How Does EMDR Work for PTSD?

EMDR is a highly effective treatment in decreasing disturbance associated with trauma.  Studies have been conducted testing efficacy of EMDR for veterans with PTSD and survivors of sexual assault with PTSD.  Knowing that EMDR is effective for PTSD is also promising in helping overcome trauma that doesn’t fully meet the DSM 5 diagnosis of PTSD.  In this blog post you will learn about PTSD and how the 8 phases of EMDR support PTSD recovery.

What is PTSD?

**Before launching into the diagnosis criteria, it is important to note that not everyone that experiences trauma meets the criteria for PTSD; AND that person may still experience symptoms related to trauma that are distressing and need support.  

PTSD can occur after a traumatic event happens.  The event that causes PTSD in one person, may not in another.  

Oftentimes people will say, “well this small thing happened, but there are people who have experienced worse, so I shouldn’t be bothered by this.”  It is important to find validation and support if something is bothering you.

Back to the original question, PTSD stands for post traumatic stress disorder.  It is a diagnosis and the criteria can be found within the DSM V (diagnostic and statistic manual, 5th edition).  

PTSD may develop after a traumatic incident has happened.  This can mean that you were directly or indirectly exposed.  For example, if a loved one experienced a traumatic event, you can develop PTSD due to the indirect exposure.  

PTSD involves re-experiencing the event, even after the traumatic event has ended.  Re-experiencing can look like nightmares, flashbacks, emotional distress, or physical reactivity.  

Another key feature of PTSD is avoiding triggers that remind the person of the trauma.  This can be avoiding thoughts, feelings, places, people, or anything that reminds them of the trauma.  

A person must  also experience negative thoughts or feelings and reactivity that started or became worse after the trauma.  

To have the diagnosis, the symptoms must last for more than 1 month, create distress or impairment, and the symptoms cannot be caused by anything other than the trauma.  

If any of the above resonates with you it is important to talk with your healthcare provider or a mental health professional. 

So, how does EMDR work for PTSD?

EMDR includes several important components for healing trauma.  During the first phase of treatment the therapist will provide space to create a safe connection.  The therapist will spend time getting to know your history, while also attuning to you in the moment.  This attuning can feel good as it helps us to feel understood, heard, and seen.  Why is that important to someone that has survived trauma? Because it means that we don’t have to hold something on our own.  

The second phase is developing resources aka coping skills.  Having resources in place helps us to stay in a window of tolerance and increases our ability to tolerate something stressful.  For example, let’s say you are in a traffic jam, what will make the traffic jam more tolerable? Your favorite music.  Similarly, when working to reduce symptoms of trauma, we need to have resources in place to help us tolerate distress.  

The third phase will be mapping out what symptom should be first targeted.  The therapist and you will work together to figure out the best course of action.  It’s important for someone with PTSD to be able to choose, with therapeutic guidance,  a starting point that feels best for their nervous system.  Being able to have this choice is also healing because often when trauma happens, there was no choice. 

The fourth phase is where reprocessing starts.  During this phase, you, along with your therapist’s guidance, will focus on an aspect of the traumatic memory while using bilateral stimulation (BLS).  The BLS will access both sides of the brain and help to decrease heightened emotions.  

This is important when working with trauma due to the intensity of emotions and physical reactivity. The BLS will also tax the working memory, which can help create distance from the memory. The memory will not be forgotten, but the emotional and physical reactions will be decreased. Using BLS also requires us to have dual attention between the present and traumatic memory. This is key in healing because it helps the brain to know that the trauma is not reoccurring.  

Once a memory has been reprocessed, the therapist will guide you to pair a positive belief with the memory.  It can be something as simple as, “I’m ok.”  This is helpful to the person that has PTSD as one of the symptoms is having an increased negative affect.  

The therapist will also guide you to check in with your body and notice if there is any disturbance.  If there is any disturbance left, after a memory has been reprocessed, the therapist will return to having you focus on the disturbance while doing BLS.  

Once there is no negative disturbance, the therapist will guide you to notice any positive sensations or beliefs.  

Benefits of EMDR

Research has shown that EMDR is an effective treatment to reduce PTSD symptoms. One of the advantages of using EMDR to treat PTSD is that it is non-invasive, which means that you do not have to talk in detail about the trauma.   

Clients may walk away with increased knowledge of their emotions, somatic experiences, tools and resources to help cope, and a decreased disturbance around traumatic memories.  The 8 phases of EMDR actively support clients in their journey to recovery from PTSD, so it can be common to start feeling even a little bit better and hopeful after the first few sessions. 

At the end of a session, the therapist will guide the client to come back to the present.  This is important for folks with PTSD, as symptoms can make it hard to be fully in the present.  A client may notice, after a memory has been fully desensitized; that the memory has no negative charge and that it is already easier to be in the present.  

Once all of the past associations or memories with a trauma have been reprocessed, the therapist will check in on present day symptoms and concerns.  After any present day concerns have been addressed, the therapist will guide you to envision future scenarios that previously were challenging due to trauma, and imagine a positive outcome.  If any disturbance comes up, you will move back into reprocessing.  Typically, once reprocessing occurs it is much easier to hold positive beliefs and a positive vision for your future.    

Final Thoughts

EMDR therapy is highly effective and supportive in the recovery from PTSD.  The 8 phases all work together and build upon one another to assist clients in healing.  It is highly structured which can help clients in tracking progress, knowing what to expect, and feeling contained.  For those struggling with PTSD, EMDR offers hope as a path for healing.