When people hear about EMDR therapy, they often associate it exclusively with severe trauma or post-traumatic stress disorder.
This can cause someone to assume that EMDR is not relevant to them because they have not been diagnosed with PTSD or do not describe their experiences as traumatic.
EMDR has strong research support as a treatment for PTSD. However, EMDR therapy also considers how distressing life experiences may continue to influence present emotions, beliefs, behaviours, relationships, and physical reactions.
A person does not necessarily need a PTSD diagnosis to discuss whether EMDR may be appropriate for their treatment.
EMDR stands for Eye Movement Desensitization and Reprocessing.
It is a structured psychotherapy approach involving eight phases that take place over a number of sessions. These phases include history taking and treatment planning, preparation, assessment, processing, closure, and reevaluation.
During parts of the process, bilateral stimulation may be used. This can include guided side-to-side eye movements, alternating taps, or sounds.
However, EMDR is not simply a technique involving eye movements.
It is a complete therapeutic approach that involves understanding the client’s current concerns, identifying relevant experiences, developing a treatment plan, preparing for processing, and regularly evaluating the client’s response.
EMDR should be provided by a qualified mental health professional who has received appropriate EMDR training.
An EMDRIA-Approved EMDR Basic Training includes instruction in the EMDR model and methodology, supervised practicum, and consultation. After completing the full EMDRIA -approved EMDR basic training, a clinician may accurately describe themselves as EMDR-trained.
Being EMDR-trained is not the same as being an EMDRIA Certified Therapist™. EMDRIA certification is a separate, voluntary credential involving additional experience, consultation, and continuing education.
When choosing an EMDR therapist, clients can ask where the therapist completed their training, whether the program was EMDRIA-approved, and whether the therapist is trained or certified. A therapist should describe their credentials accurately and clearly.
EMDR is recognized as an evidence-based treatment for PTSD, and this is where its research support is strongest.
However, not every distressing experience results in PTSD. Difficult experiences can still affect how a person sees themselves, responds emotionally, relates to others, or handles present situations.
These experiences might include:
The significance of an experience is not determined only by how it may appear to someone else. What matters clinically is how the person experienced it and whether its effects continue to influence their present life.
Sometimes, a person understands a situation logically but continues to experience a different emotional or physical response.
For example:
These reactions may have several possible explanations. When they appear to be connected to distressing experiences, therapy can explore whether those experiences remain emotionally unresolved.
EMDR may be one approach considered as part of that work.
Anxiety can develop for many reasons, and EMDR is not the appropriate approach for every form of anxiety.
It may be considered when present anxiety is connected to a particular experience, memory, trigger, or learned fear.
For example, anxiety may intensify following:
In these circumstances, treatment may address both current anxiety and the experiences that continue to contribute to it.
Other therapeutic approaches and coping strategies may also be used depending on the individual’s needs.
Experiences can influence the beliefs people develop about themselves, other people, and the world.
Common negative beliefs may include:
A person may intellectually recognize that a belief is inaccurate while continuing to experience it as emotionally true.
EMDR therapy may help identify the experiences connected to these beliefs and support the processing of those experiences.
The purpose is not to replace difficult thoughts with unrealistic positive statements. The goal is to support beliefs and emotional responses that are more adaptive and appropriate to the person’s present circumstances.
Grief is a natural response to loss. It is not a problem that must be erased.
EMDR does not remove sadness, eliminate the importance of a relationship, or make someone forget the person or experience they lost.
However, it may sometimes be considered when a particular aspect of a loss remains intensely distressing. This might involve:
The purpose would be to process the distressing aspects of the experience, not to eliminate the natural emotions or meaningful connection associated with grief.
Some people avoid trauma-focused therapy because they worry that they will have to describe every detail of a painful experience.
A therapist needs enough information to understand the concern, assess safety, and develop an appropriate treatment plan. However, EMDR does not always require the client to describe every detail at length.
Clients remain active participants throughout treatment. They can:
Therapy should be collaborative. EMDR should not involve forcing a person to disclose or process material before they are ready.
EMDR does not automatically begin with bilateral stimulation or the most distressing memory.
The early phases involve learning about the client’s present concerns, relevant history, coping resources, current supports, and treatment goals.
The therapist also explains EMDR and assesses whether it is appropriate.
Preparation may involve developing strategies for:
The amount of preparation needed varies from person to person. There is no universal timeline for beginning processing.
EMDR is not automatically appropriate for every person, symptom, or stage of therapy.
A trained therapist should consider:
A responsible therapist will not use EMDR simply because they are trained in it.
For some clients, EMDR may become an important part of treatment. For others, regular psychotherapy, emotional regulation strategies, relational work, or another approach may be more appropriate.
Choosing to work with an EMDR-trained therapist does not mean that every session must involve EMDR processing.
Some sessions may focus on:
EMDR may be incorporated when a specific experience, trigger, or negative belief becomes relevant and when the therapist and client determine that the approach is appropriate.
The treatment plan should respond to the client’s needs rather than revolve around one technique.
EMDR may be provided online when virtual treatment is clinically appropriate.
Depending on the treatment plan, bilateral stimulation can be adapted for online sessions through guided eye movements, alternating self-tapping, or other methods.
Before beginning online EMDR, the therapist should consider privacy, technology, the client’s physical environment, emotional safety, and the supports available during and after the session.
Virtual therapy may make specialized support more accessible to individuals who:
Online EMDR is not necessarily appropriate for every person. Suitability should be determined through an individualized assessment.
An assessment can help determine whether EMDR, another therapeutic approach, or a combination of methods may be appropriate.
EMDR has established research support for PTSD. It may also be considered within an individualized treatment plan when distressing experiences appear to contribute to present concerns.
Online psychotherapy and EMDR therapy are available throughout Ontario in English and Spanish. Treatment is personalized according to each client’s needs, experiences, readiness, and goals.
