When is EMDR used?
EMDR has good evidence for the treatment of PTSD (post-traumatic stress disorder). There have been 14 controlled studies that confirm the effectiveness of the study. Studies show that approx. 85-90% of the people who have developed PTSD in connection with e.g. natural disasters, accidents, losses, rape or war after treatment with EMDR no longer meet the criteria for PTSD. EMDR therapists provide emdr therapy in multiple sessions according to the condition of a person either in person or cloud emdr (online therapy).
EMDR is also used to treat other conditions, such as anxiety states, phobias and severe grief. For these conditions, however, there is not yet enough research to provide strong research support.
What is post-traumatic stress?
You risk developing post-traumatic stress when you have experienced one or more traumatic events. Traumatic means an overwhelming event that one is unable to use their existing resources to deal with.
It can be, among other things:
- Sexual assault
- Robbery and assault
- Sudden deaths
- Serious illness, life-threatening operations
The brain manages to process most unpleasant events spontaneously with its own power to heal. If time passes and you are still strongly affected by the event, it could be post-traumatic stress.
Symptoms of PTSD are:
- Intrusive memories resulting in strong emotional reactions, flashbacks and nightmares
- Avoidance of places, people, situations, activities and sensations as well as own thoughts and feelings that remind of the trauma
- Cognitive changes and changes in mood such as a high degree of fear, tension, guilt and shame, difficulty concentrating and difficulty sleeping.
If time passes and the symptoms increase in severity rather than decrease, then help with processing is needed and then EMDR is an effective method.
How does EMDR work?
Traumatic memories are not processed and stored in the same way as other memories in our consciousness. Even though we know logically that it happened a long time ago, emotionally it can feel like they are happening over and over again.
Every time the thought of the event comes up or if something reminds of the event, similar emotions and reactions are activated in the body as when it happened and it becomes difficult to calm down. Therefore, one often tries to avoid thinking about or being reminded of the event, which leads to an experience of withdrawal, isolation or an emotional roller coaster.
When bad things happen to us in life, it is also common that we begin to make negative interpretations about ourselves and feel guilt and shame about what happened. These negative interpretations become part of how we see ourselves, for example “I’m worthless” “it’s my fault”.
With the help of EMDR, it is possible to approach memories, images, thoughts and feelings associated with the event in a controlled manner. When you dare to think and feel about the event, the charge decreases and processing becomes possible. As the charge decreases, you gain increased access to your resources for healing and can look at yourself more constructively and empathetically.
How does the therapy work?
During the initial conversations, a survey is made of the problem, both what you have been through and how this affects your current life situation. Future goals are formulated. You receive information about EMDR as a method and an assessment is made as to whether it is a suitable method for exactly what you want help with.
A treatment plan is designed with current “target memories”, i.e. the events you wish to process. When processing is to begin, a protocol is followed where you will be asked to bring up the image of the event that is most disturbing and the negative thought about yourself that is related to the event, as well as a positive thought about yourself that you would rather be able to think about yourself and an estimate (scale 1-7) of how true that thought feels now.
What feelings are related to the event and where you feel this in the body are also requested, as well as an estimate of the degree of disturbance (scale 1-10). The estimates are made so that progress in the treatment can be measured. When processing starts, you are asked to focus on the event while making side-to-side eye movements. This is called bilateral stimulation. Some therapists use a special lamp for the purpose, others use their hand which you follow with your eyes.
Other sources of bilateral stimulation can also be used such as headphones with sound, vibrating pulsators that you hold in your hands or so-called tapping where you or the therapist clap at a certain rate. This aims to strain the working memory.
Working in EMDR
When the working memory is strained, the activity in our fear center in the brain is reduced. After a short moment of eye movement, you pause and you are asked to describe what comes to you. After that, eye movement processing resumes. This is repeated several times until you can think about the event without experiencing disturbance in the here and now and can think in a more constructive and positive way about yourself in relation to the event. It may take one or more sessions. An EMDR session is usually 60-90 minutes.
If there are several events in the treatment plan, they are processed one at a time. Then any present-day triggers are processed, i.e. things that remind you of the trauma here and now, as well as future fears.
Trauma processing is an emotionally demanding process. It is common to feel tired after the sessions so allow time for recovery. You will also learn different strategies to calm yourself down and deal with strong emotions during therapy. Between sessions it is good to observe and perhaps record thoughts, experiences and dreams that come to you to bring to therapy.
You should only undergo EMDR treatment with a therapist who is licensed to work in psychotherapy and who has special training approved by the EMDR International Association, EMDRIA.