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--- emdr [2023/12/23 20:42] – [Bessel van der Kolk] tom
+++ emdr [2026/10/06 20:01] (current) – Add related research and concepts links to nine detailed articles andrewtaustin
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-{{tag>Related}}
+====== Eye Movement Desensitization and Reprocessing (EMDR) ======
-===== Eye Movement Desensitization and Reprocessing (EMDR) =====
 Eye Movement Desensitization and Reprocessing (EMDR)[(Eye_movement_desensitization_and_reprocessing>Eye movement desensitization and reprocessing[[https://en.wikipedia.org/wiki/Eye_movement_desensitization_and_reprocessing|Wikipedia]])] is an evidence-based psychotherapy treatment modality used to effectively treat a wide range of psychological issues, including post-traumatic stress disorder (PTSD). Its efficacy has been extensively studied and documented.
-This therapy works by activating different networks in the brain that store and process traumatic material while simultaneously using a process of Bilateral stimulation (BLT)[(Bilateral Stimulation>Bilateral_stimulation[[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5061320/|National Library of Medicine]])] using: eye movements, tones, and/or tactile taps to stimulate the processing of memories related to the trauma.
+This therapy works by activating different brain networks that store and process traumatic material while simultaneously using bilateral stimulation (BLS)[(Bilateral Stimulation>Bilateral_stimulation[[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5061320/|National Library of Medicine]])]—eye movements, tones, and/or tactile taps—to stimulate the processing of trauma-related memories.
-In EMDR therapy, the therapist helps the client to identify connected thoughts, memories, images, and sensations related to the traumatic experience, then guides them through a series of alternating bilateral stimulation exercises.
+In EMDR therapy, the therapist helps the client to identify connected thoughts, memories, images, and sensations related to the traumatic experience and then guides them through a series of alternating bilateral stimulation exercises.
-Additionally, EMDR can also be used in combination with other treatments such as cognitive behavioral therapy for individuals on waiting lists for more intensive mental health services.
+Additionally, EMDR can be used in combination with other treatments such as cognitive behavioural therapy for individuals on waiting lists for more intensive mental health services.
 {{ :img5.png |}}
-EMDR has established its effectiveness in treating trauma and PTSD in children and adults, alongside other mental health conditions such as:
+EMDR has demonstrated effectiveness in treating trauma and PTSD in children and adults, alongside other mental health conditions such as:
   * Anxiety, panic attacks, and phobias
@@ Line 26: / Line 25: @@
   * Violence and abuse
-Although some may prefer traditional treatments like medications and talk therapy, others may find that EMDR can accelerate the process of healing. EMDR therapy is considered a safe form of treatment and aims to leave you with the emotions, understanding, and perspectives that promote healthy, positive change.
+Although some may prefer traditional treatments such as medication and talk therapy, others may find that EMDR can accelerate the process of healing. EMDR therapy is considered a safe form of treatment and aims to leave you with the emotions, understanding, and perspectives that promote healthy, positive change.
-==== What does the process look like? ====
+==== What Does the Process Look Like? ====
-[[emdr|EMDR]] is widely recommended by many of the leading mental health organizations around the world. The treatment process consists of multiple phases, including:
+Research has established a strong link between the proper application of the Eye Movement Desensitization and Reprocessing (EMDR) standard protocol and positive therapeutic outcomes. Consequently, strict adherence to this protocol is essential for maintaining EMDR’s empirical effectiveness and robustness[( :harvard:Maxfield2002>>
+authors   : Maxfield, L., & Hyer, L.
+title     : The relationship between efficacy and methodology in studies investigating EMDR treatment of PTSD.
+publisher : Journal of Clinical Psychology, 58(1), 23–41.
+published : 2002
+url       : https://doi.org/10.1002/jclp.1127
+)]. The protocol consists of eight structured phases, each incorporating specific procedures and standardised questions. These phases are outlined in Table 1.
