Most people are familiar with cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT). A treatment modality that fewer people know about is eye movement desensitization and reprocessing (EMDR). It can be highly effective, but there is some controversy surrounding this treatment. It is also not appropriate for all patients. Here we will look at some of the fundamental aspects of EMDR.
What Is EMDR?
EMDR is a type of psychotherapy. It was designed to help decrease distress related to traumatic memories. According to the American Psychological Association, EMDR was developed in the late 1980s by Francine Shapiro and was used for the treatment of post-traumatic stress disorder (PTSD).
EMDR consists of eight phases:
- Phase 1: History taking
- Phase 2: Preparing the patient
- Phase 3: Assessing the target memory
- Phases 4-7: Processing the memory to an adaptive resolution
- Phase 8: Evaluation of treatment results
During EMDR, the patient will talk through their traumatic memories or negative feelings while being led through bilateral eye movements. Other forms of bilateral stimulation such as tapping on the knees or using buzzers called tappers.
EMDR focuses on the past, present, and future. First, unpleasant and disturbing past events are addressed. Then, the focus shifts to current distressing situations. Eventually, the practitioner moves on to teaching skills that will allow the patient to take positive action in the future.
How Does EMDR Differ from Other Therapies?
Some therapies require a person with PTSD to go into a detailed discussion of their traumatic event. That is not necessary with EMDR. EMDR is not like any talk therapy. It is more similar to mindfulness-based therapies. Also, some forms of psychotherapy can take years, while benefits from treatment with EMDR can be seen rapidly. Some patients with a single trauma may only need five sessions. However, patients with multiple trauma may need more. EMDR does not involve assignments like other therapies.
Why Does EMDR Work?
The truth is that there is a lack of long-term research on EMDR explaining exactly why it works. According to Jason N. Linder, PsyD, in his Psychology Today article “How Does EMDR Therapy Work? What Makes it So Effective?” The bilateral stimulation of the eye movement while holding a disturbing memory helps desensitize those charged emotions associated with the memory. With time, this helps desensitize the emotional charge of the memory. It also helps reprocess how the memory is stored in the mind and body from self-defeating to self-affirming.
EMDR And Controversy
Treating patients with EMDR seems a great idea, but controversy swirls around this therapeutic approach. It is widely believed to be safe, but some providers believe that EMDR can have adverse side effects, including:
- Increase in distressing memories
- New traumatic memories surfacing
- Vivid dreams or nightmares
- Heightened emotional or physical sensations during therapy
- Patients could re-live the trauma rather than process it in a healthy way
- Fatigue after sessions
Some therapists believe that EMDR does not even help patients heal from their trauma. They believe that what is happening instead is that patients are dissociating from the trauma. Other therapists believe that EMDR can potentially worsen a patient’s symptoms, and that effect could be permanent. Finally, some therapists believe that EMDR is a sham. They think it simply does not work despite evidence that EMDR is effective, and some research against EMDR was discredited.
Who Should Not Undergo EMDR Treatment?
EMDR is widely accepted as safe and effective, but it is not an appropriate treatment for all patients or situations. Since stability is of utmost importance, caution should be used when treating patients actively using drugs or alcohol to feel less. If a patient is not fully ready to handle and process their emotions, then EMDR would not be the best fit. Other patients that EMDR is contraindicated for are:
- Actively psychotic patients
- Patients with neurological impairments
- Suicidal patients
- Patients with severe dissociative disorders
- Individuals with complex post-traumatic stress disorder (C-PTSD)
For these patients, the potential risks of EMDR outweigh the possible benefits. We can’t put these individuals in a situation that could worsen their symptoms.
Disorders That EMDR Can be Used to Treat
EMDR was developed for and is mainly used to treat PTSD, but it is not the only psychiatric disorder that can be effectively treated with EMDR. Its use has been expanded to include treatment for:
- Bipolar disorder
- Major depressive disorder (MDD)
- Generalized anxiety disorder (GAD)
- Intellectual disabilities when trauma is present
- Substance use disorders
EMDR can help certain patients if practiced safely by a trained practitioner. Many specialized forms of EMDR can target specific symptoms like substance cravings. It all depends on the patient’s circumstances. Ultimately, patients should discuss their treatment options—EMDR included—with their medical team.
Many therapy treatments and modalities exist to treat substance use disorders (SUD) and mental illnesses. These include eye movement desensitization and reprocessing (EMDR). While it is not appropriate for every patient, it can be an effective treatment for some. The programs at Sober Life are resiliency-focused rather than trauma-focused, but EMDR can be provided on a case-by-case basis for appropriate patients. Even if EMDR is not the right therapy for you, Sober Life offers other options, such as cognitive-behavioral therapy (CBT). You will get individual and group therapy in our partial hospitalization program (PHP) and our intensive outpatient program (IOP). In addition to treatment, we offer life skills groups for patients who might need help with tasks like financial management or cooking. Our outpatient programs allow you to apply what you have learned in a real-world setting immediately. Call Sober Life today at (619) 542-9542.
