Eye Movement Desensitisation and Reprocessing Therapy (EMDR)
Overcoming a traumatic event is one of the hardest tasks imaginable, but Eye Movement Desensitisation and Reprocessing (EMDR) therapy can offer a path to move forward. Once the trauma becomes ingrained into your mind, avoiding triggers that make you feel like you're reliving the experience becomes tough.
While you can't erase trauma, Eye Movement Desensitisation and Reprocessing (EMDR) can significantly reduce its control, helping you navigate the present. It reorganises thoughts and emotions linked to trauma, freeing you from its grasp. Stay in the loop with us to learn more about EMDR and how it can be a good fit for you.
What is EMDR Therapy?
Eye Movement Desensitisation and Reprocessing (EMDR) therapy is a relatively new form of psychotherapy which was initially designed for those suffering from anxiety conditions, like Post-Traumatic Stress Disorder (PTSD), Panic Disorder, and Public Speaking Anxiety, to process and alleviate symptoms associated with traumatic experiences. Unlike Cognitive Behavioural Therapy (CBT), a form of talk therapy commonly used, EMDR attempts to directly work with the processing of trauma in the brain through eye movements.
It helps you process and recover from past disturbing experiences that are affecting your physical and mental well-being. It involves recalling those events while simultaneously experiencing bilateral stimulation (eye movements) until those memories no longer cause distress.
How EMDR Therapy Works?
The psychological mechanisms behind EMDR are:
1. Bilateral stimulation
A key component of EMDR is bilateral stimulation, which involves simultaneously engaging both sides of the brain through eye movements, tapping, or auditory tones to activate it. This activation helps the brain to process information more efficiently.
2. Cognitive Restructuring
EMDR helps restructure negative beliefs associated with traumatic memories. Doing so helps develop positive and adaptive beliefs, leading to a more fulfilling life.
3. Emotional Processing
EMDR unravels those complex emotions linked to the traumatic event, which is the key to your healing.
EMDR works by gradually desensitizing you to those distressing memories, which can help you feel more in control and less burdened by your past.
EMDR therapy can help process traumatic memories more adaptively, allowing you to make sense of the memory and integrate it into your life story instead of feeling stuck in the past.
Who Needs To Have EMDR Therapy?
EMDR therapy has no age barrier; people of all ages can benefit from it, especially those who have experienced traumatic events and are struggling with the impact of these experiences. Some of them are:
- Post-traumatic disorder (PTSD)
- Anxiety and panic disorder
- Phobias and fears
- Grief or loss
- Chronic pain or illness
- Performance anxiety
EMDR Therapy Phases
EMDR therapy combines many elements, which is why it involves eight phases. So, you might need to attend multiple sessions, approximately 6-12 times.
Phase 1: History and Treatment Planning
Your first session will begin with a discussion of your history, including problems, behaviours, or fears that led you to therapy in the first place. What differentiates EMDR from other treatments is that you don't need to explain your traumatic experiences in great detail; the only thing that matters is the emotion and physical sensations surrounding that event. Based on your first assessment, your therapist will tailor a treatment plan and initiate subsequent phases of EMDR.
Phase 2: Preparation
This phase involves your therapist teaching you various self-care techniques to manage and cope with strong emotions that you are experiencing or emotions that may emerge during or between sessions. These techniques include deep breathing or mindful exercises.
EMDR's main goal is to bring quick and effective positive changes while ensuring individuals feel stable during and after sessions.
Phase 3: Assessment
In the assessment phase, your therapist will assist you in selecting a specific memory to activate by identifying its three components:
- Vivid image of the trauma you experienced
- Negative beliefs about yourself, such as believing you're a bad person or worthless
- Positive beliefs you would rather associate with going forward, for instance, instead of thinking “I’m in danger”, you would see that positively, such as “I’m safe”
After identifying three components, the therapist uses two measures to assess changes in emotions and cognition: The Validity of the Cognition (VOC) Scale and the Subjective Units of Disturbance (SUD) scale.
a. Validity of Cognition (VOC) Scale
On a scale of 1 to 7, you'll rate the extent of your belief in the positive thought, where 1 indicates complete disbelief, and 7 indicates complete belief.
b. Subjective Units of Disturbance (SUD) Scale
Healthcare professionals will ask you about the disturbing emotions you feel when visualising the image of a traumatic event on a scale of 0-10. A rating of 0 means no disturbance or none at all, while a rating of 10 indicates the highest level of disturbance you can imagine.