-**Phase 1:** History and Treatment Planning. The first phase of EMDR is a history-taking session, where you and your therapist will identify possible targets for therapy. With a greater understanding of you and your needs, your therapist will then develop a treatment plan that targets:
+=== The Eight Phases of the EMDR Standard Protocol ===
-  * the event(s) that occurred
+^ Phase ^ Description ^
-  * the current
+| **Phase 1: Patient History and Treatment Planning** | Gathering patient history, identifying symptoms, formulating a case conceptualization, and creating a treatment plan. |
-  * the present circumstances that cause distress
+| **Phase 2: Preparation** | Establishing a therapeutic alliance, providing psychoeducation on trauma and EMDR therapy, and enhancing emotional regulation skills. |
-  * the necessary abilities or behaviours needed to learn in the long term
+| **Phase 3: Assessment** | Identifying target memories, activating traumatic memory components (image, negative cognition, positive cognition, emotions, bodily sensations), and assessing distress levels using a 0–10 scale. |
+| **Phase 4: Desensitization** | Processing traumatic memories through dual-attention tasks (e.g., guided bilateral eye movements) until distress is no longer reported. |
+| **Phase 5: Installation** | Reinforcing a positive cognition associated with the traumatic memory. |
+| **Phase 6: Body Scan** | Conducting a full-body scan to identify and release residual distress linked to the memory. |
+| **Phase 7: Closure** | Ensuring patient stability post-session and making necessary follow-up arrangements. |
+| **Phase 8: Reevaluation** | Reviewing progress and assessing treatment effectiveness in subsequent sessions. |
-**Phase 2**:  Preparation. During the second phase of EMDR, your therapist will guide you in learning different coping and relaxation strategies to handle emotional distress. These stress reduction techniques are meant for you to use during and between sessions. Since EMDR tends to produce rapid change, the goal is to maintain balance and equilibrium in your day-to-day life.
+=== Overview of the EMDR Process ===
-**Phases 3-6**: Assessment. During the third phase, you and your therapist will identify particular memories and the components associated with them, including:
+The primary goal of EMDR therapy is to minimise distress associated with traumatic memories while strengthening positive self-referential beliefs. The therapist facilitates the process by guiding the patient through structured memory activation and bilateral stimulation exercises.
-  * A detailed mental picture of a target event (from phase 1)
+The process begins with **Phase 1**, during which the therapist gathers the patient’s history, identifies PTSD symptoms, and selects target memories for treatment. In **Phase 2**, the patient is prepared for trauma processing through psychoeducation and coping strategies.
-  * A negative belief about yourself associated with the event
-  * Relevant emotions and physical sensations
-**Phases 4-7**: Treatment. These phases focus on using EMDR therapy techniques to treat the targeted memories. While focusing on the mental image, emotion, or belief, your therapist will ask you to follow specific eye movements. These movements are also known as bilateral stimulation and can include other repetitive activities such as tapping.
+**Phase 3** involves assessing the identified traumatic memory. The therapist asks the patient to recall the most distressing aspects of the memory while evaluating their negative and positive cognitions, emotions, and bodily sensations. The level of distress is measured using the Subjective Units of Disturbance Scale (SUDS), ranging from 0 (no distress) to 10 (extreme distress).
-Afterwards, your therapist will ask you to clear your mind and pay attention to the thoughts and feelings that arise spontaneously. Once they're identified, your therapist may direct your attention back to the traumatic memory and move forward with another.
+In **Phase 4**, desensitization begins. The patient processes the memory using bilateral stimulation (typically rapid eye movements guided by the therapist’s hand or a light bar). After each set of eye movements, the therapist assesses spontaneous patient responses and encourages further processing until the distress associated with the memory is neutralised (SUDS score of 0).
-In case you get distressed, your therapist will guide you in returning to the present moment. This process is repeated until the distress over specific thoughts, images, or memories starts to fade.
+**Phase 5** focuses on reinforcing a positive cognition using the Validity of Cognition (VoC) scale, which ranges from 1 (completely untrue) to 7 (completely true). The patient recalls the traumatic memory while mentally repeating the positive cognition alongside bilateral stimulation until the VoC score is maximised.
