Thoughts on EMDR

Recently I have changed therapists. My old one never used EMDR therapy on me, she only suggested we try Cognitive Behaviorial Therapy. I go back to my next appointment next week and I told my therapist I would agree to do the EMDR during this next session. I also told her I have doubts anything will happen and that I am extremely nervous about the whole thing. She assured me she will try her best to make everything comfortable for me and that I will most likely benefit from it.

Has anyone been treated this way, if so did it help or not. What are your thoughts about EMDR vs. other methods of treatment?

So, I have done EMDR with my T. Before I saw her, I had not heard of it. The first time she explained it, I was like, “WHAT?” She told me to look at the EMDR website and to read about it. The first time I did EMDR, it was weird to me. There are several ways to do EMDR (as far as stimulating both sides of the brain is concerned), but my T sat close to me and moved two fingers on one hand back and forth like a windshield wiper…I mean there are many steps, but the majority of the time is spent alternating between T doing that and me telling her what comes to my mind. I found that the periods of silence really made me remember more things and think about things more deeply. Anyway, long story short, looking back now, it doesn’t seem odd. It may be uncomfortable at times, but it really did help me. I mean, I felt some immediate levels of relief, from telling her how anxious/upset I felt about a statement at the beginning of a session compared to the end.

In sum, don’t be scared, and it probably will be helpful. It may be awkward the first time, but it will feel fairly normal fairly quickly. I hope that it helps you like it did me!

P.S. There have been several threads in the last few months about EMDR. If you don't get many responses, I encourage you to search this site for them and read them, as you may find then helpful!

I have tried it with a couple of different t's...several ways...and I hated it. I call it one of the woo woo treatments. In studies, EMDR worked better than AL, No treatment, Non specific treatment...but exposure therapy, CBT and DBT all worked significantly better. The critics think it's the "exposure" part of the EMDR that works. (Exposure therapy has been studied significantly for a very long time, EMDR is kind of newish (1987).

(hoping you wanted both view points, if you only wanted positive I am really sorry)

((you shouldn't be forced into something you're not comfortable with, it's okay to say no))

I know people (on and off the forum) who say that they have benefited from EMDR; if it works for them, that's great. Personally, however, I am not an advocate for EMDR. As a professor/researcher, I am swayed more by science and research than by anecdotal experience. In my opinion, the theoretical grounding behind EMDR is not scientifically sound. I've also read the research studies conducted to test the efficacy of EMDR, and they showed EMDR to be far less effective than other forms of therapy (EMDR produced results equal to or just slightly better than the placebo treatment). To date, no studies have found any credible evidence to suggest that EMDR works. Personally, if I am going to undergo any kind of treatment, it has to have scientific backing. I have friends who swear by astrology, healing crystals, and various other pseudo sciences-- but I tend to think their efficacy lies only in the power of belief. I do not believe they produce actual results.

One friend of mine who does EMDR has emphasized the fact that her therapist touches her hands and knees during EMDR, and that this helps her. Outside of EMDR, her therapist has a "no touch" policy. My friend craves touch (physical affection was withheld when she was a child) and she says that, since beginning EMDR, she has felt warmer, more affectionate, and more connected. She says that this is all due to EMDR "changing her brain." Personally, I believe she is benefitting from touch. I do not think the EMDR is working as EMDR; I think the touch aspect is helping, just as touch would help in other forms (hugs, massages, etc).

I think it quite unfair to compare EMDR to astrology and healing crystals. Here is a link to a NY Times article which has links to various studies conducted on the effectiveness of EMDR. The Evidence on E.M.D.R. - NYTimes.com EMDR is noted as an effective treatment by the American Psychiatric Association, Department of Veteran Affairs, and the Department of Defense. I can assure you that none of these organizations promote healing crystals. This treatment has scientific backing. Furthermore, my T does not touch me during EMDR, and that is not part of the standard practice.

All of that being said, I am a firm believer in being in control of your own care. If you do not want to do it, then you do not have to do it. My T has suggested that we do EMDR on a couple of events/topics, and I have instead just chosen to discuss them. In other cases, I have done EMDR. Yes, I have found it helpful, and I am a skeptical, educated, grounded individual and professional in graduate school. This is not soothsaying.

Thoughts regarding GenCat's question about EMDR, as well as scorpiosis37...

First, the evidence on EMDR.

EMDR psychotherapy has been empirically validated in over 24 randomized studies of trauma victims. It is considered one of the three treatments of choice for trauma (along with CBT and PE) by organizations such as ISTSS (International Society for Traumatic Stress Studies), American Psychiatric Association, American Psychological Association, Dept of Veteran Affairs, Dept of Defense, Departments of Health in Northern Ireland, UK, Israel, the Netherlands, France, and other countries and organizations.