In the end, the healthcare professionals will identify the location in the body where an individual feels physical sensations when thinking about trauma.
Phase 4-7: Treatment
Once you complete stage 3, the processing of the traumatic event begins.
i. Phase 4: Desensitisation
During the desensitisation phase, you'll focus on specific memory while using bilateral stimulation (BLS), such as particular eye movements, tapping, audio tones, or blinking lights. Therefore, you'll learn how to digest or process the memory, ensuring they don't threaten your physical and mental well-being. In addition, the desensitisation phase continues until your distress level drops to 0 or 1, as per the SUD scale.
ii. Phase 5: Installation
In this stage, you replace old negative beliefs about yourself with the positive beliefs you identified in phase 3. Until VOC reaches 7 or above, bilateral simulations pair the most helpful positive thoughts with previously distressing memories.
iii. Phase 6: Body Scan
After installing a positive belief, the therapist will shift their focus on how your body feels. If you are experiencing any tension or physical sensations due to past stressful events, your therapist will address and alleviate them to ensure your complete relaxation and comfort.
iv. Phase 7: Closure
Before wrapping up the session, your therapist will evaluate whether or not the reprocessing of targeted memory is complete. If not, self-control techniques taught earlier in the session are employed to restore a person to equilibrium. Until you fully process trauma, we use EMDR, so you leave behind trauma where it belongs - in the past.
Phase 8: Re-evaluation
The next session begins with the re-evaluation phase, during which your therapist measures your progress. It involves looking back to ensure the treatment is effective and identifying other areas needing attention.
Conditions Treated with EMDR Therapy
Some of the conditions treated with EMDR therapy include:
Originally designed to help people with PTSD, EMDR has now become a widely used and highly recommended therapy for those who have experienced trauma. Several research studies suggest that EMDR is more effective than other forms of treatment.
2. Anxiety Disorders
Many people suffer from anxiety due to past traumatic events. Nonetheless, EMDR proves to be an effective treatment option for these disorders, including generalised anxiety disorder, social anxiety, and panic attacks, as it helps reduce the stress associated with them.
3. Trauma Disorders
Traumatic experiences such as childhood abuse, neglect, accidents, and natural disasters can leave a lasting impact on our lives. But with the help of EMDR therapy, you can process and heal from these experiences and start living your life to the fullest.
4. Depression Disorders
Research studies suggest that EMDR therapy is feasible in the treatment of recurrent and long-term depression. It can significantly help improve symptoms of depression like hopelessness, fatigue, and sadness.
5. Panic Disorders
EMDR helps to dig up and process the root cause of panic disorder by subsequently connecting the emotional part (the limbic system) of your brain that feels afraid with the logical part (the prefrontal cortex) of your brain that knows you're okay. This way, we can regulate your body's fight or flight response.
6. Psychosis Disorder
While EMDR might not be the primary treatment of psychosis disorder, it can still be a valuable tool in alleviating symptoms of psychosis that are directly related to past traumatic life events.
7. Personality Disorder
Research studies indicate that EMDR is effective for treating individuals with personality disorders; however, therapists tend to avoid using it when an individual meets the criteria for both PTSD and personality disorder.
8. Eating Disorder
Beyond treating PTSD, EMDR is also used to address conditions related to eating disorders, including anorexia, bulimia, and binge eating. There is an underlying link between trauma and eating disorders. Therefore, EMDR helps individuals recognise and develop strategies to cope with unresolved trauma, which may manifest as an eating disorder.
9. Dissociative Disorders
Dissociative disorder originates from traumatic events, which is why EMDR is an effective treatment. It addresses the root of individuals’ trauma and focuses on underlying past experiences.
10. Gender Dysphoria
EMDR therapy helps those with gender dysphoria address emotional challenges tied to their identity journey, nurturing a more positive self-concept. For instance, it helps them change their belief from "I am unlovable" to "I am worthy of love".
Duration of EMDR Therapy
Usually, EMDR therapy includes a series of sessions. However, its duration depends on the individual's needs. Depending on the severity of the trauma, some might benefit from fewer sessions, while others may benefit from more.
Frequency and Length of Sessions
EMDR is delivered once or twice a week with a total of 6-12, lasting 60-90 minutes.
Effectiveness and Success Rate of EMDR Therapy
How Effective is EMDR Therapy?
EMDR therapy has shown effectiveness, particularly in trauma-related conditions such as PTSD. Numerous studies support its efficacy in alleviating symptoms and promoting healing in these conditions.
