EMDR (Eye Movement Desensitization and Reprocessing) is a well-known therapy in the world of psychology. It was originally designed for those who have undergone trauma and were suffering from classic PTSD (post-traumatic stress disorder) symptoms. Over time, the therapy has been found to have wider applications and has been beneficial in treating depression, anxiety, OCD, grief, and addiction, among other conditions. But does it have any side effects?
Overall, EMDR is considered a safe therapy and is recommended by organizations like the World Health Organization (WHO) and the American Psychiatric Association (APA), as well as numerous professionals who have seen the benefits of the method first hand. There are no dangers of using EMDR for a trauma victim or even someone with a dissociative disorder. However, there are potential side effects that patients may experience over the course of treatment. There are some challenges and risks that the EMDR therapist must keep in mind and navigate during the sessions.
EMDR essentially uses eye movements and bilateral stimuli (stimulation of both sides which in this case refers to the brain) to help trauma victims resolve traumatic memories that have become “stuck” in the brain. During the process of EMDR, patients are instructed to remember the traumatic event while simultaneously being exposed to bilateral stimulation. This distraction allows the patient to recall the distressing memory in a new way so as to normalize the memories and make them less triggering and painful. Furthermore, it is thought that the bilateral stimulation engages the whole brain and allows the traumatic memories to be stored in amore stable part of the brain and consequently perceived differently. In simpler terms, EMDR allows trauma victims to process the traumatic event and the corresponding emotions in a more efficient and controlled way.
Is EMDR Effective?
In order to determine EMDR’s safety, it’s vital to understand its effectiveness. At the end of the day, only a safe and tested therapy can produce positive results. EMDR is supported by numerous research studies as having high rates of effectiveness, as well as positive outcomes in trial studies, all of which speak volumes about its safety.
As many as 30 clinical studies have shown that EMDR is effective for people with PTSD, especially those dealing with a single trauma. (Single trauma refers to an isolated traumatic event that causes emotional and mental problems for the victim, including PTSD symptoms.)
In fact, one review study from 2014 in the Permanente Journal suggested that EMDR may be even more effective for trauma victims than what is often considered the primary treatment option, Cognitive Behavior Therapy (CBT).
Some research also found that the benefits of EMDR extend to helping trauma victims with symptoms like anger and thoughts of self-harm or suicide.
While Francine Shapiro, the psychologist who developed EMDR, devised it for PTSD patients, it’s now used for other disorders, including dissociative disorders. It may also be used for depression or anxiety, especially when these conditions are linked with childhood trauma.
Many times EMDR is used alongside other therapies to bolster the results, especially when addressing conditions other than PTSD. For PTSD, it still remains the most frequently used therapy and has also proved to be very helpful with OCDs.
It’s clear from scientific evidence as well as accounts from many seasoned therapists that EMDR is an effective and rather quick way to help trauma victims. Moreover, it has been practiced for decades without reports of any serious side effects.
Challenges and Side-Effects of EMDR
EMDR is widely considered a safe and effective therapy by doctors and therapists alike. However, there are some challenges that therapists must address throughout the course of treatment. Similarly, there may be side effects, although with very little chance.
Understanding those challenges and risks can better equip both the therapist and the client to ensure that therapy will be successful.
EMDR, as a therapy, increases self-awareness in trauma victims. This can result in a number of side effects, including:
- Surfacing of additional traumatic memories
- Strong, intense emotions during and after the sessions, lasting from hours to days
- An overall sense of feeling more emotionally sensitive and vulnerable
- Discomfort during sessions, such as experiencing physical sensations (ie. muscle tension), tearfulness, or anger
- Vivid dreams
- Feeling fatigued after sessions
These side-effects typically don’t last very long. As the therapy progresses, the client continues to process the traumatic memories which improves their processing and resolution of trauma-related emotions.
For many, the beginning stages of the therapy can be triggering and emotional for clients. Over the course of treatment, and particularly during the sessions themselves, the client can be overwhelmed by emotions.
Premature Reactivation of Traumatic Memory
EMDR is not a single-intervention therapy. Rather, it is a structured treatment modality comprised of several stages. These stages are intended to set a pace that is neither too quick nor too distressing for the client.
Evoking traumatic memories too early in the process can be detrimental. It can be too distressing and take an emotional toll on the client. If the client becomes too overwhelmed, the treatment ceases to be therapeutic. The therapist must carefully assess the client’s readiness and ability to tolerate the trauma processing itself before moving onto the sessions that involve the actual eye movements.
Risks with Dissociative Clients
Dissociative disorders often accompany PTSD and EMDR can be useful for both disorders. Although EMDR may not be the main therapy for dissociative patients, it has the potential to improve their condition.
That being said, the risks of conducting EMDR with people with dissociative disorders are inherently the same as with people who solely have PTSD. As Dr. Shapiro herself stated in her book about EMDR, penetrating the dissociative boundaries too early can be dangerous. It can result in an increase in suicidal/homicidal risk or destabilization that is beyond the control of the therapist.
How to Ensure EMDR Safety and Effectiveness?
When executed properly, EMDR is harmless. Most people undergoing this therapy have positive outcomes and leave feeling and behaving much better than before. They gain more control over their emotions and perceive the traumatic memories in a more neutral and distant fashion.
However, there are steps to ensure the effectiveness, and, more importantly, the safety of the process. It is always best to take measures that minimize any possible risks, however minimal.
Choose a Trained EMDR Therapist
EMDR requires specialized training and is not part of the required coursework to become a general therapist; EMDR is a skill set that otherwise qualified therapists may not necessarily have. Just because a therapist has the appropriate credentials to practice therapy doesn’t automatically mean they can deliver EMDR as well.
Choose a therapist who is trained in EMDR and is actively practicing the method. While an EMDR certification isn’t required (some EMDR therapists don’t get certified), certification or membership with EMDRIA (EMDR International Association) can ensure that the therapist is indeed trained in this therapy.
When looking for a therapist near you, make sure to ask whether they are trained in EMDR. If you cannot find one or would prefer online therapy, the virtual platform BetterHelp.com may be a viable option. They have a large directory of vetted therapists, many of whom are trained in EMDR. BetterHelp is affordable and treatment can be conducted conveniently from your own home.
Alternatively, you can also use a virtual EMDR therapy tool that allows you to self-administer the therapy. This allows you to set the pace for yourself and do it in an environment that feels safe and comfortable for you. As the risks discussed above are very low, self-administered treatment is generally just as safe as delivery with a therapist.
Communicate With Your Therapist
For EMDR to work, it’s highly important for you to be comfortable with your therapist. Ask questions about the therapy beforehand and discuss what to expect, including any side effects.
During therapy sessions, don’t hesitate to voice your feelings and thoughts. If something is uncomfortable or feels wrong, communicate your concerns. This will help your therapist accommodate your needs, making the whole experience smoother and safer.
When administered properly, EMDR doesn’t cause any harmful side effects. To ensure that it’s done the right way, choose an EMDR therapist who is well-trained in this therapeutic modality.
If you live in a big city, finding a certified EMDR therapist shouldn’t be difficult. However, because EMDR therapists are less common than traditional ones, you may need to pursue other options if there is not a practitioner near you. Luckily, there are numerous EMDR trained therapists available online and there is also the option of self-administered EMDR. Whichever route you end up choosing, be proactive and educate yourself so that you understand the process and can set expectations accordingly.