Eye Movement Desensitisation and Reprocessing (EMDR)
What is EMDR Therapy?
Eye movement desensitisation and reprocessing (EMDR) therapy was developed in the late 1980s by American psychologist Francine Shapiro who discovered, during a walk in the woods whilst studying for her PhD, that bilateral eye movements (similar to those that occur during sleep) seemed to slow down and quell anxious thoughts she was experiencing. From this insight, Shapiro trialled the approach with her therapy clients, eventually going on went develop EMDR. Since then, EMDR has been extensively researched, undergone several developments and is a therapeutic intervention which has helped people all over the world.
Theoretically, EMDR is rooted in the ‘Adaptive Information Processing’ model [1], which suggests that negative thoughts, feelings and behaviours (as might characterize a variety of mental health struggles) are the result of unprocessed memories of difficult life events (which a client may or may not be aware of at the time they begin treatment). These memories are considered to be not fully ‘integrated’ across neural networks in the brain, thus causing disruption in a person’s day to day life (manifesting in negative thoughts and beliefs, as well as painful emotions and sensations). EMDR seeks to facilitate a natural, safe process through which these memories can become fully integrated. It has been found to be particularly effective in treating the after-effects of exposure to trauma and adversity, including:
-War-related experiences
- Natural disaster experiences
- Surgical trauma
- Sexual/physical abuse and neglect
- Road traffic accidents
- Workplace accidents
- Assault
Indeed, EMDR is recommended as a treatment for post-traumatic stress disorder (PTSD) by a number of highly esteemed organisations including the UK’s National Institute of Clinical Excellence [2], the World Health Organisation [3] and the American Psychological Association [4]. It has been found to be as effective as (and in some respects, slightly superior to) the current standard of care (trauma-focussed cognitive behavioural therapy or TF-CBT) in treating PTSD symptoms [5]. Patient experiences of the treatment are also reported on as being transformative [6].
While originally developed as a treatment for PTSD, increasingly EMDR is found to be an effective treatment for several types of emotional difficulties, which may in some way be linked to difficult early life experiences. Indeed, studies have found it to be an effective therapy for addictions, somatoform disorders, sexual dysfunction, eating disorders, personality disorder and mood disorders [7] including depression (with a benefit of reducing likelihood of relapse [8-9]), as well as a range of anxiety disorders including panic disorder, specific phobias, obsessive compulsive disorder [10]; substance use disorder [11] and difficulties that stem from experiences of emotional abuse, neglect, and other adverse events in childhood [12].
What does EMDR involve?
EMDR therapy sessions are typically held once a week on a one-to-one basis and can last between 50-90 minutes. The number of sessions needed will depend on a variety of factors including the severity of your difficulties, treatment goals and any adaptations to the treatment that may be warranted based on individual life circumstances and preferences.
During an EMDR session, you will be supported in bringing to mind a representation of a difficult life event that may be linked (consciously or unconsciously) to the symptom for which you are seeking treatment. For example, someone who seeks treatment for intense, debilitating anxiety whenever they are tasked with public speaking, may - during an EMDR treatment session- (spontaneously) recall a painful moment in their youth where they were humiliated by a teacher in front of their peers at school when delivering a speech. Images, thoughts, emotions and bodily sensations associated with the mental representation of this moment in time are activated, following which bilateral stimulation (BLS) is initiated. This stimulation could involve repeatedly moving your eyes from side to side (right to left, guided by your therapist) or tones being played through one ear and then the other (right to left, via a headset), or even tapping movements on different sides of the body (right to left). The type of BLS used will be based on your preferences. Whilst the effect of BLS is not fully understood, it is thought that BLS may help with rapid integration and processing of problematic memories. While BLS is underway, you will be encouraged to allow and go with any associations or feelings or thoughts that may enter your mind.
Distinctive from other talking therapies, EMDR posits a role for less ‘“talking’”, (suggesting that talking, analysing and intellectualising can in some instances prevent emotional processing). This means it can be a useful model for clients with traumatic experiences that they might struggle to put into words or talk about with another person as they will not need to describe such experiences in great detail (or even at all).
EMDR therapy in London
I offer EMDR therapy both online and in-person from my consulting room in the Harley Street, Marylebone area of London. I am especially interested in using adapted forms of EMDR to help treat relational and attachment-based, as well as complex, trauma (e.g. characterised by difficult early experiences in childhood), finding that it integrates well with other therapeutic models such as schema therapy (ST), cognitive behavioural therapy (CBT) and dialectical behaviour therapy (DBT). EMDR can be delivered as a stand alone, focussed treatment or as an therapy technique used alongside other strategies and techniques.
If you’d like to find out more about EMDR or any of the other forms of therapy I provide, please do get in touch.
[1] Shapiro, F. (2001). Eye movement desensitization and reprocessing (EMDR): Basic principles, protocols, and procedures. Guilford Press.
[3] https://apps.who.int/iris/bitstream/handle/10665/85119/9789241505406_eng.pdf
[4] https://www.apa.org/ptsd-guideline/ptsd.pdf
[5] Snyder, M., & Trang, D. (2022). Is EMDR effective in treatment of PTSD?. Evidence-Based Practice, 25(3), 14-15.
[6] Whitehouse, J. (2021). What do clients say about their experiences of EMDR in the research literature? A systematic review and thematic synthesis of qualitative research papers. European Journal of Trauma & Dissociation, 5(3), 100104.
[7] Scelles, C., & Bulnes, L. C. (2021). EMDR as treatment option for conditions other than PTSD: A systematic review. Frontiers in Psychology, 12, 644369.
[8] Carletto, S., Malandrone, F., Berchialla, P., Oliva, F., Colombi, N., Hase, M., ... & Ostacoli, L. (2021). Eye movement desensitization and reprocessing for depression: a systematic review and meta-analysis. European journal of psychotraumatology, 12(1), 1894736.
[9] Altmeyer, S., Wollersheim, L., Kilian-Hütten, N., Behnke, A., Hofmann, A., & Tumani, V. (2022). Effectiveness of treating depression with eye movement desensitization and reprocessing among inpatients–A follow-up study over 12 months. Frontiers in Psychology, 13, 937204.
[10] Marsden, Z., Lovell, K., Blore, D., Ali, S., & Delgadillo, J. (2018). A randomized controlled trial comparing EMDR and CBT for obsessive–compulsive disorder. Clinical psychology & psychotherapy, 25(1), e10-e18.
[11] Logsdon, E., Cornelius-White, J. H., & Kanamori, Y. (2023). The Effectiveness of EMDR With Individuals Experiencing Substance Use Disorder: A Meta-Analysis. Journal of EMDR Practice and Research.
[12] Hafkemeijer, L., Starrenburg, A., van der Palen, J., Slotema, K., & de Jongh, A. (2021). Does EMDR therapy have an effect on memories of emotional abuse, neglect and other types of adverse events in patients with a personality disorder? Preliminary data. Journal of Clinical Medicine, 10(19), 4333.