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| title | chunk | source | category | tags | date_saved | instance |
|---|---|---|---|---|---|---|
| Eye movement desensitization and reprocessing | 1/2 | https://en.wikipedia.org/wiki/Eye_movement_desensitization_and_reprocessing | reference | science, encyclopedia | 2026-05-05T09:19:40.858329+00:00 | kb-cron |
Eye movement desensitization and reprocessing (EMDR) is a form of psychotherapy designed to treat post-traumatic stress disorder (PTSD). It was devised by Francine Shapiro in 1987. EMDR involves talking about traumatic memories while engaging in side-to-side eye movements or other forms of bilateral stimulation. It is also used for some other psychological conditions. EMDR is recommended for the treatment of PTSD by various government and medical bodies citing varying levels of evidence, including the World Health Organization, the UK National Institute for Health and Care Excellence, the Australian National Health and Medical Research Council, and the US Departments of Veterans Affairs and Defense. The American Psychological Association does not endorse EMDR as a first-line treatment, but indicates that it is probably effective for treating adult PTSD. Systematic analyses published since 2013 generally indicate that EMDR treatment efficacy for adults with PTSD is equivalent to trauma-focused cognitive and behavioral therapies (TF-CBT), such as prolonged exposure therapy (PE) and cognitive processing therapy (CPT). However, bilateral stimulation does not substantially contribute to treatment effectiveness, if at all. The predominant therapeutic factors in EMDR and TF-CBT are exposure and various components of cognitive-behavioral therapy. Because eye movements and other bilateral stimulation techniques do not uniquely contribute to EMDR treatment efficacy, EMDR has been characterized as a purple hat therapy, i.e., its effectiveness is due to the same therapeutic methods found in other evidence-based psychotherapies for PTSD, namely exposure therapy and CBT techniques, without any contribution from its distinctive add-ons.
== History == EMDR was invented by Francine Shapiro in 1987. In a workshop, Shapiro related how the idea of the therapy came to her while she was taking a walk in the woods, and discerned she had been able to cope better with disturbing thoughts when also experiencing saccadic eye movements. Psychologist Gerald Rosen has expressed doubt about this description, saying that people are normally not aware of this type of eye movement.
== Technique == EMDR is typically undertaken in a series of sessions with a trained therapist. The number of sessions can vary depending on the progress made. A typical EMDR therapy session lasts from 60 to 90 minutes. The person being treated is asked to recall an image, phrase, and emotion that represent a level of distress related to a trigger while generating one of several types of bilateral sensory input, such as side-to-side eye movements or hand tapping. The 2013 World Health Organization practice guideline says that "Like cognitive behavioral therapy (CBT) with a trauma focus, EMDR aims to reduce subjective distress and strengthen adaptive beliefs related to the traumatic event. Unlike CBT with a trauma focus, EMDR does not involve (a) detailed descriptions of the event, (b) direct challenging of beliefs, (c) extended exposure or (d) homework."
== Possible mechanisms ==
=== Incomplete processing of experiences in trauma === Many proposals of EMDR efficacy assume, as Shapiro posited, that when a traumatic or very negative event occurs, the information processing of the experience in memory may be incomplete. The trauma disrupts normal adaptive information processing, leading to unprocessed information being dysfunctionally retained in memory networks. According to the 2013 World Health Organization practice guideline: "This therapy [EMDR] is based on the idea that negative thoughts, feelings and behaviours are the result of unprocessed memories." This proposed mechanism has no known scientific basis.
=== Other mechanisms === Several other possible mechanisms have been proposed:
EMDR may affect working memory. If a patient performs a bilateral stimulation task while remembering the trauma, the amount of information they can recall is thought to be reduced, making the resulting negative emotions less intense and more bearable. This is seen by Robin Logie of the EMDR Association UK and Ireland as a "distancing effect". The client is then believed to re-evaluate the trauma and process it in a less-harmful environment. This explanation is plausible, given research showing that memories are more modifiable once recalled. Horizontal eye movement is thought to trigger an "orienting response" in the brain, used in scanning the environment for threats and opportunities. The idea that eye movement prompts communication between the two sides of the brain. This idea is not grounded in accepted neuroscience.
=== Bilateral stimulation, including eye movement === Bilateral stimulation is a generalization of the left- and right-repetitive eye movement technique first used by Shapiro. Alternative stimuli include auditory stimuli alternating between left- and right-sided speakers or headphones, and physical stimuli such as the therapist's hand tapping or tapping devices. Most meta-analyses have found that including bilateral eye movements in EMDR makes little or no difference to its effect. Meta-analyses have also described a high risk of allegiance bias in EMDR studies. One 2013 meta-analysis with fewer exclusion criteria found a moderate effect.
== Research ==
=== Effectiveness === EMDR has been found to be as effective as other psychological interventions for treating PTSD, with no evidence of added benefit derived from eye movement. Men are more likely to drop out of an EMDR program that women. A 2023 Cochrane systematic review analyzed psychosocial interventions for survivors of rape and sexual assault experienced during adulthood and concluded that EMDR is a "first-line treatment" for PTSD along with other trauma-focused psychotherapies, such as Cognitive Processing Therapy and Prolonged Exposure.
=== Client experience === A 2021 systematic review of 13 studies found that clients had mixed perceptions of the effectiveness of EMDR therapy.
=== Treating conditions other than PTSD === EMDR has been tested on a variety of other mental health conditions with mixed results.