EMDR: An Established PTSD Therapy

I wanted to share my own experiences with EMDR. This was a treatment I only heard about in 2017 and was finally able to pursue. After having tried Cognitive Processing Therapy (CPT), and not seeing the results I was hoping for, I was optimistic about EMDR. Let me try to explain what this process is and how it works.

EMDR stands for Eye Movement Desensitization and Reprocessing. It is a type of psychotherapy designed to help people heal from emotional disturbances associated with traumatic life experiences. It is especially helpful in healing from Post-Traumatic Stress Disorder which is triggered after either witnessing or experiencing a terrifying event like having a rocket land in front of you and not going off, or the MRAP or Humvee in front of you exploding into a million pieces.

EMDR pays attention to the past, present, and future; it focuses on past disturbing memories, current situations that cause distress, and the development of skills and attitudes needed to make positive actions in the future. It shows that the mind can in fact heal from psychological trauma just as the body heals from physical trauma, as long as blockages to that healing are cleared. Through EMDR, the client is able to process the memory and disturbing feelings, and that processing can lead to symptom relief. By the end of treatment, he or she can leave feeling empowered by the memory instead of devalued.

Francine Shapiro, Ph.D. developed this therapy in the late 1980s, according to the EMDR Institute, which she founded in Watsonville, California. Dr. Shapiro was walking in a park when she realized that eye movements appeared to decrease negative emotions from her own distressing memories. She added several other treatment elements and developed a procedure called Eye Movement Desensitization (EMD). She continued to tweak the treatment using feedback from clients and clinicians, and two years later, it was renamed “EMDR” to reflect the cognitive changes that take place. In 1995, after multiple controlled studies were published, the therapy was no longer labeled “experimental,” training restrictions were removed, and a textbook of procedures was published. EMDR is now widely viewed as a first-line treatment for trauma. More than 100,000 therapists worldwide use this therapy, and millions of people have been successfully treated over the past 25 years.

What is EMDR is like?

EMDR is a treatment that includes multiple phases. First, the therapist reviews the client’s history, allows the client to talk about the trauma, then determines what traumatic memory to specifically treat. The therapist teaches the client ways to cope with emotional or psychological stress, such as deep breathing, visualizing a “safe place,” and seeking self-care activities.

When the therapist begins to use EMDR therapy techniques to treat the targeted memory, the client focuses on that internal distress while their attention is brought to an external stimulus. The client is asked to focus on a negative thought, memory or image while simultaneously doing specific eye movements, or using other bilateral stimulation like taps or auditory stimulation. Then the client is asked to let their mind wander, while noticing the thoughts and feelings that arise. If he or she becomes distressed, the therapist helps the client calm down before moving on.

Clients are not asked to relive the intensity of the traumatic experience for a long period of time, as other therapies might do. EMDR can lead to a temporary increase in distress, since it is a type of psychotherapy; however, this distress only lasts for a few moments, and then quickly decreases. Even after a session, the client may continue to process an incident, and other memories, feelings and dreams may come up. The client is trained in techniques to decrease this distress if it does not subside on its own. Over time, the distress connected to certain thoughts, memories, or images will start to fade. At the end of treatment, the client and therapist both evaluate the progress made.

Treatment Length Varies

The number of EMDR sessions needed depends on the client’s history and his or her specific problem. Usually, the active processing of memories can begin after 1 or 2 sessions, but it really depends on the client’s ability to first learn and use the self-control techniques that are taught by the therapist.

Research shows that for most people, a single traumatic experience can be processed within about 3 sessions. In two studies, one published in the Bulletin of the Menninger Clinic in 1997 and the other published in 2002 in the Journal of Clinical Psychology, 83-90% of civilians were no longer diagnosed with PTSD after 4 to 7 sessions. In a 1998 study published in the Journal of Traumatic Stress, about 77% of combat veterans reported they no longer had PTSD symptoms after 12 sessions. The length of treatment ultimately depends on the number of traumas experienced and the age of PTSD onset. If an individual experiences multiple traumas, that may require a longer treatment time.

Effectiveness of EMDR

EMDR is now so well-researched, that it is recommended as an effective treatment for trauma by the American Psychiatric Association, the Department of Defense, and Veterans Affairs. The DOD and VA have both placed EMDR in the highest category, strongly recommending it for all trauma victims. The APA Practice Guideline states that aside from anti-depressant medication, EMDR is one of only two psychotherapies that it recommends as first-line trauma treatments. Most recently, in 2013, the World Health Organization (WHO) agreed, and added that it’s for people of all ages who have PTSD.

Dr. Shapiro published her first study investigating the treatment of PTSD in the Journal of Traumatic Stress in 1989. She noted that the EMD procedure “serves to desensitize the anxiety related to traumatic memories, not to eliminate all PTSD-symptomology and complications.” It is not an overnight cure. Even so, many study participants have responded really well over the years and were no longer diagnosed with PTSD after completing EMDR treatment.

Since its development, hundreds of studies have demonstrated that EMDR is an effective treatment for PTSD specifically. This therapy may be most effective as a treatment for such anxiety disorders that result from traumatic experiences with a known onset, but less effective for disorders without a known onset. Research does not yet support the idea of using EMDR for specific phobias, panic disorders and agoraphobia.

Results That Can Last

There have been 12 studies of the PTSD population that assessed differences in outcome, with follow-up times anywhere from 3 to 15 months after treatment, to as far as 5 years after treatment. In 9 studies with civilian participants, the treatment effects were maintained in 8 of them. The 1998 study with combat veterans found that those who were provided a full course of 12 EMDR sessions maintained effects 9 months after treatment. Other studies with limited treatment showed that the effects were not maintained at the follow-up.

To read more information about Eye Movement Desensitization & Reprocessing and to find an EMDR-trained clinician near you, visit EMDR.com.

I went through EMDR treatment with a counselor through the Vet Center, a VA clinic outside of the actual VA hospital. I participated in this process once a week for a total of twelve weeks. I found it helpful in letting me realize that despite my best efforts in Iraq, the enemy ultimately got a vote. That no matter how well we planned things, the enemy still got their chance to mess our best laid plans up. This was hard to accept and it brought on a lot of strong emotions. While I believe it did help with some of what I was dealing with, it was incredibly painful and hard to go through. If I had to do it over again, I probably would have done the SGB treatment first, and then gone through EMDR. I would still recommend any veteran struggling with PTSD to give it a try, but I’d recommend doing a couple of SGB injections first. You need to get the physical and emotional effects under control first before you pull this scab wound open to clean it out.

#EMDR #EMDRtherapy #EyeMovementDesensitizationAndReprocessing #PostTraumaticStressDisorder #PTSD #PTSDtherapy #PTSDtreatment #Veterans #Civilians