Eye Movement Desensitisation & Reprocessing (EMDR)

EMDR (Eye Movement Desensitisation and Reprocessing) is a therapy that has some similarity with EFT (Emotional Freedom Techniques), but has been established longer and has a well-established evidence-base as a therapy for the treatment of trauma and Post Traumatic Stress Disorder (PTSD). It is recommended as a treatment in the NICE guideline for PTSD¹.

EMDR and EFT Comparison/Similarities

EMDR’s likely mechanism is that it uses Memory Reconsolidation², the same as EFT (See post “How EFT Works”).

The first controlled comparison of EFT and EMDR for PTSD³ was published in 2011 in an Index Medicus (Core Clinical) peer-reviewed journal by a team led by Thanos Karatzias and Theresa McGoldrick in NHS Fife. In this research EFT was compared with EMDR.

The researchers observed significant therapeutic gains at post-treatment and follow-up after an equal number of sessions for both the EMDR treatment group and the EFT treatment group. They observed very similar treatment effect sizes in both treatment groups, albeit with a slightly higher proportion of patients in the EMDR group achieving clinically significant improvement. With only a very slight difference in effect results, it would seem reasonable to conclude from this study that EFT has the potential to be equally as effective as EMDR for the treatment of PTSD. That is based just on a research paper; anecdotally practitioners of both modalities often favour EFT and have found positive change to be more easily and quickly achieved with EFT.

Advantages of EFT over EMDR

Given that both therapies can achieve similar results within a short space of time, with EFT possibly in even less time than with EMDR, it is useful to consider what EFT additionally has to offer.

EFT has a number of significant advantages over EMDR:

EFT is more gentle

• EFT, when properly applied, in therapy with a fully-trained, skilled and experienced practitioner, is an extremely gentle technique that enables trauma to be dispersed safely and gently, whereas EMDR is known for the possibility of unpleasant abreactions. Clients have reported fear of revisiting a trauma during a session as well as needing a lot of rest and processing time after a session. When EFT is carefully and skillfully applied, using the gentle techniques, the clients is constantly able to feel soothed or to self-soothe through every step of the process.
  
• Within a single EFT session the client can be taught the basics of EFT for Emotional First Aid, which can be self-applied and of great support between sessions. This ensures the client always has a tool available for self-regulation. It is also applied immediately during sessions if a client becomes distressed, since a few rounds of tapping can be relied upon to bring about a calmer state. Once learned, this is a skill for life, ever available at times of stress. Thus, with EFT a client can be supported if unpleasant emotions resurface between sessions whereas EMDR is less accessible in self-help situations
  
• Anecdotally, I know to have been shared by Therese McGoldrick, that participants in the Karatzias et al comparison study preferred the EFT. I suspect it is for this reason.

Other advantages

• There is no need with EFT for expensive equipment to create a movement for the eyes to follow. EFT can even be done over the telephone, although these days videoconferencing is used rather than telephone with voice alone. Some would prefer in-person sessions for PTSD, but it works very well via videoconferencing, provided appropriate client safety provisions are in place.
  
• The use of EMDR is restricted to expensively-trained psychologists and accredited mental health professionals. Many well-trained lay EFT-practitioners are able to facilitate trauma relief using specific EFT techniques.
  

Recommendation

On balance then, EFT should be the treatment of choice for PTSD. For the same reasons, it works well also for Complex PTSD (C-PTSD). Therapists who are trained in both modalities, but use EMDR because it is the therapy modality that is commissioned in their particular work setting, find it helps to teach clients EFT for self-regulation, alongside their EMDR treatment.