-**Phase 8**: Evaluation. In the final phase of treatment, you'll examine your progress.
+**Phase 6** involves a body scan to identify any lingering distress. If any physical discomfort is detected, additional processing is applied. In **Phase 7**, the session is concluded, ensuring that the patient is stable and comfortable before ending.
-===== EMDR example sessions: =====
+The final phase, **Phase 8**, occurs at the start of the next session. The therapist reviews the previous session’s outcomes, evaluates progress, and determines the need for further treatment.
+==== Treatment Duration and Effectiveness ====
+EMDR therapy sessions typically last between **60 and 90 minutes** and may be conducted individually or in group settings. While randomised controlled trials on group EMDR are limited, emerging evidence suggests that it effectively reduces PTSD symptoms [( :harvard:Kaptan2021>>
+authors   : Kaptan, S. K., Dursun, B. O., Knowles, M., Husain, N., & Varese, F.
+title     : Group eye movement desensitization and reprocessing interventions in adults and children: A systematic review of randomized and nonrandomized trials.
+publisher : Clinical Psychology and Psychotherapy, 28, pp. 784–806.
+published : 2021
+url       : https://doi.org/10.1002/cpp.2549
+)]. Sessions are traditionally scheduled weekly, though intensive formats with daily or twice-daily sessions have also been shown to be effective [( :harvard:Bongertz2017>>
+authors   : Bongaerts, H., van Minnen, A., & de Jongh, A.
+title     : Intensive EMDR to treat PTSD patients with severe comorbidity: A case series.
+publisher : Journal of EMDR Practice and Research, 11(2), 84–95.
+published : 2017
+url       : https://doi.org/10.1891/1933-3196.11.2.84
+)].
+Studies indicate that some individuals no longer meet PTSD diagnostic criteria after just **five EMDR sessions** following a single-incident traumatic event [( :harvard:Nijdam2012>>
+authors   : Nijdam, M. J., Gersons, B. P. R., Reitsma, J. B., de Jongh, A., & Olff, M.
+title     : Brief eclectic psychotherapy versus eye movement desensitization and reprocessing therapy in the treatment of posttraumatic stress disorder: Randomized clinical trial.
+publisher : British Journal of Psychiatry, 200(3), 224–231.
+published : 2012
+url       : https://doi.org/10.1192/bjp.bp.111.099234
+)]. However, for individuals with PTSD stemming from multiple traumatic experiences, treatment typically requires **8–12 sessions** in routine clinical practice. For a comprehensive description of the EMDR protocol, refer to Shapiro (2018).
+===== EMDR Example Sessions =====
 {{youtube>B122emzNPSU}}
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-====Francine Shapiro====
+===== Francine Shapiro =====
-Francine Shapiro, Ph.D.[(Francine_Shapiro>Francine Shapiro[[https://en.wikipedia.org/wiki/Francine_Shapiro|Wikipedia]])], is a clinical psychologist, research scientist and innovator who is the credited with the development of Eye Movement Desensitization and Reprocessing (EMDR) therapy (debated/controversial "Revisiting the Origins of EMDR"[(OriginsEMDR>Revisiting the Origins of EMDR[[https://link.springer.com/article/10.1007/s10879-023-09582-x|Springer Press]])]).
+Francine Shapiro, PhD[(Francine_Shapiro>Francine Shapiro[[https://en.wikipedia.org/wiki/Francine_Shapiro|Wikipedia]])], is a clinical psychologist, research scientist, and innovator credited with the development of Eye Movement Desensitization and Reprocessing (EMDR) therapy; this attribution is debated in "Revisiting the Origins of EMDR"[(OriginsEMDR>Revisiting the Origins of EMDR[[https://link.springer.com/article/10.1007/s10879-023-09582-x|Springer Press]])].
