What the Heck is EMDR and is it Effective?

by Monica Ross

“Memory is an experience in the past that shapes us in the present and influences how we will act, think, and feel in the future.” --Daniel Siegel EMDR stands for Eye Movement Desensitization Reprocessing. The desensitization part refers to the deescalation of the intensity of disturbance surrounding a traumatic memory. The reprocessing part refers to the cognitive shift that comes when the client completes the process of desensitization.

This shift in cognition often creates deeper insights about the trauma and how it relates to present day. Again, the goal of EMDR is not to erase traumatic memory as much as it is to neutralize it and reprocess or repurpose it.  This involves taking the negative thought or cognition that comes along with the image of the event--that negative thought that we believe to be true about ourselves based on the experience, and turning it into something else.

What it becomes is something that the client would like to believe to be true about themselves instead.  This new belief is more firmly rooted in reality. By undergoing this process the client makes the traumatic event serve a more useful purpose and reconnects to their truth.

I am participating in a weekend workshop this weekend on EMDR here in Austin, TX with Rick Levinson, LCSW. Some of the information in these next series of postings that describe the workings of memory and inner structures of the brain will come from information that I glean there. This is part one of three that I'm doing on EMDR.

The workshop this weekend was a refresher for me as I completed the training for EMDR last year at Rick’s workshops in Houston. But I wanted to dedicate some time on my blog to talking about EMDR as a mode of therapy. It is one of the modalities that I use in my practice in addition to CBT or Cognitive Behavioral Therapy.

EMDR has been around for over 25 years. Francine Shapiro, PhD developed it as a way of treating trauma back in the late 1980s. The story goes that she was in a park watching a tennis game and tracking the movement of the ball on the court back and forth and noticed how her own negative emotions decreased as her eyes tracked the rhythmic movement of the ball.

She proposed that there is something going on with the brain and with the eyes specifically that must create this effect. Our brains take in 80% of sensory information through the eyes. When we go into REM sleep or the rapid eye movement cycle of sleep our eyes moves rapidly. So to say that eye movements are are an important sensory component and are somehow significant for the brain’s processing of information is an understatement.

EMDR creates a state similar to the REM cycle of sleep and similarly helps with the brain’s processing of information. That is the best attempt we have at explaining why it is effective. Here are some other hypothesized mechanisms of action.

There are over 500 psychotherapeutic modalities. University of Scranton psychologist John Norcross is the one who gives this estimate. And so, as therapists, we are told not to go out and learn all 500, but instead to pick the ones that we feel we want to incorporate into our practice.

The reason for this approach in acquiring therapeutic skills is that it is not the mode of therapy, research shows, that facilitates change but more the relationship between the therapist and the client that is the most effective change agent.

I first heard of EMDR while living in San Diego, CA. I had a friend who told me that she had gotten through a period of agoraphobia by utilizing EMDR therapy.  I later moved to Austin and found a plethora of EMDR therapists.

The EMDR International Association headquarters themselves here in Austin.  And back in 2012 or so I underwent EMDR treatment and I personally found it effective. This led to my interest in furthering my training in it.

Search the internet for articles on EMDR and all kinds of articles referring to the controversy surrounding it will pop up. A quote from university Harvard psychologist Richard McNally about EMDR goes like this “What is effective in EMDR is not new, and what is new is not effective.” Ouch.

But let’s keep in perspective that McNally said that back in 1999 before a number of studies have come out on EMDR. Much of those studies and that research can be found here.

In addition, much of what we use in therapy across all of these modalities is cross-referential. What I mean by that is that many therapists, myself included, like to call ourselves "eclectic" stating that we use an integrated approach. We say this because we recognize the benefits at times of using different approaches and techniques and also the similarities between approaches and techniques across modalities.

For example, EMDR works with positive and negative cognitions as I mentioned above.

Well positive and negative cognitions are the foundation of Cognitive Behavioral Therapy as well. We also ask the client in EMDR to do a body scan and to notice where feelings may come up for them that may be stored in different parts of their bodies.

There is a mode of therapy called Somatic Experiencing, which also focuses on body awareness. And I could go on and on. But let’s fast forward though now to 2017 and what is going on in the field today.

“The Department of Defense recommends the usage of EMDR in treating veterans....The American Psychiatric Association has stated that SSRI’s, CBT, and EMDR are recommended as first-line treatments of trauma.  Most recently, the World Health Organization (2013) has stated that trauma-focused CBT and EMDR are the only psychotherapies recommended for children, adolescents, and adults with PTSD.”  This comes from the EMDR Institute’s website with references cited there.

Okay, so now that I have addressed the controversy let’s move on to talk more about EMDR the mode of therapy itself. Clinicians use EMDR primarily for people who have dealt with trauma with a big “T” in their lives like car accidents, deaths of a primary caregiver, and sexual assault, among other types of big “T” trauma.

We also use EMDR with people who have experienced trauma with a little “t” like minor emotional injuries. These traumas with a little “t” over time can cumulatively amount to a major trauma.