Did you know that at least one in 11 people will experience Post Traumatic Stress Disorder (PTSD) in their lifetime? Seeking trauma treatment is always tricky, as there are many treatment options available. But is EMDR an effective treatment that shows long-lasting results?
Eye Movement and Desensitization Reprocessing (EMDR) Therapy is the best treatment for those with PTSD because it produces long-term results. It focuses on reprocessing negative responses through neural pathways and reprogramming reactions to positive ones. EMDR can help reduce symptoms of anxiety.
If EMDR therapy sounds like something you’d like to know more about, then keep reading. We’ll give you a breakdown of the benefits, side effects, and whom EMDR therapy would benefit the most. Specifically, we’ll explain how EMDR treatment is an effective treatment for PTSD and other mood and trauma-related disorders.
What Is PTSD?
According to the American Psychiatric Association, PTSD may result from experiencing or witnessing a natural disaster, accident, war, rape, or being threatened with death, violence, or sex. PTSD brings intense thoughts, feelings, or experiences lingering after the event has occurred. People with PTSD often experience nightmares, flashbacks, or relive the trauma, even after time has passed.
To be officially diagnosed with PTSD, you must see a psychologist. The criteria for being diagnosed is being exposed to a traumatic event. However, this experience can be either firsthand or by simply witnessing a traumatic event.
Alongside that, you may experience physical and emotional reactions. Some of these symptoms may include being startled, on guard, self-destructive behavior, insomnia, lack of focus, and even overwhelming guilt or shame. Additionally, you may cope with increased anxiety, panic attacks, and anxiety attacks.
Diagnosis Criteria for PTSD
Of course, you can’t self-diagnose yourself with PTSD, as only a trained mental health professional can do that. However, you can look at the diagnosis criteria and let your psychologist know if you’re experiencing any symptoms.
Here is a summary of the DSM-V diagnostic criteria for PTSD:
You must have been exposed to death, been threatened, had a severe injury, or experienced sexual violence forced upon you. This can either be from direct exposure, witnessing, or learning about events to a family member or close friend. You may also have indirect exposure in rare cases, such as experiencing it through your professional duties.
One Intrusive Symptom
You’re re-experiencing the trauma multiple times through involuntary memories, nightmares, and flashbacks. You can also experience emotional distress or become physically reactive after the traumatic event. These occurrences are not related to drug use, medications, or side effects from other lifestyle choices.
Display One Characteristic of Avoidance
You’ll still experience trauma through either thoughts or feelings. You may also react negatively to external reminders. External reminders are people, places, or things that can trigger trauma or negative emotions.
Two Characteristics of Negative Alternatives in Cognition/Mood
You’ll experience negative thoughts or feelings, such as the inability to recall key features, negative thoughts about yourself or your surroundings, or the blade of yourself or others. Besides that, negative experiences can lead to decreased interest in hobbies, isolation, and struggling to feel positive.
Arousal and Reactivity
In this case, you’re experiencing changes in arousal and reactivity after a traumatic event. You may experience irritability, aggression, destructive behavior, or even hypervigilance. Additionally, you may have heightened reactions, difficulty concentrating, or insomnia.
Other criteria include symptoms lasting more than a month in duration. These symptoms must also create distress or impairment in your everyday life. However, they may not be the result of medication, substance abuse, or other mental illnesses.
What Treatment Options Are There for PTSD?
PTSD and other trauma-related psychological conditions require treatment with trauma-focused psychotherapies. These types of treatments focus on dealing with the traumatic event and any memories associated with it. Each treatment focuses on different techniques, including focusing on visualization, while others focus on talking.
There are three primary recommended psychotherapy treatments for PTSD:
Prolonged Exposure Therapy (PE)
Prolonged Focus Therapy focuses on gaining control over negative emotions and uses talking to help cope with trauma. However, you might also need exposure therapy to events or places that you’ve avoided.
The downside is that this therapy can be very stressful, and prolonged exposure can lead to heightened vulnerability and negative emotions. Outcomes of prolonged exposure include the ability to generalize certain people, places, or things to being safe, building a sense of control.
Cognitive Processing Therapy (CPT)
Cognitive Processing Therapy focuses on removing negative thoughts and replacing them with positive ones. This type of therapy mainly relies on talking and writing to help build positive emotions. The downside to this therapy is that it may be difficult for you if you aren’t comfortable with talking about traumatic events in detail. Outcomes for CPT include a more positive outlook and decreased feelings of anxiety, fear, and self-loathing.
