EMDR Treatment for Anxiety: What Is It and Why Does It Work?

EMDR treatment works by directing eye movements while imagining distressing scenarios and shifting your attention toward more positive thoughts, causing anxiety to dissipate.

While EMDR treatment is rising in popularity within the mental health community, it has not risen to the level of prominence enjoyed by modalities like cognitive behavioral therapy (CBT) and, thus, remains a mystery to many. So how does EMDR work? Arkowitz and Lilienfeld explain:

EMDR therapists ask their clients to hold the memories of anxiety-provoking stimuli—for example, the painful memories of a frightening accident—in their minds. While doing so, clients track the therapist’s back-and-forth movements with their eyes, much like a person in an old Hollywood movie following a hypnotist’s swinging pocket watch.

During this process, the therapist asks the client to notice the sensations, images, and emotions that they experience and slowly begin to shift attention away from negative thoughts toward more positive ones. In doing so, anxiety begins to lift and the client is able to regain control over their emotional state. Indeed, Shapiro herself notes that dozens of randomized controlled trials have found EMDR to be an effective treatment that produces “rapid decreases in negative emotions and/or vividness of disturbing images. Numerous other evaluations document that EMDR therapy provides relief from a variety of somatic complaints” associated with anxiety disorders.

One of the benefits of EMDR treatment is that you don’t necessarily have to talk about painful memories, making the therapy particularly inviting for those who have trouble verbalizing their experiences or for whom those experiences remain too painful to talk about. Rather, using EMDR for anxiety can be a largely internal process during which you are gently guided by a compassionate therapist who seeks to lead you out of a place of anxiety toward one of safety and inner tranquility. This process can allow you to access parts of yourself that traditional talk therapy may not be able to reach.

Although no one is sure exactly why EMDR treatment works, there are a number of theories regarding its exact mechanism of action.

Despite evidence that EMDR does work, there is scant evidence for how it works. Dr. Joseph Goldberg notes, “By inducing the recall of distressing events [and thoughts] and diverting attention from their emotional consequences, EMDR in some respects borrows basic principles used in prolonged exposure therapy, the gold standard behavioral psychotherapeutic treatment of PTSD [and other anxiety disorders].” Another theory about why EMDR works involves the way the modality may simulate the effects of rapid eye movement (REM) sleep. Shapiro writes:

REM occurs in the same stage of sleep as dreaming, and during this time, scientists believe, the brain processes survival information. The implication is that, like REM sleep, the eye movements of EMDR facilitate the transfer of episodic memory, which includes emotion, physical sensations, and beliefs associated with the original event, into semantic memory networks, in which the meaning of the event has been extracted and negative associations are no longer present.

However, do you do not necessarily have to have experienced a distressing event in order for this process to be effective; even imagined and hypothetical stress-inducing scenarios and experiences of anxiety itself can be addressed using this technique. Shapiro herself believes that part of EMDR’s success can be attributed to the way it engages the imagination “as a client feels their way through their fears” in a relaxed state, ultimately allow you to reimagine those fears and gain control over them.