What is The Success Rate of EMDR Therapy?
Like with any therapy, success rates may vary due to factors such as the nature of the trauma, individual responsiveness, and the skill of the therapist. However, many individuals experience significant symptom reduction and improved mental well-being.
When is EMDR Not Effective?
EMDR therapy is suitable as a treatment option for various mental health conditions, including anxiety, panic, trauma, depression, phobias, grief, behaviour issues, and substance abuse. However, therapists should exercise caution and refrain from using EMDR for individuals with co-occurring psychological disorders, certain physical illnesses, or an inability to reprocess trauma. Additionally, it's important to note that the misuse of EMDR has the potential to re-traumatise some individuals.
How Does EMDR Therapy Affect the Brain?
When danger strikes, our brain activates a fight-or-flight response, prioritising survival by suppressing non-essential functions. The reptilian brain, responsible for survival, takes control, while the executive brain, responsible for reasoning, is suppressed. When these memories are stored in the reptilian brain, they can trigger severe flashbacks, causing us to relive the distressful experience.
Fortunately, our brain can heal itself; we must show it how. That's where EMDR comes in. Memory processing occurs during a stage known as rapid eye movement (REM) sleep. The key element of REM sleep is bilateral stimulation.
In EMDR, we replicate this bilateral stimulation by moving the eye side to side repeatedly or using audio tunes that move from ear to ear. It simultaneously engages logical (left) and emotional (right) brain hemispheres, activating the brain's innate healing ability.
Advantages and Disadvantages of EMDR
1. Evidence-based Therapy
Numerous studies have found that EMDR is effective in reducing PTSD or other trauma-related symptoms.
2. Less Stressful
Unlike other "Talk" therapies, EMDR doesn't require you to go into detail and relive the past event for an extended period. Recalling and reprocessing of memory happens simultaneously, allowing you to release pent-up emotions and move on from trauma.
3. Fast Results
EMDR provides relatively faster results than other traditional therapies because it directly targets and processes traumatic memories, which are the root cause of various mental health conditions.
4. Doesn't Require Much Talking
Not everyone can articulate their trauma or negative experiences verbally. The positive aspect of EMDR therapy is its minimal reliance on verbal communication. Instead, it focuses on bilateral stimulation to help individuals access and process their emotions and memories.
1. Works Only for Traumatic Experiences
EMDR was developed as a treatment for trauma-related conditions, which is why it may not be as effective for mental health issues resulting from inherited genetic conditions, chemical imbalances, or brain injuries.
2. Still In Research
Even though there is prominent evidence of EMDR working for various trauma-related conditions, there is still no solid evidence for why it works.
3. Relatively New Method
Since EMDR is a relatively new therapy method, more research is necessary to determine whether it provides a long-term solution or if it requires additional therapy in the future.
4. Unadvisable for Specific Health Conditions
People with heart conditions, eye problems, or other health issues should avoid EMDR due to the potential adverse effects.
Risks and Side Effects of EMDR Therapy
As with any therapy, there are possible side effects regarding difficult or uncomfortable topics. Emotions can surface when working with clients' uncomfortable memories, but a skilled therapist will create an effective management plan.
Some of the possible side effects are:
1. Feeling Uncomfortable
At the beginning of therapy, it is normal to feel discomfort. Opening up and pouring out your innermost thoughts and feelings might feel awkward and uncomfortable, yet it is essential for your treatment. This feeling is especially true for trauma survivors, for whom trusting others can be challenging. Furthermore, their survival instinct can activate during the treatment process.
2. Emotionally Sensitive
Strong and intense emotions might engulf you during therapy, lasting hours or days after the session. These emotions will fade away as the treatment progresses.
3. Surfacing New Memories
Suppressed memories may resurface as you focus on memories, which can be deeply unsettling. Your therapist will determine the best course of action to handle these additional memories and reduce any distress they may cause.
4. Vivid Dreams
After EMDR sessions, it's quite common to notice new dreams or shifts in recurring dreams. It simply indicates that your brain is reprocessing and cataloguing information.
5. Physical Sensation
It's not unusual to experience physical sensations like muscle tension, anger, or tearfulness. If that situation arises, remember that you're in control, and asking for a break is alright. Moreover, these sensations are unlikely to persist for long periods.
6. Tiredness After Session
When your brain works hard to reprocess and make new connections, it is normal to feel exhausted.
Are There Any Dangers of EMDR Therapy?
