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EMDR was initially used for post-traumatic stress disorder but is now applied to many mental disorders. It is an integrative approach which applies an information-processing model to distress and is ideal for those who prefer a less intrusive method.

Eye Movement Desensitization And Reprocessing is a therapy which was developed in the late 1980s by American psychologist Francine Shapiro and initially applied in the treatment of trauma. It has subsequently been used in the treatment of many other conditions including anxiety disorders, and so far the results from studies appear promising.

The effectiveness of this therapy in post traumatic stress disorder (PTSD) treatment has been extensively illustrated since its emergence. Its application to disorders on the anxiety spectrum arises from literature that asserts that many anxiety disorders involve distressing experiences along with a strong sense of fear or helplessness, and so can be seen to fit the category of “life-threatening experiences”, like PTSD. In addition, anxiety memories (such as in panic attacks, for example) can often resemble traumatic memories akin to those seen in PTSD.

Eye Movement Desensitization And Reprocessing (EMDR) is an integrative psychotherapy which adopts an information-processing model in the treatment of distress. It works by employing bilateral stimulation while imagining the source of distress, and at the same time, changing attention away from negative thoughts and towards more positive ones. In turn, this causes anxiety to dissipate.

EMDR incorporates a number of different techniques within a specific framework such as:

  • Bilateral stimulation. This typically involves the therapist using finger movements to stimulate frequent eye movements but other tools may be used.
  • Free association
  • Focusing on bodily sensations (body scanning)
  • Negative and positive thoughts
  • Cognitive interweaves (additional techniques employed for those who become emotionally overwhelmed during treatment).
There are range of explanations for how EMDR works — including distraction, relaxation, a linking of the brain's two hemispheres, and processing of the kind seen in rapid eye movement (REM) sleep. Certainly, neuro-imaging studies suggest that there is a neurological basis for the effect as particular parts of the brain seem to show more activity when undergoing bilateral occular stimulation, often regarded as the most controversial aspect of the approach.

The author themselves has termed the approach as an “adaptive information-processing model”. This explanation states that humans absorb new experiences and store them in existing memory networks which link cognitive and emotional/psychological aspects of those experiences. Difficulties occur when these experiences and associated emotions or thoughts are not processed properly and are retained in this form in the memory networks. If a person then experiences external stimuli similar to the difficult or unpleasant experience, the associated thoughts and sensations are triggered. If these maladaptively stored memories remain in this unprocessed state, this forms the basis of disorders such as PTSD.

The most popular explanation for why EMDR works is to do with working memory. Our working memory is often described as like a post-it note – it is the part of our brain that enables us to concurrently remember and process information. It has a limited capacity and so when the information is not frequently retrieved, it is moved on to the long-term memory where it is not so easily retrieved from. This explanation purports that the eye movements effectively serve to tax working memory resources, which reduces the vividity of the memory and also reduces the ability to recall associated negative emotions and thoughts.

There are eight phases of treatment in EMDR:

  • Client History
  • Preparation
  • Assessment
  • Desensitization
  • Installation
  • Body Scan
  • Closure
  • Re-evaluation

After the therapist decides which memory to tackle first, they instruct the person to keep aspects of the memory in their mind and then follow the therapist’s hand with their eyes as it moves across their visual field. As a result, internal associations seem to arise to assist the processing of the memory and associated painful or disturbing feelings.

In the therapy, the person focuses not only focuses on a problematic memory but is also asked to identify self-beliefs, and where negative self-concepts may be connected to the memory, the person is then encouraged to come up with a new, and preferred positive belief. The physical sensations and emotions experienced when recalling the memory are also explored and clarified. The person then has to recall the memory. This process is repeated until the patient no longer experiences the memory as disturbing, at which point the chosen positive belief is used to replace the negative one, again using the bilateral movements.

As a therapy, EMDR is ideal for those who don't consider themselves “psychologically-minded” as the process does not require conversing with the therapist. Likewise, if the memory or trigger is too distressing to express verbally, this is not required. This can be helpful for many, as shame can be a key component of many anxiety disorders but EMDR allows the person to feel less exposed, meaning they are more likely to continue with treatment.

A considerable part of EMDR’s success may be imaginational, as the person is able to reflect on their fears and traverse them in a relaxed rather than aroused state, enabling them to regain a sense of personal control. Loss of a sense of control is a key factor in anxiety and a contributing factor to anxiety becoming pathological. Furthermore, anxiety disorders generally involve excessive worry or preoccupation with specific issues, which, according to the adaptive information processing model of EMDR, is likely to prevent the healthy processing of emotional distress. Over time, there will be a cumulative effect that may be part of the process that moves anxiety on to a disorder.

In summary, EMDR is interesting as it would be easy to dismiss it as “quackery” owing to its seemingly unusual techniques. However, research pointing to its success in treating a range of disorders including anxiety disorder exists in abundance. What helps one person may not help another, and often the key influencing factor in treatment outcomes is patient engagement and therapeutic relationship. For some, the less intrusive nature of EMDR may be conducive to forming a more constructive therapeutic relationship with the therapist and enable them to move on in their lives to become anxiety-free.

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