-As the founder of the EMDR label, Dr. Shapiro has conducted research demonstrating its efficacy for treating conditions such as post-traumatic stress disorder (PTSD), anxiety disorders, specific phobias and other psychological traumas. She has also developed an approach to understanding how memories become distorted over time and how they can be reframed ever more effective ways with EMDR therapy.
+As the founder of the EMDR label, Dr. Shapiro has conducted research demonstrating its efficacy for treating conditions such as post-traumatic stress disorder (PTSD), anxiety disorders, specific phobias, and other psychological traumas. She has also developed an approach to understanding how memories become distorted over time and how they can be reframed in ever more effective ways with EMDR therapy.
-In addition to her research into EMDR, Dr. Shapiro is the author of several books on mental health topics related to trauma resolution, including Getting Past Your Past: Take Control of Your Life with Self-Help Techniques from EMDR Therapy (2012)[( :harvard:Shapiro2012>>
+In addition to her research into EMDR, Dr. Shapiro is the author of several books on mental health topics related to trauma resolution, including //Getting Past Your Past: Take Control of Your Life with Self-Help Techniques from EMDR Therapy// (2012)[( :harvard:Shapiro2012>>
 authors   : Shapiro, F.
 title     : Getting Past Your Past: Take Control of Your Life with Self-Help Techniques from EMDR Therapy.
 published : 2012
 publisher : Rodale Books
 isbn      : 1-59486-425-X
 url       : https://en.wikipedia.org/wiki/Special:BookSources/1-59486-425-X
-)]. Through her work in promoting EMDR therapy around the world, Dr. Shapiro has had a profound impact on helping individuals address even long-standing traumas quickly, effectively and without much need for medications or psychotherapy substitutes.
+)]. Through her work in promoting EMDR therapy around the world, Dr. Shapiro has had a profound impact on helping individuals address even long-standing traumas quickly, effectively, and without much need for medications or psychotherapy substitutes.
+===== Bessel van der Kolk =====
-====Bessel van der Kolk====
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 {{youtube>Y2cPuv6jKqg}}
 </WRAP>
-EMDR gained medical mainstream acceptance with the neuroimaging studies of PTSD and of Dissociative Identity Disorder by [[types_of_memory#the_body_keeps_the_score|Bessel van der Kolk]]. He received the first grants from the National Institutes of Health to do large studies about EMDR and Yoga.[(BVK>Levin, P; Lazrove, S; van der Kolk, BA (1999). "What psychological testing and neuroimaging tell us about the treatment of PTSD by EMDR". J Anxiety Disord. 13 (1–2): 159–172. doi:10.1016/S0887-6185(98)00045-0. PMID 10225506.[[https://www.sciencedirect.com/science/article/pii/S0887618598000450?via%3Dihub|sciencedirect.com]])][(BVK2>Bessel A. van der Kolk, MD; Joseph Spinazzola, PhD;... (2007) "A randomized clinical trial of eye movement desensitization and reprocessing (EMDR), fluoxetine, and pill placebo in the treatment of posttraumatic stress disorder: treatment effects and long-term maintenance" PMID: 17284128 DOI: 10.4088/jcp.v68n0105  [[https://pubmed.ncbi.nlm.nih.gov/17284128/|pubmed]])]
+EMDR gained medical mainstream acceptance with the neuroimaging studies of PTSD and of Dissociative Identity Disorder by [[types_of_memory#the_body_keeps_the_score|Bessel van der Kolk]]. He received the first grants from the National Institutes of Health to do large studies about EMDR and yoga.[(BVK>Levin, P; Lazrove, S; van der Kolk, BA (1999). "What psychological testing and neuroimaging tell us about the treatment of PTSD by EMDR". J Anxiety Disord. 13 (1–2): 159–172. doi:10.1016/S0887-6185(98)00045-0. PMID 10225506.[[https://www.sciencedirect.com/science/article/pii/S0887618598000450?via%3Dihub|sciencedirect.com]])][(BVK2>Bessel A. van der Kolk, MD; Joseph Spinazzola, PhD;... (2007) "A randomized clinical trial of eye movement desensitization and reprocessing (EMDR), fluoxetine, and pill placebo in the treatment of posttraumatic stress disorder: treatment effects and long-term maintenance" PMID: 17284128 DOI: 10.4088/jcp.v68n0105  [[https://pubmed.ncbi.nlm.nih.gov/17284128/|pubmed]])]
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-==== Reddit Forums ====
+===== Reddit Forums =====
-With such a large client and userbase it is well worth going through the EMDR reddit forum to explore what the clients who are doing the therapy are experiencing or what the ones who are looking into getting it are afraid about.
