Eye Movement Desensitisation and Reprocessing (EMDR) is a form of psychotherapy which was originally used in the treatment of Post-Traumatic Stress Disorder (PTSD). It is now also used to treat other psychological syndromes including panic disorders, phobias, anxiety, Obsessive Compulsive Disorder (OCD), eating disorders, addictions and depressive disorders.
In EMDR the patient first recalls traumatic material or negative emotions, whilst simultaneously being involved in sensory stimulation, usually visual from a rhythmic, bilateral source.
This therapy seeks to assist the patient in processing the distressing event, which has been buried in their memory network, and develop better coping mechanisms.
There are eight phases of treatment:
History and treatment planning: At the initial consultation, a full history of the patient’s specific problems is taken, including their symptoms and the behaviour that results.
Preparation: This stage involves building trust between the patient and the therapist as well as an explanation of the process of EMDR and what the patient can expect both during and after treatment.
Assessment: The patient will rate their feelings in relation to a specific issue or memory. The ratings are repeated before, during and after each EMDR session so that both the patient and the therapist can track the progress being made in the target areas.
Desensitisation: During the desensitisation phase, the patient is led through sets of eye movements, or other bilateral stimulation, while they focus on the feelings associated with the target memory. After each set of eye movements, usually 20 to 30, the patient is asked to rate their feelings according to the assessment scales. This process is repeated until these ratings move in the right direction. After the main target has been addressed, the patient may also have associated memories that need the same process.
Installation: This phase involves ensuring that the patient deeply believes their positive cognition by rating themselves. If the rating is not high enough, the process is repeated.
Body scan: The sixth phase involves the therapist asking the patient to recall the target event to see if there is any residual body tension. If there is, then these physical reactions will need to be targeted for reprocessing.
Closure: This closure phase ensures that the patient is able to cope with any continued processing or negative feelings that may arise between sessions by providing them with techniques to cope such as relaxation exercises or journal keeping.
Re-evaluation: At the beginning of each subsequent session, the therapist will make sure that the positive results from the previous session have been maintained. They will also check whether any new target issues have arisen that will need attention. The aim is to ensure that all issues are dealt with before stopping the sessions.
Studies have shown EMDR to be effective in the treatment of PTSD and other clinical problems but conclusions are still controversial as many of the studies were for single case reports, especially for non-trauma related conditions.