A Complete Guide to EMDR (Eye Movement Desensitization and Reprocessing) Therapy by Dr Prem – The Concept, Stages, Benefits, Risks, etc

A Complete Guide to EMDR (Eye Movement Desensitization and Reprocessing) Therapy by Dr Prem

Have you ever felt like you are struggling to get past any gut-wrenching or traumatic life experiences? Does this feeling disturbs, or pain you still, or makes you feel incapable of building a quality life? If you said yes, then EMDR Therapy is your answer. What you feel can be the after-effects of trauma, which can be healed by this therapy. Keep reading to know everything about EMDR Therapy, its history, effectiveness, stages, aftercare, and a lot more in this guide.

This Guide Consists of the Following –

A Complete Guide to EMDR (Eye Movement Desensitization and Reprocessing) Therapy by Dr Prem – The Concept, Stages, Benefits, Risks, etc

The Concept – EMDR

Unhappy depressed woman turning her head and almost crying while a calm psychologist looking at herEMDR (Eye Movement Desensitization and Reprocessing) is a psychotherapy with an integrative approach. It has been extensively researched and proven to be effective for treating various traumas. EMDR process consists of standardized protocols with elements from different approaches. It has helped millions of people till now to relieve psychological problems and traumas resulting from disturbing life experiences.

This therapy works on the belief that our mind can recover from psychological traumas just like our body heals from physical traumas. For example, if a foreign object or constant external irritation festers the wound then it pains.This blockage prevents recovery, once it’s removed the wound healing resumes. Likewise, disturbing events can fester and cause suffering creating a block in the brain’s system. EMDR helps to remove and heal it.

History and Development of EMDR

EMDR Therapy was first developed by Francine Shapiro, an American Psychologist in the year 1987. It all started when she noticed that her eye movements appeared to reduce negative emotions associated with painful memories of her own. Shapiro conducted a scientific study in 1988 with trauma victims.

Her hypothesis stated that when a person experiences a distressed event or trauma, it overwhelms their normal coping mechanism and inadequately processes and stores it in an isolated memory network. This research was then published with a detailed explanation in the “Traumatic Stress” Journal in the year 1989.

She noticed her eyes moved involuntarily and rapidly when she had a disturbing thought associated with a distressing experience. Bringing these rapid eye movements under control voluntarily while having these thoughts decreased her anxiety. She speculated that traumatic psychological events disrupt the brain’s inhibitory and excitatory balance. Thereby, Shapiro developed EMDR Therapy to treatPTSD and other traumas.

Research and Evidence

substance abuseAccording to the Research Foundation of EMDR, over 30 studies have been documented in the last 30 years that show the effectiveness of EMDR Therapy. These studies were performed for mental issues caused by life-threatening accidents, sexual abuse/ rape, childhood trauma and neglect, combat traumas, substance abuse, anxiety, and depression.Some of these studies showed that 84-90% of victims with single trauma no longer had PTSD Symptoms after only 90 minutes of three EMDR Therapy Sessions.

Here is another report from another study of EMDR performed on single-trauma victims and multiple-trauma victims. It showed that after only 6 sessions of 50 minutes, 77% of multiple trauma and 100% of single trauma victims no longer had PTSD symptoms. A similar study performed on combat veterans, reported that most of these victims responded positively, wherein 77% of them were completely free from PTSD in 12 sessions.

According to a review of 15 studies performed in 2018 on children with PTSD that underwent EMDR therapy, showed reduced symptoms of PTSD and other trauma-related symptoms. Likewise, another study was performed involving EMDR therapy in 2019 on adults as an early intervention. It concluded that early intervention of EMDR significantly reduced traumatic stress symptoms and prevented them from becoming worse.

Currently, EMDR therapy is recognized and recommended as an effective PTSD treatment by the World Health Organization (WHO), the American Psychiatric Association (APA), the US Substance Abuse and Mental Health Services Administration, the International Society for Stress Studies, the US Department of Veterans Affairs and Defense, and many other national and international authorities as well.

How Does EMDR Therapy Work?

EMDR therapy works by accessing traumatic events through your memories combined with eye movements and guided instructions. This method helps in accessing those memories and reprocessing them, in order to “repair” the mental injury caused by them.

The EMDR process involves moving your eyes in a specific way as guided by your therapist with the goal to heal you from those negative or distressing experiences. The EMDR sessions are performed entirely based on the set of protocols of 8 stages to effectively activate the natural healing process of your brain.

What are the 8 Stages of EMDR Therapy? 

