What Is Eye Movement Desensitization and Reprocessing (EMDR) Therapy?
Eye Movement Desensitization and Reprocessing (EMDR) therapy has emerged as a powerful intervention for treating trauma-related conditions since its development in the late 1980s. As with any therapeutic approach, questions about potential side effects and risks naturally arise. Understanding the relationship between EMDR and depression is crucial for both clinicians and clients considering this treatment option. While EMDR therapy is generally regarded as safe and effective, responsible clinical practice demands a thorough examination and disclosure of potential outcomes, including adverse effects.
EMDR therapy, while effective for treating trauma and PTSD, can have side effects along the healing process. Some of these symptoms may include temporary emotional distress, heightened anxiety, vivid dreams, fatigue, dizziness, and memory disruptions. Processing traumatic memories may intensify emotions like sadness or anxiety, sometimes worsening depressive symptoms. Some individuals experience nightmares or physical symptoms, like exhaustion or muscle tension, after sessions. These effects are usually short-term, lasting a few hours to a few days, and most people improve with continued therapy. However, those with major depressive disorder or those experiencing symptoms of increasingly negative emotions should maintain open communication with their EMDR therapist to monitor their emotional well-being and to receive additional resources if needed.
To learn more about EMDR therapy and if it is a good fit for your healing journey, contact Balanced Mind of New York for a free, 15-minute consultation.
Understanding EMDR Therapy
EMDR therapy is a structured, eight-phase approach that combines elements of cognitive-behavioral therapy with bilateral stimulation, typically in the form of guided eye movements. EMDR works on the premise that traumatic memories may be stored differently in the brain than ordinary memories, creating ongoing distress and other trauma responses when triggered. The therapy aims to help patients process these memories by simultaneously focusing on the traumatic memory while engaging in bilateral stimulation, which appears to facilitate the brain’s natural healing mechanisms.
Initially developed for Post-Traumatic Stress Disorder (PTSD), EMDR treatment has since been applied to other mental health issues, including anxiety disorders, panic attacks, phobias, and grief. The therapy has garnered substantial empirical support, with numerous randomized controlled trials demonstrating its effectiveness for trauma-related conditions. Organizations including the American Psychological Association, the World Health Organization, and the Department of Veterans Affairs recognize EMDR as an evidence-based treatment for PTSD.
What Is the Relationship Between EMDR and Depression?
Current research does not support the conclusion that EMDR therapy directly causes clinical depression. While individuals may experience temporary emotional distress during the processing phases of EMDR therapy, this represents a normal part of working through traumatic material rather than the onset of a depressive disorder. Several meta-analyses examining EMDR outcomes have actually found reductions in depressive symptoms following successful treatment, particularly in cases where depression co-occurred with PTSD or other trauma-related conditions.
The emotional discomfort that can arise during the healing process of EMDR is typically time-limited and represents the activation of traumatic memories undergoing reprocessing. This differs fundamentally from major depressive disorder, which involves persistent changes in mood, cognition, and biological functions over extended periods.
It’s worth noting that unresolved trauma is itself a risk factor for depressive disorders, and by addressing the underlying trauma, EMDR may actually reduce depressive symptoms in many patients. However, individual responses to therapy vary significantly, and some patients with complex trauma histories or pre-existing mood disorders may require additional support to manage the intense emotions that sometimes arise during the course of this trauma reprocessing therapy.
What Does a Typical EMDR Session Entail?
A typical Eye Movement Desensitization and Reprocessing (EMDR) session follows an eight-phase structured approach designed to help individuals process and heal from traumatic experiences. EMDR sessions typically last 45-60 minutes, and the number of sessions required varies based on individual needs. Here’s what an EMDR session generally entails:
History Taking & Treatment Planning:
The therapist gathers information about the client’s history, identifies target memories for processing, and assesses readiness for EMDR.
Preparation:
The EMDR journey begins with the therapist explaining EMDR, establishing trust, and teaching coping skills (e.g., deep breathing) to manage emotional responses that may arise during this trauma healing work.