Eye Movement Desensitization and Reprocessing (EMDR)
Eye Movement Desensitization and Reprocessing focus on reprocessing trauma and bringing your body back to its senses. This happens through a back-and-forth movement or sound that reprograms the eyes while briefly recalling the traumatic event.
The downside is that this treatment results in a heightened sense of awareness, which can last after treatment sessions. Outcomes of EMDR are to feel a strong sense of control and safety while also gaining a positive outlook and mentality for the future.
How Effective Is EMDR Treatment?
Taking a closer look at EMDR therapy, studies have found that it’s effective at helping those with mood disorders, psychotic disorders, and PTSD. A 2012 study found that EMDR treatment helped at least 77% of participants. After a full treatment of EMDR therapy, participants reported reduced anxiety, depression, and delusions.
Additionally, EMDR therapy had a lower dropout rate due to being less focused on talking. Participants felt more in control and comfortable during treatment than they had in other forms of psychotherapy because it felt less invasive. However, EMDR only works in certain situations.
Listed below are areas of practice where EMDR is an efficient treatment option:
EMDR Therapy for Panic Disorder & Agoraphobia
While one study found that EMDR was effective for both panic disorder and agoraphobia, it didn’t reveal conclusive results. Participants found significantly reduced symptoms, but the treatment wasn’t enough to determine effectiveness alone. However, paired with other therapies, EMDR can be an influential factor in your success.
EMDR Therapy for PTSD: Anxiety, Depression, and General Symptoms
Other than that, a few studies have found that EMDR therapy is suitable for long-term results. Unlike medications, EMDR therapy was found to be useful in the long term. In one study conducted, participants noted that they’d maintained their treatment, even at three to six-month follow-ups. Compare that to other forms of therapy where individuals feel uneasy speaking through the details of the traumatic event.
EMDR Therapy for Depression
Aside from just PTSD symptoms, EMDR therapy was also effective with symptoms of mood disorders. One of the symptoms EMDR helped was depression. In one study, 32 participants with signs of depression found that their depression was in remission after complete treatment. From the group, at least 68% of participants remained in complete remission.
EMDR for Affective Disorders
Another study suggested that EMDR therapy is an effective treatment for trauma-related symptoms, specifically manic and depressive symptoms. In 15 studies, researchers found that there were almost no side effects and that EMDR treatment helped reduce feelings of anxiety, depression, and bipolar mood swings.
History of EMDR Therapy
Francine Shapiro is known as the founder of EMDR treatment. She first discovered it back in 1989 while walking in a park. She noticed that her eye movement seemed to decrease her negative emotions.
With this theory in mind, she set her sights on testing if others had a similar response. After testing it on a few people, she then found out that the movement of the eyes shifting can help desensitize negative emotions. Although, just one session wasn’t enough to negate all negative emotions.
From there, she worked on implementing cognitive psychology into her treatment plan, which later became known as Eye Movement Desensitization (EMD). To fully ensure that EMD was effective, she used a controlled study. Out of 22 randomly assigned individuals, only half received EMD, while the others received imagery and detailed description instead of EMD.
What she found is that just one session of EMD treatment was able to desensitize traumatic memories. With five or more treatments, those who suffer from trauma could see a sufficient reduction in their trauma. Overall, she concluded that EMD treatment was enough to desensitize anxiety, but for patients with PTSD, five or more sessions were needed.
Shapiro wasn’t the only person to contribute to EMDR. Three other studies were published in 1989. This included Brom et al., Cooper and Clum, and Keane et al., who all compared EMD effectiveness against other reported treatments.
What was found is that EMDR was sufficiently effective at desensitizing patients. However, this was only after fourteen to sixteen sessions of treatment. Hence, multiple sessions were needed to be a successful treatment option for PTSD patients.
What Is the EMDR Therapy Process?
EMDR therapy includes eight phases of treatment. Unlike other forms of treatment, EMDR therapy also doesn’t have a set number of sessions. Each treatment plan is tailored to your exact needs. So, treatment can last from a few weeks to a few months, depending on your degree of trauma.
History & Treatment
During the first phase, you can expect to have one to two sessions discussing your history and past treatments. After discussing previous treatment, the psychologist will then work with you to develop a treatment plan. During this time, the psychologist will answer any questions or issues you have.
However, one of the unique features of EMDR treatment is that, as a patient, you don’t have to talk in detail about the traumatic event. Instead, you can provide very vague answers that don’t go too in-depth about what happened.
