What is Eye Movement Desensitization and Reprocessing (EMDR)?

From the Guidelines

Eye Movement Desensitization and Reprocessing (EMDR) is a type of psychotherapy used to treat posttraumatic stress disorder (PTSD) and other trauma-related disorders.

Key Points

• EMDR is a manualized psychotherapy that involves the use of eye movements or other forms of bilateral stimulation to process traumatic memories and reduce symptoms of PTSD 1.
• The therapy is based on the idea that traumatic memories are stored in a "frozen" state and that the eye movements or bilateral stimulation can help to "unfreeze" these memories and allow them to be processed and integrated into the person's narrative in a more adaptive way.
• EMDR has been shown to be effective in reducing symptoms of PTSD, including flashbacks, nightmares, and avoidance behaviors, and is recommended as a first-line treatment for PTSD by the U.S. Department of Veterans Affairs and the U.S. Department of Defense 1.
• The therapy typically involves several phases, including an initial assessment and treatment planning phase, a stabilization phase, a trauma processing phase, and a reintegration phase 1.
• EMDR can be used in conjunction with other forms of therapy, such as cognitive-behavioral therapy (CBT), and can be delivered in individual or group settings.

Evidence

• Studies have consistently shown that EMDR is an effective treatment for PTSD, with significant reductions in symptoms and improvement in quality of life 1.
• A systematic review and meta-analysis of 10 studies found that EMDR was associated with a significant reduction in PTSD symptoms, with a moderate effect size 1.
• The U.S. Department of Veterans Affairs and the U.S. Department of Defense recommend EMDR as a first-line treatment for PTSD, based on the strength of the evidence and the clinical expertise of the guideline development group 1.

From the Research

Definition and Overview of EMDR

• Eye Movement Desensitization and Reprocessing (EMDR) is an innovative, evidence-based, and effective psychotherapy for post-traumatic stress disorder (PTSD) 2.
• EMDR has been well established as an effective treatment for PTSD, and its effectiveness has been demonstrated in numerous randomized controlled trials 3.
• EMDR is also efficacious for reducing symptoms of anxiety, panic, phobia, and behavioral/somatic symptoms, as shown in a meta-analysis of randomized controlled trials 4.

Mechanism of Action

• The mechanism of action of EMDR is not yet fully understood, but several theories have been proposed, including the working memory hypothesis, interhemispheric communication, de-arousal, and memory reconsolidation 5.
• Recent studies have described the temporal and spatial aspects of smooth pursuit and predictive saccades, which resemble those made during EMDR, and their neural correlates within the default mode network (DMN) and cerebellum 5.
• The production of bilateral predictive eye movements may be supportive of DMN and cerebellum activation, which could benefit the processes regulated by these structures, such as memory retrieval, relaxation, and associative learning 5.

Efficacy and Effectiveness

• EMDR has been shown to be a useful, evidence-based tool for the treatment of post-traumatic stress disorder, with results from randomized controlled trials suggesting its effectiveness in reducing symptoms of PTSD 6.
• A systematic review of 15 randomized controlled trials found that EMDR was a useful treatment for adult post-traumatic stress disorder, with results suggesting that EMDR is a useful, evidence-based tool for the treatment of PTSD 6.
• EMDR is recommended as a first-line treatment for PTSD by most international clinical practice guidelines, with support from more than 30 published randomized controlled trials demonstrating its effectiveness in both adults and children 3.