Why Does EMDR Work?

woman in emdr therapy session

In the 1980s, American psychologist Francine Shapiro founded a form of psychotherapy she named Eye Movement Desensitization and Reprocessing (EMDR). EMDR is based on the premise that past trauma is strongly associated with mental disorders like anxiety, depression, and post-traumatic stress disorder (PTSD), and that by resolving negative emotions related to the trauma, the mental disorder also improves.

More recently, EMDR has also been recognized as an effective therapy for substance use disorders. Over 9 million adults in the U.S. have both a mental disorder and a substance use disorder, according to the 2018 National Survey on Drug Use and Health.

The presence of both conditions is called a co-occurring disorder or dual diagnosis, and both must be treated for successful long-term recovery. Because EMDR provides an integrative approach to treat both disorders simultaneously, it is an effective component of a comprehensive treatment plan.

How and Why Does EMDR Work?

Shapiro believed that trauma causes a dysfunction, or imbalance, in how the brain processes information. Rather than processing negative emotions associated with a traumatic event, the emotions become stuck in the memory, preventing healing from taking place. EMDR therapy works to unblock the negative emotions and to replace them with more positive beliefs.

During EMDR therapy, a specially trained therapist directs the patient in rapid side to side movement of the eyes, while asking them to recall negative emotions associated with the traumatic event. Shapiro theorized that the rapid side to side eye movement connects the right and left hemispheres of the brain, releasing blockages so the memory can be processed and desensitized. As the therapy continues, the therapist asks the patient to replace negative feelings and emotions surrounding the trauma with more positive ones.

EMDR enables the patient to reprogram negative emotional associations, relieving anxiety and instilling a personal sense of empowerment. Positive results often occur within a relatively short period of time.

Shapiro cites twenty-four randomized controlled trials stating EMDR produces “rapid decreases in negative emotions and/or vividness of disturbing images,” when used to treat emotional trauma.

While there is no definitive answer as to why EMDR works, there are dozens of studies supporting that it does work.

Some theorize that it may work similarly to the function of REM sleep, during which the eyes are moving rapidly as the brain processes images and experiences, interpreting meaning and implication.

Others believe EMDR shares the basic principles of exposure therapy, which works to desensitize the patient by exposing them to the source of their anxiety. During exposure therapy, while in a safe and supportive environment, the therapist exposes the patient to something that produces intense anxiety in that individual, with the goal of resolving negative associations, and breaking the pattern of avoidance. Exposure therapy is recognized as an empirically supported treatment for anxiety disorder.

The bottom line is that EMDR is recognized as a safe, effective treatment for anxiety and other mental health disorders, including substance use disorders, and delivers results in an impressively short time.


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Taylor Brown, B.A.Com., MAADC II
Tim Coleman, M. of Ed.

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