Your therapist made it official — you have PTSD. You weren’t surprised, until she recommended EMDR therapy. You’d heard it was controversial, so you won’t go thumbs-up until you do your homework. But wanting to try her on for size, you asked, “Is EMDR a scam?”
So, in EMDR session work, it’s crucial to hold on to the belief that memories contain the emotions, thoughts, beliefs, and physical sensations experienced at the time of the traumatic event.
Introduction
Since we’re discussing a psychotherapy designed to treat posttraumatic stress disorder (PTSD), I think we ought to make sure we know how it presents.
The following are summaries of copyrighted diagnostic criteria from the American Psychiatric Association’s DSM-5-TR prepared by the Veteran Administration’s National Center for PTSD. Criteria A-E have important descriptors I didn’t include…
- Criterion A: The person was exposed to: death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence.
- Criterion B: The traumatic event is persistently re-experienced.
- Criterion C: Avoidance of trauma-related stimuli after the trauma.
- Criterion D: Negative thoughts or feelings that began or worsened after the trauma.
- Criterion E: Trauma-related arousal and reactivity that began or worsened after the trauma.
- Criterion F: Symptoms last for more than one month.
- Criterion G: Symptoms create distress or functional impairment.
- Criterion H: Symptoms are not due to medication, substance use, or other illness.
With that in our back pockets, let’s get after EMDR…
What is EMDR therapy?
Simply put, EMDR rewires the brain. After all, change and relief don’t magically happen..
Eye movement desensitization and reprocessing (EMDR) is an evidence-based, structured, individual psychotherapy that encourages the client to briefly focus on a trauma memory while experiencing bilateral stimulation — typically eye movements, but tones and taps are also used. The goal is reducing the vividness and emotions associated with the trauma memory.
EMDR is referred to as a trauma-focused therapy because it uses cognitive, emotional, and/or behavioral techniques to facilitate the processing of a traumatic event. That said, the trauma memory is the central component of the therapeutic process — not managing symptoms.
Other trauma-focused therapies are prolonged exposure therapy (PE) and cognitive processing therapy (CPT). Both are said to be effective for the treatment of PTSD.
Though primarily used to treat PTSD, EMDR may benefit those with a variety of emotional or mental health issues.
The adaptive information processing model
To max-understand EMDR, you have to get a handle on the adaptive information processing (AIP) model. EMDR was devised and developed for the treatment of PTSD by psychologist Dr. Francine Shapiro in 1987. She created the AIP model to lay a foundation for EMDR.
The AIP model submits that the brain possesses an innate physiological system designed to process experiences and integrate them. If the system is disrupted — in this case, by trauma —. the experiences become isolated as they’re stored in our thoughts, images, sensations, and emotions. Without intervention, they remain unintegrated, leading to psychological symptoms.
Is therapist certification required?
Therapist certification isn’t required to use EMDR. However, given the depth and impact of the therapeutic process, I always recommend working with a certified therapist. Knowledge and experience matter, and the time, effort, and dedication invested speak well for them.
Recommendations: government and professional organizations
EMDR is recommended for the treatment of PTSD by the World Health Organization, the UK National Institute for Health and Care Excellence, the Australian National Health and Medical Research Council, and the US Departments of Veterans Affairs and War.
It’s interesting that the American Psychological Association does not endorse EMDR as a first-line treatment, but indicate it’s likely effective for treating adult PTSD. I think it’s safe to assume they’d give it second-line status.
Health insurance coverage
Because EMDR is recognized as an evidence-based treatment for PTSD and other emotional and mental illnesses, most major health insurance companies cover it. However, we all know about assorted limits, diagnostic requirements, prior authorizations, etc.
How does EMDR work?
Common EMDR equipment: headphones, light tube, pulsators
EMDR therapy is typically delivered once or twice a week for six to twelve sessions. All components of the work are guided by Dr. Shapiro’s AIP model. In that context, the symptoms of PTSD are generated by trauma memories that weren’t adequately processed.