See Foa, E.B., Keane, T.M., Friedman, M.J., & Cohen, J.A. (2009). Effective treatments for PTSD: Practice Guidelines of the International Society for Traumatic Stress Studies New York: Guilford Press. EMDR was listed as an effective and empirically supported treatment for PTSD, and was given an AHCPR “A” rating for adult PTSD.

Last summer the World Health Organization invited me to peer review draft mhGAP WHO guidelines in the area of PTSD, acute stress and bereavement. Since then, these guidelines have been finalized by the Guidelines Development Group of external experts and approved by the WHO Guideline Review Committee. As one of the reviewers on their panel of PTSD experts who spent a year poring scrupulously over all the research, I am able to share their guidelines with you.

First, the WHO description of EMDR for PTSD:
"Eye movement desensitization and reprocessing (EMDR) therapy is based on the idea that negative thoughts, feelings and behaviours are the result of unprocessed memories. The treatment entails standardized procedures that include focusing simultaneously on (a) spontaneous associations of traumatic images, thoughts, emotions and bodily sensations and (b) bilateral stimulation most commonly in the form of repetitive eye movements. Like CBT with a trauma focus, EMDR therapy aims to reduce subjective distress and strengthen adaptive cognitions related to the traumatic event. Unlike CBT with a trauma focus, EMDR therapy involves treatment that is conducted without detailed descriptions of the event, without direct challenging of beliefs, and without extended exposure."

Here are WHO's "guidelines on problems and disorders specifically related to stress." (In press):
“Individual or group cognitive behavioural therapy (CBT) with a trauma focus, eye movement desensitization and reprocessing (EMDR), or stress management should be considered for adults with posttraumatic stress disorder (PTSD).”
"Individual or group cognitive behavioural therapy (CBT) with a trauma focus or eye movement desensitization and reprocessing (EMDR) should be considered for children and adolescents with posttraumatic stress disorder (PTSD)."

In addition, as noted in the American Psychiatric Association Practice Guidelines (2004, p.18), in EMDR “traumatic material need not be verbalized; instead, patients are directed to think about their traumatic experiences without having to discuss them.” Given the reluctance of many combat veterans [and other trauma survivors] to divulge the details of their experience, this factor is relevant to willingness to initiate treatment, retention and therapeutic gains. It may be one of the factors responsible for the lower remission and higher dropout rate noted in this population when CBT techniques are used."

And, unlike CBT or Prolonged Exposure (PE), without any homework between sessions. The lack of the necessity for detailed descriptions of memories is a major benefit for survivors or war trauma, as well as survivors of any violence.

The Department of Veterans Affairs & Department of Defense's 2010 VA/DoD Clinical Practice Guideline for the Management of Post-Traumatic Stress placed EMDR in the category of the most effective PTSD psychotherapies. This “A” category is described as “A strong recommendation that clinicians provide the intervention to eligible patients. Good evidence was found that the intervention improves important health outcomes and concludes that benefits substantially outweigh harm."

So you can continue to believe vague assertions that empirical evidence EMDR is just "anecdotal" or that it's some "woo-woo" treatment like crystals, or you can listen to (and read for yourself) the professional organizations that maintain standards using vigorous research.

See:
SAMHSA’s National Registry of Evidence-based Programs and Practices (2011)
"The Substance Abuse and Mental Health Services Administration (SAMHSA) is an agency of the U.S. Department of Health and Human Services (HHS). This national registry (NREPP) cites EMDR as evidence based practice for treatment of PTSD, anxiety, and depression symptoms. Their review of the evidence also indicated that EMDR leads to an improvement in mental health functioning."

For the most up-to-date research, Google the EMDR Institute website.

Now back to GenCat's original question. I've posted the following (or versions thereof) more than a few times on this forum and each time I do, I get great feedback. So here it is again...

I'm a psychologist who uses EMDR as my primary treatment psychotherapy and I've also personally had EMDR therapy for anxiety, panic, grief, and “small t” trauma. As a client, EMDR worked extremely well and also really fast. As an EMDR therapist, and in my role as a facilitator who trains other therapists in EMDR (certified by the EMDR International Assoc. and trained by the EMDR Inst, both of which I strongly recommend in an EMDR therapist) I have used EMDR successfully with panic disorders, childhood sexual/physical/emotional abuse and neglect, single incident trauma and complex/chronic PTSD, anxiety, depression, grief, body image, phobias, distressing memories, bad dreams and more...

