Eye movement desensitization and reprocessing therapy, commonly known as EMDR, is a mental health therapy method. EMDR treats mental health conditions that happen because of memories from traumatic events in your past. It’s best known for its role in treating post-traumatic stress disorder (PTSD), but its use is expanding to include treatment of many other conditions.
Eye movement desensitization and reprocessing (EMDR) therapy is a mental health treatment technique. This method involves moving your eyes a specific way while you process traumatic memories. EMDR’s goal is to help you heal from trauma or other distressing life experiences. Compared to other therapy methods, EMDR is relatively new. The first clinical trial investigating EMDR was in 1989. Dozens of clinical trials since EMDR’s development show this technique is effective and can help a person faster than many other methods.
EMDR can help people with a wide range of mental health conditions. Adolescents, teenagers and adults of all ages can benefit from this treatment. Some healthcare providers also specialize in EMDR for children.
EMDR therapy doesn’t require talking in detail about a distressing issue. EMDR instead focuses on changing the emotions, thoughts or behaviors that result from a distressing experience (trauma). This allows your brain to resume a natural healing process. While many people use the words “mind” and “brain” when referring to the same thing, they’re actually different. Your brain is an organ of your body. Your mind is the collection of thoughts, memories, beliefs and experiences that make you who you are.
The way your mind works relies on the structure of your brain. That structure involves networks of communicating brain cells across many different areas. That’s especially the case with sections that involve your memories and senses. That networking makes it faster and easier for those areas to work together. That’s why your senses — sights, sounds, smells, tastes and feels — can bring back strong memories.
EMDR relies on the Adaptive Information Processing (AIP) model, a theory about how your brain stores memories. This theory, developed by Francine Shapiro, PhD, who also developed EMDR, recognizes that your brain stores normal and traumatic memories differently.
During normal events, your brain stores memories smoothly. It also networks them, so they connect to other things you remember. During disturbing or upsetting events, that networking doesn’t happen correctly. The brain can go “offline” and there’s a disconnect between what you experience (feel, hear, see) and what your brain stores in memory through language.
Often, your brain stores trauma memories in a way that doesn’t allow for healthy healing. Trauma is like a wound that your brain hasn’t been allowed to heal. Because it didn’t have the chance to heal, your brain didn’t receive the message that the danger is over.
Newer experiences can link up to earlier trauma experiences and reinforce a negative experience over and over again. That disrupts the links between your senses and memories. It also acts as an injury to your mind. And just like your body is sensitive to pain from an injury, your mind has a higher sensitivity to things you saw, heard, smelled or felt during a trauma-related event.
This happens not only with events you can remember, but also with suppressed memories. Much like how you learn not to touch a hot stove because it burns your hand, your mind tries to suppress memories to avoid accessing them because they’re painful or upsetting. However, the suppression isn’t perfect, meaning the “injury” can still cause negative symptoms, emotions and behaviors.
Sights, sounds and smells with a connection or similarity to a trauma event will “trigger” those improperly stored memories. Unlike other memories, these can cause overwhelming feelings of fear, anxiety, anger or panic.
An example of this is a post-traumatic stress disorder, or PTSD, flashback, where improper storage and networking causes your mind to access those memories in a way that’s uncontrolled, distorted and overpowering. That’s why people with a history of flashbacks describe feeling as if they were reliving a disturbing event. The past becomes the present.
When you undergo EMDR, you access memories of a trauma event in very specific ways. Combined with eye movements and guided instructions, accessing those memories helps you reprocess what you remember from the negative event.
That reprocessing helps “repair” the mental injury from that memory. Remembering what happened to you will no longer feel like reliving it, and the related feelings will be much more manageable.
The most widespread use of EMDR is for treating post-traumatic stress disorder (PTSD). Mental healthcare providers also use it in the treatment of the following conditions:
EMDR therapy is very common around the world. In the United States, the Department of Veterans Affairs and Department of Defense list EMDR as a “best practice” in treating veterans experiencing PTSD. Research on EMDR includes dozens of clinical trials, research studies and academic papers. It has official approval from the World Health Organization (WHO) and government organizations and agencies in the United Kingdom, Australia and Germany, among others.
There’s some controversy surrounding why EMDR works. The creator of EMDR, Dr. Francine Shapiro, later developed a working theory about how your brain stores memories after accidentally discovering the eye movement technique she later used to create this therapy technique.
However, that controversy doesn’t extend to whether or not EMDR does work. Dozens of controlled trials and research studies have analyzed EMDR and shown that it’s effective.
EMDR therapy consists of eight phases. These phases occur over multiple sessions, with one session sometimes using parts of several phases. An example of this would be how phases 1 and 2 typically happen only in early sessions, while phases 3 through 8 are part of multiple sessions later.
For a single disturbing event or memory, it usually takes between three and six sessions. More complex or longer-term traumas may take eight to 12 sessions (or sometimes more). Sessions usually last between an hour and 90 minutes. The eight phases are:
In the early years of EMDR, stimulating a single sense on both sides of your body usually involved your vision. Healthcare providers would hold up a hand with two fingers extended and have you follow the tip of their finger from side to side with your eyes only.
Newer methods for EMDR can involve your vision, such as with specialized light devices. These have a moving light that you follow with your eyes in place of your healthcare provider’s hand. Other devices might use sound, where speakers on either side of your body play tones. Healthcare providers might also use your sense of touch (if you’re comfortable with this), tapping on your hands, arms or thighs to activate your sense of touch on both sides of your body, or holding a device that pulses in your hands.
EMDR has several advantages.
EMDR does have some drawbacks compared to other forms of therapy.
EMDR has very low risks. The most common negative effects are negative thoughts or feelings between sessions. Your healthcare provider can help you understand what to expect with these and how you can react to them.
Most people undergo EMDR for several weeks to a few months. Recovery time between sessions is minimal, and your healthcare provider can help guide you on how to take care of yourself between sessions.
You should see your healthcare provider as recommended. If you feel like you need to increase how often you see them, talk to them about this and see how they can help you. You should also talk to them if you notice your symptoms from upsetting memories are changing or affecting your life in a new or disruptive way.
You should get emergency care if you have disturbing thoughts about harming yourself, including thoughts of suicide, or about harming others. If you have thoughts like this, you can call any of the following:
A note from Cleveland Clinic
EMDR therapy is a relatively new — but very effective — method of helping people with traumatic memories. It’s also an option for people of all ages, including children. Though this treatment is best known for its use in treating PTSD, ongoing research shows it can treat many other conditions. Though it can’t treat all mental health conditions, this therapy method can make a big difference for people struggling with painful events in their past.
Last reviewed by a Cleveland Clinic medical professional on 03/29/2022.
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