Neuron cells transmitting information.EMDR Therapy is designed with the intent to reboot your brain cells to reprocess traumatic or negative memories and develop healthy coping mechanisms to heal. This process is based on the concept that certain eye movements can help to significantly reduce the intensity of emotions, suffering, and pain caused by these memories.

There is a set of fixed protocols used to perform the therapy correctly. This includes the following 8 stages of EMDR Therapy:

1 . Gathering History & Treatment Planning –

The first stage of EMDR is taking a thorough medical history of the client to understand the trauma that affects you and your potential trigger points. Based on the gathered information, your therapist will plan out the goal of your treatment with sequential processing.

This step also determines whether or not the person is going to benefit from EMDR Therapy. Once the target memory is analyzed and prioritized, the therapist will proceed to the further stage.

2. Preparation of the Client –

In this stage, the therapist will begin to prepare and educate you about how the EMDR process. They will also teach you certain self-control techniques such as muscle relaxation, deep breathing, etc before starting to access the targeted distressing memory. The therapist will also provide an overview of the planned treatment.

Building a therapeutic alliance between the therapist and the patient is very essential at this point. This will establish a good rapport and help the patient feel supported throughout the therapy.

3. Identifying and Assessing Target Memory –

At this stage, the patient and the therapist work together to identify the memory that needs to be targeted. They will help the patient to also identify the most distressing image related to that memory. Imagery, beliefs, cognition, and body sensations are also noted and understood by the therapist on a diagnostic scale.

The therapist introduces the patient to positive beliefs to create a space of safety to counteract negative emotions resulting from the trauma. Subjective Units of Disturbance (SUD) are also measured to keep a track of the treatment’s progress further.

4. Desensitization and Reprocessing the Memory

This stage of therapy is dedicated to desensitization and reprocessing the targeted memory. The therapist asks you to focus on the image of the traumatic targeted image that evokes negative emotions while simultaneously making guided eye movements. You will be instructed to take deep breaths after each set of eye movements.

Depending on your responses and intensity of emotions related to accessed traumas, the therapist will adjust the eye movements. At any point inthe session, if the patient experiences an extreme outburst or distress, the therapist will guide and bring their focus back on breathing.

5. Installation of Positive Beliefs

After reprocessing the memory along with guided eye movements, your therapist will then work on deeply “Installing” positive beliefs in your thought process. This step basically helps to replace negative emotions with positive beliefs.

For example, if a person has experienced sexual assault as a child, their distress related to that memory will be replaced with the positive belief that they are safe now. This process is continued, till the feeling of anxiety and pain is reduced. Each set done in the therapy improves and strengthens the positive feelings.

6. Body Scan

Once the installation stage is efficiently done, the therapist will ask the patient to bring back the traumatic memory in order to identify if any residual trauma exists. The responses such as intensity of emotions, raised pulses, muscle tension, raised blood pressure, etc are measured again.

If the negative emotions and distress related to the event are still experienced by the patient, the therapist will continue with bilateral eye movements until improvements are noticed. The time of healing varies from person to person.

7. The Closure

This part of the therapy refers to reviewing and re-installing the previously learned stress reduction and relaxation techniques. First, your therapist will determine and ensure that the accessed memory is fully reprocessed, if not stress reduction techniques will be used to calm and stabilize the patient before the session ends.

The patient will be asked to keep a record of any disturbances, bad dreams, uncomfortable sensations, negative feelings, etc experienced after the session.  The learned techniques will help the patients to return to a state of equilibrium in case any of the mentioned things are experienced till the next session.

8. Revaluation

At the end of the session, the patient and the therapist will evaluate the effectiveness of the therapy. Further sessions and follow-ups will be planned if any distressing memory is left uncovered or requires to be healed. 

What Conditions Benefit From EMDR Therapy?

EMDR therapy is a new form of psychotherapy best known to benefit people with Post-Traumatic Stress Disorder (PTSD). Most of the research and studies of EMDR found to be an effective treatment for the following –

  • PTSD
  • Depression
  • Other forms of traumas
  • Anxiety Disorder
  • Stress-related Issues
  • Trauma from Sexual Assault

Other conditions that can benefit from EMDR Therapy are

  • Eating Disorders
  • Anxieties and Panic Attacks
  • Some types of Phobias
  • Chronic Medical Illness
  • Dissociative Disorders
  • Different types of Pains
  • Grief or Loss
  • Personality Disorders
  • Sleep Disorder
  • Substance Abuse or other Addictions
  • Violence and Abuse

Are There any Side Effects of EMDR Therapy?

