Music. Welcome to Mr. and Mrs. Therapy, the podcast that empowers you to transform life's challenges into opportunities for personal growth and healthier relationships. We're your hosts, Tim and Ruth Olson, licensed marriage and family therapists and trauma experts. As experienced therapists with backgrounds in addressing trauma and mental health disorders, we believe there is hope and there certainly is healing.
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In our last episode, we started a series on criticisms of EMDR and then our responses to those criticisms. Today, the challenge to EMDR that we're going to be discussing is that there's overstated claims about the effectiveness of EMDR. And we're going to split this into two sections where it's overstated claims compared to other types of therapy, but also overstated claims on the effectiveness on other types of disorder other than PTSD.
So let's first look at that criticism about the effectiveness of EMDR compared to other therapies. So we're going to specifically look at EMDR compared to CBT and exposure therapy. So when we look at CBT or cognitive behavioral therapy, I think this is one of the more well-known therapies out there. And I think also CBT is known for being able to treat several different types of diagnoses or symptoms that people are experiencing. And so CBT has been around a little longer.
CBT was developed in the 1960s, whereas EMDR came out in 1987. And so it's been around longer. It's more well-known. But when you look at studies, it suggests that both EMDR and CBT are highly effective for treating PTSD and other disorders. And in one study, it showed that there was no significant difference in the effectiveness between both of those immediately after treatment of PTSD. One of the benefits of EMDR is that it could lead to quicker reductions in symptoms.
And we've seen that for ourselves, just how quickly we've been able to see the benefits of EMDR. And so I think one of the reasons might be because CBT does require a lot of homework. And so you're going to go home with homework, make sure you get it done, you come back, you kind of process that and talk about that. And then you go home, you're sent home with more homework, which there is certainly a benefit to that. But with EMDR, we are doing a lot of the processing in session.
And actually, when I work with my clients, I want to process through what's going on with their life, be a safe place for them to talk through things. But a lot of times I will challenge clients to jump into EMDR quickly because I know that they're going to experience a reduction of symptoms fairly quickly if we can get through the target and process through a lot of things that come up. And this is one of the things that I think is tough about CBT, that homework aspect.
I would say somewhere in the range of 90% of people when I assign them homework don't follow through on that homework. And so you go to the session, you learn about what you need to do in order to fix it, but then you don't follow through, then you don't get the benefit. Then it can cause you to feel like you're losing hope in the process because like, well, I'm not getting any better. And it's feeling like, well, I'm going to therapy, I'm doing the work, so I should be getting better.
But the bigger piece of that is you actually have to follow through on that homework for CBT. And especially with a diagnosis like depression, that's something that makes it extremely difficult for you to follow through on your homework. Hey, a big solution to depression is get up, go, socialize, get out of bed, make sure that you take care of yourself physically. So go out on walks, exercise, eat healthier. It requires you to do a lot of things in order for you to feel better.
But the problem with depression is it steals your motivation. It makes it much more difficult to follow through on those things. And so if you're trying to work with somebody on depression and you're giving them homework, but then they can't really complete their regular everyday tasks of living, it's very unlikely they're going to follow through on those kinds of things.
Versus with EMDR, the thing that I do really like about is that you're doing the work in the session that's going to give you the benefit. And so you don't have to do anything outside of the session in order for EMDR to be effective on its own.
And so that to me, especially with seeing how few clients really do follow through on the homework, I like it because it makes it more likely that I'm going to get a good result at the end of the day because it's more about what we're doing in the office together as opposed to teaching them what they need to be doing outside of the office.
Now, for exposure therapy versus EMDR therapy, there's a dramatic difference in the amount of time that you have to then be focused on the trauma in order to get recovery. So for exposure therapy, you're trying to maintain focus on the traumatic event, whether you're doing it in vivo or whether you're getting legitimately exposed something. So if you're fearful of spiders, it's being exposed to spiders or photos of spiders and just staring at and focusing on those versus with EMDR.
When you're going through it, you don't necessarily have to stay focused on the traumatic event. Your mind wanders around to different things. You might think about the traumatic memory.
Then you might think about a body sensation you're getting. then your mind might move on to another memory that has a similar feel to it and your brain can take you to all different places and so you're not sitting there constantly thinking about this negative uncomfortable event and so what that seems to do is it helps people not to be so uncomfortable when they're processing through the traumatizing event.
And as a matter of fact, what the research kind of shows is that people are more likely to stick through EMDR than they are to the exposure therapy. And I think a part of it is that even though EMDR is uncomfortable, it's way more comfortable than exposure therapy is. Well, for sure. And I think because of this less confrontational approach, it is more tolerable for those clients and they're able to come in and work through it.
And like you said, it is uncomfortable and it is emotionally exhausting because you are going through some emotional things, but compared to exposure therapy, I think clients do stick in there more and there is a higher completion level because if you're already going through a traumatic experience. Those with high levels of distress or avoidance aren't going to keep coming back when it's at a level where they cannot tolerate it anymore.
Now, this is definitely something that Ruth and I have experience with our clients with EMDR as well. We both have told stories, I think, in the past where we had different clients who both were successful going through EMDR, but then we came up to a memory that was particularly distressing for them. And then those people kind of avoided coming into therapy for six months or a year after that.
But then when they came in and they processed through it, I remember my client in particular was like, man, why did I wait a whole year to deal with this? This was not nearly as uncomfortable as I was expecting it to be.
Oh, and it's the same for my client, but I think we had different experiences going into it because my client warned me, hey, I'm not going to come back for another year because she knew that the memory that we were coming up on was a particularly hard one and she just didn't want to deal with it. But then true to her word, she came in a year later and we went through the process and it was that same conversation that you had with your client.
Where she said, man, I should have just stuck with it. And I don't know why I waited this whole year to face this trauma or go through it. Because she had experience completing a target and going through a memory with EMDR and finding success in it. But it is scary going into a memory where it just feels so big and so emotional and so hard to go through it.
So even though they did stop for a year, when they came back, their perceived level of the distress and intolerance and all of that really didn't match up to what the EMDR experience and process was for them. So I can definitely see with other clients as they're going through the exposure therapy versus going through the EMDR process, how the benefits of EMDR is more palatable approach to therapy.
And then when you look at the effectiveness of EMDR versus exposure therapy, they're both effective for PTSD. And when you look at a direct comparison in some studies, it shows no significant difference in the effectiveness. But that completion and the timeframe does make a difference. And EMDR does fare better in those areas. is. And so it's not to put down CBT or exposure therapy. There is certainly a place for that. And their effectiveness is certainly there.
But when we look at EMDR, there's also additional benefits in completion and timeframe in comparison with both CBT and exposure therapy. And I think sometimes there is benefit from a combination of approaches. And so certainly I have EMDR clients that I also assign homework to that's more aligned with the CBT approach. And I know for you, Tim, as you've done the EMDR process, you've also used kind of a level of exposure therapy.
Just in a slight way as you used a video to simulate different triggers in those cases. Oh, for sure. I had a child that I was working with one time who had a phobia of bees, bees but could not get emotionally engaged. And so then I looked up a YouTube video that just had like the sound of bees buzzing and I played that during the session in order to get him more emotionally activated when I was going through the EMDR process with him.
But I did use that exposure as an aside to more get him more emotionally engaged so that then the EMDR process could kind of take hold and then help him work on that discomfort. And so now let's jump over to the second piece of this. We're going to look at the effectiveness of EMDR for not just PTSD, but for other disorders as well.
And it is kind of interesting. I do think EMDR has been viewed by the community and kind of been pinched and holed into PTSD because that's originally where it got its start from. It's definitely effective for much more than just PTSD. And we've seen this in our own practice. And some of the newer research coming
out is starting to bear that out. Now, one of the things that you'll notice is that the lion's share of the research has been done about PTSD, but it definitely is effective for other things. And like I mentioned a little bit earlier, it is definitely effective for helping people to work through depression and helping them to then kind of break the bonds of depression. And the nice thing, like I said before, is that depression makes it hard to do homework.
But when you go through EMDR, you don't need to do the homework. And so you can break the depression just through your counseling sessions and not having to try to make yourself do additional things. But also the nice thing about that is that once that depression kind of gets broken, then it makes it easier for you then to then start exhibiting more positive behaviors.
And so in particular for EMDR is that the studies have shown that there's actually a higher rate of remission and a decrease in the number of relapses patients have when they're experiencing depressive disorders. And I think that's really beneficial when you are starting to feel hopeless. Because I've heard a lot of clients who come in and they say, well, I've just always been depressed. And the same with anxiety. They'll use that terminology.
Well, I've always been an anxious person. And so EMDR can certainly be a promising tool and so helpful in these situations that they've kind of given up and they've just felt like this is just my lot in life. This is just who I am. And this is something I'm always going to deal with.
And I especially love working with clients who have experienced this because there is so much light at the end of the tunnel and there's so much hope even after we finish one or two targets and they're beginning to see some of these symptoms lift and decrease in such a short amount of time. And kind of on that same line, the next diagnosis that we look at where there's a benefit is is in the anxiety, phobias, OCD area, where research has supported the use of EMDR in treating anxiety disorders.
And it helps to modify the traumatic memories associated with this and the different anxiety triggers that often underlie these conditions. And so it's that same thought of, I've always had these triggers, I've always had anxiety. And with OCD, a lot of times people will separate out and feel like, well, this is OCD, this isn't normal anxiety. But EMDR has been proven effective with specific phobias, OCD, and anxiety disorders in general.
And I think for me, my first experience with EMDR was really helped me to get over some social anxieties that Ruth and I had kind of couched as more just me being introverted. But then after going through it, it's like, oh, actually, maybe those were more social hangups as anxiety that was caused by these social interactions.
And for me, I noticed it's given me a lot more freedom just interacting with people where then I'm not constantly rethinking the conversation or worrying about how people received what I had said. It's more I can just say what I want and I worry a whole lot less about it. And it's allowed me to interact a lot more socially. Now, it hasn't changed me into an extrovert for sure. I definitely get exhausted by too much social interaction and I definitely prefer solitude more often than not.
But it's made me be able to enjoy social interactions so much more than I had before I'd gone through EMDR. And I think when we look at specific phobias, we've shared in the past about our own experience with specific phobias with hornets and bees and the experience that one of our children had gone through. So if you're interested in that story, those are in our early episodes, like episode 6, 7, 8, 9, where we have that series on EMDR specifically.
But just to recap that, our son had experience with hornets and got stung multiple times and actually Tim as well, that experience caused our son to be terrified of not just hornets, of any similar stinging insects like bees and wasps.
And then it also expanded out where because he had this experience while we were looking at a home, he didn't want to go and look for homes or he would always ask to make sure that they weren't going to be bees and wasps or yellow jackets or hornets at these homes that we're looking at. And then it expanded out further when we went back to where we were living. He always talked about Tennessee in conjunction with this fear of being stung.
And so he was starting to have kind of an aversion to our trip to Tennessee and Tennessee as a whole. And so when we did EMDR, the next day he went out and he kicked a tree with bees in it. And he just kind of said, hi, bees. And he went along his way. and it was so cool to be able to see the instant change in him. Oh, absolutely. That was definitely one where it was like very clear cut. How much time do we spend with him on that? Was it like an hour or two before
we resolved that memory? And then all of a sudden it was never a problem again. And even now thinking about it, I'm like, man, I don't even think I ever heard him say the word be your wasp or worry about it or ever comment about it when they're flying around or anything like that. And so it seems like he's become steeled to that where it's like, It was a major vulnerability for him before, and now it's like, I don't care, not a big deal at all.
And so the next area where EMDR seems to be particularly effective in treating mental disorders is addiction. For addiction, studies show that it really helps reduce the vividness of addicted-related imagery and or cravings. And so it can make it very helpful for helping people to recover from addictions. Now, the other thing, too, that I think has been coming out recently is that addiction isn't so much a chemically-based problem that people have.
