EMDR therapy: True or Woo?

December 10, 2021 6:11 PM

I've only been doing therapy for a month, but meeting mostly every week for an hour. My therapist has just suggested EMDR therapy. I've done a little reading and it seems too good to be true. Is this actually a thing, or is it pseudo-scientific woo?

The idea of erasing trauma by thinking about bad things while someone waves their hand at me seems deeply, deeply woo. But the internet seems to treat this as a real therapy with real benefits. I honestly can't sort out which is actually true, and I can't figure out if the suggestion of it is a red flag that maybe I'm with the wrong therapist.

If you have experience either treating people using this therapy or being treated with it, I would love to hear about it in as much detail as feels comfortable for you.

If you have expert opinions one way or the other and can back them up with convincing arguments and, if possible, data -- I'd love to hear that too.

I'm also interested in hearing about how this therapy would work (if it does) for people who are not single-trauma sufferers. I have no big traumas, just kind of a crappy but non-abusive childhood I can barely remember. I don't feel like I have PTSD, just some some maladaptive coping strategies that are currently getting in my way in life and relationships. Even if this is a real therapy, I'm not entirely sure how it would work for someone in my situation.

I actually quite like this therapist, she's the first one I've ever stuck with for more than one visit and the first one I feel like actually can help me sort out some of what I have to sort out. I'm happy to try anything safe, sane and consensual to try to change the stuff in my life that's giving me trouble - so if this treatment is on the level, I'm not against it. But on the other hand... if this relationship is about to take a turn down the road to Weirdville, I'll probably want to start planning an exit strategy.

Thanks in advance for any responses.

posted by anonymous to Science & Nature (35 answers total)

I’ve heard very good things about it from very rational people. No personal experience though.
posted by jitterbug perfume at 6:36 PM on December 10, 2021 [1 favorite]

My therapist forced me to do it for years. It didn’t help at all. Eventually I decided she was making a fool of the both of us and I left. Feel free to message me with any questions.
posted by dianeF at 6:44 PM on December 10, 2021 [5 favorites]

I've looked into this a little bit in the past, although unfortunately I didn't save any of the links. My impression from reading about it is that there is a limited amount of data showing that it's effective, but essentially none of that data is blinded/placebo-controlled in that way that I'd like it to be, since, for obvious reasons, it's extremely hard/maybe impossible to do that.

So, my impression is that it is potentially effective, but it's unknown whether that effectiveness is due to the details of EMDR, of whether just recalling and processing traumatic experiences in a safe environment is similarly effective.

I wouldn't characterize it as "woo" — I think it's just at a stage where it's not been studied enough to really know whether it's effective. But, basically every type of therapy starts out that way, so if you like the therapist and feel that it's helping you, I'd keep doing it.
posted by wesleyac at 6:45 PM on December 10, 2021 [1 favorite]

You might want to check out the book "The Body Keeps the Score". It's written by a psychiatrist who specializes in trauma. One part of the book focuses on the best treatments for trauma, and as I recall, there's a chapter that focuses on EMDR and is positive about its use. The book seemed to be rooted in sound science, though I admit I too have been skeptical of EMDR. I have seen a lot of people say they found it helpful, though I haven't pursued it (yet).

It sounds like so far this therapist has been a good fit for you. I'd encourage you to raise these concerns with your therapist.
posted by litera scripta manet at 6:49 PM on December 10, 2021 [10 favorites]

Yes, it works. Not for everyone but it does for many people -- and it did for me. I'm not sure where you're seeing it presented as a pseudo-science because there's plenty of evidence backing it up. Are you reading peer-reviewed scientific journals or focusing on personal narratives?

Part of living with trauma, whether more mild or complex, is that we often don't trust people with stuff like this because we have been abused or taken advantage of in the past. It took me a long time to trust my therapist who did EMDR but I'm so glad I did. Like you said, mine was the first one who I really felt got me -- it was devastating to get my official PTSD diagnosis but I trusted her and the science behind it that she explained. We took a few years to build trust but, a handful of years later, and I'm happier than I ever imagined possible. It took other changes and reflections in addition to the EMDR but it really was life changing. The fact that you focus on fuzzy memories is a big part of it; it's not about rehashing specifics but dealing with the body's subconscious response to those memories.

