Eye Movement Desensitization and Reprocessing (EMDR) therapy is increasingly becoming a more prevalent form of psychotherapy. Primarily used to treat post-traumatic stress disorder, EMDR therapy may have many additional applications, including treating patients with depression.
EMDR therapy may help decrease feelings of depression and anxiety. However, EMDR therapy can also briefly aggravate unpleasant feelings and emotions, especially during the first few sessions. Still, patients can enjoy fewer and less intense depression symptoms after multiple professional treatments.
Let’s explore what EMDR therapy is, how it works, and what benefits you can expect after undergoing EMDR therapy. We also need to address some of the potential side effects of EMDR therapy. This information can help you decide whether EMDR therapy might be right for you.
What Is EMDR Therapy?
EMDR therapy is a type of psychological therapy (psychotherapy) used to help treat individuals with post-traumatic stress disorder (PTSD), major depressive disorder (MDD), and generalized anxiety disorder (GAD).
It is also used to help patients work through recent traumatic episodes, stress, and addictions. Unlike other forms of psychotherapy, EMDR sessions focus on an individual’s feelings, not their memories.
For example, a person undergoing EMDR therapy might describe a past trauma and how it made them feel. The therapist then prompts the individual to discuss the feelings they experience when thinking about this unpleasant event.
By addressing these negative feelings and discussing them in greater detail, therapists aim to identify the emotion’s current utility. Emotions that don’t serve the patient are eliminated throughout several sessions and replace with positive feelings and thoughts.
In this way, EMDR therapists help patients identify their most distressing emotions and thoughts. They then guide these patients through the process of surrendering these unhelpful emotions, eventually replacing them with positive feelings and thoughts.
What Are the Benefits of EMDR Therapy?
There are three primary benefits of EMDR therapy. Generally, EMDR therapy may be able to help lessen:
- Anxiety
- Depression
- PTSD Symptoms
EMDR therapy might also help individuals with addictions overcome their substance dependencies. But we’ll need to take a closer look at how EMDR therapy works to understand how it can produce these benefits.
Unlike cognitive behavioral therapy or psychoanalysis, EMDR is one of the lesser-known types of psychotherapy. Fortunately, you don’t need to have a doctorate in psychology to understand how EMDR therapy works—But you will need a basic grasp on the fundamentals of trauma and how it changes us.
Trauma, Memory, and Emotion: The Three Keys to Understanding EMDR
We’ll need to address trauma, memory, and emotion before discussing the inner workings of EMDR therapy. That’s because EMDR therapy is a treatment designed to treat symptoms of trauma.
In many cases, these symptoms are caused by repressed or unprocessed memories and emotions relating to past traumatic experiences. When we examine trauma and its relationships with our memories and emotions, we can understand how EMDR therapy works and why it might be an excellent solution.
We can also begin spotting instances where EMDR therapy might not be the best idea, helping patients avoid unnecessary or unhelpful treatments. Without further ado, let’s talk about trauma.
Trauma
Trauma is described as an emotional reaction to adverse events. These events or stimuli can be incredibly diverse, and some things that may not seem traumatic to some individuals can be pretty significant to others. Still, some of the most common traumatic events include:
- Death of loved one
- Domestic abuse or violence
- Community disasters or violence
- Major illnesses and injuries
- Car accidents
Children exposed to repetitive traumatic experiences may develop inappropriate coping mechanisms or struggle with powerful emotions as adults. These life-changing, devastating experiences can change the way our brains work, leading to emotional disorders later in life.
However, children aren’t the only ones prone to trauma. Adults can also experience trauma and be changed by it. Those working in the police force, health care industry, or military are often prone to traumatic episodes.
Processing the emotions that go along with traumatic experiences can be particularly challenging. In many cases, trauma can initiate an emotional shock response. When this happens, your body enters a fight-or-flight mode designed to help you survive.
Over time, this extended stress response can make you feel exhausted, confused, and depressed. It may also change your ability to form new memories and recall past ones. Sometimes, the memory of traumatic events remains unprocessed, occasionally leading to repression.
These ‘forgotten’ memories might not cause emotional pain directly, but they can change how we perceive current and future events. As such, it’s crucial to examine trauma and its relation to memory.
Memory
You might assume that trauma only affects a person’s emotional memory. However, trauma can negatively impact several types of memory. To understand this better, let’s consider an example.
Let’s say that Susy was verbally abused for wanting ice cream when she was a child. As an adult, Susy may avoid buying or consuming ice cream. The sight of ice cream, or advertisements for ice cream, could make Susy’s muscles tense up.
