Imagine being able to help traumatized individuals heal from their trauma without talking about the trauma or even developing a therapeutic rapport, yet still achieving better results than standard antidepressants such as Prozac and standard psychotherapeutic interventions, and even achieving this more quickly (Van der Kolk, 2014). It might sound impossible, but eye movement desensitization and reprocessing (EMDR) seems to be able to accomplish this feat. EMDR was created by Francine Shapiro in 1987 after, “she noticed that rapid eye movements produced a dramatic relief from her distress” from painful memories (Van der Kolk, 2014, p. 249). She later thoroughly researched and turned EMDR into a formal treatment procedure for post-traumatic stress disorder (PTSD) and has also found it to be effective for other disorders including substance use disorders, anxiety disorders, depressive disorders, obsessive-compulsive and related disorders, dissociative disorders, eating disorders, personality disorders, and pain disorders as well as other life difficulties (EMDR International Association [EMDRIA], n.d.).
EMDR involves the use of bilateral stimulation (BLS), typically by using eye movements, but it can also take the form of tactile or auditory stimulation. For example, a patient may watch a light bar that moves a light from side to side, watch a clinician’s finger as it is rhythmically moved from side to side, listen to a tone alternating between ears, or feel tapping on opposite sides of the body. While the client focuses on this bilateral stimulation, they recall the traumatic memory and report the thoughts that emerge which often become the focus of the next set of BLS. This is continued until the traumatic memory is no longer perceived as distressing (American Psychological Association [APA], 2017).
Though not completely understood, PTSD is thought to result from unprocessed traumatic memories which, “contain the emotions, thoughts, beliefs and physical sensations that occurred at the time of the event” and, “when the memories are triggered these stored disturbing elements are experienced and cause the symptoms of PTSD” (APA, 2017, Introduction to EMDR section). The mechanism of EMDR is also not clearly understood and multiple hypotheses have been postulated. According to the APA (2017), neurobiologically, EMDR aims to “change the way the memory is stored in the brain” (Introduction to EMDR section). The goal is to take the fragmented traumatic memories and help the client integrate and process them to create a cohesive narrative and store the memory in their semantic memory network (Coubard, 2014). EMDR aids the brain in processing these traumatic memories allowing it to engage its natural healing mechanisms which includes communication between the amygdala, the hippocampus, and the prefrontal cortex. Processing of these memories also resolves the sympathetic nervous system’s fight, flight, or freeze response (EMDRIA, n.d.). Astonishingly, it has been shown to allow quicker processing than many traditional treatments for trauma such as talk based therapies. This may be due to the closer connection between the limbic system and the area of the brain that controls rhythmic movements than with the areas that control language (Coubard, 2014). Another hypothesis of EMDR’s mechanism of action is that it helps the hemispheres of the brain synchronize spatially by stimulating the adaptive information processing system similar to what occurs in Rapid Eye Movement sleep. Doing this helps decrease activity in the limbic system and allow for integration of the traumatic memories. Furthermore, EMDR is thought to synchronize patients’ sense of time with their affect. Therefore, this hypothesis categorizes EMDR as a neuroentrainment (Coubard, 2014).
It may not be known exactly how EMDR works, but it does work, and it is providing many patients with relief from their PTSD symptoms allowing them to resume living their lives. Perhaps in the future the mechanism of action will be elucidated, but for now, EMDR will continue to be used to help many patients recover from their trauma, albeit somewhat mysteriously.
References
American Psychological Association. (2017, May). Eye movement desensitization and reprocessing (EMDR) therapy. Clinical practice guideline for the treatment of posttraumatic stress disorder. Retrieved April 1, 2023, form https://www.apa.org/ptsd-guideline/treatments/eye-movement-reprocessing#
Coubard, O. A. (2014). Eye movement desensitization and reprocessing (EMDR) re-examined as cognitive and emotional neuroentrainment. Frontiers in Human Neuroscience, (8)., 1035. doi: 10.3389/fnhum.2014.01035
EMDR International Association. (n.d.). About EMDR therapy. EMDRIA: EMDR international association. Retrieved April 1, 2023, from https://www.emdria.org/about-emdr-therapy/
van der Kolk, B. (2014). The body keeps score: Brain, mind, and the body in the healing of trauma. The Penguin Group.