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What is EMDR and How Does It Work?

EMDR is a type of therapy that is gaining a lot of prominence. EMDR primarily serves as a therapy that helps patients process and heal from trauma.

Here at Zeeva, we have 3 therapists who are experienced with EMDR, and it’s one of the most sought out therapies in our practice.

Below is a complete and detailed overview of what you should know about EMDR before starting.

Here are the top questions:

What is EMDR Therapy?
What symptoms/issues does EMDR help with?
Does it really work?
How quickly does EMDR work?
How does EMDR work?
Why does EMDR work?
Who does EMDR work for?
Can I do EMDR myself?
Is EMDR for me? Can I just start now?

What is EMDR Therapy?

EMDR therapy stands for Eye Movement Desensitization and Reprocessing. It is used to treat trauma and the resulting mental health dysfunctions and illnesses. During the main portion of therapy, your EMDR therapist will be drawing your eye to move around rapidly while reliving your past traumas. We don’t fully understand the science in why it works, but the theory is that this mimics how the body uses REM sleep (rapid eye movements) to recharge for the next day.

By mixing eye movements with emotions, you are crossing the right and left side of the brain, allowing your mind to get desensitized to the trauma, and allowing you to learn different responses to your previous emotional triggers.

So, unlike cognitive behavioral therapy, which when done effectively requires serious homework to address the dysfunctional response, or talking about the event in detail for years (psychodynamic therapy), your therapist enables you to live through the emotions and feelings, and then process and desensitize yourself from those feelings and their reactions.

What symptoms/issues does EMDR help with?

EMDR is primarily a therapy that addresses trauma, both slight and severe. There are many emotional dysfunctions that come from trauma. Some of those include:

  • PTSD
  • Anxiety and phobias
  • Chronic Illness and medical issues
  • Depression and mood disorders
  • Dissociative disorders
  • Eating disorders
  • Trauma, Grief and loss
  • Personality disorders
  • Sleep disturbance
  • Substance abuse and addiction

Does it really work? How quickly does it work?

EMDR has quickly become ‘the therapy’ for trauma. The APA, WHO and DoD name it as a therapy of choice for PTSD and related symptoms. There are over 30 ‘double blind’ tests that show it’s effectiveness.

A Kaiser Permanente study showed that EMDR positively impacted 100% of the patients that had a single instance of trauma, and 77% of those that had multiple traumas.

In contrast, in many studies on cognitive behavioral therapy (CBT), the success rate was in the 40-70% range. One of the studies compared patients who went through CBT instead of EMDR. They showed that EMDR was far more effective, and got results faster.

However, EMDR isn’t a magic wand.

Many patients who report having experienced EMDR have found (unlike the studies which simply show significant improvement in 7 sessions) that EMDR can take quite a bit longer to fully maximize the benefits that they got out of the sessions. This depended on their relationship with their therapist, the depth of the trauma, and their resilience/ability to cope with the emotions during the experience.

You’ll need to be in a specific emotional place to be able to handle addressing the trauma, and in many instances we recommend either doing other therapy before EMDR, or doing EMDR concurrently with other regular sessions.

What a therapist who went through EMDR for PTSD/Trauma/Anorexia sais:

We strongly recommend a great video by Pooky Knightsmith from the UK to understand more about EMDR.

Pooky is a therapist herself, who has struggled for years with PTSD, eating disorders and suicidal ideation from past therapy. After going to therapy for a number of years; her therapist felt she was in a place to try EMR. In her video above – a great read; she has 3 things she wishes she knew about EMDR before she started. In her words:

  1. “I wish I knew it worked” – Pooky regretted not starting earlier
  2. “I wish I knew how intense it was” – as she reprocessed her issues, her PTSD kicked in much harder. She would have liked to know what was going to hit her.
  3. “It didn’t force me to relieve everything (verbally)” – Since you don’t have to ‘talk through’ everything (the focus on the physical impact of your feelings), much of the trauma isn’t as dragged out as it has to be.

Per Pooky, she spent months through regular therapy, and being in a good enough place to finally tackle the trauma though.

So how does EMDR actually work?

EMDR is an 8 step process.

The first step is “History and treatment planning”.

In EMDR, they use a model they call “past, present, future”.

There was a trauma in your past, which when triggered, creates certain effects on you mentally and physically (there are areas in your body that those feelings are expressed).

This in turn causes your mind ‘future reactions’ – or reacting in a dysfunctional way to your trauma.

During this first step, you will discuss the trauma, your current disturbances, future reactions and what you would like to see out of EMDR.

You do NOT have to completely relive the trauma in this stage. You do, however, have to be ready to address all of the ‘stuff’ that comes up when you dive in.

(1-2 Sessions)

Depending on the complexity of your trauma, this should take between 1-2 sessions.

Step 2 is Preparation.

In the preparation stage, you and your therapist will be setting the stage to begin the process of EMDR. In order to have a successful outcome, your therapist will explain to you the treatment process. The education will cover the general concepts (similar to what you see below).

You may be dredging up quite a bit of emotion and trauma. In order to effectively stay ‘present’, and get through your EMDR sessions, your therapist will be teaching you a number of practical coping skills like mindfulness, deep breathing and any other techniques they expect will be relevant for you.

(1-4 sessions)

Depending on the depth of the trauma, emotions and behaviors you are trying to change, this can take anywhere from 1 to 4 sessions.

The main portion of your EMDR session (Steps 3-8)

Step 3: Assessment

When you are done these first 2 steps, you will begin the main portion of EMDR therapy. Each session has a 6 step process to it. You begin with an assessment.

You will share a specific mental ‘image’ or experience that you are working on (past), you will share exactly what you believe and how it makes you feel (physically/emotionally).

EMDR is very feedback oriented. You are here to address a specific trauma and the resulting feelings/responses.

There are 2 ‘scales’ or ratings that you will be using.

“Validity of Cognition”

Your therapist will ask you about a specific negative belief you have, based on that mental image (“I’m useless. I’m bad. I am selfish.”). You will then be asked what belief you want to replace it with.

You will then rate how much you believe the new positive belief on a scale of 1-7. The goal of the subsequent session(s) is to improve how truly you ‘believe’ this positive belief.

“Subjective Units of Disturbance”

The therapist will ask you on a 1-10 scale basis how much that mental image/experience you are reliving disturbs you. The goal during EMDR is to reduce this number until you are desensitized. This is called the SUD test. (Subjective unites of disturbance).

These 2 objective tests help set the stage for measuring your progress in treating your previous history of trauma.

Your ultimate goal is ‘reprocessing’; to empower your subconscious to process your past experience differently. This frees you from the current symptoms affecting you.

Step 4: Desensitization

The next step in the process is desensitization. In this process the eye movments or the ‘tapping’ and other tools are used while you talk the therapist about your past trauma or experience.

Step 5: Installation

You are now ready to ‘install’ your updated, healthier belief. You will focus on what you want to believe instead – the healthier, more updated response.

Step 6: Body Scan

Research shows that unprocessed emotions have a ‘physical’ reaction to them. For example, your body will tense in a specific area, or you will have a specific motion.

You will bring up the trauma again, and scan your body to see whether you are still responding physically. Your goal through reprocessing the trauma is to completely remove the bodily response. This should correspond with higher ‘scores’ on the ‘SUD test’, which are proven to help you decrease all of the symptoms coming from your trauma.

Step 7: Closure

At the end of each session, you will be finishing with making sure that you feel better than when you came in. Should there still be alot of ‘issues’ or discomfort, your therapist will work with you to give you coping skills to help you until your next session.

EMDR can be quite intense, so it’s very important to make sure you are handling all of your experiences well.

Step 8: Re-evaluation (next session)

When you restart the next session, your therapist will be re-evaluating your treatment plan to make sure you are making progress, and that you have the tools you need to live your best life.

Why does EMDR work?

The brain is a fantastical creation and scientists don’t have enough nueroscientific data. The founder of EMDR believes that it helps use both the right and left brain in processing trauma.

Additionally, unlike many other therapies, the goal here isn’t to live and address every element of the trauma. That can often take years. Ultimately, you’re looking for a way to live with the trauma, and not let it influence your feelings thoughts and behaviors today.

EMDR goes straight to the heart of it, potentially saving you years of therapy.

You can see more details here on the official EMDR site.

Who does EMDR work for?

EMDR works for anyone suffering from symptoms tied to a traumatic past experience. You also need to be committed to therapy, and be in a place where you can bring back those old emotions and address them.

Can I do EMDR myself?

As with most therapy, we are often locked in our own prison. EMDR is something that requires months of highly specialized training for professionals who have years of mental health experience.

We strongly suggest that you work with an experienced, trained therapist to get the most out of EMDR.

Is EMDR for me? Can I just start now?

Each individual situation is unique. We strongly recommend that if you are considering EMDR to talk to our intake coordinators, and schedule a session with one of our EMDR trained therapists.

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