Could EMDR Therapy Help You Unpack Trauma?

What Does an EMDR Session Entail? 

EMDR therapy consists of eight distinct phases, which occur over several sessions (though not necessarily eight distinct sessions). Williams says, “Throughout the course of EMDR therapy, the therapist helps the client to attend to emotionally distressful memories in brief doses while simultaneously focusing on an external stimulus.” Sessions typically last between 60 and 90 minutes, though she says that marathon sessions, which can take place over hours or over a couple of days, with extensively trained therapists, are also an option for certain clients. Treatment duration varies. “For a single incident event, treatment can take between six to eight sessions (sometimes less),” Williams tells me. “For more complex events or memories, treatment can take up to 12 sessions (sometimes more).”

Per the American Psychological Association, the eight phases are:

• Phase 1: History-Taking
  The therapist gets the patient’s full history and together the two work to identify targets for treatment, which can include past memories, current triggers and future goals.

• Phase 2: Preparing the Patient
  During this phase, the therapist educates the patient about the mechanics of EMDR. This can include sharing peer-reviewed research on EMDR’s effectiveness to help reassure patients who might be hesitant.
• Phase 3: Assessing the Target Memory
  This phase, which can take as little as 30 seconds, involves questions to activate the patient’s trauma memory, and bringing it into the patient’s awareness.
• Phase 4: Desensitization
  The next three phases help reprocess the memory and bring it to a resolution. The first of these three phases is the most recognizable phase of EMDR—the eye movement/bilateral stimulation. Per the APA, “The patient is asked to focus on the traumatic event while the bilateral stimulation takes place. This continues until the client’s Subjective Units of Distress Scale (SUDS) rating reaches zero. The SUDS rating system is used to assess how disturbed one feels about an event, with ten being the most disturbed and zero being not at all disturbed.”
• Phase 5: Installation
  After desensitization, the therapist uses bilateral stimulation to help the patient associate and strengthen their preferred positive belief for the event until it feels completely true.
  Phase 6: Body Scan
  Here, the therapist asks the patient to scan their body from head to toe to see if any negative sensations arise. If they do, the therapist will continue to offer bilateral stimulation until any remaining negative sensations have been cleared.
• Phase 7: Closure
  In this phase, the therapist winds the session down and helps the patient return to a state of calm.
• Phase 8: Evaluating Treatment Results
  Each subsequent session begins with the therapist and patient discussing the patient’s current level of distress around the traumatic memory and how their symptoms are changing. If there’s been a reduction in distress, they can move on to the next target memory. If not, additional sessions may be needed.

What Conditions Is EMDR Best For?

EMDR is primarily known for treating PTSD and trauma-related disorders, but Williams tells me it’s also used to treat the following conditions: 

• Anxiety disorders: generalized anxiety disorders (GAD; panic disorder, phobias, and social anxiety
• Mood disorders: major depressive disorder and illness-related depression
• Sleep disorders: insomnia, oversleeping, nightmares, sleepwalking
• Eating disorders: binge eating, bulimia, anorexia nervosa
• Addictions: substance abuse and behavior-related addictions
• Grief and loss

“The great thing about EMDR therapy is that it is well-suited for many different individuals with diverse backgrounds who have experienced different forms of trauma,” Williams tells me. “In addition to the aforementioned list of conditions EMDR can treat, EMDR can benefit clients on the autism spectrum and children.” She says that EMDR can also help those who have difficulty speaking about disturbing events. “This includes those who have experienced adverse childhood experiences, like sexual or physical abuse or witnessing violence. EMDR does not require clients to share graphic details about the memory or event.”

Are There Any Risks Associated with EMDR? 

“EMDR has minimal risks,” Williams explains, explaining that the most common negative effects are troublesome thoughts or feelings between sessions. Still, she concedes that, “As a newer psychotherapy (developed in 1989), despite the evidence that it does work, experts have yet to fully explain the science of exactly how it works.”

Still, EMDR isn’t for everyone; Williams tells me that those with medical conditions that directly impact their brain or heart organs—like epilepsy or other seizure disorders, brain tumors, cardiovascular disorders and more—may not be suitable candidates for EMDR. Additionally, she says, folks who take benzodiazepines or use cannabis are not good candidates, because use of these substances will disrupt part of the EMDR process.