Trauma Treatment: EMDR
Eye movement Desensitization Reprocessing (EMDR)
Once considered unorthodox, eye movement desensitization reprocessing (EMDR) has earned accolades as an effective trauma treatment for adults, youth and children, supported by more than twenty randomized controlled studies, and is now considered one of the two preferred trauma therapies recommended by the World Health Organization (Farkas, Cyr, Lebeau, & Lemay, 2010; Marich, 2017; Van Bennekum, 2013). EMDR is one of the most researched trauma-specific modalities to date, and I am happy to now offer this treatment to clients. EMDR is effective in the treatment of what is considered big T traumas (for example: war, sexual assault, abuse, car accidents), as well as small t traumas (bullying, divorce, job loss, et cetera).
Trauma is defined as any event that causes an unusually high level of emotional distress and has a long lasting adverse effect on that person (Briere & Scott, 2015). Small t traumas do not imply that the emotional impact of an event is insignificant compared to that of a big T trauma; the emotional wound can be just as enduring as that experienced in a big T trauma – “trauma” is a person’s perception of an experience (Marich, 2017). Just as one’s perception of trauma is unique to them, so too is memory reprocessing and resolving of traumatic memories.
How does it work?
EMDR works on the premise that within individuals there is a physiological information processing system through which new experiences and information are normally processing to an adaptive state (Schubert & Lee, 2009). The hippocampus helps to store the information in the memory networks (Banich & Compton, 2011). For victims of trauma, memory networks can be disrupted by the amygdala (one’s “threat system”) and stops the brain from processing information; the amygdala cannot always discern between real or perceived dangers, causing inaccurate hypervigilance responses for PTSD victims (Dunne & Farrell, 2011). Because the amygdala is active, access to the hippocampus is impeded, creating the brain to be “stuck” with traumas from the past, while new memories cannot be properly processed (Banich & Compton, 2011; Shapiro, 2007). What EMDR sets out to do is help the brain become “unstuck”, by clearing the brain pathways to better access information processing, problem solving, and reasoning (Sadock & Sadock, 2007). EMDR therapy involves a bilateral stimulation of the left and right hemispheres of the brain that allows for disturbing information to be reprocessed, thus enabling the individual to attain a healthy state of emotional calm (Bilal et al., 2015; Dunne & Farrell, 2011: Gillman, 2016). This bilateral stimulation is achieved through one or all of three stimulations of eye movement, bilateral sound, or bilateral tactile; this allows the debilitating stored information to be reprocessed (Bilal et al.; Farkas, Cyr, Lebeau, & Lemay, 2010).
- Efficacy of EMDR can be achieved in a relatively timely manner and because therapy duration is shorter than traditional psychotherapy, it can be cost-effective.
- A major benefit of EMDR is that the client does not have to discuss any of his/her disturbing memories in great detail; memories can be shared in general terms with the clinician and still be effective (EMDR Network, n.d., para. 2).
- In addition to the treatment of PTSD, the techniques of EMDR also help with emotions and feelings associated with the traumatic event such as psychiatric disorders, physical challenges, and common emotional problems and life challenges such as depression, loss of pleasure in previously enjoyed activities, low self-esteem, and performance anxiety (Bilal, et al., 2015).
- EMDR mobilizes a client’s own inherent healing ability, and it can be used effectively without limitations of a client’s age, gender or culture (Bilal, et al., 2015; Dunne & Farrell, 2011; Farkas, Cye, Lebeau, & Memay, 2010).
- EMDR has universal appeal, as diversity of clients or their presentations does not alter treatment efficacy; intervention is customized to the individual needs of the client based on the specific personal problems (Dunne & Farrell, 2015).
- Akin to any form of trauma treatment, EMDR requires a client to confront painful thoughts and feelings, and reopen old wounds, and since everyone responds differently to therapy, some clients may respond adversely. Some clients may continue to process trauma after an EMDR session, causing distress (it is prudent for the client and therapist to have strategized coping and calming techniques in case of this occurrence).
- While EMDR is successful for many, it does not work for everyone, particularly those with comorbid presentations such as personality disorders (Schottenbauer, Glass, Arnkoff, & Gray, 2008).
- Research suggests that nearly one-fourth to one-third of clients treated do not experience benefits of EMDR; however, it is hypothesized that comorbidity and complex trauma may impede favorable treatment results (Edmund & Rubin, 2004; Scottenbauer, Glass, Arnkoff, & Gray, 2008).
EMDR has the power to heal, empower, and restore hope to individuals plagued by a variety of trauma experiences. While EMDR was considered cutting edge when first introduced by Shapiro in 1989 (Van Bennekum, 2013), I view the power of bilateral stimulation as a resurrection of ancient wisdom, rather than a creation of something brand new. For centuries, tribal ceremonies for grief and loss included ritualistic dancing and drumming, which echo the healing effects of bilateral stimulation Shapiro aimed to harness with EMDR, first with eye movements, and then with auditory stimulation and alternate tapping. Researchers still cannot explain the precise underlying mechanisms of EMDR, and the specific mechanisms through which PTSD develops and resolves are not entirely understood yet either. Additionally, there is no current theory adequately accounts for and explains the phenomena encompassing PTSD (Schubert & Lee, 2009). This, of course, is of little consequence for the infinite number of clinicians and clients who state that EMDR is as effective and possibly more effective than other treatments for PTSD and is more preferred by those who have tried it (Sadock & Sadock, 2007).
If you are curious if EMDR is right for you, contact me at: