Virtual therapy has risen in popularity since the COVID-19 pandemic. Now more than ever, folks are utilizing telehealth services through secure video conferencing to find support for their mental health needs. Even though this is a convenient and accessible way to get therapy, some folks might still have concerns about whether online therapy is as effective as in-person therapy. This is especially significant when it comes to more specialized approaches, like EMDR. Is virtual EMDR as effective as in-person? Let’s find out!
Eye Movement Desensitization and Reprocessing (EMDR) is a framework of psychotherapy that is most often used to treat trauma, phobias, anxiety, and depression. This is an eight-phase protocol that involves history taking, skill building, and reprocessing – focusing on a specific memory, negative conclusion, or physical sensation while following a set of eye movements, sounds, or taps, to reduce the associated discomfort in the body. This creates a platform for the brain to reorganize information in a more helpful way and reduce the intensity of any uncomfortable emotions associated with the target experience. Sounds like hocus pocus, but I swear it works on a brain-science level! In-person EMDR therapy may not be available or accessible for everyone because of location, physical limitations, or work schedules. This is where virtual EMDR therapy comes in as an alternative option, AND you can do it from the comfort of your home!
Virtual EMDR follows the same basic methodology as in-person EMDR. Remember how I mentioned that it’s an 8-phase protocol? Well, typically, when folks think of EMDR, they think of phase 4, which is when we focus on a specific thing and apply Bilateral Stimulation (BLS), the back-and-forth eye movements or taps, to reduce the intensity of the target experience. This is usually the most concerning part about online EMDR therapy, and folks often wonder how it would work.
Allow me to shed some light on the process: when getting ready to enter phase 4, your therapist might provide you with several options for BLS. This can include sending you a link to a moving dot that you will follow with your eyes, a common option used for virtual BLS. In this case, your therapist will be able to control the dot’s movement from their end while you just focus on following it back-and-forth with your eyes. An option that works really well for my folks is to tap back-and-forth on the knees. This is often a more preferred option, even when I’m doing EMDR in person. It has a way of involving the body and giving agency to the client as they reprocess.
I’ve also had folks utilize the “butterfly hug” (hands crossed over chest with fingers underneath the collar bones), as well as tapping feet or swaying from one foot to the other while standing as alternative forms of BLS. A good therapist will help you find something that feels good for you and will collaborate with you on cues, pauses, and stopping signals before jumping into the actual reprocessing. Just as they would do in person, your therapist will guide you on what to focus on during reprocessing and keep the structure so that you can focus on the healing part of things.
When it comes to reducing emotional discomfort and processing through painful experiences, several studies have found that virtual EMDR is just as effective as in-person EMDR (Sbarra & Wheaton, 2020; McGowen et al., 2021; Dyer, de Young, & Porges, 2021). These studies have found that virtual EMDR significantly reduces symptoms of PTSD, anxiety, and depression, even more so than virtual Cognitive Behavioral Therapy (McGowen et al., 2021). As it turns out, virtual EMDR does the job just as well as face-to-face EMDR therapy does. This is really good news for those of us who worry about spending resources on something that “might not work,” or “might not work as well.” As far as neutralizing charged experiences, virtual EMDR is just as good of an option as in-person services are.
Even though research shows that virtual EMDR is just as effective as in-person EMDR, there are a few sensitivities that are worth addressing. The first is that many folks may choose in-person services because it offers the felt presence of another human being. For those of us whose trauma includes being left alone, abandoned, forgotten, or left behind somehow, in-person services may offer a unique healing element of being witnessed by another human where we have been left alone before. In other words, sometimes the worst part about a hard situation is that no one was there to help us through it or to offer support. Processing through this with another person physically in the room may offer a different kind of healing than processing through it with someone who is present virtually but not physically.
On the other hand, another consideration is that virtual EMDR offers the privacy of one’s home to be as expressive, casual, and comfortable as possible. Some folks really appreciate that they can process in complete privacy without having to worry about being heard by anyone else. Others really appreciate having their pets nearby for comfort, being able to pace in between sets, and reorienting towards their home as their safe space. Sometimes, having access to the comforts of home, as well as taking up as much space as needed, is what makes the difference in shifting the charge that’s being reprocessed.
Yet another thing to keep in mind is that not every home is a safe space for vulnerable processing. Maybe you don’t have complete privacy where you live; maybe part of what needs to be processed happened within your home, making it a space of uncomfortable association; maybe the physical therapy room acts as a container that you can leave some of these experiences in to be kept safely between sessions. There are plenty of reasons that folks might prefer to utilize in-person services, even if they would be willing to engage in virtual therapy.
The bottom line is that you are allowed to prefer what you prefer. You may have a reason, or you may not. Sometimes, effectiveness of virtual therapy isn’t the determining factor in whether someone chooses it or not.
If you decide that virtual EMDR is a good fit for you, here are a few things that can help you have the best virtual therapy experience:
So many folks have reported positive experiences and successful outcomes with virtual EMDR therapy. The convenience, flexibility, and sense of safety that virtual sessions offer help to establish a strong therapeutic relationship, even without physical presence. This may be part of the reason why research has found that online EMDR therapy results in significant reductions in distressing symptoms, increased emotional regulation, and improved overall well-being. Virtual sessions have provided a platform for clients to engage in deep processing and healing, leading to positive changes in their thoughts, emotions, and behaviors.
Virtual EMDR therapy offers a promising and accessible option for folks seeking effective trauma treatment and emotional healing. With advances in technology and the growing need for remote mental health services, virtual EMDR has become a prominent and valuable therapeutic option, leveraging technology in overcoming barriers to provide effective therapy in the digital age.
Dyer, A. S., de Young, K. P., & Porges, S. W. (2021). Efficacy of Eye Movement Desensitization and Reprocessing Delivered via Telehealth in Adults with PTSD: A Systematic Review. Journal of EMDR Practice and Research, 15(3), 146-158.
McGowan, I. W., Fisher, N., Havens, J., & Proudlock, S. (2021). An evaluation of eye movement desensitization and reprocessing therapy delivered remotely during the Covid–19 pandemic. BMC psychiatry, 21(1), 1-8.
Sbarra, D. A., & Wheaton, M. G. (2020). No Place Like Home: EMDR for PTSD via Telehealth. Journal of EMDR Practice and Research, 14(3), 181-193.