+Given its large client and user base, the EMDR Reddit forum can provide insight into the experiences of people undergoing the therapy and the concerns of those considering it.
-https://www.reddit.com/r/EMDR/
+[[https://www.reddit.com/r/EMDR/|r/EMDR on Reddit]]
-==== Critique of EMDR and Francine Shapiro ====
+===== Critique of EMDR and Francine Shapiro =====
-A summary and current view on the topic :
+A summary, historical overview, and discussion of the current state of affairs:
 {{youtube>PZmvk30gJEQ}}
-[[https://youtu.be/PZmvk30gJEQ| A hard look at EMDR and its unscrupulous founder]]
+[[https://youtu.be/PZmvk30gJEQ|A hard look at EMDR and its unscrupulous founder]]
-via [[https://www.neurotransmissions.science/| Neuro Transmissions]]
+Via [[https://www.neurotransmissions.science/|Neuro Transmissions]]
-A more elaborate and historical view on the claims from F. Shapiro is available via "Revisiting the Origins of EMDR"[(OriginsEMDR>Revisiting the Origins of EMDR[[https://link.springer.com/article/10.1007/s10879-023-09582-x|Springer Press]])]
+A more detailed historical examination of Shapiro’s claims is available in "Revisiting the Origins of EMDR"[(OriginsEMDR>Revisiting the Origins of EMDR[[https://link.springer.com/article/10.1007/s10879-023-09582-x|Springer Press]])].
-==== References ====
+===== Related research and concepts =====
+These pages provide more detailed accounts of specific concepts, delivery formats and evidence. They distinguish theoretical explanations from demonstrated outcomes and identify the limits of each study design.
+  * [[adaptive_information_processing|Adaptive Information Processing Model]]
+  * [[bilateral_stimulation_dual_attention|Bilateral Stimulation and Dual Attention]]
+  * [[therapeutic_eye_movement_mechanisms|Proposed Mechanisms of Therapeutic Eye Movements]]
+  * [[measuring_therapeutic_change|Measuring Change: Distress, Vividness and Emotionality]]
+  * [[group_emdr|Group EMDR Approaches]]
+  * [[online_emdr|Online EMDR Therapy]]
+  * [[emdr_relationship_processing|Therapeutic Relationship and Processing Difficulties in EMDR]]
+  * [[emdr_depression_evidence|EMDR for Depression: Research Evidence]]
+  * [[flash_technique|The Flash Technique]]
+===== References =====
 Adams, R., Ohlsen, S., & Wood, E. (2020). Eye Movement Desensitization and Reprocessing (EMDR) for the treatment of psychosis: A systematic review. //European Journal of Psychotraumatology//, //11//(1). https://doi.org/10.1080/20008198.2019.1711349
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 Devilly, G. J., Ono, M., & Lohr, J. M. (2014). The use of meta-analytic software to derive hypotheses for EMDR. //Journal of Behavior Therapy and Experimental Psychiatry//, //45//(1), 223–225. https://doi.org/10.1016/j.jbtep.2013.10.004
 EMDR, V. (2014). EMDR interview Francine Shapiro [Video]. In //YouTube//. https://youtu.be/8GUd5hhnkVE?si=JTI3WNNuxzvEmd7l
 Enevoldsen, R. (2014). Francine Shapiro EMDR for trauma eye movement desensitization and reprocessing [Video]. In //YouTube//. https://youtu.be/bWf39Pqcoqg?si=8iP8K99ge4de9tA3
-Eye movement desensitization and reprocessing (EMDR) therapy. (2017, May 25). [[Https://Www.Apa.Org.|//Https:%%//%%Www.Apa.Org//.]] https://www.apa.org/ptsd-guideline/treatments/eye-movement-reprocessing