So, in EMDR session work, it’s crucial to hold on to the belief that memories contain the emotions, thoughts, beliefs, and physical sensations experienced at the time of the traumatic event. And when those memories are triggered, it all comes back to call — as symptoms of PTSD.
Consider this: according to psychologist Dr. Steven Silver, the brain is always trying to solve problems, which is why it continually goes back to troubling events. If it can’t find or accept an answer, and it’s a priority issue, the brain keeps plugging away. By the way, at first, the brain may have no idea what the event was.
Eight-phase approach
During therapy, eye movements (tones or taps) of rhythmic left-right stimulation are introduced while the client briefly focuses on the trauma memory. As a result, the vividness and associated emotions of the memory become less intense.
For the treatment of PTSD, EMDR uses a structured eight-phase approach that includes…
- Phase 1: History-taking
- Phase 2: Preparing the client
- Phase 3: Assessing the target memory
- Phases 4-7: Processing the memory to adaptive resolution
- Phase 8: Evaluating treatment results
Of utmost importance is bringing each session to an orderly close. That means re-assessing the client and their memories to ensure they’re progressing and staying on track to meet goals.
Processing of a specific memory is generally completed within one to three sessions. Keep in mind, EMDR therapy differs from other trauma-focused treatments in that it doesn’t include extended exposure to the distressing memory, detailed descriptions of the trauma, challenging dysfunctional beliefs, or homework assignments.
For details on each of the eight phases, check out the American Psychological Association’s article “Eye Movement Desensitization and Reprocessing (EMDR) Therapy.”
Of note: it’s understandable that many clients experience strong, and a wide variety of, emotions when facing trauma memories. But things typically calm down when additional information regarding the memory is introduced. Most all of the distressing emotions and physical sensations are transient and expected to decrease as therapy progresses. Management of such circumstances is one of the reasons why it helps to have an EMDR certified therapist
Also, clients report feeling tired and having vivid dreams following a reprocessing session. If they occur, it’s important to share with the therapist for reassurance and monitoring purposes.
Is EMDR a scam?
Well, is it warranted?
Okay, now to the million dollar question: is EMDR therapy a scam? No, it isn’t. So why would I feature a question like that? Well,in spite of its proven effectiveness and safety record, EMDR catches its fair share of controversy and criticism — and here’s why.
As we’ve discussed, EMDR uses bilateral stimulation (eyes, taps, tones, etc.) while memories are being discovered and processed. Critics believe they’re unnecessary, and benefits actually come from the good old-fashioned talk therapy involved. Some have gone so far as to refer to EMDR as a “purple hat therapy” — a snarky term for interventions with unnecessary or overly ritualistic elements.
In reality, EMDR therapy can quickly provide relief — sometimes in just a few sessions. There are clinicians who are skeptical of such results, wondering if they’ll stand the test of time.
And then there are patients and clinicians who worry about EMDR causing harm or exacerbating existing emotional and mental health challenges.
Here’s the deal. If you’re concerned about any of the above, or something else, ask your therapist before going thumbs-up.
That’ll do it
The purpose of this article is to provide easy to absorb information on eye movement desensitization and reprocessing (EMDR) therapy, and I can’t think of much I may have missed.
I believe EMDR is an effective and safe treatment for PTSD, when a certified therapist is at the helm. I also believe it’s not for everyone, so questions need to be asked and answered.
Once again, is EMDR a scam? Nah.
Are you looking for more emotional and mental illness insight and management ideas? Peruse all of the Chipur titles on the articles page — or by category below, right sidebar on desktop.
A shout-out to the American Psychological Association for some great information. Two examples…
“What Is EMDR therapy and why is it used to treat PTSD?”
“Eye Movement Desensitization and Reprocessing (EMDR) Therapy”
EMDR equipment image: EMDR KIT
