EMDR: A Remarkable Treatment for Trauma
|Copyright (c) 2008 by Kevin Thompson.
The term "trauma" refers to any a serious injury or shock. It can be
physical or emotional, and physical trauma often causes emotional
trauma. Traumatic experiences can cause permanent emotional and
psychological harm, especially if inflicted deliberately by another
person, and repeated over time. The lasting effects of emotional trauma
can include Post-Traumatic Stress Disorder (PTSD), Dissociative
Identity Disorder, and other, crippling, ills.
The emotional wounds caused by serious trauma can be very difficult to
heal. The difficulty is greater, the more severe and prolonged the
Yet recovery is often possible, and one interesting technique for
enabling recovery is called "Eye Movement Desensitization and
Reprocessing." The name is descriptive, but unwieldy enough that the
acronym EMDR is used almost universally.
EMDR was discovered by accident, when Dr. Francine Shapiro (a very
observant psychologist), found that performing certain eye movements,
while thinking about distressing subjects, caused her distress to fade.
Further research in this area allowed her and others to develop EMDR as
it is used today. EMDR is now a widely available technique, still
considered experimental, but popular because it is relatively easy to
do, does not require medication (which only a medical doctor can
prescribe, and which is of limited use in treating trauma), and no
clearly superior alternatives are available.
EMDR should be performed by a therapist who has been trained in the
technique, and is certified as an EMDR practitioner. A certified
therapist is better equipped to provide the insight, guidance, and
support necessary to get the best results from the process (and to
minimize the possible negative effects) than an "amateur." Yet it
remains the case that EMDR itself is a very simple technique, when
stripped to its essentials.
What the Therapist Does
EMDR has these fundamental characteristics:
- The therapist provides a stimulus that alternates between the left
and right sides of the patient, thus stimulating the right and left
hemispheres of the brain.
- While experiencing the stimulus, the patient focuses on a traumatic
event that has contributed to his suffering.
The most common approach, which inspired the name of the procedure, is
to provide a visual stimulus. The therapist may move his hand back and
forth horizontally, while the patient tracks the moving hand with his
eyes. Some therapists use a wand, or wand with a light on the end, and
wave the wand back and forth.
Less common, and used more often with children, is auditory
stimulation. The patient listens to a sound that alternates from side
to side. This can be done by listening to headphones, in which one
side, then the other, provides a tone.
A third approach is to use a tactile stimulus. The patient may hold or
touch vibrating objects with his hands, while the the objects take
The different techniques may be combined; for example, sound and
vibrations can be used at the same time, alternating in synchrony from
one side to the other.
What the Patient Does
While experiencing the alternating stimulus, the patient thinks about
the traumatic event. "Think" here means not just cognition, but
recalling the totality of the experience. This means the patient
remembers not only the thoughts, but other attributes of the
experience, such as behaviors, feelings (affect), and sensations. It is
important to re-experience as many of these threads of the experience
There is no single technique for summoning up such an experience. Some
people can just think back and remember, and everything that needs to
happen, does happen. Some need to "get in the mood" first by looking at
an object, a picture, or a written description of the experience. Some
need to verbalize the experience during the EMDR process itself,
walking through the experience in narrative form. What matters is doing
what works, where "works" means that the patient summons up some of the
feeling, sensations, and memory of actions that went with the traumatic
EMDR is usually performed in many sessions, not just one. One reason is
that multiple sessions may be required to treat a single traumatic
experience. Another is that several such experiences may need to be
addressed. A patient will typically visit whatever events he can recall
that seem relevant, and repeat EMDR multiple times for each. When the
emotional 'charge' has been drained from a particular experience
through repeated EMDR sessions, he moves on to another. He is done when
he has exhausted his list of traumatic events, or no longer feels the
need for more EMDR, because he has achieved his goal.
What EMDR Feels Like
The emotions that a patient experiences may range from mild to
overwhelming. In some people, the feelings can be too strong to bear,
and the therapy must either be terminated, or broken into shorter
Typically, one can espect to feel some degree of emotional distress
during the EMDR session. (This is not only typical, but a requirement
for the process to work.) Over the course of repeated EMDR sessions,
the emotional reactions usually decrease, and the impairment of the
patient's life fades.
However, nothing is guaranteed, and EMDR is no more a foolproof
technique than any other. Some patients who have experienced severe
trauma, and severe psychological consequences, may find that EMDR is
ineffective, unbearable, or worsens their symptoms.
Why EMDR Works
In the deepest sense, no one knows why EMDR works. In the practical
sense, it often reduces the effect of past trauma. Depending on the
age, duration, and severity of the trauma, anywhere from a few sessions
to dozens of sessions may be required to produce the desired results.
People who have experienced severe trauma manifest a variety of
symptoms and disorders, but these manifestations share the common
problem that they improve slowly, or not at all, with time. The patient
is "stuck" in a state that he wants to leave, but cannot.
EMDR manages to "un-stick" people who are stuck in a traumatized state.
Just why this is so is not known, but explanations usually focus on the
notion that the brain's ability to process (experience and record)
events malfunctions when an event is traumatic. Instead of storing away
the various attributes in the usual fashion, some aspects of the
experience literally "get stuck" in parts of the brain where they do
not belong. As a result, the patient cannot experience memories of the
event in the usual fashion. (This means he cannot move on from them, as
he would other, unpleasant experiences.) Instead, the different
attributes of the traumatic event are dissociated from each other. amd
cause permanent changes in the way the patient's thoughts, emotions,
and reactions work.
Why a Trained Professional is Important
There are two main reasons.
1) Success is much more likely if EMDR is done by someone who has
training and a lot of experience, and thus knows how best to set up the
most productive EMDR sessions. This is very important, as someone who
lacks this training may have no idea of how and when to employ the
technique, no matter how simple the technique itself is. Also,
important issues can arise as a result of successful EMDR sessions, and
a good therapist will have a much better idea of what to do about the
2) EMDR can re-traumatize the patient (exacerbate the trauma), by
producing a traumatic experience that reprises the original one.
Significant re-traumatization has the potential to cause serious
deterioration of the patient's emotional health, possibly leading to
suicide or violence. A trained therapist is more likely to avoid
serious re-traumatization, and better able to deal with it if it comes
up, than someone who lacks experience in the field.
Can EMDR be Done on a Self-Help Basis?
Some types of therapy can be done without a therapist, by someone who
is sufficiently motivated and knowledgeable. Others cannot. As for
EMDR, the answer is both "Yes," and "No."
"No" because the EMDR process as taught in certification classes
requires a therapist and a patient.
"Yes" because anyone can look back and forth while thinking about
A better question is probably whether it is a good idea to try EMDR by
oneself, but I have not found any guidelines on the subject. My
suspicion (which is not a recommendation), is that self-administered
EMDR might be a harmless way to speed recovery from a bad day at work,
but is not wise for someone who is suffering from life-changing trauma.
How to Learn about EMDR
Many books about EMDR are available, including some from Dr. Shapiro
herself. The EMDR Institute, whose Web site may be found at www.emdr.com
useful information about the technique.
Ph.D. is the author of Medicines for Mental Health: The
Ultimate Guide to Psychiatric Medication
You can find information about treatments for depression, bipolar
disorder, schizophrenia, and sexual problems on his Web site at