EMDR in therapy

April 4, 2016 12:22 PM

Have you done EMDR in therapy before? What was your experience? I am looking for anecdotal and/or research-based information about the efficacy of EMDR.

I have done some EMDR with my current therapist and I think it's been useful but it's also been intense, somewhat uncomfortably so. Also, I have therapy at 8 am, right before work, and so that transition is a little difficult. I can't see this therapist at any other time.

My therapist wants to do EDMR surrounding my parents' divorce, a traumatic and sudden event in my life that still echoes today. I do know I need to address this in therapy in some way, but I am not convinced that EMDR is the best way- she says it is much "faster" than simple talk therapy.

I am wondering if anyone with either direct experience with, or having some information/research about, EMDR could offer some suggestions. I have read that is is somewhat controversial- has it proven to be effective? Are there any reasons NOT to do it?

Thanks.

posted by bearette to Health & Fitness (19 answers total)

I've done extensive EMDR in therapy to treat PTSD originating from childhood abuse. I found it very useful, both effective and efficient, but my therapist always combined it with talk therapy after and during each session. Most of what we focused on was related to my PTSD, but we also used EMDR to deal work on incidents or emotions that weren't necessarily traumatic in the same way. I've also used EMDR on my own when working through various issues.

I first found out about the technique via Bessel van der Kolk's The Body Keeps the Score, which is a fantastic discussion of the biology of trauma and therapeutic techniques. There's a whole chapter devoted to EMDR, with research citations. I'm not familiar with any controversy off the top of my head.

EMDR is fairly benign. I think the biggest reasons not to do it would be that it might waste money and time if you find it doesn't work for you.

Hope this helps! Feel free to MeMail me if you want more information.
posted by zenzicube at 12:47 PM on April 4, 2016

I have! I used it for about 2 years and it really helped me sift through a lot of stuff that was improperly lumped together. Most of my work with it had to do with identifying the root cause of a lot of shame that I was feeling about who I was, and EMDR helped me create a kind of timeline that allowed me to see everything from the first trigger point to all the other incidents that were lumped on top of it and causing me continued pain. Most of these root issues were trauma based.

Obviously it's not for everyone. I think it worked so well for me because I was super receptive to it and it was framed as a tool I could really connect to (I like sorting things into compartments and categories). I say give it a shot for a month, and then if you feel like it's BS and not a good fit, tell your therapist no thanks and go back to other forms of CBT. Happy to answer any questions if you have any!
posted by Hermione Granger at 12:51 PM on April 4, 2016

In terms of it's efficacy, while still pretty new, it seems somewhat promising for some mental health issues, specifically PTSD. While I don't personally have Kaiser insurance, they are a pretty good barometer for evidence-based health services (they're pretty insistent on only covering medical procedures that are evidence based, which causes some issue with them covering mental health diagnosis sometimes). They pay for it with most plans that cover mental health which was enough for me to seek it out.

My results were mixed, but I also didn't suffer from classic PTSD symptoms. Vet your therapist though, because there's a not-zero overlap of folks who do legit EMDR, and some serious woo shit out there. I had to hit up a couple before I found someone who didn't want to follow up the EMDR with some healing crystals.
posted by furnace.heart at 12:54 PM on April 4, 2016

EMDR did not work for me (I tried it twice), probably because my therapist and I weren't able to find a specific trauma to tie it to. Sounds like this would not be your problem.
posted by ubiquity at 1:04 PM on April 4, 2016

Across randomized controlled trials of EMDR and trauma-focused cognitive-behavioral therapies (the latter of which are considered "gold standard" therapies for PTSD in the field), there is no evidence that either is superior over the other for the average patient, and I am unaware of controlled evidence that one typically works quicker than the other. The gestalt I have of the literature is that we really have no clue, scientifically, what's up with the eye movements piece of the therapy. Nevertheless, EMDR without the eye movements is not as effective as EMDR with the eye movements.

Overall: EMDR is considered an evidence-based therapy for PTSD that's as good on average as other evidence-based therapies, although there's some controversy as to the mechanism by which the eye movements improve therapeutic effect. We don't know a lot about "what works for whom" or whether EMDR may be particularly indicated for people with specific traits and backgrounds. Feel free to try it. If you don't like it, there are other approaches that could also work for you!