+Eye movement desensitization and reprocessing (EMDR) therapy. (2017, May 25). American Psychological Association. https://www.apa.org/ptsd-guideline/treatments/eye-movement-reprocessing
 Faretta, E., & Dal Farra, M. (2019). Efficacy of EMDR therapy for anxiety disorders. //Journal of EMDR Practice and Research//, //13//(4), 325–332. https://doi.org/10.1891/1933-3196.13.4.325
@@ Line 156: / Line 205: @@
 Foreman, J. (1998, September 14). //New therapy for trauma is doubted//. Judy Foreman. https://judyforeman.com/columns/new-therapy-trauma-doubted/
-Freund, B. (2017). Francine shapiro interview on EMDR [Video]. In //YouTube//. https://youtu.be/IigQZKLXIck?si=LSMg720XKUOOh_yF
+Freund, B. (2017). Francine Shapiro interview on EMDR [Video]. In //YouTube//. https://youtu.be/IigQZKLXIck?si=LSMg720XKUOOh_yF
 Gunter, R. W., & Bodner, G. E. (2009). EMDR works . . . But how? Recent progress in the search for treatment mechanisms. //Journal of EMDR Practice and Research//, //3//(3), 161–168. https://doi.org/10.1891/1933-3196.3.3.161
-Herbert, J. (2000). Science and pseudoscience in the development of eye movement desensitization and reprocessing Implications for clinical psychology. //Clinical Psychology Review//, //20//(8), 945–971. https://doi.org/10.1016/s0272-7358(99)00017-3
+Herbert, J. (2000). Science and pseudoscience in the development of eye movement desensitization and reprocessing: Implications for clinical psychology. //Clinical Psychology Review//, //20//(8), 945–971. https://doi.org/10.1016/s0272-7358(99)00017-3
 Kenchel, J. M., Domagalski, K., Butler, B. J., & Loftus, E. F. (2020). The messy landscape of eye movements and false memories. //Memory//, //30//(6), 678–685. https://doi.org/10.1080/09658211.2020.1862234
@@ Line 184: / Line 233: @@
 Mikelson, B. (2018, April 13). IMPLEMENTING EMDR THERAPY: REFLECTIONS AFTER TRAINING WITH FRANCINE SHAPIRO - Blog. //EMDR & Beyond//. https://emdrandbeyond.com/blog/2018/4/13/reflections-on-training-with-francine-shapiro
 RodaleBooks. (2011). Getting Past Your Past / Francine Shapiro [Video]. In //YouTube//. https://youtu.be/nylajeG6uFY?si=0LYFRKMbTFLqYpxQ
 Opheim, E., Andersen, P. N., Jakobsen, M., Aasen, B., & Kvaal, K. (2019). Poor quality in systematic reviews on PTSD and EMDR – an examination of search methodology and reporting. //Frontiers in Psychology//, //10//. https://doi.org/10.3389/fpsyg.2019.01558
@@ Line 224: / Line 273: @@
 Weber, M., Schumacher, S., Hannig, W., Barth, J., Lotzin, A., Schäfer, I., Ehring, T., & Kleim, B. (2021). Long-term outcomes of psychological treatment for posttraumatic stress disorder: A systematic review and meta-analysis - Corrigendum. //Psychological Medicine//, //51//(16), 2946–2946. https://doi.org/10.1017/s0033291721003214
-Wetherford, R. (2014). //Francine shapiro EMDR interview//. Psychotherapy.Net. https://www.psychotherapy.net/interview/francine-shapiro-emdr
+Wetherford, R. (2014). //Francine Shapiro EMDR interview//. Psychotherapy.Net. https://www.psychotherapy.net/interview/francine-shapiro-emdr
+{{tag>Related emdr eye_movements trauma ptsd memory}}