It's really crucial that the therapist spends enough time in one of the initial phases (Phase 2) in EMDR that involves preparing for memory processing or desensitization (memory processing or desensitization - phases 3-6 - is often referred to as "EMDR" which is actually an 8-phase psychotherapy). In this phase resources are "front-loaded" so that you have a "floor" or "container" to help with processing the really hard stuff. In Phase 2 you learn a lot of great coping strategies and self-soothing techniques which you can use during EMDR processing or anytime you feel the need. So if you start feeling overwhelmed or that it's too intense, you can ground yourself (with your therapist's help in session, and on your own between sessions) and feel safe enough to continue the work. In my practice, after the Phase 2 work lets us know that my patient is safe enough and able to cope with any emotion and/or physical sensation both during and between EMDR processing sessions, I often suggest we try a much less intense memory first if there is one that happened BEFORE the trauma(s). If there isn't one, then I suggest we start developmentally with the least disturbing memory and work our way "up" to the most disturbing event(s).

Grounding exercises are indispensable in everyday life, and really essential in stressful times. Anyone can use some of the techniques in Dr. Shapiro's new book "Getting Past Your Past: Take Control of Your Life with Self-Help Techniques from EMDR." Dr. Shapiro is the founder/creator of EMDR but all the proceeds from the book go to two charities: the EMDR Humanitarian Assistance Program and the EMDR Research Foundation). Anyway, the book is terrific. It's an easy read, helps you understand what's "pushing" your feelings and behavior, helps you connect the dots from past experiences to current life. Also teaches readers lots of helpful techniques that can be used immediately and that are also used during EMDR therapy to calm disturbing thoughts and feelings.

As I’ve mentioned about Phase 2, during EMDR therapy you learn coping strategies and self-soothing techniques. You learn how to access a “Safe or Calm Place” which you can use at ANY TIME during EMDR processing (or on your own) if it feels scary, or too emotional, too intense. There are other kinds of Resource Development strategies that can be used depending on the skill level and experience of your therapist (Google "Resource development and installation" and find articles by Janina Fisher, Debbie Korn, and/or Andrew Leeds, ask about John Omaha's AMST - Affect Management Skills Training, or the Imaginal Nurturing protocol).

One of the key assets of EMDR is that YOU, the client, are in control NOW, even though you likely were not during past events. You NEVER need re-live an experience or go into great detail, ever! You NEVER need to go through the entire memory. YOU can decide to keep the lights (or the alternating sounds and/or tactile pulsars, or the waving hand, or hand/knee tapping - all forms of bilateral stimulation that should be decided by the client for the client's comfort) going, or stop them, whichever helps titrate – measure and adjust the balance or “dose“ of the processing. During EMDR processing there are regular “breaks” and you can control when and how many but the therapist should be stopping the bilateral stimulation every 25-50 or so passes of the lights to ask you to take a deep breath and to say just a bit of what you’re noticing. The breaks help keep a “foot in the present” while you’re processing the past. Again, and I can’t say this enough, YOU ARE IN CHARGE so YOU can make the process tolerable. And your therapist should be experienced in the EMDR techniques that help make it the gentlest and safest way to neutralize bad life experiences and build resources.

Pacing and dosing are critically important. So if you ever feel that EMDR processing is too intense then it might be time to go back over all the resources that should be used both IN session and BETWEEN sessions. Your therapist should be using a variety of techniques to make painful processing less painful, like suggesting you turn the scene in your mind to black and white, lower the volume, or, erect a bullet-proof glass wall between you and the painful scene, or, imagine the abuser speaking in a Donald Duck voice... and so forth. There are a lot of these kinds of "interventions" that ease the processing. They are called "cognitive interweaves" that your therapist can use, and that also can help bring your adult self's perspective into the work (or even an imaginary Adult Perspective). Such interweaves are based around issues of Safety, Responsibility, and Choice. So therapist questions like "are you safe now?" or "who was responsible? and "do you have more choices now?" are all very helpful in moving the processing along.

In addition to my therapy practice, I roam the web looking for EMDR discussions, try to answer questions about it posted by clients/patients, and respond to the critics out there. It's not a cure-all therapy. However, it really is an extraordinary psychotherapy and its results last. In the hands of a really experienced EMDR therapist, it's the most gentle way of working through disturbing experiences.

Pattijane thanks so much for your post. I've just started phase 2 (i think) my first session was good but second session i had a panic attack and i didn't want to do it again last week. I think we are going to step back a bit to the containment phase again. But everything you've described about the process seems to be the direction my therapist is going in so that gives me faith.