In general, EMDR is considered a safe therapy. "Dangers" might arise if EMDR-trained therapists do not practice it appropriately. For instance, those not trained in this approach might inappropriately follow the 8 steps of EMDR. It's essential to follow these 8 steps to help clients reprocess their memories thoroughly and to teach coping mechanisms.
What to Expect in EMDR Sessions?
EMDR therapy involves a systematic 8-phase structure that guides clients through the processing of traumatic memories and the development of various coping mechanisms.
How to Prepare for EMDR Mentally and Emotionally?
Some of the ways to prepare for EMDR mentally and emotionally are:
- Gain a clear understanding of how EMDR works.
- Build a good relationship with your therapist to openly discuss your concerns, questions, or expectations.
- Collaborate with your therapist to build coping mechanisms to deal with intense emotions you may experience during or after therapy.
- Reflect on a specific memory that you want to target during therapy.
- Practice self-care and relaxation techniques to support your mental and emotional well-being.
EMDR Recovery Time
Typical Recovery Time
The recovery time varies from person to person. It depends on the severity of the trauma, the individual's responsiveness to the treatment, and the therapist's expertise. Since everyone is different, some individuals might need more sessions than others to get full relief from their distress. Research studies indicate that after only 3 sessions (each lasting 90 minutes), 84-90% of single-trauma victims overcome PTSD.
Indicators of Successful Treatment
Some of the indicators of the success of EMDR include:
- Decreased nightmares and flashbacks
- A positive shift in perspective
- Improved relationship
- Diminished clarity and vividness of difficult memory
- Reduced distress when thinking about trauma
- Increased sense of empowerment
- Reduced anxiety, depression, and avoidant behaviours
EMDR Therapy in Different Age Groups
Although EMDR therapy is effective for all age groups, therapists need to consider and adapt their approach according to the specific requirements of each age group.
Children are vulnerable to the effects of trauma, and EMDR can help them process and heal from it. However, due to children's varying communication styles, attention spans, and cognitive abilities, modifications to the EMDR protocol may be necessary.
Some of the factors to consider include:
- Use age-appropriate language and explanation to ensure children can comprehend the process.
- Shorter sessions to match children's attention span and energy levels.
- Incorporate play and creative elements to make the process more enjoyable.
- Involve parents in the treatment process to provide support.
Adolescents face various challenges related to bullying, school stress, self-esteem, body image, peer relationships, emotional regulation, and identity development. To employ EMDR, certain modifications to the EMDR protocol are essential; they are:
- Integrating individual therapy to address specific behavioural or emotional challenges
- Developing coping skills to enhance emotional regulation
- Putting adolescents' maturity level and cognitive development into consideration
EMDR can help address long-held burdens in older people. However, the therapist must consider age-related factors such as physical limitations, sensory sensitivities, and cognitive changes while tailoring EMDR treatment. Some of the modifications that are essential to cater to older people include:
- Using shorter sessions to accommodate sensory sensitivities and potential fatigue
- Addressing specific concerns relating to ageing, such as health challenges, loss, or grief
- Using tactile aids or visual cues to enhance engagement
Integration of EMDR into Comprehensive Treatment
EMDR therapy can seamlessly integrate into comprehensive treatment plans for individuals struggling with various mental health challenges. By integrating EMDR, we can leverage its unique approach to addressing and alleviating the underlying cause of the trauma. Moreover, EMDR is known for its adaptability, allowing therapists to tailor the treatment plan to address the specific needs or requirements of the individuals, resulting in effective outcomes.
How does EMDR complement other therapies?
EMDR's direct reprocessing and desensitisation of trauma complement other therapies like Prolonged Exposure (PE) and Cognitive Behavioral Therapy (CBT). While CBT and PE work on trauma through cognitive and behavioural approaches, EMDR directly addresses emotional and physiological elements of trauma, alleviating the severity of symptoms and subsequently eradicating them. Moreover, when we integrate EMDR with other therapies, it produces a synergic effect on symptom management. For instance, EMDR complements pharmacotherapy in treating anxiety and depression by directly addressing the root cause and promoting healing.
How is EMDR Therapy Different from Other Therapies?
EMDR therapy differs from other therapies in the following ways:
1. Bilateral Stimulation
In contrast to traditional therapies, EMDR employs visual, audio, or tactile bilateral stimulation to facilitate the processing of distressful events.
