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EMDR Therapy: How Does It Work? | Process & Side Effects

A life-threatening event can do more harm than you realize. You may be left with bruises, injuries, or scars, but even if you get out unscathed, there’s another element to consider. 

The psychological effect of a frightening event is called trauma, and it’s more common than you might think. After a terrifying moment, you and the people around you might focus on physical healing, but psychological healing is important too. When the psychological stress from a traumatic event leads to lasting symptoms, it can be diagnosed as post-traumatic stress disorder (PTSD). According to the U.S. Department of Veterans Affairs, seven to eight percent of Americans will experience PTSD at some point during their lifetime.

PTSD is common among military service members that see active combat. However, it can happen to civilians too. One of the most common causes of PTSD among civilian populations is car accidents and severe injuries. But it can also be caused by violent crimes and sexual assault. PTSD is characterized by agitation, irritability, paranoia, isolation, flashbacks to the event, fear, panic attacks, and insomnia. 

Trauma is a common problem that occurs alongside substance use disorders. This can be caused by self-medication, which is when you use drugs or alcohol to mask unpleasant feelings or psychological problems. 

To effectively treat addiction, trauma must also be addressed. One of the methods clinicians used to treat addiction is through Eye Movement Desensitization and Reprocessing, or EMDR therapy. 

What Is EMDR Therapy?

EMDR therapy is an approach to treating trauma that utilizes the body’s own natural response to stress. The theory behind this form of therapy has to do with Rapid Eye Movement (REM) sleep. During REM sleep, your brain is said to process your day, which is theoretically why dreams are random and disjointed. They are a product of your brain going through this process. 

EMDR therapy was developed by psychologist Francine Shapiro in the 1990s. She theorized that by simulating the movement of your eyes during REM sleep, you could address traumas and stress and reprocess it with a therapist. 

However, EMDR is a controversial form of therapy, even though it’s fairly common. Some critics say that its effectiveness actually has nothing to do with eye movement. Instead, it’s just a form of talk therapy where you work through your thoughts and memories with a professional.  Proponents say that eye movement is vital to help the patient stay present through the desensitizing process. 

Either way, EMDR is intended to be a short term process that’s used in conjunction with other therapeutic options like cognitive-behavioral or talk therapy. EMDR doesn’t have a set minimum or maximum number of sessions, but it usually doesn’t last longer than a few sessions. 

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How Does EMDR Work?

During EMDR therapy sessions, your therapist will use what is called bilateral stimulation, or some sort of left to right stimulation. They may ask you to focus on a finger or hand as they move it back and forth. Others may use clickers or tapping on either side of you. As you focus on bilateral movement, you will go over traumatic memories, reprocess them, and alter them in your mind to assert control and create positive memories that make memories less painful. 

The Eight Phases of EMDR

EMDR therapy works in eight phases that clients will go through before they complete treatment. Not everyone moves through each phase in order. In some cases, clients may need to return to certain phases or repeat them for the therapy to be effective. 

This phase is an important step, and it’s similarly seen in other types of psychotherapy. In this phase, your therapist will go over your history with trauma, your history with treatment, and what you’re planning on working on next.

In this phase, you’ll be preparing for the therapy session and EMDR as a whole. You’ll go over what you can expect, how to relax and remain mentally present through the sessions, and how you can effectively respond to treatment.

Assessment refers to the specific memory of the traumatic event you’ll be working on. The memory will be split up into several parts, like the image you picture in your mind, how you think about the memory, and how the memory affects your body physically. Assessment is one of the phases that takes the longest amount of time.

At this point, you will begin eye movement or another bilateral movement as you focus on the negative memory. You are asked to focus on new thoughts and insights about the experience. This helps to desensitize or ease the pain associated with the memory.

This helps you to “install” or internalize new positive thoughts and emotions surrounding a painful memory. You may even imagine a change in that scenario to assert control over the memory. Changes can be something like changing the image of the trauma to black and white or imagining a supportive friend in the scenario.

Next, the client examines how the memory affects their body physically by paying attention to physiological responses, specifically related to the newly installed positive thoughts. The eye movement continues through this phase.

Closure happens at the end of each session, even if you haven’t moved through the whole process yet. If you aren’t finished processing the memory, the closure phase can help you stabilize and essentially save your place until the next session.

At the beginning of each session, you re-evaluate your current state before moving forward. You will also examine any new thoughts or memories that may have come about between sessions.

How Can EMDR Help Addiction Recovery?

Trauma that co-occurs with substance use disorders needs to be addressed for addiction treatment to be effective. In many cases, issues like PTSD are underlying causes of addiction. If a substance use problem is treated without addressing trauma, negative feelings, and mental health problems may lead you right back to substance use in order to cope. 

If you or someone you know is struggling with PTSD and a substance use problem, it’s important to address both issues as soon as possible. Addiction can get worse over time, but treating it can help you avoid new or worse consequences. Begin your road to recovery by learning more about trauma and addiction treatment today. 

Sources

Amano, T., & Toichi, M. (2016, October 12). The Role of Alternating Bilateral Stimulation in Establishing Positive Cognition in EMDR Therapy: A Multi-Channel Near-Infrared Spectroscopy Study. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5061320/

Mayo Clinic. (2018, July 6). Post-traumatic stress disorder (PTSD). Retrieved from https://www.mayoclinic.org/diseases-conditions/post-traumatic-stress-disorder/symptoms-causes/syc-20355967

Psychology Today. (n.d.). Eye Movement Desensitization and Reprocessing Therapy. Retrieved from https://www.psychologytoday.com/us/therapy-types/eye-movement-desensitization-and-reprocessing-therapy

Shapiro, F. (2002, May 28). Eye movement desensitization: A new treatment for post-traumatic stress disorder. Retrieved from https://www.sciencedirect.com/science/article/pii/0005791689900256

U.S. Department of Veterans Affairs. (2018, September 13). PTSD: National Center for PTSD. Retrieved from https://www.ptsd.va.gov/understand/common/common_adults.asp

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