Although the EM in EMDR represents the notion of eye movements, not every therapist using the EMDR technique incorporates the eye movement component. Sometimes, the therapist simply tabs their finger, uses sound, or uses some other technique instead of the eye movement component in conjunction with the overall EMDR treatment package. As will be revealed later on, this is a problem for the theoretical foundations of this particular technique.
EMDR does include the following components in its overall treatment package that have empirical validation for their usage:
Session assignments and homework: The majority of cognitive and behavioral therapies require that clients in therapy complete certain practice assignments during the therapy sessions and that they complete assigned homework given to them by the therapist. The principle of giving homework for clients to practice newly develop skills in an effort to deal with some type of emotional issue has a long history in psychotherapy.
The notion of developing a strong therapeutic alliance: EMDR practitioners attempt to develop a strong working alliance between the client and the therapist as a main contributor to the success of the treatment. This is a longstanding aspect of successful therapy that dates far back in the history of psychotherapy.
The notion of exposure treatment: As part of the reprocessing component of EMDR, individuals are required to reflect on aspects of their traumatic experience that are particularly distressing for them. The process of this type of reflection, especially when individuals are instructed to visualize, try and hear aspects of the experience, and involve all the senses, is borrowed from a behavioral psychology therapeutic technique known as exposure therapy. Exposure therapy has a long history of use, with behavioral therapy and Cognitive Behavioral Therapy, to assist individuals who have experienced traumatic events to desensitize themselves emotionally to those events. The basic premise behind exposure therapy is that when people feel anxious, fearful, etc. as a result of some particular stimulus, having them re-experience the stimulus/event or remain in the presence of the stimulus eventually results in their anxiety peeking and then leveling off. Repeating this process of exposing a person either directly or through mental imagery results in the individual’s anxiety levels steadily decreasing to the point where recalling the experience no longer produces any significant distress. Individuals can also be taught breathing and relaxation during exposure to facilitate the process. A major component of EMDR is to have the person recollect important aspects of the traumatic event while undergoing the eye movement component of the treatment.
The notion of cognitive restructuring: Cognitive restructuring is a technique that is borrowed from Cognitive Behavioral Therapy (CBT), one of the most popular therapeutic paradigms used by therapists today. Cognitive restructuring involves re-conceptualizing one’s attitudes, thoughts, belief systems, etc. in a manner that is more functional and realistic. CBT works on the notion that many dysfunctional behaviors, such as substance abuse or psychological disorders like depression, are fueled by an irrational and dysfunctional belief system. CBT identifies these core irrational beliefs and, through a therapeutic process, helps the individual restructure them so they are more in line with reality. Part of the process of EMDR is for the therapist to help the client develop a different attitude and value system regarding aspects of their traumatic experience. This is done in conjunction with the exposure technique and eye movement component.