EMDR Therapy: Information & EMDR Specialists

EMDR therapy is a relatively new but now well-established psychotherapeutic method. This form of therapy was developed by the American psychologist Francine Shapiro. She observed that horizontal, saccadic eye movements have a soothing effect.

EMDR stands for Eye Movement Desensitization and Reprocessing. EMDR therapy was developed to treat post-traumatic stress disorder (PTSD). However, it has significantly more potential beyond that.

PTSD is a mental health condition that occurs in some people after experiencing a threatening situation. They are mentally transported back to the situation they experienced over and over again and relive it. This is often accompanied by panic attacks and nightmares. PTSD can severely impair daily life.

The neurological mechanisms underlying PTSD have not yet been sufficiently researched. However, it is believed that the brains of those affected were unable to process and store the experience correctly. This is therefore referred to as a dysfunctionally stored memory.

The EMDR method stimulates the brain to process the traumatic experiences correctly. Once the brain is able to “let go” of the traumatic situation, the person affected can resume a normal life.

During therapy sessions, the patient, prompted by the therapist, thinks about the distressing situation. The therapist then asks the patient to follow the therapist’s finger movements with their eyes. The eye movements stimulate the brain to process what happened.

Key Elements of EMDR Therapy

Normally, the brain processes stressful experiences. We learn from experiences and continue to develop. Even psychologically stressful experiences cease to affect mental stability after a certain amount of time. As the saying goes, time heals all wounds.

Under certain circumstances, however, this ability to process comes to a standstill. As a result, the memory persists for the affected person in its raw, emotionally charged form.

PTSD and its symptoms are thus a reaction to an experience. The therapeutic approach is, consequently, the reprocessing of the maladaptively stored information.

The ideal approach here is processing through the EMDR process. This allows for accelerated reprocessing of the harmful memory.

The memory loses its recurring and emotionally charged nature. It can become a “normal” memory of a traumatic event. This usually leads to an improvement in the patient’s symptoms.

History of EMDR Therapy

In 1989, behavioral therapist Francine Shapiro reported on her observations regarding the relieving effect of eye movements.

She initiated a systematic trial with test subjects and subsequently with PTSD patients. She initially hypothesized that the eye movements resulted in desensitization. The patients thus no longer seemed to react as strongly to the distressing memories. Shapiro therefore named the method Eye Movement Desensitization (EMD).

However, as experience grew, it quickly became clear that this therapeutic process is not merely desensitization. It is rather a reprocessing of memories. Consequently, Shapiro developed EMDR therapy from EMD.

Various Treatment Protocols and Techniques in EMDR Therapy

Various treatment plans and techniques are now part of the therapeutic toolkit of EMDR therapy. The treatment plans provide instructions for working with different clinical presentations and are referred to as “protocols” in EMDR therapy.

The standard protocol for EMDR therapy is the treatment plan for simple post-traumatic stress disorder. It guides the therapist to first address the patient’s old traumatic memories. The therapist then addresses the patient’s current trauma-related problems. Finally, the therapist addresses the patient’s anxiety about the future.

There are now protocols for a wide range of mental health conditions. In the treatment of complex conditions, EMDR therapy is often integrated into a comprehensive treatment plan.

Preparation for EMDR therapy

EMDR therapy naturally requires a thorough medical history and patient preparation. The therapist will allow sufficient time for stabilization. During the stabilization phase, EMDR techniques for building positive resources—such as the “place of strength”—are often used.

The therapist first helps the patient select the memory to be processed. The therapist then uses targeted questions to gently prompt the patient to activate the memory. This preparation facilitates the subsequent processing of the memory.

Processing Phase in EMDR Therapy

The therapist now asks the patient to briefly focus on the memory and then follow the finger movements with their eyes. The rapid eye movements are very likely to activate the brain’s information processing. The therapist then has the patient perform a series of eye movements.

Afterward, the therapist asks the patient to briefly share their impressions. The therapist then asks the patient to follow the fingers with their eyes again. This alternation is repeated until the distress associated with the memory has subsided.

