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EMDR for anxiety

Reviewed by Robert Bogenberger, PhD

An anxious student leans against a cement wall outdoors

Anxiety disorders affect the mental and emotional well-being of tens of millions of people.1 Traditional therapy can be very effective for anxiety, but eye movement desensitization and reprocessing (EMDR) has emerged as a promising alternative.

EMDR is a form of psychotherapy that helps you work through heightened emotions or traumatic experiences by combining elements of exposure therapy, cognitive behavioral therapy (CBT), and bilateral stimulation (BLS). This type of therapy helps survivors of trauma reprocess distressing memories and make new connections, thereby reducing the symptoms associated with the trauma.

Due to the success of EMDR in treating trauma, therapists have expanded their work with this method to include anxiety disorders, depression, and other mental health conditions.

What is EMDR?

EMDR was developed in the late 1980s by psychologist Francine Shapiro, PhD.2 The underlying principle of this method is that anxiety and other mental health issues stem from unresolved traumatic experiences or disturbing memories. These memories can become “stuck” in the brain’s processing system, leading to emotional stress and anxiety symptoms. EMDR aims to locate these memories and help the brain build less upsetting connections around them.

EMDR typically progresses through several phases. Initially the therapist and client work together to build a treatment plan and identify specific distressing memories or events. The client then focuses on a target memory while engaging in BLS. In BLS, the therapist guides the client through a rhythmic, alternating pattern of left-to-right eye movement, tapping on the knees or shoulders, or auditory cues.

BLS is thought to mimic the rapid eye movement we experience during sleep.3 It engages both sides of the brain at once, which allows the client to develop new thoughts, feelings, and reactions around targeted memories.

Understanding anxiety disorders

Worrying is a normal part of the human experience. We worry about our families, our health, and our homes, to name a few things. In an anxious moment, you might feel your heart race a little or a bead of sweat run down your back. But right away or shortly afterward, you’re usually able to put your worry in context and save it for another time. This is everyday anxiety.

For many people, though, that worry can’t be contextualized and filed away. Instead it becomes pervasive and affects other parts of life. This is an anxiety disorder, and different kinds include:

Generalized anxiety disorder (GAD): If you have GAD, you struggle with constant worry for at least half the year, mainly about ordinary parts of life. Instead of having a specific focus for your anxiety, you feel anxious about many things at once and can’t seem to escape those feelings.

Panic disorder: If you have panic disorder, you have panic attacks: short episodes of excessive anxiety and fear that come and go quickly but are often hard to shake.

Social anxiety disorder: Social anxiety disorder is characterized by deep fear and worry when socializing with other people, especially strangers.

Phobias: A phobia is an intense form of fear that’s irrational, uncontrollable, and often disruptive to your life. It’s provoked by a certain object, situation, event, or activity.

Historically, the most common treatment for anxiety disorders has been a combination of psychotherapy (such as CBT) and medication.4 Recently, researchers have started exploring EMDR’s potential for treating anxiety disorders as well. One meta-analysis of 17 different trials concluded that EMDR can significantly reduce symptoms of anxiety, panic, and phobias.5

How EMDR works for anxiety

While EMDR is used to treat posttraumatic stress disorder (PTSD) by focusing on a traumatic moment, anxiety disorders may be more general and therefore seem harder to treat. But author and psychologist Laurel Parnell, PhD, director of the Parnell Institute, believes anxiety disorders can be approached similarly to trauma.

“When I see a patient with anxiety, I immediately want to explore what has brought them to this current state,” Parnell says. “What in the past is linked to the problem in the present?”

The first phase of EMDR therapy, history-taking, is especially important for treating more generalized disorders, says Parnell. A therapist can often uncover the root of a client’s anxiety by learning this history.  For example, Parnell says that GAD often begins with insecure attachment, which happens with a child’s primary caregiver doesn’t take care of their needs consistently or well. In this case, attachment-focused EMDR would be an appropriate method to use.

Sometimes anxiety is a symptom of a traumatic event from the past, such as an assault. An EMDR therapist works with that kind of trauma similarly to how they’d approach treating PTSD.

Bridging technique

A client’s past trauma may not be immediately obvious to them or their therapist, says Parnell. She uses a technique called bridging to help people trace the origins of their trauma. This is when a therapist helps a client use their present state of mind to access a past memory where they had similar thoughts or feelings. “Bridging derives from the affect bridge that comes out of hypnotherapy,” Parnell explains.6 “It’s a technique we use to find the early roots of an issue and then treat them.”

One of the strengths of EMDR is its ability to target the root causes of anxiety instead of just its symptoms. As EMDR helps someone reprocess a traumatic memory associated with anxiety, it also helps them develop a new emotional response. This can lead to a significant reduction in anxiety and an improved ability to cope with future triggers.

If you’re interested in exploring EMDR therapy for anxiety, browse our directory to find a licensed provider near you.

“Big-T” trauma vs. “little-t” trauma

When treating PTSD, therapists are working with they call “big-T” traumas, such as war or a serious car accident. However, a collection of little-t (or “small-t”) traumas can also impact how safe and secure we feel. Little-t traumas, such as bullying at school or microaggressions at work, can happen at any point and build up over time.

“They’re not life-threatening, but they go into our nervous system and impact how we view ourselves and how we approach the world,” says Parnell. “Think of a flowing river. When you have a large dam, like a big-T trauma, it really blocks things up until that dam is dismantled. But a bunch of small-t traumas can also cause a blockage and be just as difficult to live with.”

For example, if you’re told repeatedly that you’re not smart enough or not good enough, those traumatic moments can add up to create a feeling of anxiety about being in the world. To treat it, a therapist tries to target the initial events where you were introduced to an idea of yourself that shook your sense of safety. Little-t traumas can take longer to heal, says Parnell, because they tend to have many roots.

EMDR for depression

Like anxiety, depression can be linked to one big-T trauma or a number of little-t traumas. There are several types of depression, with the most common being major depressive disorder (MDD). Also called “clinical depression,” MDD generally appears as episodes that can last days, weeks, or months. This disorder affects more than 17 million adults and almost 2 million children in the United States.7

MDD is usually treated with therapy, medication, or a combination of both. However, some research has shown that EMDR can be even more effective than pharmaceuticals at helping people with PTSD manage and heal from depression.8 More research is needed, but Parnell feels hopeful about the results she’s seen using EMDR to treat depression stemming from little-t traumas.

A promising future

In addition to being a highly effective treatment for PTSD, EMDR offers a groundbreaking approach for people with anxiety, and it may be a promising option for people with depression. Its combination of traditional therapeutic techniques, exposure therapy, and bilateral stimulation has shown strong results in reducing symptoms and improving overall well-being.

To find an EMDR therapist near you and begin the healing process, browse our directory.

About the author

The editorial team at therapist.com works with the world’s leading clinical experts to bring you accessible, insightful information about mental health topics and trends.