Your therapist should be willing to take time to build trust; a good trauma-specialized therapist knows that we need that and a questioning and/or initial rejection of an approach is not a rejection of her but rather our coming to terms with something. If I may be so bold as to project a bit of my own experience into what you've written: I had a childhood that was great in many ways but that doesn't negate the possibility and/or reality of trauma. It was very hard for me to accept this at first but I understand it better now and, as I said before, am doing better than ever.

In addition to or even more than the EMDR itself, having someone who understands me has been wonderful even if the talk therapy sessions -- which we did and still do now occasionally that the EMDR is done and after a break of a few years -- were initially so often painful after breaking through my walls of denial. If anything, you can always get a second opinion or ask her to explain the process to you more. A cool thing about EMDR is that it's focused on results, which you will probably feel within a few days or weeks even if the final good results take longer to notice. She can tell you how many sessions she expects you'll need, which may feel bogus but actually is a sign that she sees it as a means to an end versus, say, a way to gets lots of money from you for doing weird things. Finally, to borrow something my mom said this week, you have to believe in something to work. You don't actually have to believe that it absolutely will work -- none of us can predict 100% -- but you have to believe that it might work and decide for yourself to take that risk -- or not, which is OK too. I'm glad I did but there are many modalities for treating trauma out there and you have your entire life to explore them.
posted by smorgasbord at 6:52 PM on December 10, 2021 [21 favorites]

I also had a general miasma of suck, rather than a specific trauma incident, and I found EMDR very helpful. One of the things about it is you can work with a specific incident that can stand in for your overall issues and resolve it that way. I don't know why it works, but I thought that it really did. For some reason, EMDR used focusing on one thing as a way to contextualize and move past general trends, which was super helpful.

One reason it worked for me is that I had a therapist I liked and trusted to not make it weird. My therapist at the time was open to many ideas, but generally rational and had proved to me that she was legit in terms of being a real MFT and also being a good and helpful fit for me as a therapist. I'm not sure I would go to EMDR without a few sessions to build some trust in the practitioner first. I also wonder if it was just the right time for me to be doing that specific work, and it wouldn't have mattered if it were that or some other method.

I also found that I was surprisingly wiped out after an EMDR session-- in my case, I had to go sit in a cafe and very slowly eat a pastry while staring off into space for a while before I went home. YMMV but it was super weird that this seemed to be an essential part of the process for me. I kind of wonder if it has something to do with how an individual processes information-- like, it is very easy for me to hyperfocus or get into what I'd call a trance state, and I wonder if EMDR works on me because of that where it wouldn't work for someone else.
posted by blnkfrnk at 6:52 PM on December 10, 2021 [14 favorites]

My therapist did a few sessions of EDMR with me. I also feel deeply suspicious about it and can't really believe it could be effective, but...it seems to work for me?

I'm not sure if it was the EDMR process that actually worked as it's supposed to, or for some other reason, but the traumatic memory I was recounting stopped being frightening so quickly that I felt baffled and surprised.
I was sort of going along with the EDMR partly out of politeness, partly out of curiosity.
At first I was wondering whether I was doing it correctly, whether it would work, whether I was remembering in the "right" way.
Then I decided that there was no right way to do it and just to go with it.

My therapist kept checking in with me, and very early in the process, the memory started to feel like a normal memory rather than something that was still happening.
This happened so quickly that I felt baffled and surprised, and for some reason, as if I had made some kind of mistake.

Afterwards I was tempted to Google the process, but I decided that it would be better for me not to do that at the moment.
As another data point, I had just started taking an SSRI for the first time a few days before but I was still on such a low dose (2.5mg) that it's very unlikely that it had much effect. It certainly hadn't affected my anxiety and depression in any way at that point, or changed the way I experienced frightening memories outside of the EDMR experience.

My therapist has also done BRT with me, (Brain Recursive Therapy I think?) before I started on the meds. It's a very similar process to EDMR and it did seem to work as well, despite my doubt. I had a very similar experience, of the memory losing its power to upset me.