Lonely sad man staring outside house balcony feeling depressed distress and miserable.

  • Potential side effects of EMDR Therapy include emotional distress. This can be experienced by an individual when they re-visit or re-experience the traumatic event during the session. This distress is typically short-lived only, as it can occur because it can be emotionally difficult to access these memories.
  • However, even if a person experiences this, a skilled and trained practitioner can very well handle it with the use of safety protocols of EMDR to efficiently avoid this overwhelming distress.
  • Another potential side effect can include vivid dreams. Individuals undergoing EMDR are informed prior to the session about the possibility of experiencing vivid dreams after the session. This can happen because your mind may continue to process the accessed information or memory during the REM stage of your sleep.
  • EMDR therapy sessions are generally longer than any other traditional therapy sessions so that the person gets time to process the memory fully. However, these side effects can be said as a part of the process and do not occurinthe long term.

What Happens in the EMDR Session?

EMDR Therapy takes place in a therapeutical space that can be a specially designed area for EMDR or your therapist’s office. The environment and vibes of this space are always set welcoming and warm to make the patient feel comfortable.

During every EMDR session, depending on the phase/ stage of treatment an individual is in, the therapist guides you to focus on the memory that needs to be reprocessed. The therapist will ask you to just think about the event while you watch their hand as it moves across the field of your vision. These hand movements performed by the therapist stimulate rapid eye movements allowing you to process painful experiences.

These painful experiences and emotions are triggered, processed, and gradually but eventually reprogrammed and healed. The negative emotional traumas are replaced with positive emotions and empowered beliefs. Until that happens, the set of protocols is repeated including short breaks in between each set. During these breaks, your therapist will check in with your responses, intensity of emotions, and may ask you a series of questions to understand you better.

After several sets, once the distress related to the targeted memory reduces, the therapist will guide you to take your attention to the parts of memory that still needs to be healed. With this repetitive process, negative sensations are reduced. Now, at any point, if the patient gets too overwhelmed or pained, a qualified therapist will be able to gently bring their focus back on breathing and calm you.

Nevertheless, remember that the patient has full control to stop the procedure if needed and continue until the memory becomes less disturbing. EMDR Therapy will work best when an individual allows the EMDR Therapist to guide and help them. It is necessary for you to be mentally prepared for the session. The EMDR goal is to help you lead a healthy life with positive emotions, better perspectives, and sound understanding.

How to Prepare for Your First EMDR Therapy Session? 

Young frustrated man solving his mental problems while having therapy session with psychologistEMDR Therapy session involves a lot of mental and emotional effort and tolerance. The therapy is going to make you revisit experiences that may be extremely disturbing. However, in order to repair the trauma, it is necessary to reprocess these memories, which is why it is essential to prepare yourself for it. Preparing yourself can help you to go for your first EMDR Therapy session without much worry.

These are the following preparations you should consider:

  • Know What to Expect – Not knowing about EMDR therapy can create space for many surprises you may not be ready to handle. Visiting traumatic memories can get emotionally overwhelming, but knowing what to expect can help you to be mentally prepared and carry out the treatment effectively.
  • Find a Qualified and Trained EMDR Therapist – Your therapist is the most important aspect on which your treatment results depend. You must ensure the qualification, success rate, and authorization of a practitioner before undergoing EMDR. As therapy deals with traumatic experiences, incorrect implementation of protocols can result in worsening the case.
  • Remember, It’s Okay to be Vulnerable – This is your time to accept and let go of all the pains, fears, and negative emotions. It can be overwhelming at the start of your first EMDR Therapy session, but you will need to trust your therapist. Be vulnerable and go through the process openly to allow the treatment to work effectively.
  • Prepare Yourself for an Intense Emotional Experience – In order for EMDR Therapy to work, it is necessary to be prepared to experience intense emotions. Until a person is ready to confront traumatic memories, it will not be possible to reprocess them.
  • Plan to Rest Post-Session – It is highly advised to keep an entire day of your EMDR Therapy aside for complete rest. Your brain will require some time to rest and relax after processing such emotions during therapy. It is usually recommended to sleep to provide rest and soothe both body and mind.

Tips for EMDR Post-Procedure Care

Your therapist will provide you with some relaxation techniques and lifestyle changes if required. Taking care of yourself after the session is necessary to support and maintain a good emotional and mental state. These can be helpful to avoid any uncontrolled emotional outbursts.

