EMDR (Eye Movement Desensitization and Reprocessing)

Presentation

EMDR (Eye Movement Desensitization and Reprocessing) is a psychotherapeutic approach developed in 1987 by Francine Shapiro, an American psychologist. Discovered serendipitously when Shapiro noticed that spontaneous eye movements reduced distress associated with disturbing memories, EMDR has become one of the most validated therapies for treating post-traumatic stress disorder (PTSD).

Recognized by the WHO (2013) and the French High Authority of Health as a first-line treatment for PTSD, EMDR is based on the Adaptive Information Processing (AIP) model. This model posits that the brain has a natural information processing system that can become blocked during traumatic events, leaving memories 'improperly stored' with their original emotions, sensations and negative cognitions.

Founder: Francine Shapiro (1948–2019), psychologist, Mental Research Institute, Palo Alto

Core Principles

The AIP model proposes that experiences are normally processed and integrated into adaptive memory networks. Trauma prevents this processing: the memory remains stored in raw form with the emotions, physical sensations and negative cognitions from the event. When activated, it triggers the same reactions as during the trauma (flashbacks, emotional reactivity, body sensations).

Alternating bilateral stimulation (eye movements, alternating tapping or sounds) during evocation of the traumatic memory appears to facilitate natural information reprocessing. The memory is progressively desensitized — its emotional charge decreases — and reprocessed — integrated with an adapted positive cognition (e.g., shifting from 'I am in danger' to 'It's over, I am safe now').

Main Indications

• Post-traumatic stress disorder (PTSD) — primary indication
• Complex and developmental trauma
• Specific phobias
• Panic disorder
• Pathological grief
• Trauma-related chronic pain
• Performance anxiety
• Addictions with traumatic component

Session Overview

The standard EMDR protocol unfolds in 8 phases: 1) History and treatment plan — identifying target memories; 2) Preparation — psychoeducation and safe place installation; 3) Assessment — identifying the image, negative cognition, desired positive cognition, emotions and body sensations; 4) Desensitization — bilateral stimulation during memory evocation until disturbance reduces (SUD = 0); 5) Installation — strengthening the positive cognition; 6) Body scan — checking for residual sensations; 7) Closure — stabilization at session end; 8) Reevaluation — checking gains at the next session.

A session lasts 60 to 90 minutes. Session count varies by complexity: 3 to 6 for simple trauma, more for complex or multiple traumas.

Variations and Sub-techniques

• Standard EMDR (8-phase protocol)
• EMDR for children and adolescents
• Group EMDR (IGTP protocol)
• EMDR for phobias
• EMDR and addictions (DeTUR protocol)
• Flash technique (ultra-brief EMDR-derived protocol)
• Online EMDR (adapted teleconsultation)

Contraindications

• Acute psychotic episode
• Unstabilized structural dissociation
• Uncontrolled epilepsy (eye movements)
• Severe ocular pathology (alternative: tapping or sounds)
• Imminent unstabilized suicidal risk
• Active unstabilized substance abuse
• Insufficient stabilization resources