The second phase of EMDR therapy will last anywhere between one to four sessions. But if you’re suffering from a higher degree of trauma, it may take even longer than the four sessions. The main goal here is to properly prepare you while teaching specific techniques to help deal with emotional disturbances.
Once you master that, you’ll focus on building a stronger bond between yourself and the psychologist. Trust is vital to treatment, as a stronger bond will help you and your therapist feel at ease with one another. This also allows you to feel safe enough to provide all necessary feedback and feelings during treatment.
After that, the psychologist will explain EMDR, why it’s recommended, and a brief history of how it can be an effective treatment option. The psychologist will then ask if you have questions.
Once that’s done, the psychologist may teach you some relaxation techniques to remain calm.
During the assessment phase, you’ll select a specific image from the traumatic event. From there, you’ll come up with a personal statement that expresses that negative self-belief and where it’s associated with. You’ll then work with your psychologist to see how distressing the trauma was.
After that, you’ll choose a positive belief or statement. This statement can be as simple as “I am a good person, and I am in control” or “I am safe, and nothing can hurt me.” No matter the statement, this positive cognition will help you understand what is currently happening in the present moment. Then, you’ll use a Validity of Cognition scale VOC (1-7), with one being false and seven being entirely true if you believe the statement.
You’ll also identify the negative emotions and physical sensations you have with a target at this stage. This will be rated on a Subjective Units of Disturbance SUD (0-10) scale, and the higher you rate the feeling, the worse it is. This will help the psychologist better understand what you’re feeling right now.
During phase four, you’ll focus on the negative emotions and sensations you had during SUD training in the previous phase. This is key to allowing you to resolve some of the events if exposed to multiple possibilities. Some patients find that they initially completed more goals towards healing at this phase than they originally had.
Now the psychologist will switch to using desensitization techniques. During this time, the psychologist will lead your eye movements using either taps, sounds, or shifts in focus. You’ll use the SUD scale to assess progress. Once the response drops to lower levels, the psychologist will provide resolution of the target memory.
Here is a video from Konstantin Lukin, who is demonstrating the EMDR therapy process:
After desensitization, the psychologist will then switch to focusing on Installation. Installation is to learn how to concentrate and increase positive beliefs over negative ones. This is where your psychologist will use the VOC scale.
These next few sessions’ goal is to help you feel the max rating of seven, hopefully. However, this phase may take a few sessions. Additionally, not all patients can make it to the maximum rating because each patient is different and may not shed all negative feelings relating to the event.
After successfully bringing you to positive cognition, the psychologist will then assess your body. If there’s any physical stress remaining from imagining the traumatic event, they’ll also need to be reprocessed. Hence, EMDR treatment will continue until you have zero residual negative responses when recalling the event(s).
Closure isn’t precisely a phase in itself. Instead, closure happens at the end of each treatment session. Closure is designed to give you the time to voice concerns and explain if you feel better or worse after each session. The outcome of EMDR treatment is that you’ll feel at least a little better after each session.
If trauma isn’t addressed in a single session, the psychologist will implement self-calming techniques to help you gain safety. Additionally, the psychologist will brief you on what to expect between each session, recommending calming techniques to practice until next time.
Same with the last phase, reevaluation happens at the beginning of each session. The psychologist uses this time to address any concerns and adjust the treatment plan according to your needs. The reevaluation phase is vital for the success of treatment. Having too few EMDR treatments without fully getting rid of the trauma can cause it to affect you after sessions end still.
What Are the Benefits of EMDR Therapy?
EMDR therapy was initially designed to help those who’ve experienced traumatic events. Specifically, it’s been helpful for those who have Post-traumatic Stress Disorder (PTSD) and mood disorders.
It Doesn’t Require Talking
The most significant benefit of using EMDR therapy over other psychotherapy types is that it doesn’t require talking. If the particular trauma is hard to talk about, EMDR treatment doesn’t require more than a few details. This allows you to feel under control and won’t further your discomfort by talking about the event in detail.
Specifically, those who have PTSD may benefit because they won’t have to talk about what happened to them. This is useful for patients who have experienced a large amount of trauma from repeat events or domestic violence. It’s also been useful for young children and teens who haven’t learned how to express themselves through words fully.
Additionally, EMDR therapy is effective at reducing the following:
- Drug addiction
- Panic attacks
The Results Are Long-Lasting
Another benefit of EMDR therapy is that the results are long-lasting. Unlike medications or other forms of treatment, EMDR produces long-lasting results because treatments are tailored to you, the patient. Sessions also minimize talking about past trauma, which is helpful if you don’t want to talk about your trauma verbally.
