Anxiety can be distressing at best and debilitating at worst. Finding relief from anxiety can be a difficult process as identifying the deep-rooted source of the anxiety can be a long journey and a practice in self-awareness that not everyone may be able to do. There is a therapy that has been successful in helping those suffering with anxiety, however: eye movement desensitization reprocessing (EMDR).
EMDR is a therapy in which a trained therapist works with a client to address the disturbing memory or thought that triggers anxiety by reducing the emotional, mental, and physical reaction to it. Over the course of multiple sessions, the therapist and client work together to improve symptoms of anxiety and replace the negative feelings associated with the memory with a positive thought to undo the trauma it has caused.
What is EMDR?
In 1987, Dr. Francine Shapiro noticed that moving her eyes a certain way, back and forth, seemed to reduce the negative emotions she felt when thinking about upsetting memories. Shapiro began studying the effects of these eye movements with others and developed eye movement desensitization reprocessing (EMDR) based on her research.
Combining these eye movements with cognitive therapy and mindfulness techniques, this treatment model was originally used to help people improve and minimize symptoms of post-traumatic stress disorder (PTSD). Since then, many clinicians have learned this therapeutic modality and have found that EMDR relieves symptoms of a range of mental health conditions including anxiety disorders.
EMDR is based on an adaptive information processing model. In basic terms, it means that when we go through a traumatic experience, the negative emotions like humiliation, guilt, or fear that arise interrupt our ability to store the memory properly. As a result, anything that triggers that memory—a thought, image, smell, sound, or another similar experience—causes distress, which, for many, comes in the form of anxiety.
For example, a person who is bullied as a child may feel anxious and fearful walking alone on a street because it reminds them of times that their bullies followed them and harassed them while walking home from school. It can manifest as anxiety, and if it is not addressed, the anxiety can prevent the person from doing things like going for an evening stroll or jogging along the river—things they want to do but for some reason, feel too anxious to try. In EMDR therapy, the person will work with a therapist to address one or a few specific memories about the bullying that are at the root of their anxiety and will help them to reintegrate those negative memories properly.
How does EMDR do this? There are cognitive therapy approaches involved along with mindfulness techniques that help a person to recognize how they experience anxiety in the body. The therapist also directs eye movements and uses a technique called bilateral stimulation (BLS) to reduce or neutralize the intense emotions attached to the traumatic memory. There are usually six to 12 EMDR sessions, and these are broken up into eight phases.
The Eight Phases of EMDR
EMDR sessions typically happen over the course of six to twelve sessions and have eight phases. EMDR is not an immediate fix but can potentially provide lasting effects and relief from anxiety if the entire session is completed. The eight phases of EMDR therapy for anxiety include:
• Phase 1: Client History and Treatment Planning – To start, the client will meet with their therapist to talk about treatment goals, their experience with anxiety. The therapist will test their tolerance for anxiety triggers and distressing thoughts to understand the symptoms and behaviors that result to develop a treatment action plan for the session.
• Phase 2: Client Preparation – The therapist will prepare the client therapy by explaining how EMDR works and develop a trust-based relationship. They will also discuss coping mechanisms and relaxation techniques to deal with heightened emotions or distress that may arise during the sessions.
• Phase 3: Assessment – The therapist and client identify and assess the memory that the EMDR therapy will address and the images, bodily sensations, and cognitive effects it causes. The client will also select a positive replacement, which can be an image, thought, or memory.
• Phase 4: Desensitization – The desensitization process is when the therapist works with the client to reduce their reactions to the negative memory. The therapist will ask the client to recall the memory and will direct their eye movements and use other BLS. This is repeated until the client does not display adverse reactions to the negative memory.
• Phase 5: Installation – The therapist guides the client to reinforce the positive memories or thoughts that were chosen as replacements for the negative or distressing thoughts, memories, or images.
• Phase 6: Body Scan – While the client thinks about the negative memories they are working on, they do a scan of their body, looking for any sensations or physical responses to the trigger.
• Phase 7: Closure – The therapist will check in with the client and go over the relaxation and grounding techniques taught in phase 2 to come back down from any heightened emotions that may have come up in the session.
• Phase 8: Re-Evaluation – The therapist and client review their session and evaluate the effects of the EMDR on the memory targeted.
What are EMDR Techniques?
In EMDR, there are elements of cognitive behavioral therapy, particularly in the first phases as the therapist and client discuss the history of anxiety and the distressing thoughts or memories they want to address. Traditional talk therapy can be helpful, but Shapiro, the founder of EMDR, saw that the eye movements in combination with talk therapy was more effective.
The eye movements or BLS mentioned earlier is another important technique in EMDR. The idea is that the client develops a dual focus: as they are talking about the negative memory and focusing attention inward, they are also focusing on the external stimulation, following the movements of the therapist’s hands with their eyes. This is thought to help with reintegrating the traumatic memory into their personal story without the intense emotional reaction, so they can move past it and talk about the experience without feeling distressed.
Another technique that is integral to EMDR is mindfulness. The therapist will train the client on mindfulness techniques to be present in the body and aware of the effects of the memory on them. This may be done throughout the sessions. The therapist may ask the client to describe what they are feeling as they are talking about the distressing memory or as the session winds down to recognize what effects they are still feeling. Mindfulness techniques are also key to help people between sessions when difficult emotions arise from dredging up traumatic memories, so they can remain calm and gain more self-awareness throughout the process.
EMDR therapy at DreamLife Recovery, one of the only Pittsburgh rehab facilities that offers this level of clinical car, can help people to feel liberated from the traumas of their past that may be causing them to experience anxiety disorders. EMDR sessions can have lasting benefits, helping people improve their self-image, boosting self-esteem, reducing their reaction to painful memories and even extending to other similar traumas and negative experiences beyond those specifically addressed in the sessions.
There are now a number of studies that have found EMDR therapy to be effective at reducing symptoms of anxiety disorders and other mental health conditions, particularly PTSD and trauma-related issues. These studies have been small and lack long-term follow up, but the initial findings have been promising for this therapy and its lasting benefits. In fact, the only negative effects relate to delving into traumas, which can bring up intense emotions as is the case with any other type of talk therapy.
The mindfulness techniques taught during the sessions are another beneficial aspect of EMDR that clients can incorporate into their lives outside of the therapy. Mindfulness and relaxation techniques can help people experiencing anxiety to reduce symptoms and better manage anxiety, putting them in control of their anxiety and not the other way around!
- “Eye Movement Desensitization and Reprocessing (EMDR) Therapy” – American Psychological Association, Clinical Practice Guideline for the Treatment of Post-Traumatic Stress Disorder; 17 July, 2017
- Shapiro, F. (2007). EMDR, adaptive information processing, and case conceptualization. Journal of EMDR Practice and Research, 1, 68–87
- Frequent Questions – EMDR Institute, Inc.
- Francine Shapiro, Ph.D. – EMDR Institute, Inc.
- “What Happens in an EMDR Session” – Oxford Therapy
- “EMDR therapy: Everything you need to know” – Leonard, Jayne; Rev. by Timothy J. Legg, Ph.D.; Medical News Today, 11 July, 2019
- “EMDR Therapy: What You Need to Know” – Gotter, Ana; Rev. by Timothy J. Legg, Ph.D.; Healthline, 15 July, 2019