By Jamie Sedgwick, LCPC, NCC
EMDRIA Approved Consultant
The therapy world seems full of abbreviations for various treatment modalities: CBT, DBT, ACT, IFS…. The list can go on and begin to feel a bit like sorting through alphabet soup. With Prince Harry's and other celebrities' help, another therapy abbreviation has been growing in popularity: EMDR, which is short for “Eye Movement Desensitization and Reprocessing.” EMDR has been catching the attention of clients and clinicians, and, like the other alphabet-soup therapies, many are wondering: What is EMDR therapy?
EMDR was created in 1987 by Francine Shapiro, who was a doctoral student at the time. The idea to begin exploring the link between eye movements and desensitizing distressing material came to her one day on a walk (Shapiro, 2018). Francine realized that the distressing material she was thinking about became less and less uncomfortable as she walked. She also noticed that her eyes moved back and forth (horizontally) while walking and thinking about the material. This sparked Francine to begin researching the connection between eye movements and the reduction in distress, ultimately leading to the creation of EMDR. Today, EMDR is an 8 Phased, evidence-based treatment modality for PTSD (Posttraumatic Stress Disorder).
Since Francine’s walk, many trauma and mental health experts have continued to research the efficacy of EMDR and why it works. They have also continued to create numerous protocols to treat a variety of diagnoses not limited to but including PTSD, C-PTSD, Depression, Anxiety, OCD, Eating Disorders, and Personality Disorders. If you can name it, EMDR can most likely treat it.
At this point, some people don’t need to hear anymore. They just want to know the name of a trained clinician and when they can get started. Other people are skeptical and wonder how EMDR can actually treat and cure the diagnoses listed above. For the skeptics, here is a quick lesson in neuroscience.
The Eye Movement referenced in the name of the modality refers to what we now know as something a bit broader than originally researched eye movements called Dual Attention Stimulus or DAS (because we love a good abbreviation).
Dual Attention Stimulus refers to any alternating (right to left) bilateral stimulation. This could be eye movements, tapping, or auditory stimulation. Research has shown that this action seems to break down barriers in the brain, allowing all parts of it to be simultaneously activated. EMDR is also based on a theory called Adaptive Information Processing Theory (AIP Theory). According to AIP Theory, the brain will move towards adaptive processing given the right environment and circumstances.
Dual Attention Stimulus (DAS) and EMDR Protocols create the right environment and circumstances to allow Adaptive Information Processing (AIP) to take place. This means that during an EMDR session, any maladaptive information (cognitive, emotional, or somatic) related to a memory is discarded so that only adaptive information remains. The end result: a memory that has been emotionally desensitized and adaptively reprocessed.
Questions people usually have when they start EMDR therapy are, “What can I expect? What is it like?”
As mentioned earlier, EMDR Therapy consists of 8 Phases. While there are phases to this modality, it is not “one size fits all.” Each phase of treatment will be adapted to meet the individual client’s needs and will take place over a varying number of sessions from one client to the next.
Phase 1 of EMDR is History and Treatment Planning. During this phase, the therapist gathers vital information to help formulate a plan. They will likely ask questions about what experiences brought the client into treatment and explore areas of strengths. An EMDR therapist typically will NOT ask you to detail all of your past traumas during this phase. There is a reason. When humans talk about an event in detail, it lights up the brain's memory network, and they can begin to experience the feelings, thoughts, and body sensations as if they are reliving the event. An EMDR therapist will be mindful of a client’s preparedness for trauma work before asking for information that lights up the memory networks.
Phase 2 is called Preparation. This is usually the phase that differs the most from one person to another because different people require different skills to prepare for trauma reprocessing. Don’t get discouraged in this phase. The work that happens here is so important to be sure that the trauma reprocessing that happens later goes as smoothly as possible. The therapist will focus on establishing critical coping skills and building therapeutic rapport. EMDR is a very relational therapy because a good relationship is important to feel safe during trauma reprocessing. It is also during Phase 2 that the therapist will introduce Dual Attention Stimulus (DAS) for the first time.
Phases 3–8 typically occur over the course of two sessions and repeatedly happen—depending on how many memories are being reprocessed. During these phases, memories are identified, and the appropriate protocol is utilized to desensitize and reprocess the memories.
After the memories have been identified, successfully desensitized and reprocessed using phases 3–8, the therapist will assist the client in identifying and desensitizing present-day triggers. Finally, the therapist will utilize protocols to assist the client in preparing for possible distressing situations in the future.
For therapists reading this hoping for some clarification on EMDR, understand this is not simply a therapy tool. This is a therapy modality. EMDR therapists constantly think through an EMDR lens, which completely changes how cases are conceptualized—starting with the very first session.
Becoming EMDR trained can almost feel like becoming a therapist all over again because of how much it shifts the treatment approach. It is also a modality where the therapist needs to be prepared to be a life-long learner. The EMDR community is full of incredible clinicians that are continuously researching and creating new protocols to help improve the treatment of trauma.
Finally, there truly is a community of EMDR-trained clinicians. It is amazing to go to conferences or advanced training sessions to connect with other like-minded professionals.
If you are someone reading this because you are interested in engaging in EMDR therapy, be sure that the therapist you find received their training through an EMDRIA-approved training. You can search for EMDRIA-trained therapists in your area by going to emdria.org.
If you are a clinician reading this because you are interested in getting trained, be sure the training you choose is EMDRIA approved. You can find EMDRIA-approved training by going to emdria.org. Trauma Specialists Training Institute (TSTI) is an EMDRIA-approved training provider that offers EMDR Basic Training, Advanced Training and ongoing consultation options. Check out our website for more information: traumaspecialiststraining.com.
Shapiro, Francine. Eye Movement Desensitization and Reprocessing (EMDR)Therapy: Basic Principles, Protocols and Procedures. Third Edition. c. 2018.