Therapy Near Me Mental Health Articles

Introduction

Eye Movement Desensitisation and Reprocessing (EMDR) is a psychotherapy approach originally developed for post-traumatic stress disorder (PTSD). Since its introduction in the late 1980s by Francine Shapiro, EMDR has been evaluated across hundreds of studies and is now recognised as an evidence-based treatment for trauma and related conditions (Shapiro, 2018; Bisson et al., 2019).

Today, EMDR is used worldwide by psychologists, counsellors, and trauma specialists to treat PTSD, complex trauma, anxiety, depression, and phobias. This article explains what EMDR is, how it works, the research evidence, and what to expect if you begin EMDR therapy.

1. What is EMDR therapy?

EMDR is a structured therapy designed to help people process distressing memories and traumatic experiences that remain “stuck” in the nervous system.

• Developed by Francine Shapiro (1989).
• Involves recalling traumatic events while engaging in bilateral stimulation (e.g., guided eye movements, tapping, or auditory tones).
• The goal is to reduce the emotional intensity of traumatic memories and support adaptive reprocessing (Shapiro, 2018).

Key feature: Unlike traditional talk therapy, EMDR does not require detailed verbal descriptions of the traumatic event, which can make it more tolerable for trauma survivors.

2. How does EMDR work?

The exact mechanisms are still debated, but several theories explain how EMDR reduces trauma symptoms:

1. Working memory hypothesis: Bilateral stimulation taxes working memory, reducing the vividness and emotional charge of traumatic memories (van den Hout & Engelhard, 2012).
2. Neurobiological processing: EMDR activates brain regions involved in memory reconsolidation, enabling traumatic material to be reprocessed in adaptive ways (Pagani et al., 2017).
3. Dual attention model: Clients focus simultaneously on the traumatic memory and an external stimulus (e.g., eye movements), facilitating desensitisation (Shapiro, 2018).

3. What conditions can EMDR help with?

a) Post-Traumatic Stress Disorder (PTSD)

EMDR is most strongly supported for PTSD. Multiple meta-analyses show that EMDR is as effective as trauma-focused CBT and sometimes faster (Watts et al., 2013; Cusack et al., 2016).

b) Complex trauma and childhood trauma

EMDR has been adapted for survivors of prolonged abuse or neglect, often used alongside stabilisation techniques (Cloitre et al., 2012).

c) Anxiety and phobias

Studies show EMDR can reduce specific phobias and panic symptoms by reprocessing the core fear memories (de Jongh et al., 2019).

d) Depression

Emerging evidence suggests EMDR may benefit depression linked to trauma or adverse life events (Hase et al., 2015).

e) Other applications

EMDR is being trialled for addictions, grief, chronic pain, and performance anxiety, though evidence here is less robust (Valiente-Gómez et al., 2017).

4. What happens in an EMDR session?

EMDR therapy is typically delivered in 8 phases (Shapiro, 2018):

1. History-taking: Therapist assesses trauma history and suitability for EMDR.
2. Preparation: Client is taught grounding and self-soothing strategies.
3. Assessment: Specific traumatic memory is identified, with associated thoughts, images, and body sensations.
4. Desensitisation: Client recalls the trauma while following eye movements or bilateral stimulation.
5. Installation: Positive beliefs are strengthened to replace negative trauma-related cognitions.
6. Body scan: Client checks for residual physical distress.
7. Closure: Therapist ensures client returns to a state of calm.
8. Re-evaluation: Progress is reviewed in subsequent sessions.

5. Evidence and clinical guidelines

• WHO (2013): EMDR recommended as a first-line treatment for PTSD.
• NICE (UK, 2018): EMDR is recommended for adults with PTSD when trauma-focused CBT is not tolerated.
• Meta-analyses: EMDR is highly effective for reducing trauma symptoms, often with fewer sessions than traditional therapy (Watts et al., 2013; Bisson et al., 2019).

6. Benefits of EMDR

• Effective in reducing flashbacks, nightmares, and hyperarousal.
• Often shorter duration than CBT for trauma.
• Does not require prolonged verbal retelling of traumatic events.
• Can be adapted for children and groups.

7. Risks and limitations

• Distress during sessions: Processing trauma can temporarily increase anxiety.
• Requires specialised training: Not all therapists are properly trained; choosing a credentialed EMDR practitioner is essential.
• Evidence strongest for PTSD: Applications to depression, pain, or addiction are promising but less conclusive.

8. EMDR and mental health in Australia

In Australia, EMDR is increasingly recognised in clinical practice:

• Many psychologists list EMDR under Medicare-rebated sessions for PTSD and trauma.
• The Australian Psychological Society acknowledges EMDR as an evidence-based trauma treatment.
• EMDR training is provided by EMDR Association of Australia (EMDRAA).

FAQs

Q: Is EMDR effective?
Yes. EMDR is strongly supported as a treatment for PTSD and is recommended by the WHO and NICE.

Q: How many EMDR sessions are needed?
On average, 6–12 sessions may be required, depending on trauma severity.

Q: Is EMDR better than CBT?
Both EMDR and trauma-focused CBT are effective. Some studies show EMDR achieves results in fewer sessions, though CBT has broader applications.

Q: Can EMDR treat anxiety or depression?
Yes, particularly when symptoms are linked to trauma, though evidence is strongest for PTSD.

References

• Bisson, J.I. et al. (2019) ‘Psychological therapies for chronic post-traumatic stress disorder (PTSD) in adults’, Cochrane Database of Systematic Reviews, Issue 12.
• Cloitre, M. et al. (2012) ‘The ISTSS Expert Consensus Treatment Guidelines for Complex PTSD in Adults’, Journal of Traumatic Stress, 25(6), pp. 399–408.
• Cusack, K. et al. (2016) ‘Psychological treatments for adults with posttraumatic stress disorder: A systematic review and meta-analysis’, Clinical Psychology Review, 43, pp. 128–141.
• de Jongh, A. et al. (2019) ‘The status of EMDR therapy in the treatment of specific phobias’, Journal of Anxiety Disorders, 66, pp. 102–110.
• Hase, M. et al. (2015) ‘EMDR therapy in the treatment of depression: A review’, Journal of EMDR Practice and Research, 9(4), pp. 179–195.
• Lambert, M.J. (2013) Bergin and Garfield’s Handbook of Psychotherapy and Behavior Change, 6th ed. Hoboken, NJ: Wiley.
• Pagani, M. et al. (2017) ‘Neurobiological mechanisms of EMDR therapy’, Frontiers in Psychology, 8, 1935.
• Shapiro, F. (2018) Eye Movement Desensitization and Reprocessing (EMDR) Therapy: Basic Principles, Protocols, and Procedures. 3rd ed. New York: Guilford Press.
• Valiente-Gómez, A. et al. (2017) ‘EMDR beyond PTSD: A systematic literature review’, Frontiers in Psychology, 8, 1668.
• van den Hout, M.A. & Engelhard, I.M. (2012) ‘How does EMDR work?’, Journal of Experimental Psychopathology, 3(5), pp. 724–738.
• Watts, B.V. et al. (2013) ‘Meta-analysis of the efficacy of treatments for posttraumatic stress disorder’, Journal of Clinical Psychiatry, 74(6), pp. 541–550.
• World Health Organization (2013) Guidelines for the Management of Conditions Specifically Related to Stress. Geneva: WHO.