Her heart may begin to race. She may express hatred toward ice cream and feel angry with others when she sees them eating ice cream. Though these responses don’t seem to make logical sense to Susy, she cannot help but experience them. That’s because Susy has underlying trauma stemming from those initial childhood encounters.
A therapist may attempt to help Susy lessen her discomfort surrounding this trauma in several ways, depending on their specialty. But no matter the type of psychotherapy, therapists generally try to identify the source of a patient’s trauma by exploring their memory.
However, many therapy types shy away from this practice, as re-telling traumatic stories can trigger strong emotional responses and potentially worsen feelings of depression or anxiety. Memories tied to traumatic events tend to be colored with emotion.
Emotion
Most of us would like to feel happy all the time. However, this desire is unreasonable. Life is full of events, people, and things that cause us to feel a wide range of emotions. It’s entirely normal to feel sad, anxious, or uncertain occasionally.
However, long-term feelings of depression or anxiety can be a symptom of past trauma. Individuals with PTSD may also experience ‘triggers,’ which cause past trauma to resurface unexpectedly. For example, soldiers returning home from war may panic after hearing a car backfire, as it sounds similar to a shot being fired.
One of the aims of EMDR therapy is to address the emotions we experience when we remember a traumatic event. It also helps patients work through negative emotions without having to revisit specific traumas.
Is EMDR Effective?
Though there is some controversy surrounding the effectiveness of EMDR therapy, many medical professionals agree that it is a worthwhile treatment option for individuals who have PTSD and related mental conditions, including depression and anxiety.
Unlike other types of psychotherapy designed to help treat trauma symptoms, EMDR doesn’t focus on having the patient relive or re-experience their trauma. Instead, it focuses on the emotions related to unresolved traumatic episodes.
In this way, EMDR therapy may be one of the best therapies for those struggling with intense emotions. Still, EMDR therapy is not without potential side effects of adverse reactions.
Are There Any Side Effects of EMDR Therapy?
As with counseling sessions, there are some short-term side effects of EMDR therapy that patients may find distressing. Some of the most common adverse side effects include:
- Intense emotional surges or outbursts
- Lucid dreaming
- The emergence of repressed memories
Still, it’s crucial to remember that these reactions are both normal and temporary. Repeated sessions should help reduce the intensity and severity of such troublesome effects, helping patients find a sense of peace and calm.
Being open and honest with your therapist is the best way to minimize adverse side effects. A professional psychotherapist will never push you past your comfort levels or put you into a dangerous emotional state.
EMDR therapy shouldn’t make you feel anxious. That said, it’s easy to feel uncertain about EMDR therapy if you’re unsure what to expect.
What To Expect With EMDR Therapy
Before you can decide if EMDR therapy is right for you, you’ll need to delve more deeply into what each EMDR session entails. Generally, EMDR therapy consists of eight distinct stages. You could summarize these eight stages as:
- History
- Preparation
- Assessment
- Evaluation
- Installation
- Body Scan
- Closure
- Reevaluation
Let’s take a closer look at each stage to discover what it entails and what you can expect. This way, you can feel more relaxed and confident about starting EMDR therapy.
The Institute for Creative Mindfulness has produced a practical video demonstration to show how EMDR therapy works, which may help you grasp these concepts a little better:
As with most medical procedures and psychotherapy sessions, everything begins with a comprehensive review of the patient’s medical and emotional history.
History
The first thing an EMDR therapist does is review their patient’s medical history. This helps the therapist identify trends, symptoms, and potential problem areas. They may also administer a specialized emotional inventory to gauge their patient’s current and past mental status.
Once the therapist feels they have a solid grasp on these essential aspects of the patient’s life and mentality, they invite the patient to an initial trust-building session. During this first treatment session, the therapist might introduce themselves, describe their treatment techniques, and familiarize them with EMDR therapy.
Preparation
During the preparation phase, the therapist and patient get to know one another. During these conversations, the therapist helps prepare the patient for further EMDR therapy sessions.
This includes describing the process of EMDR therapy in greater detail and exploring positive coping mechanisms that can help the patient face triggers in everyday life. The therapist may also recommend specific safety gestures and phrases that the client can use to end a session prematurely.
Such ‘stop words’ help patients retain a sense of control throughout each session, allowing them to relax. EMDR therapists also tend to discuss the patient’s symptoms and diagnoses. The primary goal of the preparation phase is to inform the patient and brace them for further sessions.
