A few months ago, I was watching Law & Order: SVU. In this particular scene, Olivia Benson (Mariska Hargitay) sits across from her therapist. The therapist holds her finger in front of Olivia’s eyes and moves it back and forth while talking about stressful situations like you would in a regular therapy session. What’s all that about, I thought. A quick Google search told me I was watching an EMDR (eye movement desensitization and reprocessing) session, a type of psychotherapy that’s primarily used to treat PTSD and other trauma-related disorders. Interested to learn more about EMDR, I tapped Dr. Chinwé Williams, LPC, an author, speaker and certified EMDR therapist.
Could EMDR Therapy Help You Unpack Trauma?
A certified EMDR therapist explains
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Published Apr 12, 2024
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Meet the Expert
Dr. Chinwé Williams, LPC, is a Licensed Professional Counselor, a Board Certified Counselor, a Counselor Educator & Supervisor and a certified EMDR therapist. She is the co-author of two books, SEEN: Healing Despair and Anxiety in Kids and Teens Through the Power of Connection and Beyond The Spiral, and has a practice in Atlanta, Georgia.
What Is EMDR Therapy?
Eye Movement Desensitization and Reprocessing (EMDR) is a psychotherapy method developed by psychologist and educator Francine Shapiro in 1989. Per Williams, “EMDR was created to help individuals heal from the emotional distress that are the result of disturbing life experiences.” The technique, she explains, works directly with disturbing memories in the brain. “During normal life events, the brain’s memory network stores memories smoothly. When a traumatic event happens, unprocessed memories get stored in the brain in an unhelpful manner. Therefore, when an experience occurs in the present (e.g., emotional triggers) that reminds someone of a past disturbing or traumatic event, the brain reacts as if the event is happening right now.”
Reactions to these triggers, she says, vary from person to person, but can include distressing thoughts, emotions and uncomfortable physical body sensations, all of which can get in the way of life. “EMDR helps move the unprocessed memory to a more functional part of the brain,” Williams adds. “The individual can now respond to present day reminders (or triggers) without the disturbances from the past interfering.
In EMDR therapy, a patient recalls—and attempts to process—these traumatic events while the therapist uses bilateral stimulation, meaning they use images, sounds or sensations that activate both sides of the brain. This can look like a therapist moving their finger back and forth in front of the patient’s face, or a light machine like the one seen in the TikTok below that encourages the patient’s eyes to follow the moving light.
What Does an EMDR Session Entail?
EMDR therapy consists of eight distinct phases, which occur over several sessions (though not necessarily eight distinct sessions). Williams says, “Throughout the course of EMDR therapy, the therapist helps the client to attend to emotionally distressful memories in brief doses while simultaneously focusing on an external stimulus.” Sessions typically last between 60 and 90 minutes, though she says that marathon sessions, which can take place over hours or over a couple of days, with extensively trained therapists, are also an option for certain clients. Treatment duration varies. “For a single incident event, treatment can take between six to eight sessions (sometimes less),” Williams tells me. “For more complex events or memories, treatment can take up to 12 sessions (sometimes more).”
Per the American Psychological Association, the eight phases are:
- Phase 1: History-Taking
The therapist gets the patient’s full history and together the two work to identify targets for treatment, which can include past memories, current triggers and future goals.
- Phase 2: Preparing the Patient
During this phase, the therapist educates the patient about the mechanics of EMDR. This can include sharing peer-reviewed research on EMDR’s effectiveness to help reassure patients who might be hesitant. - Phase 3: Assessing the Target Memory
This phase, which can take as little as 30 seconds, involves questions to activate the patient’s trauma memory, and bringing it into the patient’s awareness. - Phase 4: Desensitization
The next three phases help reprocess the memory and bring it to a resolution. The first of these three phases is the most recognizable phase of EMDR—the eye movement/bilateral stimulation. Per the APA, “The patient is asked to focus on the traumatic event while the bilateral stimulation takes place. This continues until the client’s Subjective Units of Distress Scale (SUDS) rating reaches zero. The SUDS - Phase 5: Installation
After desensitization, the therapist uses bilateral stimulation to help the patient associate and strengthen their preferred positive belief for the event until it feels completely true.
Phase 6: Body Scan
Here, the therapist asks the patient to scan their body from head to toe to see if any negative sensations arise. If they do, the therapist will continue to offer bilateral stimulation until any remaining negative sensations have been cleared. - Phase 7: Closure
In this phase, the therapist winds the session down and helps the patient return to a state of calm. - Phase 8: Evaluating Treatment Results
Each subsequent session begins with the therapist and patient discussing the patient’s current level of distress around the traumatic memory and how their symptoms are changing. If there’s been a reduction in distress, they can move on to the next target memory. If not, additional sessions may be needed.
What Conditions Is EMDR Best For?
EMDR is primarily known for treating PTSD and trauma-related disorders, but Williams tells me it’s also used to treat the following conditions:
- Anxiety disorders: generalized anxiety disorders (GAD; panic disorder, phobias, and social anxiety
- Mood disorders: major depressive disorder and illness-related depression
- Sleep disorders: insomnia, oversleeping, nightmares, sleepwalking
- Eating disorders: binge eating, bulimia, anorexia nervosa
- Addictions: substance abuse and behavior-related addictions
- Grief and loss
“The great thing about EMDR therapy is that it is well-suited for many different individuals with diverse backgrounds who have experienced different forms of trauma,” Williams tells me. “In addition to the aforementioned list of conditions EMDR can treat, EMDR can benefit clients on the autism spectrum and children.” She says that EMDR can also help those who have difficulty speaking about disturbing events. “This includes those who have experienced adverse childhood experiences, like sexual or physical abuse or witnessing violence. EMDR does not require clients to share graphic details about the memory or event.”
Are There Any Risks Associated with EMDR?
“EMDR has minimal risks,” Williams explains, explaining that the most common negative effects are troublesome thoughts or feelings between sessions. Still, she concedes that, “As a newer psychotherapy (developed in 1989), despite the evidence that it does work, experts have yet to fully explain the science of exactly how it works.”
Still, EMDR isn’t for everyone; Williams tells me that those with medical conditions that directly impact their brain or heart organs—like epilepsy or other seizure disorders, brain tumors, cardiovascular disorders and more—may not be suitable candidates for EMDR. Additionally, she says, folks who take benzodiazepines or use cannabis are not good candidates, because use of these substances will disrupt part of the EMDR process.