I realize that I probably should have used a more objective tone in my first response, so I apologize if I offended anyone. I also probably should not have alluded to a comparison between EMDR and things like healing crystals. However, the reason I did so is because my friend's EMDR therapist actually does use healing crystals in her practice (I realize that most EMDR therapists do not). However, despite my tone in my first response, I still believe that the research on EMDR is inconclusive (and have cited resources below). I had already read the studies parttijane cites, as well as the EMDR Institute Website, so my opinion is not based on misinformation or vague assertions, but on carefully reading and considering the available scientific literature. Those in the field have differing opinions on the efficacy of EMDR, so it is not surprising that those of us on the forum have differing opinions as well. I was also aware that the APA recognizes EMDR, but I am still of the opinion that just because the APA recognizes something as a therapeutic treatment, does not mean that it is beyond reproach. The APA still recognizes Electroconvulsive Therapy for severe major depression (American Psychiatric Association). There have been studies conducted that indicate Electroconvulsive Therapy is effective-- however, I believe there are some serious flaws (and cultural and gender biases) in the way in which these studies were conducted. There is a reason why some APA-approved forms of psychiatric treatment are controversial. The APA also frequently gets it wrong with respect to what constitutes a mental disorder. The APA "got it wrong" about homosexuality (and its "treatments") for decades, and the APA still "has it wrong" about transgender issues (it still pathologizes trans identity and diagnoses "gender dysphoria"). My point here is not to make any direct comparisons but, rather, to explain why I do not believe that the APA's endorsement necessarily means that a form of therapeutic treatment is valid. I prefer to read the available research studies and scientific literature and come to my own conclusions. That does not mean I don't respect those who hold different opinions, practice, or benefit from these therapies. Like I said initially, a very good friend of mine does EMDR and finds it helpful. If it helps her, that's great. My views, however, are much more in line with those of Professor of Psychology Scott Lilienfeld, who is now a researcher at Emory University (and used to work at my own University). He wrote the following article on EMDR.

EMDR Treatment: Still Less Than Meets the Eye?

The wikipedia page also recognizes that there is a lot of controversy surrounding EMDR, and presents both sides quite well. (Even though I recognize that Wikipedia should not be used as an academic source, as I tell my students).

From the wikipedia page: "EMDR has generated a great deal of controversy since its inception in 1989. Critics of EMDR argue that the eye movements do not play a central role, that the mechanisms of eye movements are speculative, and that the theory leading to the practice is not falsifiable and therefore not amenable to scientific inquiry.[41]

The working mechanisms that underlie the effectiveness of EMDR, and whether the eye movement component in EMDR contributes to its clinical effectiveness are still points of uncertainty and contentious debate.[42][43][44]

Although one meta-analysis concluded that EMDR is not as effective, or as long lasting, as traditional exposure therapy,[45] several other researchers using meta-analysis have found EMDR to be at least equivalent in effect size to specific exposure therapies.[30][31][32][33]

Despite the treatment procedures being quite different between EMDR and traditional exposure therapy, some authors[28][46] continue to argue that the main effective component in EMDR is exposure.

An early critical review and meta-analysis that looked at the contribution of eye movement to treatment effectiveness in EMDR concluded that eye movement is not necessary to the treatment effect.[47][48] Salkovskis (2002) reported that the eye movement is irrelevant and that the effectiveness of the procedure is solely due to its having properties similar to cognitive behavioral therapies, such as desensitization and exposure.[49]

A 2009 review of EMDR suggests further research with different populations is needed.[50]

I don't know much about it in terms of personal experience. The first therapist I ever saw became a big fan of EMDR and my partner went to her a few times and did it reporting back that it had positive effects on her. I have done sacral cranial therapy and, whether real or not, doing it has helped me with why I went. I have done it more than one time in my life.
Remember the reports about placebo's - they work a lot of the time.
Does it matter why something works as long as it does? I don't think with things like this, that they are particularly harmful and so why not give it a try and see- the worst thing is they don't help and you move on to something that does. Best case is they do help.

GenCat, my concern for you regarding EMDR is what you stated in your other thread that you sometimes make up bad things that have happened to you. Insofar as EMDR is used primarily to treat trauma, do you think this therapist is planning on using it for what you told her but wasn't true? Because if so, I think it would be important to talk to her about that issue before starting this treatment. If it has nothing to do with it, of course please ignore this.

Good point but no, I haven't told my new T much that isn't true, it was mainly with my older T. The EMDR is to help with my social anxiety, depression and possible trauma (that actually happened) that may be the root of the issues.