Assessment
During this stage, the therapist and patient work together to choose a particular traumatic memory that’s causing harm. This memory is often called the ‘target.’ This third stage of EMDR therapy is often one of the most challenging for patients, as it requires some focus on past traumas, which can cause feelings of anxiety, panic, and depression.
However, the goal of this step isn’t to have patients relive their worst experiences. In most cases, EMDR therapists won’t delve deeply into the patient’s chosen memory. Instead, the therapist may only ask the patient to select a traumatic memory rather than discuss it at length.
Once a target is chosen, the therapist guides the patient to focus on a particular image associated with the unpleasant memory. Once the patient has this specific mental image in mind, the therapist will ask what negative feelings the patient experiences when visualizing this image.
At this point, the therapist may begin to contradict the patient by introducing positive qualities relating to the image. By observing and recording the patient’s response and emotional intensity, therapists can assess their current sensitivity to the triggering memory.
Evaluation
This stage of EMDR therapy primarily focuses on evaluating the target memory and reducing the negative emotions associated with it. The therapist may ask the client to reimagine the image, then pull the client’s attention to their hands or a small rod.
The patient is then asked to keep the mental image at the center of their focus while also focusing their eyes on the therapist’s hands or a moving target. Inducing this type of rapid eye movement, therapists attempt to help patients disassociate their traumatic memory’s negative beliefs.
This stage also involves deep breathing exercises and some principles commonly found in meditation. For example, after each period of focus and rapid eye movement, the therapist will ask the patient to clear their mind and help guide them into a state of mental and physical calm.
Installation
The installation phase is closely tied to the evaluation phase. In many cases, these two stages are the longest-lasting parts of EMDR therapy. If the patient isn’t receptive enough yet, the therapist will not move into the installation phase.
Still, if the evaluation phase has elicited progress toward the installation phase, the therapist may begin guiding the patient through positive beliefs and affirmations relating to the target memory.
By discussing these beliefs and repeating them, therapists hope to ‘install’ positivity into a previously negative experience. This portion also relies heavily on rapid eye movement that’s guided by the therapist.
Body Scan
During this stage, the patient is asked to check in with their body and mind. This requires the patient to relax and focus on how their body feels. If they report feeling tension or pain, further sessions may be necessary.
An ultimately successful EMDR therapy session will leave patients feeling loose, limber, and relaxed. Still, many therapists begin the body scan process by reinforcing positive affirmations and beliefs. This small action may help patients wind down and reach a sense of peace.
Additionally, some EMDR therapists may give their patients a verbal questionnaire to gauge their current sense of confidence, fear, hope, and despair. Not only can this help therapists assess the patient’s mental state, but it can also help patients learn to become more self-aware of their thoughts and emotions.
Closure
This penultimate stage is a further step that can help clients process their emotions and thoughts between sessions. Therapists may recommend specific coping mechanisms or techniques to help patients remain calm throughout the week or month.
Patients may choose to keep a diary of their emotions and thoughts that they can share with their therapist at the next session. EMDR therapists often recommend keeping such a journal or record, as it’s a fantastic way to continue building a stronger sense of self-awareness.
Reevaluation
Finally, the therapist will reevaluate the patient to measure their progress and identify additional triggers or targets. This final step ensures that patients are never left feeling as though their treatment is unfinished or unsuccessful.
Because many patients with trauma-related disorders have difficulties trusting others, therapists must follow through with a proper post-closer reevaluation. Otherwise, patients can develop emotional trauma relating to therapy and decide to avoid further sessions.
Can EMDR Therapy Decrease Depression?
The bottom line is: Yes, EMDR therapy can help decrease depression. Many people who’ve tried EMDR therapy have reported lessened feelings of sadness, depression, and anxiety.
However, EMDR therapy isn’t 100% effective at treating major depressive orders. Some patients may not experience as many positive benefits as others. As such, it’s crucial, to be honest about your feelings and experience when trying EMDR therapy.
If you sincerely feel a noticeably positive difference in your outlook and mental status, then EMDR therapy might be the best solution. However, if you’re not responding well to EMDR therapy, you may want to seek alternative forms of depression treatment.
Conclusion
EMDR therapy is a relatively novel form of psychotherapy. Its primary purpose or application is treating patients with PTSD, depression, and anxiety. However, EMDR therapy may be used as a treatment for a wide range of trauma-based conditions.
This therapy type relies on our current understanding of trauma and how traumatic events affect our memory and emotions. While EMDR therapy can briefly increase the intensity or incidence of negative emotions, it’s often far less emotionally disruptive than other forms of psychotherapy. As such, it could be an excellent treatment for those with depression.