And it might be a coincidence, but I have begun to be able to change the behavior pattern that I seem to have developed as a result of the events in the memory the EDMR session was focused on.

I still feel deeply ambivalent about the whole thing. I have no idea whether it works as it's supposed to. But it did seem to be effective so who knows?
posted by Zumbador at 7:20 PM on December 10, 2021 [7 favorites]

One of the things about it is you can work with a specific incident that can stand in for your overall issues and resolve it that way.

Sorry, had to add, this was my experience as well. I'm sure that many people would not consider the memory I was working on particularly traumatic, although I found it deeply upsetting. It was from my early childhood.
posted by Zumbador at 7:27 PM on December 10, 2021 [1 favorite]

I did some EMDR for trauma (domestic violence). Like you, I was suspicious but ... it genuinely helped. It didn't solve everything, but it did genuinely help with the nervous system responses that were making things very difficult. Like, I never understood the real meaning of "triggering" (a word that has been overused and watered down) until I experienced it as a physical, nervous system response that my logical brain was not in control of. EMDR helped me not to have that response.
posted by pleasant_confusion at 7:28 PM on December 10, 2021 [4 favorites]

EMDR is an effective treatment for PTSD. However, the eye movement part may not be why it's effective.
posted by shadygrove at 7:31 PM on December 10, 2021 [8 favorites]

I've done it for about a year. I definitely see an improvement in how I feel, that is, things that bothered me before don't bother me nearly as much. One of the things I like about it is that doing a trauma narrative is not necessary for it to be effective. Memail me if you wish.
posted by Rumi'sLeftSock at 7:52 PM on December 10, 2021 [1 favorite]

My partner did EMDR with her clients for well over a decade, and traipsed off to seminars run by one or more originators of the technique whenever they came within a few hundred miles.

I thought the most persuasive theoretical justification for the somewhat paradoxical effectiveness of EMDR invoked the clear resemblances between voluntary therapist-directed eye movements of EMDR, and involuntary REMs of sleepers in the grip of a dream.

PTSD very often causes extremely upsetting nightmares, and it is a small step to wonder whether these nightmares are part of the psyche's strategy for coping with PTSD as well as an aspect of its pathology.

My partner told me that Bessel van der Kolk elaborated a view of EMDR based on this analogy when she came home from a seminar he led about 5 years after she first started using it.
posted by jamjam at 8:00 PM on December 10, 2021

Anecdotal, and may be old data, but a (very staunchly anti-woo) therapist of mine about 10 years ago told me that EMDR can be really effective in some PTSD cases, not because the eye movements are actually doing anything but because you end up going through the process of trauma recall and exposure with the help of a trained professional.

She referred to it as a "purple hat treatment": like, if your therapist is doing therapy with you while making you wear a purple hat, is the purple hat the reason you feel better afterward, or is it the therapy?
posted by DeadliestQuack at 8:04 PM on December 10, 2021 [7 favorites]

I did EMDR and it was effective for me, although my trauma was more on the mild side - lower-case “t” trauma as my friend called it, to try to get me to understand it was still trauma, when I told her I hadn’t been through trauma. (And she was right that it was). Can’t speak to anything beyond that anecdata, although I’ve heard good things.
posted by sillysally at 8:45 PM on December 10, 2021 [1 favorite]

I’ve done EMDR myself and subsequently got trained to provide EMDR. The way I explain it is it’s not about erasing traumatic memories, but changing the way you experience them. Before EMDR, if I was reminded of a target memory, I’d feel it in the pit of my stomach. After EMDR, when I think about the same memory, I remember how I felt at the time, but I don’t get that same active visceral feeling. It’s like the difference between remembering how much it sucked when I had norovirus and actually feeling nauseous just thinking about it .

