The Effectiveness of EMDR (and Virtual EMDR) on the Treatment of Trauma and Other Mental Health Conditions

“The past affects the present even without our being aware of it.”

— Francine Shapiro

EMDR stands for Eye Movement Desensitization and Reprocessing, which was developed by Francine Shapiro. It is a psychotherapy approach primarily used to treat post-traumatic stress disorder (PTSD) resulting from traumatic events, such as sexual assault, car accidents, and witnessing or experiencing violence. It is also effective for individuals struggling with other forms of trauma, including childhood abuse or neglect, as well as a range of other mental health difficulties, including anxiety, depression, complex grief, chronic pain, panic attacks and phobias.

EMDR is based on the Adaptive Information Processing Model (AIP), which promotes the idea that our minds have a natural capacity to process distressing life events in a healthy and adaptive way. However, overwhelmingly traumatic experiences can negatively impact the brain’s natural processing and healing capacity. When the information related to distressing life experiences is not processed adaptively, it can be stored dysfunctionally in the brain. Later, when there is a trigger or reminder of the trauma, the individual will experience negative affect and sensations, along with distorted thoughts, beliefs, images, and perceptions that they experienced when the trauma happened.

In EMDR, you will be able to access and process the dysfunctionally stored memories through bilateral stimulation, such as eye movements, tapping or auditory stimulation while recalling traumatic memories. By engaging in bilateral stimulation, EMDR helps to disrupt the maladaptive memory networks associated with trauma, link up helpful information between different networks in the brain, and facilitate adaptive processing to “heal” the trauma.

EMDR and the underlying brain processes

Numerous studies have demonstrated the effectiveness of EMDR in reducing symptoms of PTSD and other trauma-related conditions. Research suggests that during EMDR, bilateral stimulation helps to facilitate the integration of traumatic memories by engaging both hemispheres of the brain. When we experience something distressing and relive the traumatic event, the pre-frontal cortex (the rational part of the brain) has less capacity to control the overstimulated amygdala and hippocampus (the amygdala is the emotional brain and hippocampus is the memory centre of the brain). Simply put, the rational thinking part of our brains can’t control the emotional part because traumatic memories are “stuck” (unprocessed) in the amygdala-hippocampal complex, and when we get triggered, we feel as if we are going through the trauma in the present moment. This is why when we are reminded of the traumatic event, we don’t have capacity to think and feel frozen or overwhelmed.

During sleep, we process and consolidate memories from the hippocampus to the neocortex. Normal or less traumatic memories don’t become “stuck” because, during REM (dream) sleep, these memories are moved out of the amygdala-hippocampal complex and processed by the rest of the brain. Neuroscientists believe that when our eyes move side to side during REM sleep, it is a similar process to what happens during EMDR processing when you move your eyes from side to side while focusing on a traumatic memory. EEG studies have found that EMDR temporarily slows down the over-stimulated amygdala and coordinates brain waves, which helps process the traumatic memory like any other normal memories.

What can I expect during an EMDR session?

During the initial sessions, I will conduct a thorough assessment to determine your treatment goals, history of trauma, and readiness for EMDR therapy. Together, we will create a treatment plan tailored to your needs. During EMDR sessions, I will guide you through a structured process that involves recalling distressing memories while simultaneously engaging in bilateral stimulation, typically through eye movements, auditory tones, or tactile sensations. This will facilitate your brain's natural healing processes, allowing you to reprocess traumatic memories in a way that reduces your emotional intensity and associated distress.

The number of sessions needed for EMDR therapy can vary depending on several factors, including the nature and severity of the trauma, your overall mental health, and your level of readiness to engage in the therapeutic process. We will continually assess your progress throughout the treatment process and adjust the treatment plan as needed to ensure the best possible outcomes for you.

Is EMDR different from traditional talking therapy?

Yes, it is. In traditional talking therapy, traumatic experiences are accessed via discussing, exploring, and analysing the traumatic event, in an attempt to help you to make sense of and process the trauma. During EMDR, you do not have to talk about the negative event or trauma in detail; you only need to hold the image in your mind to access and process the traumatic experience via bilateral stimulation. EMDR's flexibility means it can be integrated with other therapeutic approaches, such as Acceptance and Commitment Therapy, allowing me to tailor my approach to best suit your individual needs to address traumatic memories and improve overall psychological wellbeing. EMDR can lead to a successful outcome in a shorter amount of time than talking therapy. Studies have shown that for some individuals, EMDR can produce noticeable relief from their PTSD symptoms after just a few EMDR sessions. For others, especially those presenting with multiple or complex traumas, an extended number of sessions may be required to achieve the desired therapeutic outcomes.

