EMDR Therapy FAQ

What is EMDR?

 

EMDR, or Eye Movement Desensitization and Reprocessing, is a type of therapy used to treat individuals who experience mental health conditions such as PTSD / psychological trauma, anxiety, depression, and more. 

It’s an 8-phase, comprehensive therapeutic process that is used to help identify and process through experiences that have overwhelmed or disrupted the brain’s natural capacity to cope, thereby leaving a negative impact on the mind. This negative impact may contribute to the aforementioned conditions, so processing through these experiences can help individuals reprocess in a way that is more adaptive, and thus, healing. 

TLDR: EMDR is a type of therapy used to help process trauma or negative life experiences. 

 

What’s the deal with eye movements?

 

The EMDR process consists of much more than the part using eye movements. In fact, eye movements are just one aspect of an entire 8-phase treatment.

Several theories exist to explain the use of eye movements in EMDR. There has been much research on the use of eye movements in EMDR, with findings supporting their inclusion in therapy. 

As reported, “Research has consistently found that eye movements lower self-ratings of vividness and emotionality of memories, with the central executive likely responsible for this effect. This research adds to existing knowledge by showing that eye movements lower the number of intrusive thoughts of negative memories during suppression.”

TLDR: Eye movements can help facilitate the desensitization of memory.

 

Is EMDR like REM sleep?

 

Yes. Studies show that EMDR affects our memories in a similar way as rapid eye movement (REM) sleep affects our memories. 

In explaining the effectiveness of EMDR in his book, The Body Keeps the Score, Bessel van der Kolk, MD points out that REM sleep “reshapes memory by increasing the imprint of emotionally relevant information while helping irrelevant material fade away” and “make(s) sense out of information whose relevance is unclear while we are awake and integrate it into the larger memory system (p. 262)” 

TLDR: Yep.

 

How does virtual EMDR work?

 

As explained in Counseling Today, “The first three phases of EMDR (history and treatment planning, preparation and assessment) are similar to other counseling approaches because they focus on understanding the client’s full history, building a strong therapeutic relationship, creating safety, and cultivating coping skills that are centered on the mind and body.”

The integration of eye movements begins in phase four. The core component of the eye movement phase is bilateral stimulation (BLS). BLS occurs when an external stimulus is applied rhythmically from side-to-side. It is believed that this  enhances accessibility to certain parts in the brain that store unprocessed negative memories, by inducing a mental state similar to that of REM sleep.

When done virtually, the BLS or eye movement portion can be done by the client tapping on both sides of their body. It has the same effect as when EMDR is done in office. Rather than the therapist tapping on the client’ body, the client simply taps on their own body. Furthermore, for clients who prefer to use a visual form of BLS, such as a light bar, the therapist may utilize a digital version. EMDR therapists report similar outcomes no matter which form of BLS is used.

Click here for a demonstration of how EMDR is done online.

TLDR: It’s easy and effective. For the eye movement portion, you can simply cross your arms over your chest and tap on your shoulders.

 

 

Is EMDR legit?

The National Library of Medicine includes an article from the Permanente Journal wherein Francine Shapiro, PhD, explains, “Eye movement desensitization and reprocessing (EMDR) therapy is an empirically validated treatment for trauma, including such negative life experiences as commonly present in medical practice. The positive therapeutic outcomes rapidly achieved without homework or detailed description of the disturbing event offer the medical community an efficient treatment approach with a wide range of applications.”

 

In a review of the literature, Shapiro points out:

• Dozens of randomized controlled trials support the positive effects of EMDR therapy in the treatment of emotional trauma and other adverse life experiences.

• Seven out of 10 studies show that EMDR is more effective and rapid than cognitive behavioral therapy (CBT).

• Randomized studies show rapid decreases in negative emotions and/or vividness of disturbing images when utilizing eye movements.

• Studies have also shown EMDR to be effective in providing relief for a variety of physical problems.

TLDR: Yes. The legitimacy of EMDR is backed by robust research.

 

 

What are the phases of EMDR?

 

EMDR consists of eight phases:

1. History taking and treatment planning
2. Preparation
3. Assessment
4. Desensitization
5. Instillation 
6. Body Scan
7. Closure
8. Reevaluation

First, your EMDR therapist will inquire about your personal history to identify areas of treatment, assess readiness for treatment, and uncover contributing factors to problem areas. Your therapist will need to analyze your symptoms, dysfunctional behaviors, and specific characteristics to determine suitable targets for treatment.