That said, don’t do EMDR if you don’t want to, or don’t feel comfortable with it. I like it, but it’s not the only option, and you need to feel comfortable.
posted by theotherdurassister at 12:18 AM on December 11, 2021 [5 favorites]

I've read The Body Keeps the Score, and I felt that van der Volk was evangelizing and way overstating his case. The book has been very popular with a number of friends, but I have lived through too many therapeutic "perfect solutions" to buy into it. I looked him up and his behavior has not been good. However, my friends who have done EMDR have liked it and felt it was useful. Since I"ve also had friends/family who swore by everything from CBT to full Freudian analysis, YMMV.
posted by Peach at 1:15 AM on December 11, 2021 [2 favorites]

I thought it sounded extremely woo but figured it wouldn't hurt/wouldn't make things worse even if I didn't believe in it. It worked. I was treating a discrete traumatic event and that's what I was told it is good for, as opposed to more generalized difficulties (and I can confirm that it ONLY worked for the trauma for which we did EMDR). I did about two years of weekly talk therapy to deal with more generalized childhood stuff and I was astonished at how fast EMDR worked, maybe 2-3 sessions, but I don't think it would have been a shortcut for those other years of therapy (my traumatic event happened about five years after that other stint of therapy and with a different therapist in a different state). My experience was like theotherdurassister; I went from hardly being able to touch the memory of my experience, much less talk about it, to being able to remember it without the fear and panic associated with it. I can share it publicly without batting an eye now. It didn't dull or taint the memory but actually made it accessible to me for processing. I wonder if it's the haziness of your childhood memories that is making your therapist suggest EMDR.

If you've found a therapist you connect with, I suggest talking about EMDR more with them. Discussing your comfort level with therapies of any kind is a part of doing therapy.
posted by peanut_mcgillicuty at 2:19 AM on December 11, 2021 [2 favorites]

I tried it for an insect phobia. One session, billed as curing phobias completely. Very snake oil, but other approaches have not worked, and this phobia limits my life to a frustrating degree.

It worked in part.

A key part of the process is visualising the frightening / traumatic thing. In this case, I was told ideally I would imagine the incident that triggered the phobia, and if not that, then the earliest phobic event I could remember. Two problems here. First, the triggering incident happened before I was two years old, and I have no conscious memory of it, while subsequent incidents mostly just blur together into a lifetime of terror. Second, my visual imagination is limited and completely static. I can't replay a memory like a video.

So I did the best I could, remembered a specific occasion when I'd found one of the insects in my house, tried to picture the scenario. And what I found afterwards was that seeing the insect sitting still was completely fine. Oh look, an insect. Amazing! Huge improvement! But seeing it moving? AHHH HELP IT'S AN *INSECT*! Phobia triggered. Hearing it buzz, same thing; I'd forgotten to mention that the sound was a trigger in its own right, or to think about it in the session.

So my take is that it does work, but it's only as good as your imagination.
posted by ManyLeggedCreature at 2:23 AM on December 11, 2021 [1 favorite]

I've tried it a little. What I found is that it made emotions and images come to the surface in a way that I'm normally very good at repressing, but within a container that generally felt comforting and safe to do so. Well, sometimes I didn't want to release all those emotions because I didn't really like that therapist. Still it was very helpful.
posted by slidell at 5:49 AM on December 11, 2021

I had about 10 EMDR sessions that helped me with trauma-based anxiety and extremely disturbing recurring nightmares. This was over twenty years ago and I have not had a recurrence of those particular issues.

I don’t think it works for everyone. For me, it started helping immediately and I am very grateful to my therapist for her help.
posted by hilaryjade at 5:50 AM on December 11, 2021 [2 favorites]

I just had my second session of actually doing EMDR and it’s working very well for me. I am a very overcognating person, and after 18 months of talk therapy needed another modality to help me *feel* and bring out emotions rather than let myself analyze myself to death. I do not have any major trauma, just the constant micro-traumas of being a neurodiverse person in a world not built to help me thrive.
posted by emkelley at 6:49 AM on December 11, 2021 [4 favorites]

I have done four sessions recently with my long-time therapist. She first suggested it a few years back but I was hesitant because it sounded implausible and I wasn’t really ready to face the events I needed to process. Now that I am doing it, of my own initiative, I think it’s helping a lot.

After the first session I felt calm at the end of it and then suddenly really, really sad and depressed for about a day. After the subsequent sessions I felt better.

