EMDR: Eye Movement Desensitization and Reprocessing

Eye movement desensitization and reprocessing (EMDR) is a fairly new, nontraditional type of psychotherapy. It's growing in popularity, particularly for treating post-traumatic stress disorder (PTSD). PTSD often occurs after experiences such as military combat, physical assault, rape, or car accidents.

Although research continues, EMDR remains controversial among some health care professionals.

At first glance, EMDR appears to approach psychological issues in an unusual way. It does not rely on talk therapy or medications. Instead, EMDR uses a patient's own rapid, rhythmic eye movements. These eye movements dampen the power of emotionally charged memories of past traumatic events.

What Can You Expect From EMDR?

An EMDR treatment session can last up to 90 minutes. Your therapist will move his or her fingers back and forth in front of your face and ask you to follow these hand motions with your eyes. At the same time, the EMDR therapist will have you recall a disturbing event. This will include the emotions and body sensations that go along with it.

Gradually, the therapist will guide you to shift your thoughts to more pleasant ones. Some therapists use alternatives to finger movements, such as hand or toe tapping or musical tones.

People who use the technique argue that EMDR can weaken the effect of negative emotions. Before and after each EMDR treatment, your therapist will ask you to rate your level of distress. The hope is that your disturbing memories will become less disabling.

Although most research into EMDR has examined its use in people with PTSD, EMDR is sometimes used experimentally to treat many other psychological problems. They include:

How Effective Is EMDR?

More than 20,000 practitioners have been trained to use EMDR since psychologist Francine Shapiro developed the technique in 1989. While walking through the woods one day, Shapiro happened to notice that her own negative emotions lessened as her eyes darted from side to side. Then, she found the same positive effect in patients.

EMDR appears to be a safe therapy, with no negative side effects. Still, despite its increasing use, mental health practitioners debate EMDR's effectiveness. Critics note that most EMDR studies have involved only small numbers of participants. Other researchers, though, have shown the treatment's effectiveness in published reports that consolidated data from several studies.

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What Do the Guidelines Recommend?

Guidelines issued by more than one professional organization have recently boosted the credibility of EMDR. These guidelines define who may benefit from the treatment. For example:

  • The American Psychiatric Association (APA) has noted that EMDR is effective for treating symptoms of acute and chronic PTSD. According to the APA, EMDR may be particularly useful for people who have trouble talking about the traumatic events they've experienced. The APA guidelines note that other research is needed to tell whether improvements from EMDR can be sustained over time.
  • The Department of Veterans Affairs and the Department of Defense have jointly issued clinical practice guidelines. These guidelines "strongly recommended" EDMR for the treatment of PTSD in both military and non-military populations. They also note that this approach has been as effective as other psychological treatments in some studies, and less effective in others.

How Does EMDR Work?

Even the most enthusiastic supporters of EMDR have not agreed on how the therapy works. At this point, only theories exist. By inducing the recall of distressing events and diverting attention from their emotional consequences, EMDR in some respects borrows basic principles used in prolonged exposure therapy, the gold standard behavioral psychotherapeutic treatment of PTSD. Some therapists believe that EMDR reduces anxiety. This allows patients to better take control of their upsetting thoughts. Others simply say that we don't yet understand how EMDR works. According to the APA guidelines, EMDR needs further study to more fully understand it.

WebMD Medical Reference Reviewed by Joseph Goldberg, MD on August 15, 2015

Sources

SOURCES:
McCabe, S., Perspectives in Psychiatric Care, July-September 2004.
"EMDR," Harvard Mental Health Letter, February 2002.
American Psychiatric Association: "Practice Guideline for the Treatment of Patients with Acute Stress Disorder and Posttraumatic Stress Disorder."
United States Department of Veterans Affairs/National Center for PTSD: "Empirical Evidence Regarding Behavioral Treatments for PTSD: A National Center for PTSD Fact Sheet."
Lee, G.K., et al, Journal of Psychosocial Nursing and Mental Health Services, June 2003. EMDR Institute: "A Brief Description of EMDR." Veterans Administration/Department of Defense Clinical Practice Guideline Working Group, Veterans Health Administration: "Management of Post-Traumatic Stress," 2003.

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