That said, all of the above assumes that your traumatic experience fits into the PTSD umbrella per se, which you did not indicate explicitly one way or the other. I'm not aware of much controlled literature on EMDR for people without diagnosed PTSD or with other "types" of problems. That could be one reason not to do it.
posted by Keter at 1:31 PM on April 4, 2016

If having to go to work immediately afterward is making you hesitate to address the trauma, you could ask your therapist to wind the session down a few minutes earlier and give you time to put yourself back together.
posted by lazuli at 1:37 PM on April 4, 2016

I've had EMDR. It worked fantastically for me where talk therapy failed.

I feel like the key is having specific traumatic events, even micro-events, that you want the EMDR to address. I don't think it would work well for overall bad feelings about a given time or event, but works well for the mind to re-cast specific traumatic moments to something more neutral.

I don't think there is any downside even if it doesn't work. And yes, expect to be emotionally exhausted.
posted by littlewater at 1:42 PM on April 4, 2016

My wife would say that it changed her life. It's been so effective for her that I'm arranging to do it as well, starting in the next couple of weeks.
posted by SpacemanStix at 1:47 PM on April 4, 2016

If you have concerns about the pace or the time of the day, I strongly urge you to discuss these concerns with the therapist. And insist that she take them seriously. You don't want to get re-traumatized, which can happen if the pace of work is too quick, or you start to feel that your wishes about the work aren't listened to or honored.

Yes, the work is likely to be uncomfortable, but don't allow anyone to put you into a place where you feel pushed to work with these traumas in a way you don't feel good about.
posted by jasper411 at 1:47 PM on April 4, 2016

The Tucson V. A. used 2 therapists for EMDR, 1 to do the treatment, 1 as a safety referee. They had unfortunate experiences of uncovering masked traumas more severe than anyone was expecting.

They also tended to view it as a symptom management tool vs. a cure. This isn't to say its not a valuable treatment, I just believe it get tends to get a little over hyped.

G'luck
posted by ridgerunner at 1:53 PM on April 4, 2016

Eh, it's alright. It's about on par with many of the other treatments/therapies out there for mental health issues. I had decent results when I did it years and years ago, but I think a huge portion of why it helped was simply that as I was still a child,having someone to guide me through things was enough treatment in and of itself . I have found revisiting EMDR to be just alright. I had some luck when I did it with a great therapist, but there was a lot of incompetent ones to wade through.

Also, it is not the place of a therapist to tell you what kind of treatment you need, or to suggest specifics. Good therapy will figure out what you want and how you want it(and lay out very general options), not force you to go along with something just because they think it'd help you. You know yourself best. If your therapist is not only failing to create productive timing for your appointments(treating ptsd is tons of work and is exhausting, and expecting someone to start the day like that makes me kinda angry), but also trying to "sell" you on the idea of a treatment, you need a new therapist.

I'd say to try EMDR again, but with someone who can do it on a comfortable schedule as well as provide talk therapy/other resources for self care while you do the treatments(and if it's not working for your after several treatments, it's okay not to "Stick it out").
posted by InkDrinker at 1:54 PM on April 4, 2016

I actually had my first EMDR session this weekend! It was with a therapist that I've been working with for a while (3 years), and she thought it would be useful for me - I've had a lot of trauma in my background, and a lot of shame/sadness/insecurity that stems from trauma for me comes up for me in certain stressful situations.

After the first session, I actually can tell a difference - honestly, I was super duper skeptical, but it's kind of astonishing. I went in with a really specific thing to discuss, and it helped me process that without completely spinning out into panic mode like I tend to do. I just generally feel a lot more peaceful and optimistic, which is sort of new to me, especially when I'm dealing with uncertainty.

For me, making the time afterward to rest was important - while I did feel drained, it was mostly a happy drained. Still, drained nonetheless. I think if you can swing skipping the morning from work, it would be good.