If EMDR therapy did require talking, more patients would likely drop out, especially those triggered by certain words. This is why it’s beneficial to use EMDR rather than other forms of treatment, such as CBT or psychotherapy.
Another benefit of EMDR is that it produces long-lasting results compared to medications, which often only help manage symptoms but don’t generally fix the deep-rooted issues of PTSD. Hence, using other forms of treatment and EMDR is crucial to resolving the trauma.
Treatment Is Shorter
On top of that, EMDR therapy generally has a shorter duration for complete treatment than other psychotherapy techniques. For EMDR treatment, you can expect to receive 8 to 12 sessions lasting 90 minutes over three months.
Of course, this duration can range from patient to patient. Some will require more if they have more complex issues to work out during therapy. In comparison, others may only need a minimum of eight sessions to work through their trauma fully.
Compare this to other psychotherapy, which takes six months or more. CBT treatment can take up to four months of continuously weekly meetups. Cognitive Processing Therapy also takes up to 12 weeks. Lastly, prolonged exposure therapy takes up to three months with weekly sessions.
As you can see, some forms of treatment can end up taking longer to cure PTSD. That being said, EMDR doesn’t work for everyone. Hence, it’s important to choose a treatment plan based on effectiveness rather than treatment length.
It’s Effect for Resolving Symptoms
Lastly, EMDR therapy is highly effective for resolving symptoms by the end of treatment. Other forms of treatment may require follow-up sessions to help you maintain your results. However, EMDR therapy generally finds that patients are just as consistent with their results even three to six months down the line.
That being said, EMDR therapy is different for everyone. Most studies have found that EMDR therapy is only effective for specific symptoms. So, there is still speculation as to whether EMDR can help other types of issues long-term.
More studies still need to be conducted to determine if EMDR therapy is effective for agoraphobia, peak performance, and other mood disorder symptoms. However, it’s been proven through numerous case studies that EMDR treatment is highly effective at curing PTSD and other trauma-related issues.
Side Effects of EMDR Therapy
While EMDR treatment may be a good option for those who don’t want to talk, it does have possible side effects. Of course, these side effects aren’t as harmful as taking medications. However, they still should be carefully considered before starting treatment.
First off, EMDR therapy focuses on the neural pathways in the brain. Because of this, you may feel a heightened sense of awareness after a session of EMDR. During this time, you may be more susceptible to sensitivity and even lightheadedness. If the session is followed up with sleep, you may also experience more realistic and vivid dreams. This can be very triggering for those suffering from nightmare syndrome or PTSD.
Secondly, EMDR treatment could make some patients feel a heightened sense of vulnerability. Since EMDR therapy requires multiple sessions, you may feel easily triggered, which is especially true at the start of any treatment plan. For those with complex trauma, it may be better to seek other types of therapy first.
If you’ve experienced prolonged PTSD exposure to trauma or are emotionally sensitive, you may struggle during EMDR treatment. That said, bring up any issues to your psychologist so that the treatment plan can be adjusted accordingly.
Who Shouldn’t Get EMDR Treatment
Aside from side effects, EMDR isn’t designed for everyone. While EMDR is effective at helping with anxiety, panic attacks, and other mood disorders, it does have its limits. Listed below are a few instances where EMDR treatment won’t be effective.
If symptoms are tied back to being a side effect of medication, then skip EMDR treatment. Instead, seek help from your general practitioner to adjust your dosage. Many times, just a few adjustments in dosages or even removing overlapping medications can help improve your mental health regarding the traumatic event.
Mental Illnesses require the proper treatment. EMDR therapists are only specialized in mood disorders, anxiety, panic attacks, and peak performance. However, they can’t successfully treat any other type of mental illness. If you have another mental illness, contact a professional who can point you in the right direction.
Those suffering from substance abuse should first see a doctor or other substance abuse counselor for help. Unfortunately, EMDR therapy has not been proven to be effective for substance abuse. So, it’s best to look at your other treatment options or possibly check into rehab.
While EMDR therapy helps those with PTSD, only a handful of scientific backups show that it’s effective for other symptoms. However, more research is being conducted each day, which means there could be room for even better treatment options.
If you feel like EMDR therapy could be right for you, we highly suggest contacting a professional to get their opinion. Many forms of EMDR are now moving online through telehealth, meaning you can do it from home or at a doctor’s office.