Eye movement desensitization and reprocessing (EMDR) therapy exercises and techniquesBrowse all therapists
Eye movement desensitization and reprocessing (EMDR) therapy combines talk therapy with guided eye or sensory movement exercises.
EMDR is often used to help alleviate symptoms associated with trauma and post-traumatic stress disorder (intrusive memories or flashbacks, avoidance, panic, negative emotional reactions, persistent negative beliefs about yourself, difficulty concentrating, etc.), and other mental health challenges.
EMDR was developed by American psychologist, Dr. Francine Shapiro in 1987. While trying to work through some painful memories, she decided to take a stroll through a park and noticed her sweeping eye motions were impacting the intensity of those emotions.
In a New York Times feature article following Dr. Shapiro’s death in 2019, she’s quoted as saying, “I noticed that when disturbing thoughts came into my mind, my eyes spontaneously started moving very rapidly back and forth … the thoughts disappeared, and when I brought them back to mind, their negative charge was greatly reduced.”
She followed this experience and continued to develop her theory, eventually achieving her PhD in psychology in 1988, publishing her thesis on EMDR in the Journal of Traumatic Studies in 1988 and then her first EMDR textbook in 1995.
How does EMDR work?
Growing bodies of research show how negative life experiences impact us both psychologically and physically—we can feel the effects of stressful experiences in our bodies and minds long after the event takes place. We might remain in a “fight or flight” mode, meaning we stay too hypervigilant (charged up) as an unconscious way to protect ourselves against such an experience again. Unlike some other therapy approaches, like cognitive behavioural therapy (CBT), which help us challenge distorted thoughts and emotions, EMDR aims to change the way a memory is actually stored in the brain to discharge these emotions.
EMDR techniques involve recalling traumatic or emotionally charged memories while the therapist incorporates some kind of bilateral (left-right) exercise. This could be done with side-to-side eye movements, audio tones on each side of the head, or knee tapping (note: tapping is also part of a different therapy called Emotional Freedom Technique). Recalling distressing experiences while activating the brain in this way helps create new neurological connections so we can re-process those memories.
If this seems a bit far-fetched, it helps to understand a little bit about how our brains work.
Our brains are amazing information processors that code (organize) and store our experiences and the emotions associated with them. We first take in an experience in sensory ways (see, hear, feel), our brains work to help us understand our situation, then it stores everything (the facts of an event and our emotions) in different parts of our memory to be recalled later when we need to use that information again.
When something highly stressful happens, or we’re in a state of stress over long periods of time (“big T” trauma vs. “small t” trauma), our memory storage process gets disrupted and fragmented. The facts of an event can become blurred or unclear, in part because our brains kick into gear focusing only on what’s most important for survival, and the surrounding details fall away. This can result in us storing certain memories more as more sensory than fact—our emotional memories stay heightened and at the forefront of the experience.
The distressing emotional memory is sensitive so the feelings surrounding that experience can be easily triggered. Because this can be unconscious, we can unknowingly become less capable of handling situations that remind us of that experience later, or we might develop negative beliefs about ourselves and the world around us.
The bilateral actions while recalling past memories helps the brain restart its coding process. We can lessen the intense emotions (desensitize them) so we can re-examine our experiences with a fresh perspective. This can be referred to as processing trauma.
What to expect if your therapist or counsellor suggests EMDR
It’s important to ensure you’re working with a trained and qualified therapist in EMDR. While you might work with a therapist on EMDR techniques to help with symptoms associated with trauma, keep in mind that only certain levels of mental health professionals can actually provide an official diagnosis for mental illnesses or disorders, like PTSD.
EMDR typically involves these eight phases:
- History and planning: to begin, the therapist is looking to identify which memories or stressors are going to be addressed by evaluating your background and life’s experiences.
- Preparation: this involves building a strong relationship with your therapist, understanding the process and what’s involved, and perhaps building some other techniques to deal with anxiety and stress.
- Assessment: together, you and your therapist will identify the first memory to be targeted, including negative and positive beliefs about yourself and that memory, and identifying body sensations associated with that memory.
- Desensitization: this is when the stimulation begins with guided eye movements and could include other sensory techniques like auditory tones.
- Installation: in this phase, negative beliefs about the memory are addressed and challenged with the goal to replace them with positive beliefs.
- Body scan: you will recall the negative memory again and evaluate if there are still body sensations associated with it.
- Closure: the end of each session involves evaluating the day’s progress and discussing any homework, or to evaluate coping techniques.
- Reevaluation: the beginning of each new session will involve reviewing the outcome of the previous one, and any new stressors that arose in between to set new goals and targets for treatment.
EMDR sessions can run a little bit longer than traditional counselling or psychotherapy appointments (up to 90 minutes), and it often takes a number of sessions to work through these phases (six to 12 sessions). You can ask your therapist or counsellor to outline their plan for you before starting EMDR.
It’s important to be aware that EMDR has a history of controversy amongst psychological researchers. Professionals have disputed if the method of eye movements is actually more effective than other types of exposure therapies (that also aim to expose someone to their painful memories to address and process them). However, more recent scientific studies are continuing to prove EMDR’s effectiveness for re-coding or reprocessing traumatic life experiences for positive psychological and physical outcomes. EMDR was recognized by the World Health Organization in 2013 as the elective psychotherapy for treating PTSD, and it has been added to practice guidelines in jurisdictions around the world.
This modality also recently hit the mainstream when Prince Harry talked about his EMDR treatment in The Me You Can’t See, a docuseries co-produced by Oprah Winfrey.
You can easily search for therapists and counsellors in Canada who specialize in EMDR therapy on First Session.