Eye Movement Desensitization and Reprocessing (EMDR) benefits extend beyond trauma resolution and post-traumatic stress disorder (PTSD). Clinicians now use this psychotherapeutic method to treat a wide variety of physiological and psychological conditions. But does it benefit everyone?
EMDR therapy is appropriate for people with medical conditions related to anxiety, stress, panic, trauma, depression, phobias, grief, loss, behavior issues, and substance abuse. Those who would not benefit from it include people with co-occurring psychological disorders and some physical illnesses.
This article discusses what EMDR is and who it is better suited to. Read on to find out whether or not you’re a good candidate for EMDR therapy.
What Is EMDR?
According to Signature Health, the human brain heals itself naturally the same way the body does. This healing and coping activity happens during rapid eye movement (REM) sleep, a sleep state characterized by fast eye motion, dreaming, body movement, a quick pulse, and rapid breathing.
EMDR speeds up the healing process by tapping into this natural ability to resolve trauma. This technique is called bilateral stimulation (BLS), wherein therapists induce eye movements or equivalent activities to revitalize both sides of the brain.
Experts believe that doing so jolts a “traumatized” brain into properly processing disturbing memories associated with distressing events, making them less bothersome when patients recall them.
Who Should Consider EMDR?
According to the EMDR Research Foundation, more than 30 gold standard studies have documented EMDR’s effectiveness over the last three decades. Though therapists previously used EMDR only for PTSD and trauma-related disorders, they now also use it to treat many other problems, including those below.
People who can benefit from EMDR are those who have:
- PTSD—victims of or witnesses to abuse (physical, emotional, psychological, sexual), crime (robbery, sexual assault), burns, accidents, war (veterans, refugees), and natural disasters
- anxiety—including nervous stomach
- stress—including the kind caused by chronic illness
- panic attacks—flashbacks
- grief and loss
- sleep disorders—insomnia, oversleeping, nightmares, sleepwalking
- eating disorders—binge eating, bulimia, anorexia nervosa
- obesity connected to anxious-depressive disorders or trauma
- complex psychiatric disorders—schizophrenia, personality disorders, body dysmorphia
- addictions—substance abuse and behavior-related
- chronic pain—including phantom limb pain
- self-esteem issues
- sexual dysfunctions
- performance anxiety—sports, public speaking
- recurring self-defeating patterns of behavior and negative thinking
- out-of-control anger
- tried many therapies but haven’t found a resolution
Special Cases EMDR Can Benefit
In addition to the above list, there are special cases in which EMDR can be used. These include patients on the autism spectrum, nervous speakers, and children.
Autism and Asperger’s Syndrome
One study examined EMDR’s effectiveness in autistic children, and researchers found that 12 out of 18 children showed marked improvements after treatment. Some participants experienced a reduction in anxiety and aggression after only one session.
Another study involved autistic adults with a history of trauma subjected to an eight-week therapy program supplemented with EMDR. After treatment, they experienced an improvement in characteristic features of autism. Case studies of adults with Asperger’s syndrome yielded similar results.
People who have trouble talking about traumatic events because they’re too painful to discuss— especially sufferers of childhood trauma—will benefit from EMDR because therapists don’t require patients to talk about memories or events in detail.
EMDR is different from other psychotherapeutic interventions in that it zaps the brain into processing traumatic memories without physical or verbal input from patients. The brain does all the healing work.
Psychologist Dr. Katherine Compitus claims EMDR works quite well for juveniles, with some adaptation. Therapists must explain EMDR to kids in a way they can understand. EMDR can also be administered to nonverbal children or those with autism because it’s a sensory-based therapy.
Clinicians interested in EMDR for children may want to read Dr. Ana Gomez’s book, “EMDR Therapy and Adjunct Approaches with Children: Complex Trauma, Attachment, and Dissociation.”
Who Would Not Benefit From EMDR?
When misused, any form of treatment can become re-traumatizing, and EMDR is no exception. It does not benefit everyone, and only a trained, experienced professional should deploy it, and only to the appropriate patients. People who should not undergo EMDR include patients who are unable to reprocess their trauma and people of certain medications.
Those Incapable of Fulfilling (or Aren’t Willing To Fulfill) the Basic Requirements of an EMDR Session
EMDRIA-approved consultant Thomas Zimmerman from the Institute for Creative Mindfulness stresses that many clients won’t get better until they reprocess their trauma, so they should adequately prepare and stabilize before starting EMDR.
To reprocess traumatic memories using EMDR on a basic level, patients should:
- be present in mind and body to notice what’s happening during the session
- be able to feel worse for a short period
- be able to tolerate some distress
- be emotionally equipped to avoid panic
- have enough adaptive resources for coping
For some, recapturing a flashback produces so much anguish that EMDR cannot take place. So, before therapy can proceed, their therapists have to reduce any flashback anxiety intensity by giving them anti-anxiety medication or the patient’s preferred equivalent.
