EMDR stands for Eye Movement Desensitisation & Reprocessing. It is a psychotherapy that was originated and developed by Dr Francine Shapiro in the United States in 1987 after making the chance observation that eye movements can reduce the intensity of disturbing thoughts and feelings under certain conditions.

When an individual is traumatised, they may experience such strong emotions that their brain becomes overwhelmed. The brain is consequently unable to cope with, or process information as it usually does. Distressing experiences become ‘frozen in time’. Such events are stored in the brain in their original ‘raw’ form and can then be repeatedly remembered as ‘action replays’ or intrusive memories. As a consequence, the person repeatedly relives the original unpleasant event. Re-experiencing in this way may feel as distressing as experiencing it for the first time because the images, sounds, smells, and feelings do not change or become processed. Such memories have a lasting negative effect on the way a person sees themselves, the world and other people. It can have a profoundly negative effect on all aspects of their lives.

EMDR seems to directly influence the way that the brain functions. It helps to restore normal ways of dealing with problems (i.e. information processing). Following successful EMDR treatment, memories of such events are no longer painful when they are brought to mind. What happened can still be recalled, but it is no longer distressing. EMDR can be thought of as an inherently natural therapy which assists the brain in working through distressing material utilising a natural process. This is described by Francine Shapiro as “Adaptive Information Processing”. EMDR therapists help clients to reprocess their traumatic memories by using repeated left-right (bilateral) stimulation of the brain while noticing different aspects of the traumatic memory.

EMDR was originally developed to process traumatic or “dysfunctional” memories and experiences and their psychological consequences. The therapy was initially used therefore principally in the treatment of Posttraumatic Stress Disorder (PTSD). However, EMDR has been increasingly utilised over the years to treat, for example, depression, phobias, anxiety disorders, pain, psychosis and a wide range of psychological disorders which have their basis in adverse life events which the
individual has not yet psychologically processed.

EMDR is an evidence based therapeutic procedure. That is, although the procedure originally developed out of self-observation, the evolution and development of the procedure has been dictated by clinical and research findings. Most of the components in EMDR are recognisable from other well-known therapies although they are arranged in a unique order. However, one unusual element in EMDR is bilateral stimulation, usually in the form of eye movements, but also sometimes in the form of bilateral auditory or tactile stimulation. There is empirical evidence (Lee & Cuijpers, 2013) that bilateral stimulation speeds up the reprocessing of disturbing emotional or traumatic material and at the same time helps the client to feel safer in making contact with traumatic material. Research trials have consistently demonstrated that eye movements reduce the vividness of emotional and traumatic imagery.

In EMDR, the therapist will always firstly carry out a careful psychological assessment of whether EMDR would be suitable for the problem presented and will elicit a specific memory that represents the problem. With more complex problems there will be an extended period of preparation in which the client becomes sufficiently stabilised in order to tolerate EMDR therapy.

Once they are ready to start processing their traumatic memory, the client will be asked for a picture that represents the memory, a negative belief that they have about themselves in relation to the memory, and to notice associated physical sensations. Thereafter, eye movements or other bilateral stimulation are commenced, and after each set of eye movements the therapist will ask the client what they noticed. Typically, the images, emotions, and sensations experienced will change through this process. At some point these changes become more positive and adaptive as the client reprocesses old dysfunctional information and connects with presently held adaptive and functional information. The aim is always to enable the client to recollect the original traumatic material without disturbance and to develop new and more adaptive beliefs about themselves in relation to the experience.

With simple or “one off” traumas or experiences in adult life, EMDR can be remarkably rapid in its effects, and average treatment times for these kinds of problems are from 3 to 5 sessions. With more “complex” or multiple traumas, treatment can take much longer but the evidence to date suggests that EMDR is one of the most efficient and rapid psychotherapeutic procedure available for the treatment of traumatic memories and PTSD.

A considerable amount of research into EMDR has now been carried out, particularly in relation to post-traumatic stress disorder (PTSD). Meta-analyses of published randomised controlled trial (RCTs) consistently show that EMDR is as effective as Trauma Focussed Cognitive Behaviour Therapy (TFCBT) in the treatment of PTSD (Bisson et al. 2013; Kline et al. 2017) . EMDR has been recommended as one of the treatments of choice for PTSD by NICE (National Institute for Health and Clinical Excellence, 2005) . The World Health Organisation (World Health Organisation, 2013) recommends EMDR for both adults and children in the treatment of PTSD.

There is also increasing evidence for the efficacy of EMDR for other disorders such as depression (Carletto et al. 2017) , OCD (Nazari et al. 2011) and psychosis (van den Berg et al., 2015) .

Basic introductory book regarding EMDR Therapy:
Shapiro, F. (2018) Eye Movement Desensitization and Reprocessing (EMDR) Therapy. Basic Principles, Protocols and Procedures (3rd Edition). New York: Guilford Publications.

For more information about EMDR, please look at the following website: www.emdrassociation.org.uk

Bisson, J. I., Roberts, N. P., Andrew, M., Cooper, R., & Lewis, C. (2013). Psychological therapies for chronic post-traumatic stress disorder (PTSD) in adults. Cochrane Database Syst Rev, 12.

Carletto, S., Colombi, N., Ostacoli, L., & Hofmann, A. (2017). EMDR for depression: A systematic
review of controlled studies. Clinical Neuropsychiatry, 14, 306-312.

Kline, A. C., Cooper, A. A., Rytwinksi, N. K., & Feeny, N. C. (2017). Long-term efficacy of psychotherapy for posttraumatic stress disorder: A meta-analysis of randomized controlled trials. Clinical Psychology Review.

Lee, C. W., & Cuijpers, P. (2013). A meta-analysis of the contribution of eye movements in processing emotional memories. Journal of Behavior Therapy and Experimental Psychiatry, 44, 231-239.

National Institute for Health and Clinical Excellence. (2005). Post Traumatic Stress Disorder (PTSD):
The Management of Adults and Children in Primary and Secondary Care. Retrieved from London:

Nazari, H., Momeni, N., Jariani, M., & Tarrahi, M. (2011). Comparison of eye movement desensitization and reprocessing with citalopram in treatment of obsessive – compulsive disorder. International Journal of Psychiatry in Clinical Practice,, 15, 270–274.

van den Berg, D. P., de Bont, P. A., van der Vleugel, B. M., de Roos, C., de Jongh, A., Van Minnen, A.,
& van der Gaag, M. (2015). Prolonged exposure vs eye movement desensitization and reprocessing vs waiting list for posttraumatic stress disorder in patients with a psychotic disorder: a randomized clinical trial. JAMA psychiatry, 72(3), 259-267.

World Health Organisation. (2013). Guidelines for the management of conditions specifically related to stress. Geneva.

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