How EMDR Works: Mechanism and Research-backed Efficacy
By Diana Schaefer, LCSW and William Schroeder, LPC
How EMDR works is a question that comes up commonly and there is a lot that goes into this answer. Eye Movement Desensitization and Reprocessing (EMDR) is an innovative therapeutic technique that has captured attention within the psychological community. Back in 2013, when Diana became a certified EMDR therapist, she observed that while traditional talk therapies yielded positive results, there were cases where patients recognized their patterns yet struggled to change them. Interestingly, the interplay between the emotional right-side and the logical left-side of our brains plays a pivotal role in this.
The Brain’s Hemispheric Divide and EMDR
Research has illuminated the distinct roles played by the brain’s two hemispheres in how EMDR works. The right hemisphere is proficient in decoding symbols, images, and sensory stimuli, but it often operates without the linguistic understanding of the left hemisphere. This dichotomy is evident in everyday experiences. For instance, even when someone understands the importance of a balanced diet (left brain’s logical understanding), they might still crave sugary treats or fried foods driven by the pleasure-seeking right brain. EMDR acts as a bridge, facilitating communication between these two brain hemispheres.
What Exactly is EMDR?
EMDR stands for Eye Movement Desensitization and Reprocessing. It’s a specialized therapy aiming to process and integrate distressing memories from past traumas in a way that they no longer trigger disproportionate emotional reactions. Bilateral stimulation while following a specific protocol and treatment plan is part of the process of treatment.
The Underpinning Theory of EMDR
Memory storage in our brain influences our perceptions, attitudes, and behaviors. When distressing memories become entrenched in our neural pathways, they can induce persistent distress. While many traumas naturally fade with time, some linger and continue to distress an individual. EMDR assists in the adaptive resolution of these lingering memories, encompassing experiences from the past, their current implications, and prospective effects.
The EMDR Process
During an EMDR session, the therapist commences with information collection, pinpoints the distressing issues, and then introduces bilateral stimulation, followed by feedback.
Bilateral stimulation, the cornerstone of EMDR, involves activating both brain hemispheres through synchronized left-right patterns. This can be achieved through eye movements (following the therapist’s fingers), tactile stimuli (vibrating tappers alternating between hands), and sometimes auditory cues (beeps alternating between ears). Research underscores that all these bilateral stimulation techniques are comparably effective. The choice often rests on individual preferences and the therapist’s assessment.
During the process, patients might experience a flurry of memories, emotions, or sensations. They’re encouraged to passively observe these, akin to watching landscapes from a moving train, without clinging to or overly analyzing them.
Efficacy and Duration of EMDR
EMDR’s efficacy, particularly in trauma resolution, is well-documented. Many find it expedited compared to other therapeutic methods. The timeline, however, is inherently subjective, given the unique experiences and resilience of each individual. Yet, the consensus in both research and personal experience points towards EMDR being a relatively faster approach to trauma resolution.
- Research has shown that EMDR therapy is highly effective in the treatment of trauma, with 100% of single-trauma survivors and 77% of multiple-trauma survivors no longer meeting diagnostic criteria for PTSD after just six 50-minute EMDR sessions.12
- EMDR is not only clinically effective but the most cost-effective in the treatment of adults with PTSD.3
- EMDR is found to be much more effective to help adults and children lessen (or lose) PTSD entirely after 6 months compared to other medications.4
Diana Schaefer – Client Example:
“I assisted a woman who experienced a traumatic car accident during daylight when a truck veered into her lane, causing her to crash into a guardrail at 65 mph. The accident’s vivid memories, including the impact sound and the ambulance ride, haunted her, leading to nightmares and high anxiety around driving. This significantly disrupted her daily life. In our sessions, besides understanding her trauma history, she was equipped with coping tools for distressing memories. Using EMDR, we focused on the accident’s memory over three months, assessing her distress level each week. By the end of our sessions, her distress level dropped to zero. While the accident’s memory remained, its emotional intensity had diminished completely.”
How EMDR works in the brain
- Bilateral Stimulation and Brain Hemispheres: One of the main features of EMDR is bilateral stimulation, often achieved through guided eye movements. Some researchers believe that this rapid back-and-forth eye movement might help in the integration and communication of the right and left hemispheres of the brain. The right hemisphere is more associated with emotional processing, and the left with cognitive functions and language. EMDR may help link emotional and cognitive aspects of the traumatic memory.
- Working Memory and Cognitive Load: Another theory suggests that recalling a traumatic event while simultaneously engaging in the distraction of bilateral eye movements imposes a certain cognitive load on working memory. This might cause the traumatic memory to become less vivid and emotional when recalled in the future.
- Accelerating the Adaptive Information Processing System: EMDR practitioners believe in an innate human ability to move towards psychological health. Traumatic memories can block or skew this adaptive information processing. EMDR might work by unblocking the system, allowing the traumatic memory to be integrated and stored adaptively in the brain.
- Activation of the Default Mode Network: Some neuroimaging studies have shown that EMDR activates the default mode network (DMN) in the brain, a network associated with self-referential processing and autobiographical memory. Activation of the DMN might help in integrating and reprocessing the traumatic memory.
- Mimicking REM Sleep: The eye movements in EMDR are thought by some to be similar to the rapid eye movements observed in REM (Rapid Eye Movement) sleep. REM sleep is believed to play a role in memory consolidation. EMDR might simulate this process, allowing for traumatic memories to be reprocessed and integrated in a manner similar to how our brains process information during sleep.
- Neurobiological Changes: Some studies have indicated that EMDR can lead to changes in the amygdala, hippocampus, and anterior cingulate cortex—brain areas involved in fear response and memory. Post-treatment, these areas might show altered activation patterns, indicating that the traumatic memory has been reprocessed.
Who is it best for?
In my training when I experienced EMDR, I found that it helped my thoughts and the connections of those thoughts happen much faster. It also surprised me how well it works to improve processing of memories and experiences. EMDR works in treating anxiety, depression, trauma, and PTSD. If you suffer from any of these, EMDR therapy might be a helpful for you. EMDR therapy is something that we offer, so do not hesitate to contact us to make a counseling appointment.
Bonus: How EMDR Heals Trauma
Photo by Norman Toth on Unsplash