I just did it this past weekend, so obviously I can't speak to any long-term benefits. But I was definitely pleasantly surprised and will likely be trying it again.
posted by superlibby at 2:20 PM on April 4, 2016

I did it over about ten sessions when my regular therapist and I got to a road block with talk therapy. EMDR is great for getting at problems where you know something is wrong, but you have more emotions about it than you do words. I would recommend EMDR where you have a specific trauma you want to resolve, where you've done a lot of the basic talk therapy about it and you feel like you definitely want to put the topic to bed for good, and when you're confident/not in an adversarial relationship with your therapist. EMDR feels like it shouldn't work-- it's a lot like cartoon-style hypnosis with a big swinging watch-- but it worked for me.

I also felt really drained afterwards, and I wouldn't want to go straight to work or interacting with my family right away. I found that I need an hour or so of getting back to reality afterwards.
posted by blnkfrnk at 2:33 PM on April 4, 2016

I tried it and it did not work for me at all. Completely useless, in my case.
posted by Violet Hour at 3:30 PM on April 4, 2016

EMDR worked for me about six years ago to get over a driving phobia. The therapy was was short and focused, and for a specific, traumatic car crash. I also started driving lessons after a couple sessions, and the two together worked almost immediately, after twenty years of being unable to get behind the wheel at all. If it matters, I used a device that caused vibrations between my two hands, while moved my closed eyes along. (Following the light with my eyes was too difficult for me.) The therapist I saw for the driving phobia only dealt with that, and then I moved on to another therapist for other anxiety issues and CBT.

Even though EMDR worked so well for me, I haven't had it again, because my other issues aren't related to PTSD.
posted by quarterinmyshoe at 5:29 PM on April 4, 2016

I did EMDR to deal with PTSD. It was far more intense than talk therapy has ever been for me - and also much faster (like, four sessions vs. 18 months in talk therapy). I found it to be tremendously useful. In fact, although we only did EMDR for the specific traumatic events I was focused on, I actually feel like it helped much older traumas, including my parents' divorce (covered ad nauseum in the 18 months of talk therapy I did a few years earlier). I'm a pretty skeptical person so I wasn't expecting much out of it, but I'm a big fan and highly recommend it.

So, anecdotal, but I don't think there's much reason not to try it.
posted by peanut_mcgillicuty at 6:43 PM on April 4, 2016

I found that EMDR helped me break through and get in touch with some deep feelings that talk therapy wasn't getting to. I found it effective even though I didn't have one or two very traumatic events to process; it was more trying to get at various childhood feelings of being unsafe, alone, etc. that didn't necessarily have a single defining event or root. I'd like to continue with it, since it helped me feel like a weight was lifted off my heart, and nothing else has really gotten me to open up like that. That being said, I don't have any kind of dissociative tendencies or other forms of PTSD that might make it too difficult to bear, so make sure you're taking that into account.

Your therapist is right that EMDR is very fast, but I don't think that they should be focused on how fast your therapy is going, but rather on whether it's going at all. My therapist used EMDR with me because I was stuck, after several appointments of talk therapy only, with no real movement at all. If that's not where you are with talk therapy and you feel uncomfortable with EMDR, then I would recommend sticking with talk only for now and only adding EMDR when it won't feel like your brain's being split open.
posted by inky_the_pinky at 7:39 PM on April 4, 2016

I've had good luck with EMDR twice, for a driving phobia and for early childhood trauma. For the session on the childhood stuff, I booked a longer appointment (90 min, which flew by) and did it in the evening with nothing planned afterwards, which was great because I was completely exhausted. Sorry, I know you're stuck with a pre-work time but I hope you can carve out some extra time for yourself to get your bearings.

Overall, I'd recommend it. One session made more of a difference than many years (and thousands of dollars) of therapy.
posted by bighappyhairydog at 7:40 PM on April 4, 2016

I had it for a few months when I was 12 to address PTSD from a specific event. It completely sorted me out, and I wouldn't hesistate to have it again in similar circumstances. But as you've found the process is painful and draining, and after my afternoon appointments I was really no good for anything. If you can see another therapist late in the day, or build in some time to decompress afterward so that it doesn't have such an impact on your work I would recommend it.
posted by daisysteiner at 2:08 AM on April 5, 2016