Eye Movement Desensitization and Reprocessing (EMDR) for PTSD
Eye Movement Desensitization and Reprocessing (EMDR) is a trauma-focused psychotherapy that is one of the most studied treatments for PTSD. A large number of studies demonstrate it is effective to treat PTSD when administered over approximately 3 months. EMDR has the strongest recommendation for being an effective treatment in most clinical practice guidelines for the treatment of PTSD.
EMDR is based on the theory of Adaptive Information Processing (AIP; 1). According to AIP, humans process new experiences by connecting and integrating them with related emotions and information in existing memory networks. This helps individuals to make sense of their experience. Useful new information is added to existing memory networks (i.e., learning), and extraneous material is discarded. PTSD can occur when an experience is inadequately processed and is consequently stored dysfunctionally. The original, often fragmented perceptions of the stressors are not integrated with other memories, but rather held separately in a state-specific form with the original distress, making it difficult to resolve the distress.
PTSD symptoms are considered to result from the activation of these inadequately processed memories. Grounded in the AIP model, the goal of EMDR is to first access this inadequately processed information, then use alternating bilateral stimulation to re-stimulate the ability to process distressing events. This allows the memory to become integrated into the patient’s larger memory system which enables reduction of PTSD symptoms (1).
How Does It Work?
After trauma, people with PTSD often have trouble making sense of what happened to them. EMDR helps you process the trauma, which can allow you to start to heal. In EMDR, you will pay attention to a back-and-forth movement or sound while you call to mind the upsetting memory until shifts occur in the way that you experience that memory and more information from the past is processed. Although EMDR is an effective treatment for PTSD, there is disagreement about how it works. Some research shows that the back and forth movement is an important part of treatment, but other research shows the opposite.
What Can I Expect?
During the first stage, you will learn about physical and emotional reactions to trauma. You and your provider will discuss how ready you are to focus on your trauma memories in therapy. To prepare, you will learn some new coping skills. Next, you will identify the “target”, or the upsetting memory you want to focus on–including any negative thoughts, feelings and bodily sensations related to the memory. You will hold the memory in your mind while also paying attention to a back-and-forth movement or sound (like your provider’s moving finger, a flashing light, or a tone that beeps in one ear at a time) until your distress goes down. This will last for about 30 seconds at a time, and then you will talk about what the exercise was like for you. Eventually, you will focus on a positive belief and feeling while you hold the memory in your mind. Towards the end of treatment, your provider will re-assess your symptoms to see if you need to process other targets.
Is It Effective?
Yes, trauma-focused psychotherapy (including Eye Movement Desensitization and Reprocessing) is one of the most effective types of treatment for PTSD.
What Are the Risks?
You may feel uncomfortable when focusing on trauma-related memories or beliefs. These feelings are usually brief and people tend to feel better as they keep doing EMDR. Most people who complete EMDR find that the benefits outweigh any initial discomfort.
Group or Individual?
EMDR is an individual therapy. You will meet one-to-one with your provider for each session.
Will I Talk in Detail about My Trauma?
No, in most cases you will not be asked to talk about the details of your trauma out loud. But you will be asked to think about your trauma in session.
Will I Have Homework?
No, EMDR does not require you to complete homework or practice assignments between sessions.
How Long Does Treatment Last?
About 1-3 months of weekly 50-90 minute sessions. But, many people start to notice improvement after a few sessions. And the benefits of EMDR can last long after your final session with your provider.
Source: https://www.ptsd.va.gov/understand_tx/emdr.asp