Eye movement desensitization and reprocessing therapy and related treatments for trauma: An innovative, integrative trauma treatment.

Eye movement desensitization and reprocessing (EMDR) therapy is a very useful and innovative evidence-based treatment for posttraumatic stress disorder (PTSD), complex trauma, dissociative disorders, and many other conditions. It has received a strong recommendation in all of the recently published treatment guidelines for PTSD, with the exception of the American Psychological Association, Guideline Development Panel for the Treatment of PTSD in Adults (2017), which gave it a conditional recommendation, largely due to the limited research reviewed. This article describes the development of EMDR therapy and its method, outlines its 8-stage protocol, provides an overview of literature on the topic and research that supports its efficacy, and describes various clinical offshoots utilizing bilateral stimulation. EMDR therapy is an integrative treatment that incorporates methods from other treatment modalities while focusing on a number of elements involved in the traumatic response—such as emotions, cognitions, and somatosensory responses. EMDR therapy directs the client to imagine elements of the trauma memory while engaging in saccadic (back and forth) eye movements (or other bilateral stimuli) to create a condition of dual-awareness that assists in the processing of the traumatic material. It follows an 8-stage protocol starting with engagement in treatment and assessment of the client and the trauma memory, to processing of the trauma with bilateral stimulation conducted in sets, to evaluation of the ratings of positive and negative cognitions and somatosensory scanning until they are reported by the client to be “cleared” (i.e., resolved, with no residual distress). EMDR therapy is now often used in integrative ways with other therapies (relational psychoanalysis, ego state therapy, somatic therapies). Several of EMDR’s better known and more frequently practiced offshoots, include brainspotting (Grand, 2013) and life span integration (Pace, 2003) are discussed.