How Does EMDR Treat Trauma? Psychologists Explain
Eye Movement Desensitization and Reprocessing (EMDR) therapy was developed in the 1980s to help people with post-traumatic stress disorder (PTSD). Since then, use of the treatment has grown—and so has the evidence behind it. Nancy J. Smyth, Ph.D., a dean and professor at the University at Buffalo School of Social Work, uses EMDR with patients coping with trauma; here, she explains how it works.
What is EMDR, and why does it help with PTSD?
Smyth: Trauma can overwhelm our minds’ natural information processing system, leaving the memory stuck as though the experience is still happening. When people have PTSD, rather than remembering the trauma, recognizing that it was disturbing, and knowing that it’s over, they can feel as if they’re reliving it. EMDR is a type of psychotherapy in which a therapist uses bilateral dual attention stimulation (such as side-to-side eye movements) to help change the way memories are stored.
What happens during EMDR treatment?
Smyth: First, you’ll talk to your therapist about the reason you’re seeking out therapy and about events in your past that have been distressing for you. Next, you’ll do preparation, during which your therapist will see if you have the skills and tools you’ll need to cope with difficult emotions. If you don’t, they will help you learn them (possibly using other types of therapy). Then the therapist will ask questions to make sure you’re both on the same page about the target of treatment.
During treatment, the therapist will prompt you to start by focusing on a traumatic memory as you follow their fingers or an object as it moves from side to side. (Sometimes sounds on the sides of the body—the “bilateral” part of the stimulation—are used instead.) Throughout this, your therapist will ask you to notice thoughts, feelings, or sensations you’re experiencing. They won’t do a lot of talking, but will ask questions like “What comes up now?” The idea is that the bilateral stimulation activates the body’s natural adaptive information processing system in a safe environment, letting you stay in the present moment as you’re simultaneously remembering a distressing experience so your mind can reprocess that memory as a neutral one.
Is there evidence that it works?
Smyth: Yes, research indicates that compared with other types of therapy, like trauma-focused cognitive behavioral therapy or prolonged exposure, EMDR is just as effective for addressing PTSD or perhaps more so.
How quickly does it work?
Smyth: It varies. If you have healthy coping skills for managing stressors, the prep phase of treatment may be shorter. If you’re seeking treatment for an isolated traumatic experience, the history-taking and stimulation parts of treatment may be shorter than if you’ve experienced a lot of trauma. Typically, the process takes at least three to 12 sessions.
How can I find a provider?
Smyth: You’ll want a licensed mental health professional who is trained in EMDR. The EMDR International Association is the major professional organization that certifies therapists; you can search the group’s directory at emdria.org.
Is this the same therapy Mel B used?
Yes, in 2018, the Spice Girls singer (whose full name is Melanie Brown) told British tabloid The Sun that she was checking herself into rehab for alcohol and sex issues and undergoing treatment for post-traumatic stress disorder. Brown revealed that working on her book, Brutally Honest, surfaced "massive issues" that she suppressed following her divorce from film producer Stephan Belafonte, whom she has claimed physically and emotionally abused her for years. The singer told The Sun she was diagnosed with PTSD and had begun EMDR. "After trying many different therapies, I started a course of therapy called EMDR, which in a nutshell works on the memory to deal with some of the very painful and traumatic situations I have been through," said Brown. "I don’t want to jinx it, but so far it’s really helping me," she said. "If I can shine a light on the issue of pain, PTSD and the things men and women do to mask it, I will."
As an addiction and relationship therapist, Paul Hokemeyer, Ph.D., a psychotherapist based in New York City and Telluride, Colorado, says he recommends EMDR frequently. “Its success, however, depends of the integrity of the therapeutic relationship the patient has with the clinician providing the actual EMDR treatment and me, the primary therapist making the referral,” he says. “This heightened level of care is essential because EMDR requires the patient to reprocess their original trauma.” If you have symptoms of PTSD and are not yet seeking treatment, the U.S. Department of Veterans Affairs provides a PTSD Treatment Decision Aid to help you learn more about the various treatment options. You can use this as a jump-off point to start the conversation with your mental health provider.