Eye movement desensitization and reprocessing (EMDR) is a psychotherapeutic technique that has evolved over the past few decades as a treatment option for post-traumatic stress disorder (PTSD). The technique includes horizontal eye movements, bilateral tapping on the back of the patient’s hands, and auditory stimulation. Combined with accessing the traumatic memory and encouraging positive thoughts, the therapy is intended to “reprogram” the brain to break the association between the traumatic event and current feelings of fear and pain. Several studies have shown it to be effective in allowing those experiencing symptoms of PTSD to heal.
EMDR is based on the theory that PTSD is rooted in memories of traumatic events that have not been adequately processed by the brain. A 2018 review of 25 years’ worth of EMDR studies noted that many had found the technique to be as effective as cognitive behavioral therapy (CBT) but conceded that further study is needed to better understand its neurobiological underpinnings, as well as its mechanism of action. It also noted that the technique holds promise not only for addressing PTSD but also for addiction disorders, depression, bipolar disorder, and psychosis.
Italian researchers studied two groups of people experiencing symptoms of PTSD after the 2002 earthquake in San Giuliano di Puglia. Of the individuals studied, 14 received four treatment cycles of trauma-focused cognitive behavioral therapy (TF-CBT) and 17 underwent four cycles of EMDR therapy. In addition to administering tests that measure symptoms of trauma, researchers looked at functional MRI (fMRI) patterns before and after treatment. On the clinician-administered scales, both groups showed significant improvement, with no difference in results based on which treatment had been used. Interestingly, on fMRI imaging both groups also showed increased connectivity between two parts of the brain in one area as well as decreased connectivity between two parts in another area. Improvements on scores in the clinical tests correlated with the changes in connectivity in the brain. Researchers concluded that EMDR is as effective as TF-CBT in treating symptoms of PTSD precipitated by a natural disaster.
In a Turkish study in 2020, researchers conducted EMDR therapy on 30 children and adolescents who had experienced one or more traumatic events. The study data showed a significant reduction in symptoms of PTSD and anxiety six weeks after treatment. The researchers concluded that EMDR is a useful tool for youngsters but conceded that larger sample sizes would help establish the technique’s effectiveness.
The American Psychological Association rates EMDR as “conditionally recommended” for the treatment of PTSD, while more established treatments like CBT are “strongly recommended.” I would agree that we need more studies, with larger populations, to come to a reliable conclusion on EMDR, but it is certainly an interesting option that appears to hold promise.
Andrew Weil, M.D.
Novo Navarro P, Landin-Romero R, Guardiola-Wanden-Berghe R, Moreno-Alcázar A, Valiente-Gómez A, Lupo W, García F, Fernández I, Pérez V, Amann BL. 25 years of Eye Movement Desensitization and Reprocessing (EMDR): The EMDR therapy protocol, hypotheses of its mechanism of action and a systematic review of its efficacy in the treatment of post-traumatic stress disorder. Rev Psiquiatr Salud Ment (Engl Ed). 2018 Apr-Jun;11(2):101-114. English, Spanish. doi: 10.1016/j.rpsm.2015.12.002. Epub 2016 Feb 11. PMID: 26877093. https://pubmed.ncbi.nlm.nih.gov/26877093/
Wilson G, Farrell D, Barron I, Hutchins J, Whybrow D, Kiernan MD. The Use of Eye-Movement Desensitization Reprocessing (EMDR) Therapy in Treating Post-traumatic Stress Disorder-A Systematic Narrative Review. Front Psychol. 2018 Jun 6;9:923. doi: 10.3389/fpsyg.2018.00923. PMID: 29928250; PMCID: PMC5997931. https://pubmed.ncbi.nlm.nih.gov/29928250/
Karadag M, Gokcen C, Sarp AS. EMDR therapy in children and adolescents who have post-traumatic stress disorder: a six-week follow-up study. Int J Psychiatry Clin Pract. 2020 Mar;24(1):77-82. doi: 10.1080/13651501.2019.1682171. Epub 2019 Oct 30. PMID: 31663396. https://pubmed.ncbi.nlm.nih.gov/31663396/
Santarnecchi E, Bossini L, Vatti G, Fagiolini A, La Porta P, Di Lorenzo G, Siracusano A, Rossi S, Rossi A. Psychological and Brain Connectivity Changes Following Trauma-Focused CBT and EMDR Treatment in Single-Episode PTSD Patients. Front Psychol. 2019 Feb 25;10:129. doi: 10.3389/fpsyg.2019.00129. PMID: 30858808; PMCID: PMC6397860. https://pubmed.ncbi.nlm.nih.gov/30858808/