Considering EMDR in psychotherapy
Starting psychotherapy is an important decision. Learning about the different therapeutic options available can help you choose the one that best suits your needs.
In a few words
EMDR is a recognized psychotherapeutic approach, particularly used when difficult past experiences continue to influence emotional, psychological or relational well-being in the present (Institut National de Santé Publique du Quebec [INSPQ], 2022; Canadian Agency for Drugs and Technologies in Health [CADTH], 2018; Canadian Psychological Association [CPA], 2019).
Who is EMDR primarily intended for?
EMDR is most often offered to people with symptoms associated with psychological trauma, particularly in the context of post-traumatic stress disorder (PTSD), but also when past experiences contribute to anxiety, relationship difficulties or a negative self-image (Institut universitaire en santé mentale de Montréal, 2020; Courtois & Ford, 2016/2019).
Why do some adverse experiences continue
to have an impact?
Research in the psychology of trauma shows that certain events can overwhelm normal coping capacities and disrupt information processing and emotional regulation mechanisms (INSPQ, 2022; McFarlane & Yehuda, 2017). This can lead to persistent reactions of stress, hypervigilance, intrusive memories, intense emotions, or a lasting sense of insecurity, even after the event has ended (Center of Expertise on Traumatic Stress, 2021; American Psychiatric Association, 2022).
Trauma-focused approaches, including EMDR, therefore aim precisely to work on these psychological traces in order to reduce their influence in current life (CADTH, 2018; CPA, 2019).
How does EMDR therapy work?
EMDR is based on a structured protocol comprising several phases, including assessment, preparation, memory reprocessing, and integration (Shapiro, 2018; EMDR Canada, 2023). During sessions, attention is focused on a distressing memory and combined with alternating bilateral stimulation, such as eye movements. This stimulation facilitates a change in how the experience is stored and felt, promoting a gradual reduction of distress (Institut universitaire en santé mentale de Montréal, 2020; Landin-Romero et al., 2018).
Effects, limitations and precautions
Like any psychotherapy addressing emotionally charged experiences, EMDR can be accompanied by transient reactions such as increased fatigue, more intense dreams, or heightened emotional sensitivity (Center of Expertise on Traumatic Stress, 2021; American Psychiatric Association, 2022). These reactions are anticipated and managed during follow-up.
A significant phase of the work is therefore devoted to stabilization, developing internal resources, and learning emotional regulation strategies before addressing difficult memories (Centre of Expertise on Traumatic Stress, 2021; Courtois & Ford, 2019). This step aims to ensure that you have sufficient internal and external safety to engage in trauma-focused therapy (OPQ, 2021; EMDR Canada, 2023).
How to choose?
Choosing EMDR means first and foremost making an informed decision about your goals, expectations, and the various therapeutic options available. By discussing this with your psychologist, you can determine if this approach is suitable for your current needs and pace, taking into account the difficulties you are experiencing.
When the indication is appropriate and you feel confident in the therapeutic relationship, EMDR can help to significantly reduce distress related to the past and improve your current quality of life (INSERM, 2020; Veterans Affairs Canada, 2024).
However, EMDR is neither a universal solution nor an obligation: it is one option among other scientifically validated approaches (Hamblen et al., 2019).
Who should I turn to and who can practice EMDR?
It is important to know that EMDR training can vary considerably from one practitioner to another. To ensure safe and compliant practice, EMDR therapy is based on rigorous training criteria. In Canada and North America, professionals authorized to use this approach are trained and certified by recognized organizations, either EMDR Canada or the EMDR International Association (EMDRIA) .
You can verify the certification of psychotherapists directly in the directories available on the websites of these organizations:
Accredited professionals typically display the corresponding official logos in their communications, making them easier to identify. You can find my profile on the EMDR Canada directory by clicking this link .
Bibliographic resources
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Bisson, J. I., Roberts, N. P., Andrew, M., Cooper, R., & Lewis, C. (2013). Psychological therapies for chronic post-traumatic stress disorder (PTSD) in adults. Cochrane Database of Systematic Reviews, 2013(12), Article CD003388.
https://doi.org/10.1002/14651858.CD003388.pub4
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https://www.ciusss-estmtl.gouv.qc.ca/expertise/stress-traumatique
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https://doi.org/10.7326/M15-2660
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https://emdrcanada.org/about-emdr/
Hamblen, J. L., Norman, S. B., Sonis, J. H., Phelps, A. J., Bisson, J. I., Nunes, V. D., & Schnurr, P. P. (2019). A guide to guidelines for the treatment of posttraumatic stress disorder in adults: An update. Psychotherapy, 56(3), 359–373.
https://doi.org/10.1037/pst0000231
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Haute Autorité de Santé. (2020). Évaluation et prise en charge des syndromes psychotraumatiques chez l’enfant et l’adulte : note de cadrage. https://www.has-sante.fr/jcms/p_3215921/fr/evaluation-et-prise-en-charge-des-syndromes-psychotraumatiques-enfants-et-adultes-note-de-cadrage
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https://www.inserm.fr/dossier/troubles-stress-post-traumatique/
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https://iusmm.ca/soins-et-services/trauma
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Landin-Romero, R., Moreno-Alcázar, A., Pagani, M., & Amann, B. L. (2018). How does EMDR work? A systematic review on suggested mechanisms of action. Frontiers in Psychology, 9, Article 1395.
https://doi.org/10.3389/fpsyg.2018.01395
Lewis, C., Roberts, N. P., Gibson, S., Dropinski, S., & Bisson, J. I. (2020). Dropout rates from psychological therapies for post-traumatic stress disorder (PTSD) in adults: A systematic review and meta-analysis. European Journal of Psychotraumatology, 11(1), Article 1709709. https://doi.org/10.1080/20008198.2019.1709709
McFarlane, A. C., & Yehuda, R. (2017). Resilience, vulnerability, and the course of posttraumatic reactions. World Psychiatry, 16(1), 1–3. https://doi.org/10.1002/wps.20387
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Royal Devon University Healthcare NHS Foundation Trust. (2024). Eye movement desensitisation and reprocessing (EMDR): Patient information leaflet. https://www.royaldevon.nhs.uk/media/fzqjovex/patient-information-leaflet-eye-movement-desensitization-and-reprocessing-emdr-rde-21-052-002.pdf
Shapiro, F. (2018). Eye movement desensitization and reprocessing (EMDR) therapy: Basic principles, protocols, and procedures (3rd ed.). Guilford Press.
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