Eye Movement Desensitisation and Reprocessing (EMDR)
Eye movement desensitisation and reprocessing (EMDR) is a therapeutic process used to treat psychological traumas, such as war experiences, natural disasters, road accidents and assault, though it is increasingly being used in other situations too. People may develop PTSD (post-traumatic stress disorder) from a range of life experiences. However, EMDR has been shown to be more effective for event-specific trauma rather than complex trauma such as chronic neglect or abuse.
The theory is that after a distressing event, a person may feel overwhelmed and unable to process the information like a normal memory. EMDR uses bilateral eye movements to help the client process memories.
Developed by Francine Shapiro in the 1980s as a treatment for PTSD, the bilateral stimulation of the eyes while focusing on a traumatic memory can help reduce its emotional impact.
EMDR follows an eight-phase protocol, detailed below.
The stages of EMDR
History and treatment planning
This includes a discussion of the issue/event which has bought the client to therapy
Preparation
For many clients this can take as little as 1-4 sessions, for others it may be much longer. The duration of this stage is tailored to the client's needs and the aim is to build a relationship of trust between the client and therapist.
Assessment
During this phase, the client is asked to identify a specific image associated with the event discussed in stage one. The client is asked first to choose a negative self-expression such as 'I am in danger', 'I am bad' and to find the positive expression to oppose it: 'I am safe', 'I am good'.
In brief, the idea here is to help the client become comfortable with the idea that the negative association is in the past, though it may feel locked in the present, and that the positive affirmation is actually more suitable to the present moment.
Desensitisation
This stage deals with the clients responses as the identified issue changes and its disturbing elements are resolved.
Installation
This stage aims to solidify the positive belief that the client has identified to replace their original negative belief.
Body scan
After the positive belief has been installed, the therapist will ask the client to bring the issue to mind, to see if there is any residual tension in the client's body.
If so, the aim is to take these physical sensations and memories and translate them to a verbal mode of expression, thus resolving the physical sensations and memories associated with the traumatic event.
Closure
This stage, which ends each session, ensures the client is leaving the therapy session feeling better than they did before
Re-evaluation
This stage opens each new session. The therapist uses it to assess whether positive changes have been maintained and whether there are any new issues to address.
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Why does EMDR work?
In order to understand how and why EMDR works, we need to understand how the brain processes information and the impact of trauma.
Even though the traumatic event is in a person's past, the impact is very much in the present. Regular, non-traumatic memories are processed and stored without any effort. They also become part of a network, linked to other memories. Traumatic memories are different.
During traumatic events, the brain goes 'offline' and disconnects what you are experiencing sensorily and what you store in memory as language. This is also partly why people can find it extremely difficult to articulate their traumatic experiences. It can feel like they literally don't have the words for their experience.
A traumatised person re-experiences the feelings, sensations, and sometimes images in the form of flashbacks, in the present day and their body responds as though they are currently experiencing the trauma again.
The traumatised person's brain hasn't processed the traumatic memory sufficiently; it's as though it is stuck and stored as a sensory memory rather than a factual memory.
The bilateral stimulation adopted during EMDR therapy helps to stimulate both sides of the brain and create new neural connections when thinking about the traumatic memory. This helps to transform the memory from its pure sensory form to a more logical, integrated form.
The aim of EMDR is thus to reduce the strong physical and emotional responses to a traumatic memory.
In EMDR sessions, the client doesn't even have to talk about the traumatic event if they don't want to. They can just keep it in their mind, and the therapy can still go ahead in the same way as if the therapist had been told about the event.
EMDR can be a shorter course of treatment, however it can also be emotionally intense. You may also experience dreams and nightmares after EMDR sessions as your mind continues processing.
EMDR may be used alongside other forms of more long-term talking therapy, like psychodynamic, person-centred, or integrative therapy.
Training as an EMDR therapist
Only professionals who are already qualified as counsellors, psychotherapists, psychologists, registered mental health nurses and psychiatrists with a lot of clinical experience can train as EMDR therapists. They must also have the full support of their clinical supervisor.
All members of the Welldoing directory are verified annually as members of reputable professional associations to ensure a high standard of training.
Relevant organisations
Last updated October 2024
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