I think the way it works is that it helps us reprocess memories so that when we think of traumatic events we are remembering them rather than reliving them. It also helps you get unstuck if those memories are the basis of a negative belief you have about yourself. I still feel the same bad feelings about those past events, but I now feel that I can move forward in a healthier way.
posted by mai at 7:55 AM on December 11, 2021

It has worked surprisingly well - we were fairly skeptical - for someone in my life, also a general crappy childhood situation.

I'm here to anti-recommend The Body Keeps The Score for some fairly self-serving science and content I found traumatic in and of itself, but I enthusiastically recommend Complex PTSD: From Surviving to Thriving and, if applicable, Adult Children of Emotionally Immature Parents: How to Heal from Distant, Rejecting, or Self-Involved Parents.
posted by Lyn Never at 10:08 AM on December 11, 2021 [7 favorites]

I'm a therapist trained in EMDR. I haven't been trained/using it for that long, but I have done it with maybe 10 clients, and it was helpful for all but one. I have also tried it for myself, and found it to be really effective. Several clients seemed hesitant and surprised when it was effective. Part of any modality being helpful is not just the modality itself, but the client's comfort level in doing it, as well as the rapport with the therapist and the therapist's skill level. Some people do not really feel ready or have a "part" that is blocking them (See Internal Family Systems theory for more info on parts)

Also, EMDR can be eye movements, but it can also be butterfly tapping or alternate tapping on legs, or alternating vibrating "buzzers"- the idea is for it to be bilateral stimulation.

As far as "why it works", there are a lot of theories and not necessarily a clear answer. I think that the bilateral stimulation helps the person stay with and feel and visualize the traumatic memory rather then getting too cognitive and distant as things can be in talk therapy. This causes people to make connections and have insights that are different than in just talk therapy , in my experience. A lot of times in talk therapy, people talk around a traumatic memory or distance themselves from it by intellectualizing it, and therefore the emotions are not being processed through. The EMDR/bilateral stimulation helps one stay with the emotions and memory, and process it through more thoroughly. At least in my experience/view.
posted by bearette at 10:26 AM on December 11, 2021 [5 favorites]

I did the version of EMDR with buzzers after a long time of talk therapy. My therapist suggested it as a supplement to regular therapy. We did several sessions of EMDR to tackle one specific issue and it was super helpful even though it totally sounds like woo to me.
posted by Bella Donna at 11:50 AM on December 11, 2021

This previous question might be helpful, particularly quiet coyote’s answer, the longer comment she links to there, and the research links in her profile.
posted by daisyace at 12:34 PM on December 11, 2021 [4 favorites]

For me, it's been very good. And I was skeptical as hell. I can't say for sure if the particular therapy is more "helpful" than other types, as I'd not explored this particular trauma with other therapies. It was honestly very hard for me to even talk about, much less try to lessen the feelings of. HOWEVER I will say the EMDR sessions gave me a safe space to talk about the trauma that I'd experienced, without shame, without judgement.

Feel free to memail me.
posted by Pretty Good Talker at 1:44 PM on December 11, 2021 [1 favorite]

I did EMDR and it was a breakthrough for me in a way regular therapy and meds had not been. Part of that is in talk therapy I talk, like it says on the tin. But talking is a defense mechanism of mine against actually feeling something, and so I could (with effort) talk about the trauma* and feel wrecked but the flashbacks wouldn't stop.

The way I think about it is that EMDR helped me put those memories into my memory - they were not sitting in my brain ready to run the whole flashback at any time they got triggered. There was an imagination component (the big chest of drawers filled with glass bottles of emotion vs shoving them haphazardly into a box and kicking it into an abyss) that we used, and I did art around that bit, but primarily going through the whole memory while still present, still in my body, helped make it into a memory not a flashback.

Now I do have a high enough disassociative score that we did a LOT of the prep for EMDR. More sessions of that than actual eye movement stuff. Apparently I score high enough to warn for disassociative disorders. So we spent hours on preparation, the imagining safe spaces and words associated with those, and so on.

Now I still do occasionally have a Bad Time, but it is far less disruptive. I need to do a triggery thing, or something happens, and I have a response. But it's not as bad. Not as firmly tied to my physiology or my brain and I don't re-live the memory the way I used to.

