On the definition of EMDR, how it is applied, its effectiveness and duration…
To date, EMDR (Eye Movement Desensitization and Reprocessing), which stands for Eye Movement Desensitization and Reprocessing, has successfully treated millions of people of all ages with different types of psychological disorders.
EMDR theory is based on the adaptive information processing model. According to this model, the brain processes and makes functional the information that reaches it through each new experience, with a physiologically based system. Information such as emotion, thought, sensation, image, sound, smell are processed and integrated by connecting to related memory networks. Thus, learning about that experience takes place. The information we acquire is stored to guide our responses appropriately in the future.
This system seems to be disrupted when traumatic or very disturbing events occur. New information is not processed and integrated into the existing memory network. In order to make sense of the experience, it is not possible to connect functional information in memory networks and to draw sane conclusions. As a result, learning does not occur. Emotions, thoughts, images, sounds, body sensations are stored as they are experienced. Therefore, if some situations experienced today trigger these isolated memories, the person will be affected as if reliving some or all of that memory.
According to EMDR, these types of memories that are maladaptive, dysfunctional, unprocessed and stored in isolation lie behind the disturbances, negative emotions, thoughts, behaviors, and personality traits. Negative beliefs about oneself (eg: I am stupid), negative emotional reactions (fear of failing), and negative somatic reactions (abdominal pain the night before the exam) are not the problem itself, but its symptoms, its present manifestations. The unprocessed memories that lead to these negative beliefs and emotions are triggered by events in the present.
In addition to major traumas such as natural disasters, major accidents, losses, war, harassment and rape, all kinds of experiences with traumatic effects, especially in childhood; Negative events in family, school, work environment, exposure to violence, humiliation, rejection, neglect and failures in daily life can be among the memories that cannot be processed.
EMDR is a physiologically based therapy that enables the processing of such isolated memories. It allows the brain to perform the operation that it could not do in time. It is possible to establish a relationship between the locked memory and other memory networks and to store information in an adaptive way by providing learning. The client is no longer disturbed and sees the memory from a new and healthy perspective.
With EMDR therapy, not only the symptoms disappear. Positive beliefs and positive emotions brought by the new perspective change the person’s view of himself, his relationships and the world in a positive way and provide personal development.
How is EMDR Therapy Applied?
In EMDR therapy, an 8-step, three-pronged (past, present, future) protocol is applied. The aim is to depersonalize by reprocessing the memories of the past, to treat the present symptoms, and to show the behaviors guided by the new perspective developed by the positive beliefs and emotions that the client has gained in the face of similar problems in the future.
Client History:The memories and future goals that are the source of the symptoms and problems are determined and a treatment plan is created.
Preparation:The client is informed about EMDR and made ready for processing.
Evaluation:The therapist helps the client identify the image that represents the target memory, his current negative belief and emotions about that image, his feelings and place in his body, and his desired positive belief.
Desensitization: This stage begins with the client focusing on the picture he has chosen to represent the memory, thinking about his negative belief, experiencing negative emotions and feeling the change that all these have created in his body. Then the client frees his mind. He becomes aware of everything that goes through his mind without checking its content or where it is headed.
The client follows the therapist’s finger, which he moves in two directions, with his eyes during the processing. It is thought that when the client pays attention to the thoughts and eye movements at the same time, the right and left hemispheres of the brain are connected.
The brain processes information from experiences during REM sleep (Rapid Eye Movement Sleep). It is predicted that the bidirectional eye movements applied in EMDR can provide a similar physiological effect while awake. At the same time, different stimuli such as bidirectional auditory stimulation and bidirectional touching are also used.
After each set, the therapist asks the client what’s on their mind, controls the processing, and guides the client through the entire process. The process continues until a connection is established between the memory and the client’s positive thoughts and beliefs about himself (eg: I did everything I could) and the memory becomes less disturbing.
Placement:Sets are applied to reinforce the client’s positive belief.
Size Scan:It is ensured that the client scans his body and if there is an uncomfortable sensation, it is processed.
