EMDR Therapy For PTSD

Veterans and other patients suffering from post-traumatic stress disorder (PTSD) often struggle to process the psychological wounds they endured from past experiences. In order to access these feelings and address them head-on, therapists may opt for EMDR therapy. Learn more about EMDR therapy and how it can help patients suffering from PTSD.

Post Traumatic Stress Disorder (PTSD)

Before undergoing EMDR therapy, it’s important to understand the condition it’s used to treat – PTSD.

PTSD is a psychological disorder that affects people who have suffered through a trauma that continues to haunt them subconsciously.

PTSD manifests itself in patients in unique ways that distinguish it from a generalized anxiety disorder or depression, even if some of the symptoms overlap.

Symptoms of PTSD include:

• Flashbacks
• Nightmares
• Compulsive thoughts
• Paranoia
• Seclusion
• Defensive behavior
• Sensitivity to light and noise
• Self-medication
• Suicidal tendencies

PTSD Patients

While most often associated with veterans who saw war, it can and does impact civilians who went through a traumatic experience, too.

Witnessing the atrocities of war cause PTSD in many soldiers. Car accidents, severe abuse, school shootings, and numerous other possible traumas can all bring about PTSD in civilians.

Types of PTSD

There are a couple of types of specialized PTSD that some patients fall into:

1. Complex PTSD – Sometimes referred to as Disorders of Extreme Stress Not Otherwise Specified (DESNOS), complex PTSD develops after prolonged trauma, such as living as a POW or suffering domestic abuse for years.
2. Comorbid PTSD – Comorbid PTSD describes patients with clear PTSD as well as clear signs of an additional disorder, such as depression or mania. Since these patients suffer from multiple disorders, treatment varies more than other PTSD patients.
3. Dissociative PTSD –  Emphasizing dissociation and escapism, patients with PTSD emotionally remove themselves from situations to the point that they experience an out-of-body experience and severe derealization to the point that the patients lose time and other aspects of reality.

Eye Movement Desensitization and Reprocessing (EMDR) for PTSD

Eye Movement Desensitization and Reprocessing Therapy  is a type of trauma-focused talk therapy, under the broader umbrella of psychotherapy.

Psychotherapy refers to the treatment of mental and behavioral disorders using psychological methods as opposed to medical methods, such as medication or electrolysis.

EMDR Therapy attempts to use concepts currently familiar to the patient’s cognitive processes to make it easier for the patient to explore past trauma. So the patient will think about the incident in question while simultaneously performing a simple rhythmic task, such as following a light or finger with their eyes or listening for a beep.

The idea is that when the patient connects the past trauma to normal brain functions, it will make the trauma more accessible for the patient’s brain. Despite the anxiety-inducing thoughts, the rhythm helps keep the patient calm, allowing them to tap into their trauma in ways they previously couldn’t.

The process does not aim to overwhelm the patient. The patient will start by accessing the trauma for short periods of time.. As they show signs of calm, their therapist will encourage more and more time inside their traumatic memories until they’ve fully processed them.

How Does It Work?

After the patient identifies the traumatic event they experienced, a therapist will encourage them to mentally rest in that place.

The brain will automatically respond to the trauma with distress. However, this is the desired reaction.

A therapist will ask the patient to continue exploring their trauma, while also following a simple back and forth movement, such as a moving finger or light, with their eyes.

Once the patient combines the basic cognitive processes with their trauma, their stress level should decrease.

Eventually, the patient should fully access their memories and feelings regarding their trauma, allowing them to truly get past it instead of burying it underneath the surface.

What Can I Expect?

There will be a significant amount of buildup before EMDR therapy begins. Preparation depends on the frequency of sessions and the patient’s speed.

Therapy takes place one-on-one between a patient and their therapist. The therapist will assess the patient to verify the diagnosis of PTSD.

During initial conversations between the patient and therapist, they will talk about trauma in general terms, including common physical responses to trauma. The patient may identify certain behavior in themselves, and the psychologist will suggest new defense mechanisms, too.

After going over trauma in general terms, the therapist will encourage the patient to explore their personal trauma.

Most patients struggle to open up. To start, the therapist will ask the patient to acknowledge the traumatic incident in question. The “target” can refer to one single memory, such as witnessing a death, or a period of time, such as a  year of severe abuse.

Finally, the therapist will start the EMDR therapy.

The two videos embedded below from Australian EMDR practitioner Dr James Alexander are a superb in depth introduction to the issue of trauma and how the process of EMDR works to resolve it. Combined together they are perhaps the best video resources available online regarding trauma and EMDR and should be essential viewing for people looking to know more about the topic.

The first video covers more the history of how trauma has been viewed and diagnosed by society, including an in depth discussion of the trauma suffered by veterans in the aftermath of the Vietnam and Korean wars. The second video covers the exact process of how EMDR works in resolving trauma.

Combined together they are around 100 minutes long but are an excellent resource for war veterans or any other PTSD sufferers who are interested in pursuing EMDR as a potential treatment for trauma. Click on the videos to pop up a full size version of each video.

