What is EMDR?

What is EMDR, and why is it so popular?

If you’ve looked into mental health therapy and the different methods therapists use, especially in the past few years, you’ve probably heard the term “EMDR.” I recently became trained in this practice, and before I knew the ins and outs, I thought it was mostly intended for people who have undergone intense “big-T” traumas, like a natural disaster or an assault. Nope! EMDR can definitely help people with major trauma histories, but it's also beneficial for anyone with any negative thought patterns and beliefs about themselves… in other words, I would probably say—anyone.  

EMDR was founded by Francine Shapiro, a PhD student, in 1989, but there’s a surprising amount of research on its efficacy already. EMDR stands for “Eye Movement Desensitization and Reprocessing…” it’s clear why everyone shortens it to the acronym! Basically, the process involves using “bilateral stimulation,” or activating both sides of our bodies so that we can stimulate both the right and the left sides of our brains. You might have heard in the past that our “left brain” is the more logical, objective, mathematical side, while the “right brain” is associated with our more artistic, emotional, and subjective thoughts. In EMDR, we want to activate both sides so we can “process” what’s happened in the past and rewire the negative beliefs that have become engrained in us, which involves targeting logical thoughts as well as emotions and sensations.

When using EMDR, therapists and clients undergo several different steps together, including securing a safe space so the client feels at ease during the session, identifying a mental “container” so the client can put away triggering thoughts until they’re more accessible, and practicing coping skills to deal with unwanted emotions that might come up after the session. Then, the therapist will help the client identify a “target,” which is the negative event the client wants to reprocess. The client, in their own words, verbalizes a negative belief that they developed from that experience—this might be something like, “I’m not good enough,” “I’m powerless,” or “I’m unwanted.” Then, the client and the therapist go through several rounds of bilateral stimulation (or BLS) together. 

So what exactly does bilateral stimulation look like? 

There are several ways a therapist might use BLS, but the most common form comes in eye movements, as represented in the title “EMDR.” Here, a therapist will move their fingers back and forth in front of the client while the client follows by moving their eyes back and forth rapidly. At the same time, the client holds the target event in their mind, allowing negative emotions to come up and then “process” until they’ve essentially become less painful. This might sound difficult, but it’s more of a passive activity for the client; clients are encouraged let negative emotions arise and then “go with that,” or sit with the emotion instead of pushing it away.  

Other forms of BLS include clients touching their right and left shoulders with alternating taps, or doing the same thing on their knees, or holding two vibrating devices that buzz in alternation in each hand. Clients might like to try out several different methods to see what works best for them—you can even switch methods in the middle of a session if necessary! 

In short, the sets of bilateral stimulation take up the bulk of the EMDR process, but there are lots of little nuances that make it a more cognitive or thought-based therapy in addition to the more physical, emotion-focused BLS. Clients come up with new, positive beliefs and retrain their minds to accept those instead of the unhelpful negative ones. 

So why does this actually work… and does it?

The short answer is yes. Research over the past few years strongly supports EMDR, but the field still isn’t completely sure why. One big theory is that it has to do with the same neurological mechanism that we use during REM sleep, while we dream, process emotions and events from the day or any time in the past, and experience rapid eye movement. Some critics have said EMDR’s success has to do with simply talking about the negative events so that we can come to terms with them, but research using control groups has shown that the same methods without the BLS isn’t as effective. During the roleplaying portion of my EMDR training, I underwent reprocessing myself, and I noticed a clear shift in my negative beliefs. I also felt exhausted for the rest of the week, and even experienced some vivid dreams! These are common “side effects” of EMDR, but I took them to mean the process was really working.

Try EMDR for yourself and see what you think! 

Source: Shapiro, F. (2018). Eye Movement Desensitization and Reprocessing (EMDR) Therapy (3rd ed.). Guilford Publications.