Afterward, the therapist helps the patient anchor a positive thought. Eye movements are also used in this process. At the end of the EMDR therapy session, the therapist checks whether the patient is able to conclude the session feeling physically well. 

This is followed by a discussion of the patient’s experiences during the treatment.

A therapy session can last up to 90 minutes. Patients often find it exhausting, but also liberating. After a therapy session, patients should allow themselves time to rest.

At the beginning of the next session, the therapist will ask about any changes since the last session. The therapist then works with the patient to determine the next steps.

Standard Protocol for EMDR Therapy

The standard protocol for EMDR therapy outlines a framework for therapeutic work. The application of EMDR therapy always requires working through

• the past,
• the present, and
• the future.

In the past phase, dysfunctional memories are reprocessed.

In the present,

• post-traumatic nightmares,
• behavioral disorders, and
• triggers

are entry points for EMDR therapy.

Work focused on the future aims to change avoidance behaviors. Developing alternative behaviors is also a goal of EMDR therapy.

EMDR therapy is a well-researched treatment for post-traumatic stress disorder (PTSD). In the Federal Republic of Germany, its recognition by the Scientific Advisory Board for Psychotherapy as an evidence-based treatment method for PTSD in adults is important. Recognition for the treatment of PTSD in children and adolescents is still pending.

A prerequisite for EMDR therapy is the identification of the traumatic memories that trigger the symptoms. Only in this way can the root cause be addressed and the anxiety disorders and other impairments resolved. The connection between the remembered situation and the symptoms is not always easy to recognize. Therefore, hypothesis-driven attempts may also fail.

The dysfunctionally stored memory may, for example, be the memory of

• a traumatic experience,
• a pain memory,
• an addiction memory,
• an anxiety memory, or
• memories from the network of depressive experiences in a chronically depressed patient

. The starting point can be chosen flexibly. Ultimately, treatment with EMDR therapy is always guided by

• the connection between the original experience and the symptoms, as well as
• the alternation of focusing and stimulation

.

EMDR therapy is used for chronic and complex PTSD, as well as acute trauma. Publications also indicate its effectiveness in

• pain disorders,
• anxiety disorders,
• substance dependence, and
• recurrent depression

. One study reports positive results in patients with schizophrenia-spectrum psychoses.

A prerequisite for treatment with EMDR therapy is

• sufficient real-world safety
• sufficient physical, social, and psychological stability
• sufficient emotional tolerance

In cases of

• acute risk of suicide,
• uncontrolled drug use,
• severe self-harming behavior, and
• acute psychosis,

EMDR therapy cannot be used.

Ultimately, an assessment through a consultation with a well-trained therapist is necessary.

In addition to the central work on unprocessed memories, EMDR therapy also offers other possibilities. These include techniques for strengthening resources, such as the absorption technique or the “Position of Power.”

Two elements are always involved in this process: focusing and stimulation. Focusing means that the therapist helps the patient

• focus on a resource or
• guides them to examine a distressing memory closely.

The patient follows the therapist’s fingers with their eyes. The therapist then adds bilateral stimulation, usually through eye movements.

Although the type of stimulation—for example, in terms of speed—may vary, the basic principle remains the same: EMDR therapy is characterized by focusing on memory content and bilateral alternating stimulation.

EMDR therapy is a very effective method. However, it requires

• precise application,
• experience in psychotherapy, and
• experience in using the method.

The quality of training in EMDR therapy is monitored by the national professional association EMDRIA Deutschland e.V. and the European professional association EMDREA.

The quality of therapists is ensured through a certification process administered by the professional association. If a therapist holds the “EMDR Therapist EMDRIA Deutschland” certification, they have completed a regulated training program at a recognized training institute that includes self-awareness exercises and supervision.

EEG recordings taken in real time during therapy sessions appear to support the information-processing hypothesis. Various studies show profound normalization at the hormonal and neurophysiological levels in PTSD patients.

Treatment with EMDR therapy appears to influence the deep-seated traces of trauma within the body.