How Long Does Treatment Last?

Each patient is different. However, the U.S. Department of Veteran Affairs suggests weekly 60 – 90 minute sessions over 1 – 3 months.

The actual duration of the EMDR therapy starts with 30 seconds. After 30 seconds, the therapist will chat with the patient about the experience. If the patient showed a positive response right away, they may try the process again. The therapist will increase the time based on the patient’s comfort level.

At first, patients may only undergo 1 occurrence of actual EMDR therapy in a session with their therapist.

Will I Talk in Detail about My Trauma?

No. Patients don’t need to talk about their trauma in detail.

EMDR therapy requires patients to tap into repressed memories, so many patients assume they will need to talk about those memories. However, that’s not necessarily the case.

EMDR therapy forces patients to think about traumatic memory. However, patients don’t need to divulge details they don’t feel comfortable talking about.

Instead of going into the gory details, the patient talks about their experience during the therapy. For example, patients can tell the therapist in general terms that they were able to see detailed images they couldn’t see before without saying the image.

If the patient feels comfortable with it, they can eventually open up about the trauma in detail.

Is It Effective?

EMDR therapy is highly effective for most PTSD patients.

In particular, EMDR therapy works well for patients with dissociative PTSD. These patients space out when the topic of their trauma comes up. EMDR forces these patients to let the trauma enter their minds instead of disassociating.

EMDR therapy also works well for PTSD patients who demonstrate trauma avoidance.

Patients who regularly explore their trauma in detail may not get the same revelations as other patients. However, the therapy can still be beneficial in exploring trauma.

Linked below are some studies showing the effectiveness of EMDR in treating trauma for war veterans. See also the success stories further below for some video accounts of EMDR effectively helping out war veterans.

• 2008 Study on EMDR for War Veterans
• 2018 Study on Different EMDR Treatment Schedules for War Veterans
• EMDR International Association’s Page on Combat Trauma and Links to Studies on EMDR

Some War Veteran EMDR Success Stories

We want to also add to these more theoretical accounts a couple of actual accounts of EMDR being successfully used on war veterans. Both the accounts below report pretty much the standard of experience of most EMDR patients; the treatment allows the person to process and “digest” traumatic experiences to the extent they no longer bother the person and are seen as just another memory.

What Are the Risks?

There are little to no physical or health risks associated with EMDR therapy. There are no medications or controlled substances involved. The therapy also doesn’t require physical activity, making the possibility of an injury zero to none.

Opening up old wounds may impact a patient emotionally. After an EMDR session, a patient may feel somewhat retraumatized, making them resistant to continued treatment.

Additional PTSD Treatments 

There are a couple of alternative PTSD treatments to be aware of before you definitely decide on EMDR therapy.

Cognitive Behavioral Therapy (CBT)

Instead of embracing traumatic events like with EMDR therapy, CBT aims to replace reoccurring unpleasant memories with something positive.

For example, if someone finds their friend killed by an explosion, they may see the image of that moment every time they close their eyes. Therapists will attempt to replace that image with a more positive memory of the deceased, such as a picture of both friends drinking while on vacation.

Prolonged Exposure

Some therapists force patients to face their trauma directly for prolonged periods of time in a process known as prolonged exposure.

Unlike EMDR therapy, which eases into traumatic memories gradually, prolonged exposure therapy takes a jarring, fast-track approach. Prolonged exposure is sometimes used to treat phobias by forcing the patient to come into direct contact with their phobia until the panic finally subsides. The process works similarly in PTSD but with memories instead of exposure.

While it may work quickly, stewing in past wounds for a long period of time may cause more emotional damage to the patient in the beginning.

Medications

In extreme cases of PTSD, a psychiatrist may offer medication, usually SSRIs  (selective serotonin reuptake inhibitors).

Zoloft and Paxil are the two SSRIs on the market approved by the FDA for PTSD.

Choosing the Best PTSD Treatment for You

To select the best PTSD treatment for you, start by clarifying your goals.

Do you want to address thoughts you keep suppressing, or do you want to suppress thoughts that keep popping into your head unwelcomed?

Talk to your therapist about your options to get a brief rundown on the pros and cons of each technique. Don’t forget to ask the therapist if they have a suggestion based on the details of your situation.

Once you make a selection, stick to treatment for 6 – 12 weeks before trying something else. Therapy takes time to work, especially EMDR therapy.

Conclusion

EMDR therapy is a highly effective and low-risk treatment for PTSD that encourages patients to address their trauma. However, there are other options available to you.

Whatever treatment you choose, be sure to get help for your PTSD in some way, shape, or form.

Without proper treatment, PTSD can seriously reduce your quality of life as you self-medicate or seclude yourself. Just like a broken leg, the problem will persist until you seek medical attention.

Help yourself and your family by getting treatment for your PTSD today!

See our Find a Therapist page for links to resources which will help you find a qualified practitioner in your area if you would like to enquire further about the treatment.

See also:

• Can Eye Movements Heal Our Traumas?
• The 8 Step EMDR Process
• Trauma and Powerlessness