EMDR therapists have to give patients of this nature in-depth preparation, and they have to understand that their treatment will take longer. To prepare patients for EMDR, therapists should orient them properly, arm them with relaxation strategies, and fortify them with support systems.
People Taking Medications That Block EMDR Therapy
This is especially true of users of benzodiazepines or marijuana. Both recent and current use of these substances will interfere with the BLS part of the EMDR process.
Zimmerman explains that therapists cannot monitor the entire chest and stomach areas because these will be “offline”—not able to manifest what’s going on inside. Patients can only report sensations at shoulder level and above.
Also, people who use these substances during sessions tend to go on a “loop”—repeating themselves to the point that whatever they’re sharing no longer serves the therapeutic process.
Suppose substance users are adamant about getting EMDR treatment. In that case, Zimmerman recommends they should avoid using at least 12 hours before they undergo reprocessing—and for as long as they can post-sessions because the effects continue long after.
Those With Dissociative Disorders
Very Well Mind defines dissociation as a disconnection between one’s sense of self, emotions, memories, behaviors, or perceptions. Likened to an “out of body” experience, it happens automatically and is beyond control.
EMDR should not be administered to people with dissociative disorders, like dissociative amnesia, as people with these conditions feel emotionally detached. Therapists must deal with this dissociation using other therapies before applying EMDR techniques.
Those With Co-Occurring Mental Health Disorders
Clinical social worker Michelle Wexelblat, who studied EMDR Therapy at the Children’s Trauma Initiative, says EMDR may not work when simultaneously occurring mental health conditions are present.
- Dissociative disorders
- Personality disorders
- Complex trauma
These affect focus, complicate processing and impact how EMDR clears traumatic memories.
Those With Co-Occurring Physiological Health Disorders
People with complicated medical conditions that directly impact their physical health are not good candidates for EMDR. Examples include those with epilepsy and other physiological conditions that cause seizures, brain tumors, cardiovascular disorders (especially people who have undergone triple-bypass surgery), and certain eye disorders (glaucoma, light sensitivity).
Those with eye disorders can still undergo EMDR but not the standard one that delivers BLS using eye movement.
Although EMDR initially delivered BLS through eye movement, now, there are BLS alternatives for people who cannot do eye movements because of the conditions mentioned above.
Instead of fingers or a bar with blinking lights, therapists use tappers (pods that alternately vibrate on each hand) or audio delivered via headphones. The latter comes in the form of music or blips that play alternately in each ear.
Alternatives to finger movements include hand, knee, toe, and shoulder tapping (aka butterfly hug).
Those With Complex Forms of PTSD
Most mental health activists agree that those with complex PTSD from childhood abuse should not undertake EMDR. Or at least delay it to avoid nightmares, exhaustion, and violent or uncontrollable outbursts.
Regain therapists say people with minor trauma don’t require intense preparation for EMDR. But those who have had multiple minor ones, especially during childhood, need it.
When patients have multiple abnormal flashbacks from many traumatic experiences, therapists should treat each separately with EMDR. After treatment, patients should undergo a diagnostic test to see if all problems have been resolved. Only if this test is negative and the abnormal flashbacks have entirely disappeared can treatment end.
Therapist Robyn E. Brickel disagrees. She believes EMDR is an effective intervention for complex, developmental, ongoing trauma like C-PTSD, aka complex trauma disorder. C-PTSD is a psychological disorder resulting from the prolonged, recurrent interpersonal trauma experience where the sufferer has little or no chance of escape.
People with complex trauma histories are usually in a constant state of mental and physical stress, despair, and hyper-vigilance. That’s why Brickel uses a mind-body approach to trauma resolution.
EMDR is possible for people suffering from developmental trauma or childhood attachment, such as physical/emotional neglect or abuse. But they have to accept that their cases will take longer to resolve (as with any kind of therapy) because it takes time to be emotionally stable and establish the self-care needed to comfortably and safely process trauma.
Those Who Are Skeptical
Narcissistic abuse survivor and advocate Wanda Frost says that EMDR will work for most people. But for it to be effective, clients need to believe in the therapy and genuinely want to heal. She cites an EMDR consultant who had only treated two people for whom EMDR didn’t work in her many years of practice. One didn’t believe in EMDR, and the other held on to limiting beliefs.
Those Who Aren’t Ready
EMDR can fail if patients’ brains aren’t ready to address a traumatic event. They need to spend more time in talk therapy before their brains will allow them to revisit it. When people’s brains completely shut down to invoking a traumatic memory, it’s their brains’ way of protecting them, confirming they aren’t ready to divulge yet.
Still unsure if EMDR is suitable for you? Read EMDR founder Dr. Francine Shapiro’s book, “Getting Past Your Past: Take Control of Your Life with Self-Help Techniques from EMDR Therapy,” and see if your case is discussed there.
You should also interview at least three EMDR specialists, asking them what kind of experience they have using EMDR with your condition. Although most studies have focused on EMDR’s effectiveness in treating trauma, its extra benefits continue to emerge with ongoing research. Take advantage of its techniques to resolve your problems and move forward with your life.