Eye Movement Desensitization and Reprocessing (EMDR) is a structured psychotherapy initially designed to address the distress associated with traumatic memories. While known for its effectiveness in treating Post-Traumatic Stress Disorder (PTSD), EMDR’s application has expanded significantly. Researchers are now exploring its effectiveness for various forms of anxiety disorder, which often share underlying mechanisms with trauma.
Understanding EMDR’s Core Mechanism
EMDR operates based on the Adaptive Information Processing (AIP) model. This model suggests that psychological distress arises from past disturbing experiences that were not fully processed and are dysfunctionally stored in memory networks. These “unprocessed” memories retain negative emotions, beliefs, and physical sensations, influencing current responses and leading to symptoms like anxiety. EMDR aims to facilitate the brain’s innate capacity to process and integrate these memories.
The mechanism uses bilateral stimulation, typically involving the patient following the therapist’s hand movements with their eyes, or using alternating auditory tones or tactile tapping. This side-to-side stimulation is thought to activate the brain’s information processing system. Conceptually, this mimics the mental activity that occurs naturally during Rapid Eye Movement (REM) sleep, where the brain processes and consolidates memories. Bilateral stimulation may help unblock the system where disturbing memories are “stuck.”
This dual attention—focusing on the distressing memory while simultaneously engaging in bilateral stimulation—allows the memory to be reprocessed. The goal is to transform the memory so it is stored in a more adaptive, less distressing way, not to erase it. Once processed, the memory is recalled without the intense emotional charge, negative self-belief, or physiological arousal that previously accompanied it. This results in relief from related anxiety symptoms.
Clinical Evidence for Anxiety Treatment
Research suggests EMDR is an effective therapeutic tool for reducing symptoms across a spectrum of anxiety disorders, especially when anxiety stems from identifiable traumatic or highly stressful life events. Meta-analyses of randomized controlled trials indicate that EMDR significantly reduces general anxiety, panic symptoms, and phobia-related behavioral and somatic symptoms.
Evidence is accumulating for specific anxiety disorders, particularly Panic Disorder and phobias. Studies on Panic Disorder, with and without agoraphobia, show that reprocessing past traumas can significantly reduce panic attacks and avoidance behaviors. EMDR has also shown positive outcomes for specific phobias, especially those with a clear traumatic origin, such as a fear of dogs following a bite.
Research on Generalized Anxiety Disorder (GAD) and social anxiety is less extensive but promising. Preliminary studies targeting experiential contributors to GAD, such as past events and worry triggers, have reported reductions in pathological worry and anxiety scores. For social anxiety, case studies and clinical trials suggest EMDR can effectively address the negative self-beliefs and underlying memories that fuel social fears. While Cognitive Behavioral Therapy (CBT) is often considered a first-line treatment for anxiety, EMDR is recognized by several major health organizations as an evidence-based approach for trauma-related anxiety.
The Eight Phases of EMDR Therapy
EMDR is a highly structured intervention that follows a comprehensive eight-phase protocol, ensuring a systematic and safe approach to reprocessing.
The eight phases are:
- History-taking: The therapist assesses the client’s history and develops a specific treatment plan, identifying the target memories, current triggers, and future goals.
- Preparation: The therapist teaches the client coping skills and grounding techniques to manage emotional distress that may arise during later reprocessing.
- Assessment: The specific target memory is activated, along with the associated negative belief, the desired positive belief, and the emotional and physical sensations.
- Desensitization: This uses bilateral stimulation while the client focuses on the memory until the emotional distress is significantly reduced.
- Installation: This strengthens the positive belief by pairing it with bilateral stimulation until the client feels the belief is completely true.
- Body Scan: This checks for any lingering physical tension or discomfort related to the memory, which is then also processed using bilateral stimulation.
- Closure: This ensures the client leaves the session feeling grounded and safe.
- Reevaluation: This starts each subsequent session to check the stability of the treatment gains and determine the next memory to target.
Setting Expectations and Finding a Qualified Practitioner
The duration of EMDR treatment for anxiety often differs from traditional, long-term talk therapy, frequently requiring only a limited number of sessions to achieve significant relief. For less complex issues, a course of treatment may involve between six to twelve sessions. Individuals with more complex or long-standing anxiety may need additional time. Sessions typically last between 60 and 90 minutes.
Patients should anticipate that the initial reprocessing sessions may lead to a temporary increase in emotional distress as the disturbing memories are brought to the surface. This is a normal part of the processing but highlights the importance of the preparation phase and the grounding techniques learned. Finding a practitioner who is properly trained and certified is paramount for safety and effectiveness.
It is advisable to seek a therapist who has completed EMDR Basic Training and is certified by an organization such as the EMDR International Association (EMDRIA). These certifications ensure the practitioner has met rigorous training and consultation requirements, demonstrating the necessary expertise to administer the full, eight-phase protocol effectively. A qualified therapist will also have experience specifically treating anxiety disorders with EMDR.