Assessment:
The client identifies a specific traumatic memory, including the associated image, emotions, physical sensations, and negative self-talk or negative beliefs about themselves. A preferred positive belief is also identified.
Desensitization:
The therapist guides the client through bilateral stimulation (usually eye movements, tapping, or auditory tones) while they focus on the painful memory. This helps the brain reprocess the trauma, reducing the intensity of difficult emotions.
Installation:
During this phase of the EMDR session, the client strengthens a positive belief to replace the old negative belief related to the memory.
Body Scan:
The therapist checks for residual physical tension or distress related to the memory and continues processing if needed.
Closure:
The therapist ensures the client feels stable before ending the EMDR session, using relaxation techniques and discussing coping skills for continued use throughout the healing process.
Reevaluation:
In the next EMDR session, the therapist assesses progress, ensuring the memory has been fully processed and identifying any remaining distress.
What Are Potential Risk Factors for Developing Depressive Symptoms During EMDR Treatment?
Several factors may increase the likelihood of negative mood responses during EMDR therapy, though these should not be confused with causing clinical depression. Patients with pre-existing depressive disorders may temporarily feel worse during the processing phases of EMDR as traumatic material is activated. This highlights the importance of comprehensive pre-treatment assessment and careful treatment planning.
Improper administration of EMDR by inadequately trained therapists represents another significant risk factor. EMDR therapy sessions involve a complex therapeutic protocol requiring specialized training and supervision. Deviations from established protocols may leave patients emotionally vulnerable without proper containment strategies. Choosing a compassionate, highly-trained EMDR therapist, such as those at Balanced Mind of New York, is an essential step in your healing journey.
Additionally, insufficient therapeutic support between sessions can contribute to difficulties managing the emotions that arise during processing. EMDR therapy can trigger big emotions or uncomfortable physical sensations that may continue to unfold between therapy sessions, and patients need appropriate coping strategies and access to support during these periods.
Perhaps most concerning is premature termination of EMDR therapy, which may leave traumatic material partially processed and trauma work unfinished. When therapy ends before adequate resolution and integration of traumatic memories, patients may be left with activated emotional responses without the therapeutic context needed for completion of processing, potentially contributing to mood deterioration.
Preventing Depressive Symptoms from EMDR Therapy
Professional organizations providing EMDR training emphasize specific guidelines for managing emotional reactions during treatment. These include careful patient preparation, establishing safety and stabilization before trauma processing begins, and techniques for containing intense emotions when necessary. Ethical EMDR therapists monitor for signs of depression throughout the course of treatment, using standardized assessment tools at regular intervals and clinical observation during sessions. Therapists are trained to distinguish between the temporary emotional activation that accompanies productive processing and signs of clinical depressive disorders that require additional intervention.
Clients may adopt self-care routines between EMDR sessions that prioritize rest, nutrition, healthy relationships, and gentle physical activity. These self-care exercises can manage feelings of anxiety or sadness, allow space for continued processing of the target memories, and foster a stronger sense of self-reliance, leading to more adaptive engagement with life and all of its joyful offerings.
How Do I Pay for My EMDR Therapy?
At Balanced Mind of New York, we offer multiple payment options to fit your needs and budget.
In-Network Insurance Provider:
Balanced Mind is proud to be an in-network provider for clients covered by Aetna insurance plans.
Out-of-Network Insurance Provider:
For all other insurances, we provide superbills for reimbursement. We will contact your insurance company to confirm your eligibility and benefits, including the reimbursement rate for each session. We will also guide you through the process of sending superbills to your insurance.
If you have an out-of-network plan, any reimbursements will be sent directly to you from your insurance provider. Insurance typically reimburses 50-80% of the fee, but note that each policy is different.
Self-Payment Options:
If no insurance coverage is available, clients may choose to pay for services out of their own pocket. If you need to pay out of pocket, we offer a sliding scale as part of our commitment to providing affordable care.
We accept Visa, MasterCard, Discover, American Express, and HSA/FSA cards.
Contact Us to Learn More About EMDR Therapy
To learn more about EMDR, please contact Balanced Mind of New York to schedule an appointment.
