EMDR therapy: from anxiety to serenity

Bilateral stimulation of the hemispheres of the brain using the fingers of both hands to tap rhythmically is known as tapping. It is very popular on the internet for treating anxiety and panic attacks. But behind it is a burgeoning technique – EMDR therapy – that manages to reprocess major traumas until they no longer carry enough weight to affect present life.

EMDR stands for Eye Movement Desensitisation and Reprocessing Therapy, and is an effective and widely researched method of psychotherapy. It has been shown to help people recover from trauma and other distressing life experiences associated with mental health problems such as post-traumatic stress disorder, anxiety, depression and many other conditions.

Although its name refers only to eye movements, three different bilateral stimulation techniques are used in this therapy, and are applied according to the individual needs of the patient:

1. horizontal saccadic eye movements, where the patient follows the therapist’s fingers with his or her gaze
2. Bilateral auditory stimulation, which uses tones or bilateralised music.
3. 3.Tapping, where the therapist gently taps the patient’s knees and hands alternately.

Since 2013 the WHO considers it a therapy of choice for addressing trauma and post-traumatic stress. The Cochrane Database of Systematic Reviews indicates that it is very effective in post-traumatic pathologies. In addition, the International Society for Traumatic Stress Studies (ISTSS) lists EMDR as one of the treatments of choice for dealing with stress following trauma. Various clinical guidelines and international bodies also recommend this therapy.

Unlike other psychotherapies, EMDR does not require the patient to talk in detail about the problem that affects him or her. The EMDR Spain association explains that, for example, in classic exposure therapies, the aim is for the person to be in contact with the emotions generated by the memory, until a process of habituation occurs progressively, which reduces the discomfort. However, during an EMDR therapy, the person will contact the memory very briefly, to make way for an associative process with other memories, sensations or thoughts. This also leads to a decrease in distress (desensitisation), but also triggers multiple associations (reprocessing).

“Both therapies are effective, but operate through different mechanisms. In cognitive therapies, the patient’s beliefs about the event are worked on to change to a healthier perspective. In EMDR, although the subject’s beliefs are collected, no specific work is done on them, but they change as a result of the processing of the memory,” explain the EMDR Spain association.

Cynthia Molina, clinical psychologist at SHA Wellness Clinic Spain, says that many people come to her office looking for EMDR. “People arrive who say: ‘I have impostor syndrome’. They usually say that they don’t think they are too good at what they do, that they feel they are not good enough, that they are not good enough. When you ask them questions about when they first felt they were not good enough, they often go back to childhood. EMDR takes you back to that traumatic event, identifies the bodily sensation and emotion that triggered that moment, and changes that negative belief into a positive one. When the 8-phase protocol is completed and the childhood event is desensitised, the patient gets used to seeing it and reconceptualises it, then the traumatic event loses weight and stops having an impact on the present“, explains Cinthya Molina, adding that in the present we work on the situations that exacerbate the idea of ‘I am not worth it’ and have an impact on the future, and everything is done with bilateral stimulation, which can be done with tapping or eye movements. “What currently has the most scientific evidence is eye movements” explains the expert.

Molina explains that EMDR is a perfect complement to the cognitive-behavioural approach to a problem that is usually done through habituation. “For example, if you are afraid of dogs, the therapy will try to expose you little by little to that fear. What EMDR does is that it exposes you to the first and most important event that has generated that phobia. The EMDR protocol will take you to that first experience, to the worst of them, and to the most recent one, and it will work with the past, the present and the future.”

With EMDR, the patient not only habituates to the stimulus that generates a problem, but also reprocesses all the information surrounding the phobia that has probably been integrated in a disjointed way and prevents the event from re-traumatising the patient.

“EMDR therapy integrates the memory, the image, the belief, the emotion and the bodily sensation, and reprocesses it with a positive belief. In this way, it desensitises, reduces discomfort and creates new and varied associations”, explains Cinthya Molina, who points out that in Clinical Psychology the most solid evidence for treating trauma and post-traumatic experiences corresponds to the combination of Cognitive Behavioural Therapy and EMDR. It has also shown efficacy in anxiety and depression. “It’s what people are looking for, the waiting lists are very long” says the expert.

For EMDR work, it is important to treat the specific memory that is blocked, but also the connections between the traumatic experience and other previous situations, which may have the same thoughts or sensations associated with them. An EMDR therapist will work with the patient to understand the roots of the trauma, and to develop a comprehensive work plan to minimise its influence on the present.

“The central idea of the EMDR model is that the nervous system has mechanisms for processing and integrating everything that happens to us, including difficult or stressful experiences. Sometimes, when these experiences are more intense or complex for the person, the system becomes blocked and the memory remains stored unprocessed, with the same perceptions, thoughts, emotions and sensations. These unprocessed memories are not a source of learning, but can give rise to problems and symptoms in the present, when something that happens is connected to those experiences. EMDR therapy has defined procedures to access and unblock these memories, so that the nervous system can finally integrate them. Within these procedures, one of the elements used is eye movements or other forms of bilateral brain stimulation (tactile, auditory). Although eye movements have given the therapy its name, it is important to bear in mind that this element by itself does not constitute a therapeutic approach, and its isolated use is not recommended“, explain the EMDR Spain Association.