It was exhausting though. Several times I cried enough to feel ill. Mostly I just felt tired and empty. So setting up a nice safe space at home to go to after was important for me. A list of good things so I didn't have to try decide what to do or what to eat.

It also helped beyond the specific memories I went over - it became easier to recognise when a memory was making me re-experience vs feel bad or sad, and shift it. It almost feels like physically rerouting things in my brain (which is something I tend to use as an analogy for thought patterns anyway).

That said, working out how to be a person who isn't in a constant high state of anxiety is difficult. I'd used it to fuel everything from work to chores. But I'm not stuck re-experiencing horrible things because I put a mask on, so that's worth it.

*Primarily one Big Trauma but there were a number of others from childhood.
posted by geek anachronism at 2:57 PM on December 11, 2021 [4 favorites]

The way it was explained to me, distracting yourself with hand waving, tapping, etc while recalling distressing memories reduces the severity of the recalled memory as you are forced to split focus. A scary movie watched while you’re distracted doing something else is less scary.
posted by Geckwoistmeinauto at 4:16 PM on December 11, 2021 [1 favorite]

EMDR is now the go-to, approved treatment for PSTD by none other than the Department of Defense. It's considered legit by many therapists. Studies include MRIs showing brain activity changes before and after EMDR treatment. I'm doing it for past trauma and it's working for me.

It doesn't erase a memory. Treatment helps to move the memory from where it's currently stored and highly charged to the correct place in your brain where it's not as reactive. This helps with flashbacks, phobias, and intrusive thoughts.

I'm a huge fan. Hope it works for you.
posted by Ink-stained wretch at 6:01 PM on December 11, 2021 [2 favorites]

I’ve been doing it and I think this is a YMMV thing. I’ve definitely found it useful, but it’s been a less linear process than I was expecting. It hasn’t been a magic bullet for me as I hoped - more of a “mind expansive” experience. I would say keep an open mind and give it a go for a handful of sessions before you say yay or nay. I will say I could not do it with a therapist I don’t trust and feel comfortable with.
posted by cultureclash82 at 6:02 PM on December 11, 2021 [1 favorite]

Mod note: This is a followup from the asker:

Everyone in the thread has been so open and informative, it's been VERY helpful for me, and I'm going to move forward with my therapist's suggestion. I'd really like to say thank you to everyone who shared their thoughts/experiences with me.

posted by cortex (staff) at 8:03 PM on December 11, 2021 [8 favorites]

It sounds deeply woo to me too but a friend had such a specific story of a good result with it I'm about to try it myself.
posted by less-of-course at 9:50 AM on December 12, 2021

I tried it and it was completely ineffective. There's not much actual scientific evidence it does anything, and also most therapists doing it aren't doing it correctly.
posted by Violet Hour at 4:49 PM on December 12, 2021 [1 favorite]

Last summer I dipped my toes in EMDR and did a few self administered eye movement exercises (from youtube, but I also read few books) and oh boy I was like a crying machine for several days after just doing a few minutes on my back moving my eyes. I just cried and sometimes I knew why but mostly I didn't even have a story I was telling myself about why I was crying. Should I point out that I had no idea this was going to happen. I was thinking of gifting myself a few sessions with a licensed emdr therapist for christmas.

The exercises are so simple, it's just so easy to scoff at it.... I mean, I scoffed. I'm open minded just enough to try stuff, no more. But the premise that there's this residual/stored trauma in the body unreleased and that it can be released, again, I scoff but pooof, I find it true.

On a side note, I dislocated my knee a few weeks back and for the first 20 minutes of shock I was like shaking and a few days later I was reading some random kindle book (Feel To Heal) about breath work and releasing stored trauma and the author mentioned how the body will shake after a trauma to release/burn off all the adrenaline and stuff it produced in the first seconds of the experience. I think my point is that the body does things that are necessary/good and yet seem very unsophisticated, very simple.

I've read that ETF Tapping is known to be more effective.
posted by BeeLIC at 7:32 AM on December 13, 2021 [2 favorites]