Second, your therapist will prepare you for the following phases by equipping you with coping skills for emotional regulation. You will use these skills in your therapy sessions and encouraged to use them outside of therapy as well. The coping skills you learn in EMDR can equip you with the ability to calm your mind and body when anxious, distressed, or overwhelmed.

In the third phase, assessment, you and your therapist will work together to identify the target memory to be processed along with maladaptive cognitions that may be attached to it.

The fourth phase, desensitization, includes utilizing eye movements or bilateral stimulation while the EMDR therapist guides the client through deep processing. The therapist may help the client with breathwork and grounding techniques in this stage to help regulate the client’s nervous system. 

In the fifth stage, the therapist helps the client integrate positive material into the memory network to replace maladaptive memory. Bilateral stimulation is also used in this phase.

In the sixth phase, the client will be led through a body scan and asked to notice any somatic responses that could be related to any unprocessed maladaptive material in the memory. 

In the seventh phase, the therapist helps bring the client back into a state of equilibrium. And in the final stage, reevaluation, the therapist will evaluate the client’s psychological state and the efficacy of treatment. 

TLDR: EMDR is an eight phase process that looks a lot like any other therapy in the beginning phases while also integrating bilateral stimulation or eye movements.

Can EMDR help me?

 

If you remain emotionally impacted by a negative experience such as relationship issues, neglect, abuse, loss, bullying, or other such experiences, you may be a good candidate for EMDR.

Although EMDR works well for many individuals with various problems, EMDR is not for everyone. Some factors that may present a barrier for effective EMDR include: 

• The client isn’t invested in the process. If a client enters therapy due to pressure from others, they may not be invested in the processes. EMDR, like any other therapeutic process, is a cooperative partnership between therapist and client.

• Facing the feelings can be too difficult. Sometimes it’s simply too painful or scary to face memories or feelings. Sometimes we bury them deep inside, compartmentalize them, and have difficulty accessing them. Having too much of a guard up can be a barrier, but it’s something that can be worked through with a skilled therapist. 

• Some conditions may be contraindicated. There is a possibility that certain conditions such as pregnancy, seizure disorders, certain neurological disorders, psychotropic medications, and substance abuse can be worsened by the intense levels of emotion that can result from reprocessing. 

TLDR: Probably. You can schedule a free 15 minute consultation here to speak with an EMDR therapist to see if you’re a good candidate for EMDR therapy.

 

 

How many sessions does it take?

 

If you are seeing an EMDR therapist, then EMDR starts with your first session. The EMDR therapist conceptualizes your presenting issues from the theoretical framework of EMDR. Even though it will take several sessions to get to the eye movement portion, you are still ‘doing’ EMDR from the first session.

EMDR therapy (or any therapy) for individuals with relational trauma, developmental trauma, complex trauma, or significant dissociation may need more sessions than those with single-incident of trauma. 

When working on a single incident trauma such as an accident or assault, treatment could last for 8-12 90-minute sessions or 12-18 60-minute sessions. But this range can vary widely per each unique individual and various factors. 

Because people and our histories are so complex, it cannot be determined from the outset how many sessions will be needed. However, EMDR is shown to be quicker and more efficient than many other types of therapy. For example, many studies have found EMDR therapy to be more rapid and/or more effective than trauma-focused cognitive behavioral therapy (source).

EMDR is relatively short-term as far as therapy goes, but it isn’t a quick fix. It is not advantageous to sacrifice quality for speed. In fact, trying to rush through treatment can have negative consequences and a negative outcome. 

TLDR: It depends, and there’s really know way of knowing for sure.

 

 

How much does EMDR cost?

 

The fee for EMDR therapy is the same as with any other therapy. But it’s worth considering session cost vs overall cost. Since EMDR requires fewer sessions, it may cost less overall than other, longer forms of therapy.

At the time of this blog post, the average cost of therapy in the United States is around $150 per the standard 50 minute session. According to GoodRx, in the year 2020, “the average cost of an hour-long therapy appointment can range from $65 per hour to $250 (or even more). The pricing usually depends on the therapist’s level of training, their years of experience, and location — therapy is pricier in more expensive cities.”

You can learn about the fees for EMDR with Mend Modern Therapy here. 

TLDR: It depends, but it could be comparatively less than other forms of therapy. 

 

Is EMDR worth it?

 

Many people don’t realize that much of the distress they hold in their minds and bodies actually comes from unprocessed negative life experiences or trauma. EMDR may help you gain a sense of calm, confidence, clarity, and peace of mind. For many of us, few things are worth more than that.

TLDR: Absolutely.