2. Direct Processing of Trauma
EMDR directly targets and processes the traumatic memory, whereas other therapies focus on cognitive restructuring, behavioural modification, and emotional regulation without directly tackling the underlying issue.
3. Structured Protocol
EMDR has a structured 8-phase protocol, which includes history and treatment planning, assessment, desensitisation, body scan, closure, and re-evaluation. These phases follow a systematic structure, unlike other approaches that are open-ended.
4. Adaptive Processing Model
The adaptive processing model is the foundation of EMDR therapy, which posits that trauma arises from unprocessed negative information stored in the brain. Therefore, EMDR works by systematically processing this information, leading to a significant reduction in symptoms and an improvement in emotional well-being.
5. Limited Verbalisation
Traditional "Talk" therapy heavily relies on verbal expression throughout the session, whereas EMDR has limited verbalisation in specific phases. This limitation allows individuals to use bilateral stimulation for internal processing and to facilitate the reprocessing of distressful memories.
Role of the Therapist in EMDR
The success of EMDR therapy depends on the therapist's abilities, including skills, approaches, and the therapist-client rapport. We can divide the role of the therapist into three distinct categories:
- Possess a comprehensive understanding of theoretical and practical techniques of EMDR.
- Demonstrate strong clinical skills, including empathy and creating safe and trustful relationships.
- Proficiently perform bilateral stimulation techniques, such as eye movements, tapping, or auditory cues.
i. Client-centered approach
Therapists prioritise client's needs and requirements, tailoring treatment plans accordingly.
ii. Phased approach
The therapist systematically follows eight structured phases of treatment, ensuring proper navigation through each stage.
iii. Collaborative partnership
Therapists work collaboratively with clients, actively involving them in treatment plans and decision-making processes.
3. Therapist-Client Rapport
Building a solid and trustworthy bond between a therapist and client is essential, like in any other therapy. This connection helps create a safe and comfortable environment where clients can confidently open up and share their innermost thoughts and feelings.
Finding the Right EMDR Therapist
Some of the factors to consider while selecting the right EMDR therapist include:
1. Qualification and Training
- Ensure that your therapist is certified in EMDR by reputable institutions.
- Verify that they possess the necessary credentials and licensure for practice.
- Seek treatment from a therapist with extensive experience in trauma treatment.
2. Personal trait
- Non-judgemental and respectful attitude
- Empathy and compassionate
- Strong communication skills
3. Therapy approach and style
Inquire about the therapeutic style they practice, whether directive or non-directive. Choosing a therapist whose style resonates with you and can make you feel more comfortable is essential.
Cost and Financial Considerations
Cost of EMDR Therapy
The cost of EMDR therapy in Singapore depends on the therapist's experience, session duration, and location. Typically, the therapy price ranges from SGD 150 to SGD 300 per session.
To learn about coverage for EMDR therapy, contact your insurance provider, as mental health services may be covered depending on your policy.
Numerous financial assistance programs are available for EMDR therapy, which provide grants, subsidies, or loans. Some of them include:
- Medifund Singapore
- Singapore Mental Healthcare Institute
- National Healthcare Group (NHG) Fund for the Needy
EMDR Therapy at Psychology Blossom
At Psychology Blossom, a Therapy and Counselling Centre in Singapore, we understand it's hard to move forward when you carry the heavy burden of the past. Our team of experienced psychologists and counsellors in Singapore is here to support you in overcoming your traumatic past, leaving it where it belongs– in the past. You don't have to let your past haunt you. Get the help you deserve by contacting us today. We are here to guide you every step of the way for as long as you need us. Notice the difference EMDR therapy can make in the quality of your life.
Some of the reasons to choose Psychology Blossom are:
- Qualified and Experienced EMDR Therapists
- Personalised Treatment Plans
- Safe and Supportive Environment
- Multicultural Sensitivity
- Holistic Treatment Approach
- Proven Success with Clients
- Continuous Support and Follow-Up
- Convenient Location and Flexible Scheduling
- Professional and Confidential Service
- Client-Centered Collaboration
EMDR, although a relatively new therapy, has proven to be highly effective in treating trauma-related conditions such as PTSD. It is not limited by age, as therapists can customise the treatment according to individual needs, making it accessible to everyone.
While EMDR is widely known for treating PTSD, ongoing studies have shown its effectiveness in treating other conditions. With EMDR therapy, you can overcome your traumatic past and move towards a brighter future with comfort and ease.
To make an appointment with our EMDR therapist Celestine Chua, call 8800 0554 today.