Closing: The therapist gives feedback to the client, applies some relaxation techniques when necessary, and explains what can happen after the session. Asks him to take short notes about his psychological reactions.
Reassessment: Evaluation of the previous session is made. The therapist checks whether the positive results achieved in the previous session are established. It also evaluates new data from the client. As a result of these evaluations, the processing process continues or other memories are started to be worked on.
Once the processing of unprocessed, past, and recent memories or memories is complete, the present troubling symptoms also largely disappear. Yet each symptom is screened again and processed if necessary. Thus, the protocol PastAnd Todayphases are completed and Futurestage is reached.
The therapist asks the client to indicate desired behaviors for each current triggering situation that activates predetermined, dysfunctional responses. The therapist and client together prepare scenarios in which desired behaviors are exhibited. The client experiences these scenarios step by step in his imagination and if uncomfortable points are encountered, they are processed. If necessary, the client gains new knowledge and skills. Thus, clients become ready to deal with situations in which they have had problems before.
How Long Does EMDR Take?
It is included in the ‘short-term therapies’ group in the EMDR therapy literature. How long EMDR treatment will last depends on the type of problem, the client’s current living conditions, the number and impact of previous traumas. Each person’s processing of information in a unique way in line with their own values and experiences also affects the duration.
Is EMDR Proven Effective?
According to a study conducted in 2019, more than 30 randomized controlled studies have shown that EMDR effectively reduces or eliminates the symptoms of post-traumatic stress in the majority of clients, and reduces symptoms (such as anxiety) that are usually associated with psychological problems (de Jongh et al. al., 2019.) EMDR is also effective by many international health and government institutions. Some of those:
- World Health Organization (WHO, World Health Organization)
- American Psychiatric Association (American Psychiatric Association)
- International Society for Traumatic Stress Studies
- US Department of Veterans Affairs
- US Department of Defense
- United Kingdom Department of Health
- Israel National Council for Mental Health
More information can be found at the following websites:
EMDR International Association: www.emdria.org
EMDR Europe: www.emdr-europe.org
EMDR Institute: www.emdr.com
EMDR Türkiye: www.emdr-tr.org
- Shapiro, F., Eye Movement Desensitization and Reprocessing: Basic Principles, Protocols and Procedures, 2nd Edition, Guilford Press, New York, 2001.
- Shapiro, F. , Erasing Painful Memories with EMDR Therapy Techniques, Ruled Publishing, Istanbul, 2012.
- Royle, L. , Kerr, C. , Integrating EMDR into your Practice, Springer Publishing Company, New York, 2010.
- Parnell, L. , EMDR in the Treatment of Adults Abused as Children, WW Norton & Company, New York, 1999.
- Kavakci, O. , EMDR for Mental Trauma Treatment, HYB Publishing, Ankara, 2012.
- EMDR Treatment and Training Manual / Level 1, EMDR Institute.Inc,2002 (Unpublished text in Turkish, DBE).
- EMDR Treatment and Training Manual / Level 2, EMDR Institute.Inc, 2002 (Unpublished text in Turkish, DBE).
- Facilitator Guidelines, Policies and Training Handbook, EMDR Institute.Inc, 2002 (Unpublished text in Turkish, DBE).
- EMDR as an Integrative Psychotherapy Approach, Edited by Shapiro F., American Psychological Association, Washington, DC, 2002.
- Grand, D., Emotional Healing at the Speed of Light – EMDR, Rulegal Publishing, Istanbul, 2005.
- Professional Brosure; EMDRIA (EMDR International Association) Press, 2005.
- Ören, E., Solomon, R. , EMDR Therapy: An overview of ist Development and Mechanisms of Action, Ç: Önder Kavakçı, EMDR Turkey E-Bulletin, Issue 2, January 2013.
- Jongh, A., Amann, BL, Hofmann, A., Farrell, D., & Lee, CW (2019). The Status of EMDR Therapy in the Treatment of Posttraumatic Stress Disorder 30 Years After Its Introduction. Journal of EMDR Practice and Research, 13(4), 261-269. https://doi.org/10.1891/1933-3126.96.36.1991