Mental Health

Eye movement desensitisation and reprocessing therapy (EMDR) is a treatment that’s gaining traction in South Africa. It has been proven to be highly effective in assisting people to overcome severe trauma.

Both the World Health Organization (WHO) and American Psychological Association recommend EMDR for people believed to be suffering from post-traumatic stress disorder (PTSD), says Dr Philip van Rensburg, a clinical psychologist at Mediclinic Denmar Mental Health Services. EMDR, first developed more than 30 years ago, is a type of therapy that assists people to process traumatic experiences and has been shown to be helpful in treating a range of psychological conditions.

During an EMDR session, the therapist guides the patient to recall distressing memories while moving a pen, their finger, or another object from side to side. This is known as bilateral stimulation, a process that helps desensitise the emotional impact of the trauma. The individual is then guided to help them reprocess the memories in a healthier way. 

Different approach to trauma

Although methodologies like cognitive behavioural therapy (CBT) and psychotherapy have long been considered the best way to help people assimilate trauma, Dr Van Rensburg maintains that the opposite is true: the more you think about a particular memory, which traditional therapy encourages you to do, the stronger that memory becomes.

“Because your brain is neuroplastic [able to change and reorganize its structure and connections in response to experience], you constantly form new neural pathways, based on where you invest your energy,” Dr Van Rensburg explains. “If you replay a memory in your head, you’re strengthening the pathways to that memory – despite the fact that your intention is, in fact, the opposite.”

Understanding trauma and PTSD

Increasingly, the EMDR process is used for conditions besides PTSD, including anxiety, depression, grief, performance anxiety and complicated grief. However, it’s especially effective for PTSD because many people experience this condition like a movie running on a loop.

“PTSD occurs when you’re exposed to something that is beyond what an ordinary individual can be expected to bear,” says Dr Van Rensburg. “The brain responds by going into shock, and you may experience symptoms like an exaggerated startle response to sudden sounds and movements, sleep disturbances and changes to your appetite. Effectively, your body shuts down. It is essential to address the issue causing these responses because, if left untreated, the resulting anxiety may present in other forms, possibly even leading to relationship and career problems or addiction.”

The 8 steps of EMDR

EMDR prevents the side-effects of PTSD by ensuring that the memory is processed differently, so that it falls into the category of any other recollection. It’s a lengthy procedure that must be conducted by an experienced and qualified professional. Dr Van Rensburg explains that EMDR comprises eight steps:

  1. The therapist takes the client’s history.
  2. They explain the process to the client and help them relax.
  3. They help the client to target the traumatic memory.
  4. Desensitisation phase – using bilateral stimulation, the therapist guides the client to recall, feel, and process the memory.
  5. Installation – therapist helps the client replace negative thoughts associated with the trauma with positive and adaptive beliefs.
  6. Body scan – the client is asked to focus on any leftover physical tension or discomfort related to the memory. Bilateral stimulation is again used to release these.
  7. Closure – therapist checks client is stable and calm and reinforces coping strategies to manage any distress between sessions.
  8. Re-evaluation – in subsequent sessions they review progress, reassess responses, and address remaining issues or related memories.

How bilateral stimulation works

The key part of the therapeutic process is when the therapist rapidly moves their finger or another object from side to side. This bilateral movement is designed to stimulate the patient’s eye movement, which in turn stimulates first one side of the brain and then the other. This is what helps the patient reprocess the memory, rendering it harmless by “filing” it away in the part of the brain that stores other, less upsetting memories. Eventually, the memory is normalised and loses its power. Dr Van Rensburg says the same effect can be achieved by rapidly tapping the patient’s left hand, then their right; or by stimulating an aural response via headphones.

Essentially, EMDR breaks the cycle of trauma by allowing the difficult and upsetting memory to fade. This makes it an effective and long-lasting solution to a condition that can have a profoundly negative impact on an individual’s life.

Disclaimer: The information provided in this article was correct at the time of publishing. At Mediclinic we endeavour to provide our patients and readers with accurate and reliable information, which is why we continually review and update our content. However, due to the dynamic nature of clinical information and medicine, some information may from time to time become outdated prior to revision.