stress more effectively.

11. Behavioural Issues: EMDR can help address and modify problematic behaviours, especially those rooted in past trauma or distress.

What happens in an EMDR therapy session?

Each EMDR therapy session varies as the healing process is internally guided. Past issues or memories may surface, often leading to temporary discomfort. However, persisting through these moments typically results in the gradual fading of upsetting emotions or memories. EMDR therapy sessions move through 8 phases.

What are the 8 Phases of EMDR therapy?

EMDR Phase 1: History Taking and Treatment Planning

In the first phase the therapist gathers information about the client's history, including traumatic experiences, current symptoms, and the client's readiness for EMDR therapy. Together, the therapist and the client develop a treatment plan tailored to the client's specific needs and goals.

EMDR Phase 2: Preparation

During this phase, the therapist educates the client about EMDR therapy and establishes trust and rapport. The client learns coping skills to manage distress and enhance emotional regulation. Preparation also involves identifying safe places or calming imagery that the client can use as resources during EMDR sessions.

EMDR Phase 3: Assessment

The assessment phase involves identifying target memories or experiences to process using EMDR. The therapist helps the client choose specific memories related to distressing emotions, negative beliefs about themselves, or traumatic events. They explore the emotions, sensations, and beliefs associated with each target memory.

EMDR Phase 4: Desensitisation

In this phase, the therapist guides the client through bilateral stimulation, such as eye movements, taps, or auditory tones, while the client holds the target memory in mind. The bilateral stimulation facilitates the processing of the memory, allowing the client to reprocess it in a less distressing way. As the memory is desensitised, the associated emotions and beliefs begin to diminish in intensity.

EMDR Phase 5: Installation

Once the distress associated with the target memory has decreased significantly, the therapist helps the client strengthen positive beliefs or adaptive coping strategies related to the memory. Through bilateral stimulation, the client "installs" these positive beliefs, enhancing their sense of self-worth, safety, and resilience.

EMDR Phase 6: Body Scan

During the body scan phase, the therapist helps the client identify and process any residual physical sensations or tension associated with the target memory. The client learns to release tension and relax their body, further integrating the positive changes made during desensitisation and installation.

EMDR Phase 7: Closure

At the end of each session, the therapist ensures that the client feels stable and grounded before concluding the session. They may use relaxation techniques or grounding exercises to help the client return to a state of equilibrium. Closure provides a sense of containment and safety, preventing the client from feeling overwhelmed between sessions.

EMDR Phase 8: Re-evaluation

In the final phase, the therapist reviews the progress made in previous sessions and assesses whether additional targets need to be addressed. They may also address any new material that emerged during processing and update the treatment plan accordingly. Re-evaluation ensures that the client's therapeutic goals are being met and guides future sessions.

These eight phases constitute the standard framework of EMDR therapy, guiding clients through a structured process of reprocessing traumatic memories and fostering healing and resilience.

Why bring up a painful memory in EMDR therapy?

Avoiding painful memories perpetuates their distressing impact. However, a flashback or nightmare can feel as upsetting and overwhelming as the original experience, yet not be helpful. In therapy, and with EMDR, you can face the memory in a safe setting, so that you do not feel overwhelmed. Then you can get through it and move on.

Will I be in control during EMDR therapy sessions?

The thoughts, feelings, or memories that surface during EMDR are unpredictable and depend on each individual's healing process. Clients retain control over whether to continue or halt the session, as well as the extent of disclosure to the therapist.

Are there any precautions to know about before engaging in EMDR therapy?

Yes, adherence to specific procedures is vital in EMDR therapy. These are based on the client's presenting issues, emotional stability, medical condition, and other factors. Proper training in EMDR therapy is essential for therapists to ensure the therapy's effectiveness and safety. It is important that a client's capacity to cope with disturbing and distressing memories is assessed before the bilateral stimulation sessions stair in the EMDR therapy. 

What happens after a session of EMDR therapy?

After a session of EMDR therapy, clients may continue processing the material, experiencing insights, dreams, strong emotions, or memory recall. These reactions are normal and part of the ongoing healing process in, but any concerns should be communicated to the EMDR therapist.

How long does EMDR therapy take?

The duration of EMDR therapy varies based on factors like the nature of the problem, client history, and tolerance for emotional disturbance. While some may experience significant improvement after one session, others may require weeks, months, or even years of treatment. The typical short term EMDR therapy process would span over 8 to 12 sessions.

What is an EMDR therapy session like?

During an EMDR therapy session, the therapist and client collaborate to identify the most distressing aspect of the trauma, along with associated negative beliefs and preferred positive beliefs. The client then engages in sets of rapid eye movements that stimulates the brain bilaterally while holding these elements in awareness, gradually diminishing the disturbance associated with the traumatic memory.

How does EMDR therapy work?

Research into the mechanisms of EMDR therapy is ongoing, with studies exploring changes in brain activity post-treatment. EMDR appears to facilitate the brain's natural trauma processing mechanisms, particularly those occurring during REM sleep, thereby reducing the distress associated with traumatic memories.

Is EMDR therapy evidence-based?

Yes, EMDR therapy is considered an evidence-based therapy. Numerous studies have demonstrated its effectiveness in treating various mental health conditions, particularly trauma-related disorders such as post-traumatic stress disorder (PTSD).

The effectiveness of EMDR therapy has been supported by a significant body of research spanning several decades. Many randomised controlled trials (considered the gold standard in research methodology) have shown that EMDR is as effective as, or sometimes more effective than, traditional forms of psychotherapy in reducing symptoms of PTSD and other trauma-related disorders.

Additionally, meta-analyses, which combine data from multiple studies, have consistently found positive outcomes for EMDR across diverse populations and settings. These findings have led organisations such as the American Psychological Association (APA), the World Health Organization (WHO) and the National Institute for Health and Care Excellence (NICE) to endorse Trauma-Focused Cognitive Behavioural Therapy (CBT-TF) and EMDR therapy as a recommended treatment for trauma-related conditions.

While the precise mechanisms underlying EMDR's effectiveness are still being studied, research suggests that the therapy facilitates the brain's natural healing processes, allowing individuals to process traumatic memories and associated emotions in a more adaptive way.