5 Atypical Use Cases for EMDR
Atypical Use Cases for EMDR
As a counseling student roughly half way through my program, I have been drawn to trauma as a fascinating topic. It runs a common thread throughout the majority of psychological issues, as well as the day-to-day personal struggles that we all face. I would go as far as to say that trauma is responsible for more negativity in the world than most people give it credit for. In my current studies, I am roughly halfway through a trauma concentration. One of the things that we learned early on is that, like with many other psychological disturbances, cognitive behavioral therapy (CBT) is considered the gold standard for trauma treatment. However, one of the newer, lesser known, and more interesting and exciting treatment modalities that have emerged in the trauma space, is Eye Movement Desensitization and Reprocessing (EMDR). I will do more posts on this in the future, but to provide a cursory explanation for context's sake, EMDR is a treatment modality that uses rhythmic right-left eye movements to access (and as the name suggests) desensitize and reprocess traumatic memories. This is combined with therapeutically directed questions/prompts that encourage patients to heal their trauma over time. It is a fascinating modality for trauma, but here I want to share five atypical use cases for EMDR that I have come across in my own research.
#1 - Reducing Anxiety
That’s right, EMDR can help treat anxiety! Random control trials on multiple anxiety disorders have shown EMDR to be an effective treatment for disorders including generalized anxiety disorder (GAD), social anxiety disorder (SAD), specific phobias, and panic disorders with and without agoraphobia. While EMDR is well known as a leading treatment for PTSD, EMDR helps in treating anxiety disorders by reprocessing memories at the root of such anxiety disorders. Because I hope to train in EMDR in my future practice, this is something that I was thrilled to learn since anxiety is such a prevalent issue today.
#2 - Coping with Cancer
Although it may not be intuitive, EMDR can help people cope with cancer diagnoses! It is easy to imagine the pain and despair that can follow a cancer diagnosis, and how most occurrences commonly evoke symptoms of anxiety and depression. Cancer is, within itself, a traumatizing event which can potentiate the occurrence of PTSD in survivors. The type and severity of cancer, along with factors such as socioeconomic status, and prior experiences of trauma have implications on the likelihood of developing PTSD following a cancer diagnosis. Given the traumatizing nature of having cancer, EMDR may be an effective treatment for alleviating psychological distress for this population. Along with trauma focused cognitive behavioral therapy (a specialized form of CBT that has been impactful in treating trauma) EMDR have proven to be the most effective treatment modalities for alleviating symptoms of psychological distress in cancer patients. While additional supporting research is still needed, the application of EMDR for cancer patients makes sense, as going through cancer is a conceivable traumatic event.
#3 - Assuaging Child Abuse
You are probably wondering how this could possibly be true. However, to date, therapeutic rehabilitation for child abusers have mainly been limited to relapse prevention techniques that yield unsatisfactory results. Utilizing EMDR for childhood abusers is based on the idea that trauma may be one of the main motivating factors for sexually offending behavior. This is based on findings from the Sex Offender Treatment Evaluation Project (SOTEP) which identified that offenders who did not have a history of physical abuse had an increased likelihood of sexual misconduct. Additionally, high ACE scores are also highly correlated with a myriad sexually aggressive behaviors. As such EMDR can be an effective treatment for existing traumatic experiences that eventually lead to abusive mentalities. However, it’s worth noting that the research community has largely avoided investigating trauma and environmental factors that can produce behavioral outcomes linked to child abuse. One of the reasons for this avoidance is a fear that offenders could use such research as a means of justifying their behavior.
Encouragingly, EMDR significantly increases victim empathy in adolescent offenders and in general forensic populations. Because it has come to light that several offenders have prior sexual trauma, which contribute to their offending behaviors, EMDR can offer a way to mitigate these past traumas that ultimately lead to offending. Because I do not plan to work with the sexual offender population, I would not be comfortable using EMDR in this respect. Despite my stance on the issue, I can see EMDR playing an important role and future treatment programs for this population.
#4 - Reducing Physical Pain
This is perhaps my favorite use case, as it demonstrates how incredibly powerful the mind is. There is increasing recognition of the occurrence of somatic pain (mentally induced physical pain) and the role that it plays in chronic pain. Chronic pain is a prevalent and serious issue that often receives unsatisfactory treatment. Over the past few decades, there has been an emergence of studies that focus on the efficacy of EMDR on pain, by targeting the memories associated with past injuries and accidents.. Given the emerging acceptance that psychological distress can negatively impact physical health, EMDR may grow as a treatment considered for use with chronic pain. While previously, pain management treatment focused on behavioral contributors and coping strategies, EMDR can be effective in treating a variety of pain types, including headaches and musculoskeletal issues. This research is still nascent, but growing. Essentially, pain may be treated effectively as a traumatic memory, or as a standalone phenomenon. Personally, I plan to follow this research in the hopes of some day using it to help people dealing with chronic pain. As an active person, I understand the struggle that chronic pain can produce. I would also consider participating in further research, should the opportunity present itself. To put it bluntly, I believe somatic pain is one of the most fascinating and beneficial fields in mental health and would be interested to pursue pain management as a primary focus.
#5 - Eating Disorders
The two main therapeutic interventions for healing eating disorders (EDs) include treating the problem as a behavioral issue, or as an emotional regulation issue. The latter usually involves some sort of trauma during development. To that end, PTSD is often one of the main comorbidities that are common with EDs. However, psychological distress during development that does not meet the criteria for PTSD can also have strong implications on the occurrence of EDs. Although CBT and family-based treatment (FBT) are considered the most effective treatments for EDs, neither of these modalities take prior trauma into consideration. Since EMDR is designed to help densitize and reprocess such memories, it can make for an effective treatment. In essence, non-traumatic stress can contribute to the development of eating disorders similarly to a traumatic occurrence. With my current understanding of EMDR, I do not see a clear application for this modality in such cases. Until the supporting research on this topic can be better established, I would be uncomfortable utilizing EMDR for eating disorder populations. Additionally, this is not a population I currently aim to work with.
As I mentioned, I will share more on EMDR as I dive deeper in my personal and professional studies. For now, I wanted to spread the word that this innovative and intriguing modality is one that can be considered for a myriad of cognitive, behavioral and emotional issues. I have personally spoken to several people who have experienced EMDR as a patient in hopes of treating past traumas both big and small. The results were unequivocally positive. So if you are someone who is considering therapy and have past traumas you wish to work out, I hope this post gives you the context to consider visiting an EMDR specialist.
