EMDR (Eye Movement Desensitization and Reprocessing) is an integrative psychotherapy approach that has been extensively researched and proven effective for the treatment of trauma. EMDR is a set of standardized protocols that incorporates elements from many different treatment approaches. To date, EMDR has helped an estimated two million people of all ages relieve many types of psychological stress (2012 Emdria.org).

EMDR was first developed by Francine Shapiro upon noticing that certain eye movements reduced the intensity of disturbing thought. She then conducted a scientific study in 1989. The success rate of that first study using trauma victims was posted in the Journal of Traumatic Stress. Shapiro noted that, when she was experiencing a disturbing thought, her eyes were involuntarily moving rapidly. She noticed further that, when she brought her eye movements under voluntary control while thinking about a traumatic thought, anxiety was reduced. Shapiro developed EMDR therapy for post-traumatic stress disorder. She speculated that traumatic events upset the excitatory/inhibitory balance in the brain, causing a pathological change in the neural elements. EMDR is now recommended as an effective treatment for trauma in the Practice Guidelines of the American Psychiatric Association.

EMDR uses a structured eight-phase approach to address the past, present, and future aspects of a traumatic or distressing memory. The therapy process and procedures are according to Shapiro.

EMDR treatment consists of 8 phases and each phase has its precise intentions.

Phase I History and Treatment Planning

The therapist will conduct an initial evaluation of the client’s history and develop a general plan for treatment.

Phase II Processing

During the processing phases of EMDR, the client focuses on the disturbing memory in multiple brief sets of about 15–30 seconds. Simultaneously, the client focuses on the dual attention stimulus, which consist on focusing on the trauma while the clinician initiates lateral eye movement. Following each set, the client is asked what associative information was elicited during the procedure. This new material usually becomes the focus of the next set. This process of personal association is repeated many times during the session.

Phase III Assessment

During phase III, the therapist will ask the client to visualize an image that represents the disturbing event. Along with it, the client will describe a thought or negative cognition (NC) associated with the image. The client will be asked to develop a positive cognition (PC) to be associated with the same image that is desired in place of the negative one. The client is asked how strongly he or she believes in the negative and positive cognitions to be true. The client is also asked to identify where in the body he or she is sensing discomfort.

Phase IV Desensitization

At this time, when the client is focused on the negative cognition as well as the disturbing image together, the therapist begins the bilateral gestures and requests the client to follow the gestures with their eyes. This process continues until the client no longer feels as strongly about the negative cognition in conjunction with the image.

Phase V Installation

At this time, the therapist will ask the client to focus on the positive cognition developed in phase III. The therapist will continue with the gestures and the client is to continue following with the eyes while focusing on the new and positive thought. When the client feels he or she is certain the positive cognition has replaced the negative cognition, the installation phase is complete.

Phase VI Body Scan

At this phase the goal of the therapist is to identify any uncomfortable sensations that could be lingering in the body. While thinking about the originally disturbing event, the client is asked to scan over his or her body entirely, searching for tension or other physical discomfort. Any negative sensations are targeted and then diminished, using the same bilateral stimulation technique from phases IV and V. The EMDR network has asserted that positive cognitions should be incorporated physically as well as intellectually. Phase VI is considered complete when the client is able to think and speak about the event without feeling any physical or emotional discomfort.

Phase VII Closure

Naturally, not all traumatic events will be resolved completely within the time-frame allotted. In this case the therapist will guide the client through relaxation techniques that are designed to bring about emotional stability and tranquillity. The client will also be able to use these same techniques for experiences that might arise in between sessions such as, strong emotions, unwanted imagery, and dismal thoughts. The client may be encouraged to keep a journal of these experiences, allowing for easy recall and processing during the next session.

Phase VIII Re-evaluation

With every new session, the therapist will re-evaluate the work done in the prior session. The therapist will also assess how well the client managed on his or her own in between visits. At this point, the therapist will decide whether it is best to continue working on previous targets or continue to newer ones.

For further information see http://www.emdr-europe.org/

EMDR (Eye Movement Desensitization and Reprocessing) to date has been recommended by the National Institute for Clinical Excellence as a Treatment of choice for Trauma and PTSD.

Though to date the EMDR approach is developing evidence to support its efficacy with other mental health problems.