What is EMDR therapy?
EMDR therapy is an abbreviation of “Eye Movement Desensitization and Reprocessing Therapy”. EMDR is a psychotherapy method that can help people reduce the discomfort after experiences from the past that can interfere with daily life.
Many times these past experiences are about traumas of various kinds such as e.g. assault, abuse, accidents or natural disasters and which may have developed into post-traumatic stress syndrome (PTSD). Although first developed to treat post-traumatic stress disorder (PTSD). According to EMDR therapists in London, the emdr treatment has now been effective in treating a wide range of disorders where intense feelings are linked to prior events.
The therapy has its starting point in a model for how information is processed in the brain’s memory system. EMDR therapy combines elements from several psychotherapeutic schools, including psychodynamic theory, behavioral therapy, cognitive behavioral therapy, and systems theory. The treatment is combined with so-called bilateral stimulation, which usually takes place via eye movements. Eye movements add valuable elements to the trauma treatment in that the communication between different parts of the brain seems to be positively affected and the anxiety effect when the trauma memory is activated is reduced.
The method rests on a scientific basis and can easily be applied to other psychological problems as well, for example anxiety problems or depression that are associated with negative life events. In short, it can be said that EMDR therapy stimulates a natural internal system in the brain to process information. Disturbing memories stored in a dysfunctional way in the memory system can begin to be processed. Francine Shapiro, founder of the treatment model, has called this the “Adaptive Information Processing (AIP) model” (Shapiro, 2018).
The AIP model
The AIP model assumes that adaptively stored memories are accessible and flexible, open to new impressions and possible to revise if new information suggests this. Memories from traumatic events (or other negative life events that have not been able to be processed) have instead been stored in the memory in a dysfunctional way that means they are more static and locked. These memories are more difficult to influence and are not as easily accessible for ordinary processing. This impairs the individual’s ability to integrate such experiences and instead gives rise to symptoms of various kinds such as, for example, anxiety, fears, depression, feelings of guilt and difficulty sleeping.
Traumatic events and/or other disruptive negative life events that have been dysfunctionally encoded in memory result in connections to memory networks with more adaptive information becoming inadequate or damaged. Memories thus become sensitive to distortions regarding time, place and context and can be experienced in a fragmented way. Different types of disturbances can thereby arise. Consequently, new information, positive experiences and positive affects find it difficult to functionally link into the painful memory. This deficiency and subsequent inadequate integration contribute to the continuation of symptoms.
EMDR therapy makes it possible to resume a natural way of processing and integrating the information stored in memory. More specifically, it means that in EMDR therapy you pay attention to disturbing memories from past experiences, what is currently triggered by these memories and what entails potential future challenges. The result of the processing process is reduced symptoms, reduced or total freedom from discomfort caused by the disturbing memory, an improved self-image, relief from bodily symptoms that were associated with the disorder, and that any reminders of the memory no longer cause discomfort.
The underlying mechanisms and explanatory models for EMDR therapy continue to be developed through continued research and theory development.
How does EMDR therapy work?
EMDR therapy uses specific and well-defined approaches. One element is to give the client the task of focusing on alternating bilateral visual, tactile or auditory stimulation while at the same time being asked to focus on the traumatic memory, thus so-called “double attention”. This process activates the memory components from the distressing memory and facilitates the ability to resume processing the memory. The result is that the memory can be integrated in a more adaptive way.
The treatment methodology includes training the client to be able to apply stabilization tools before, during and after the processing of disturbing and traumatizing memories and what may be associated with the memory. The psychotherapeutic approach in EMDR therapy is to promote one’s own inherent ability to heal. Interventions from the therapist are therefore kept to a minimum during processing to facilitate information processing.
What does the research say?
EMDR therapy is an effective treatment method for PTSD. More than 30 controlled studies have been published proving its effectiveness. The studies show that after abuse, accidents, losses, natural disasters or war, 85-90% of people no longer meet the criteria for PTSD after completing EMDR treatment. Several meta-analyses (i.e. a compilation of a number of scientific studies) that made a systematic overview of different treatment methods for PTSD (e.g. (Lewis et al., 2020), conclude that there is robust scientific support for EMDR.
Several international guidelines for the treatment of PTSD recommend EMDR therapy: National Institute for Health and Care Excellence (NICE), 2018; International Society of Traumatic Stress Studies (ISTSS), 2018; the US Department of Veterans Affairs, VA/DoD, 2017. Also WHO (2013) recommends EMDR therapy as a treatment for stress-related disorders. In a compilation that studied the cost-effectiveness of different treatment methods in primary care in Great Britain, EMDR therapy proved to be the most cost-effective method (Mavranezouli et al, 2020).
The National Board of Health and Welfare’s national guidelines for care in depression and anxiety disorders (National Board of Health and Welfare, 2020) state that EMDR can be offered for the treatment of PTSD and that there is good clinical experience with the method. A commentary from the SBU (The State Committee for Medical and Social Evaluation (SBU), 2019) highlighted the aforementioned report from NICE. Despite the fact that the scientific basis was considered to be deficient in most methods regarding the evaluation of treatment of PTSD for adults, the SBU writes that above all EMDR and trauma-focused CBT are recommended.
The importance of eye movements for the treatment has been discussed. In a Swedish literature study from 2020 (Bjernhede, 2020), it is concluded that there is a consensus that eye movements add valuable elements to trauma treatment. The eye movements seem to be able to facilitate new association paths to the trauma memory in the brain, which contributes to new learning. The communication between different parts of the brain is positively affected and the anxiety effect of trauma activation is reduced. The effect is that this helps the individual to be able to stay in the trauma memory and process it. See the study in its entirety on the website under the Reports tab.
EMDR therapy for other types of problems
EMDR therapy can be applied to many other clinical conditions that have their basis in negative distressing experiences, such as anxiety disorders, depressive disorders and complicated grief, but the scientific support is not yet as strong as for the treatment of PTSD. EMDR therapy has also been successfully combined with other forms of therapy, enhancing the effect of the treatment.
EMDR therapy for children and adolescents
Children respond well to EMDR treatment. The World Health Organization (2013) recommends eye movement desensitization and reprocessing (EMDR) treatment for children and adolescents who have encountered traumatic situations. The method has also received a strong recommendation from ISTSS (International Society of Traumatic Stress Studies (ISTSS), 2018).