Eye-movement, desensitisation and reprocessing theory, or EMDR, is a time-limited therapy that is recommended as an alternative choice to Cognitive Behavioural Therapy for the treatment of post-traumatic stress disorder (PTSD). EMDR uses eye movements to help your brain connect useful information e.g. the fact that the traumatic experience is over now, with old memories of traumatic experiences. This serves to reduce the impact of the old memories, which can make you feel as if the trauma is happening again right now.
- Aim: To reduce the ‘now-ness’ of unprocessed trauma memories and update with important information that may be useful in being able to put the trauma in the past where it belongs. It does not aim to erase trauma memories, but to take the ‘sting’ out of them so that they can be remembered without distress.
- Most helpful for: people who have experienced a single traumatic event in their adult life that they are having trouble getting over. Usually symptoms will have a significant impact on your ability to function as you used to in your day to day life. This may be because you avoid many things that remind you of the trauma, or because you are highly reactive to situations that you used to be able to manage; for example, experiencing ‘flashback’ memories or significant anxiety or irritability in response to triggers.
- Less likely to be helpful (in a brief therapy service) for: people who have experienced long-standing extensive abuse, especially in childhood. People who struggle to tolerate distress and are unwilling to think about the traumas in detail yet. People who are using high levels of substances or self-harming to cope with distress.
- What is it?: EMDR is an emotion-focused therapy designed specifically for the treatment of post-traumatic stress disorder [PTSD]. It has been shown to be as effective as Cognitive Behavioural Therapy in treating trauma. Increasingly it is being used to treat other anxiety disorders where their origins can be traced to a specific incident.
- What is talked about in EMDR? In the first few sessions your therapist will ask you about your current symptoms, things that trigger them and how you cope. They will also want to know a bit about your history. You then learn some self-soothing techniques before beginning to process the worst memory. There is not a requirement to talk in depth about what you are experiencing. The therapist will check in often to make sure that the memory is processing but most of the time you will just be silent whilst the eye movements are occurring. You will have a debrief at the end with your therapist to discuss how the processing went and any new information or insights that you may have made.
- What about medication? Medication is commonly prescribed for managing moderate to severe PTSD, and there is no problem in taking appropriate medication whilst doing EMDR; as long as you are able to feel some emotions, processing can still take place. However, if you have been using benzodiazepines to manage the symptoms of PTSD you would be recommended to speak to your GP about alternative symptom management before being put forward for therapy.
- What can I expect to happen over the course of treatment? In a typical EMDR session you will be asked to bring to mind the worst moment of a traumatic experience and notice the feelings associated with that. When you feel connected to the memory, your therapist will then ask you to follow their fingers with your eyes. To an outsider, this might look like you are being hypnotised but you are not. You remain totally aware of where you are and what is going on at all times during this process. The movement of the eyes whilst you are thinking about the trauma helps your brain allow new, helpful information to come up and resolve the old distress. People find that emotions can come and go in quite an intense way during this process and your therapist will be there to help you manage that. Some people may notice an increase in symptoms during the first half of therapy. If you can tolerate that period, however, you will begin to notice that the memories become less vivid and the distress previously associated with them will be lessened.