Some of the tips for EMDR post-procedure care are:

  • Drink lots of water
  • Practice relaxation techniques learned previously
  • Keep away from stress and tensions
  • Practice Yoga or simple Meditation
  • Take proper sleep of at least 8 hours
  • Eat healthily
  • Choose an active lifestyle
  • Avoid toxic substances
  • Practice 5 senses mindfulness exercises
  • Start with a daily journal

EMDR Vs Hypnosis

 Hypnotic Treatment And Hypnotherapy

  • EMDR Therapy is sometimes confused with Hypnosis, however, these two therapies are not the same.While both are psychotherapies, EMDR and Hypnosis approach traumas much differently and also use different techniques to deal with related emotions.
  • EMDR therapy uses reprocessing technique repetitively that involves processing the disturbing event carefully till the negative emotions and distress that arise from trauma are significantly reduced.
  • Unlike EMDR, the Hypnosis process involves bringing a person into a hypnotic trance-like state while the therapist repeats one desired goal again and again, to directly set one positive belief deep within.
  • Both therapies arerequired to be performed only by a trained, qualified, and licensed therapist only. However, the training required for them is apparently different as well.
  • Another difference is the time required for the sessions. EMDR can last for as less as two sessions or more than 10 sessions depending on the individual’s response. However, Hypnosis does not last that long and can usually be done in two or three sessions.
  • While EMDR can be beneficial for people with multiple traumas, Hypnosis has been proven beneficial for treating single trauma at a time.
  • At the end of the day, both therapies have their own ways of effectiveness. It is advised to talk with your therapist to know which therapy can give you the best results depending on your goals and needs.

Does EMDR Therapy Work for Children?

EMDR is an evidence-based and effective therapy for treating children struggling with PTSD, dissociation, self-regulation, and attachment issues. Many negative emotions can form related to unpleasant, disturbing, or yucky events that they have experienced.

For example, it has often been seen that children blame themselves for their parent’s divorce and create an ugly image of self in their minds. Such kind of emotions, beliefs, and pain from disturbing experiences are processed and repaired in children with EMDR therapy. It has also shown effectiveness in reducing symptoms related to anger, depression, guilt, anxiety, and increasing self-esteem and confidence.

EMDR therapy is one of the two therapies recommended by the WHO (World Health Organization) for treating PTSD in adolescents, children, and adults. Among these two modalities of treatment, several researchers suggested EMDR therapy as significantly more efficient.

Below are the issues that can be addressed and healed with EMDR therapy for children:

  • Grief or Loss
  • Trauma/ Abuse
  • Separation Anxiety
  • Impulsivity or Tantrums
  • Family Separations or Divorce
  • Depression
  • Phobias or Nightmares
  • Natural Disasters
  • Abandonment
  • Accident Trauma
  • Natural Disasters
  • New Siblings
  • Yucky Feelings from other Traumatic Experiences

EMDR therapy has been beneficial, in particular, for adolescents and children due to its sequentially step-based stages/process. Many studies have reported that children as young as 3 years old can experience relief from disturbing symptoms caused by traumas. However, it is highly advised to find a well-qualified and experienced therapist who knows and is trained to work with children for EMDR therapy sessions.

Does EMDR Works For Everyone?

self-harming behaviorEMDR Therapy is not an appropriate solution for everyone. People with certain mental health problems and those actively intaking drugs, alcohol, or are engaged in serious self-harming behaviors are not recommended to opt for EMDR Therapy. It is required for a person to be willing to face intense and disturbing emotions and desire to heal.

However, people struggling with PTSD, depression, anxiety, or emotional disturbances that are caused due to serious accidents, abuse, or traumatic events can find EMDR therapy to be significantly helpful. With help of a trained and licensed therapist, you will be able to unlock the healing power of your brain and empower yourself!

What to Look for in Your EMDR Therapist?

  • Ask about their qualifications, experience, and credentials
  • Consider if the therapist is able to make you feel comfortable and safe
  • Check if they are involved in the ongoing advanced training and are updated
  • Know what types of clients they specialize in
  • Ask them about EMDR, their answer will give you an idea about their proficiency
  • Check if you are able to build a trustful relationship with them
  • Make sure you find your EMDR Therapist from a trustworthy source

Summary

EMDR therapy is an effective psychotherapy that involves guided eye movements toprocess, reprocess, and replace negative responses with positive ones. It has proven to be highly beneficial for people struggling with PTSD and other mental traumas and is suitable for all ages, including children. However, EDMR may not be recommended for everyone. Concerning your safety, it is advised to seek professional advice before opting for any therapies to ensure the right solution for you.

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