Watch this animated video to learn more about how EMDR works

Is EMDR effective for complex trauma?

EMDR therapy has increasingly been recognized as an effective treatment for complex trauma, which involves exposure to multiple traumatic events over an extended period, often beginning in early life. Complex trauma can result from experiences such as ongoing emotional, psychological, or physical abuse, neglect, or exposure to violence, and it can have profound and long-lasting effects on an individual's mental health and well-being. Please read my article here on Understanding Complex Post-Traumatic Stress Disorder (CPTSD).

EMDR is effective for addressing complex trauma because it targets the underlying memories and beliefs associated with the traumatic experiences, rather than just managing the presenting symptoms. By reprocessing these memories and beliefs in a safe and supportive therapeutic environment, EMDR can help individuals to heal from the emotional wounds of their past and develop healthier coping mechanisms for the present.

Some key aspects of EMDR therapy that make it particularly effective for complex trauma include:

1. Targeting multiple traumatic memories- EMDR allows individuals to address a range of traumatic experiences, including those that may have been previously fragmented or repressed. By systematically processing these memories, you can gain a more integrated and coherent understanding of your past traumas.
2. Addressing core beliefs- Complex trauma often leads to negative beliefs about oneself, others, and the world. EMDR helps you to identify and update these negative beliefs to more adaptive and positive beliefs that support recovery and resilience.
3. Promoting emotional regulation- Many individuals with complex trauma struggle with intense emotions and difficulty regulating their emotional responses. EMDR (and particularly if combined with other therapeutic approaches) helps you to develop skills for managing distressing emotions and building emotional resilience.
4. Strengthening self-awareness- EMDR promotes increased self-awareness and insight into the ways that past traumas continue to impact your lived experiences in the present. By breaking the link between the past and the present, you can make positive changes in your life and relationships.
5. Empowering the individual- EMDR therapy empowers you to take an active role in your own healing process. By providing a structured framework for processing trauma, EMDR helps you regain a sense of control and agency over your life.

Is virtual EMDR effective?

Virtual EMDR offers a promising alternative for individuals seeking therapy in a flexible and accessible manner. Many clients have reported significant improvements in their symptoms and overall well-being through remote sessions. With advances in technology and the growing acceptance of telehealth services, virtual EMDR has the potential to reach and help more people, breaking down barriers such as geographic distance and transportation limitations. When we are ready to enter the processing phase, I will provide you with several options for BLS. One of these options is sending you a link to a remote EMDR platform, where you will follow a moving dot on the computer screen with your eyes. I will be able to control the dot’s movement from my end while you just focus on following it back-and-forth with your eyes. Another option the butterfly tapping, which is often a more preferred choice, even in in-person EMDR, because it involves the body and gives you control as you process the traumatic event.

From a clinical perspective, virtual EMDR holds promise as an effective therapeutic intervention. Research has shown that virtual EMDR can produce outcomes comparable to in-person sessions for various mental health conditions, including PTSD, anxiety, depression, and phobias (Sbarra & Wheaton, 2020; McGowen et al., 2021; Dyer, de Young, & Porges, 2021; McGowen et al., 2021). Additionally, virtual EMDR offers several advantages, such as increased accessibility, flexibility in scheduling, and reduced barriers to treatment. You can engage in therapy from the comfort of your own homes, which may promote a sense of safety and comfort, leading to more productive sessions. Moreover, the integration of technology allows for innovative adaptations of EMDR techniques, potentially enhancing treatment outcomes. While further research is needed to fully understand the long-term effectiveness of virtual EMDR, initial findings suggest that it is a valuable and viable option for individuals seeking therapeutic support.

Overall, EMDR therapy offers a comprehensive and holistic approach to healing from complex trauma, addressing the underlying roots of psychological distress and promoting long-term recovery and resilience. It is important for individuals seeking EMDR therapy for complex trauma to work with a qualified therapist who has experience and training in treating trauma-related disorders.
If you would like to have psychological support for trauma, please do get in touch here.