Because getting people sober from the chemical addiction isn't that hard. Even if they're sober for three, six months or even a year later, if they haven't worked on the emotional side or the emotional problem that caused them to want to go to the addiction, then they still go back to that addiction. So if somebody is incarcerated for a year and they have zero contact with the substance, then they get out. The first thing they're looking for is the substance.
Why? Not because their body is still craving that substance, but because emotionally it helps them to run away from their negative feelings that they have. And so if you reduce the overall, what I like to call emotional burden that people are walking around with, then it also reduces the need for that substance because there's not much left that you have to run away from. And when you address that, it's not that hard to get rid of that piece of it.
We're not minimizing the difficulty or struggles that people have with addiction, but we're seeing that particular portion of it is not nearly as difficult as the other portions or pieces of addiction. Oh, sure. And I think it's great to clarify that a little bit more is that when I'm saying that's not really the hard part, it can be very hard. And some of the withdrawal symptoms can be absolutely awful. But oftentimes people can white knuckle getting out of those withdrawal symptoms.
But then even after they've made it past the withdrawal symptoms. They've made it past their body craving the substance, they still turn back to it because what actually ends up being the harder aspect of recovering is the emotional aspect. Right. And I think that is such an important piece to make sure that you're addressing within addiction, because that's really helping you to dig up the roots.
And there is certainly the chemical piece to it that we want to acknowledge and make sure that we give voice to. But the deep roots that we want to really address is in addition to the chemical piece of it, oftentimes why maybe people that don't necessarily have that higher risk of chemical addiction, but they turn to it because of trauma or because of the experiences that they've gone through.
But even more, if you do have that genetic predisposition, as well as the trauma and the experiences that you've been through, it roots it even deeper. And so we are really wanting to get to the root of things and really wanting to help to heal it at its core to give you a better chance and a higher success rate of not relapsing. Another area that EMDR is effective with is chronic pain.
And this is also, I think, another area where people start to feel hopeless because they feel like there's no end to the pain that they are experiencing. But a lot of times trauma is held within the body. And there's a book called The Body Keeps the Score. And so even though you feel like and you come to session, you've told us, oh, I've already worked through that. I've really processed through a lot of that stuff.
We want to make sure that we double back and just look at the possibility of there still being stuff that hasn't been processed fully and is now being stored in your body. Because by processing the traumatic or stressful experiences that are possibly showing up in your body or amplifying the pain, you're that oftentimes it can help reduce the pain intensity in some patients.
Or if it is a psychosomatic symptom that you're experiencing, if we get to the root of that and we take out the trauma that is causing that pain or the physiological symptoms. There can certainly be some healing there.
And this actually even goes along with phantom limb pain. So if you have lost your leg or your arm in some type of an accident, a lot of times people will still report that they still feel pain or discomfort from that limb that no longer exists and actually i've worked on this with not very many clients actually i think it's only been one but i've seen where we've been able to get rid of phantom limb pain through processing the event in which
they lost the limb and it almost seems like your brain's in kind of denial that that limb is limb no longer being there but then as you process the trauma of losing that limb your brain comes to accept it and then it stops sending out or receiving signals from that limb that doesn't exist anymore. All right, guys, so that's about all the time that we have for today.
So a brief recap of what we were talking about is that we explored the idea about EMDR not being any more effective than CBT or long exposure therapy. And although they do tend to have relatively similar outcomes, people going through EMDR are more likely to complete the process compared to people who are going through exposure therapy. And EMDR does seem to have quicker results compared to cognitive behavioral therapy.
Also, we've challenged the misconception that EMDR is only for PTSD, and that we have seen that EMDR is also effective in treating depression. Anxiety, phobias, OCD, addiction, and chronic pain. And there's many other besides that. I think EMDR is effective at treating almost all mental health disorders. And on top of that, it does more than just treating mental health disorders.
It also treats and corrects our negative core values. And that is really where we believe the vast majority of mental health disorders come from, from some type of negative core value. Now, you may have a negative core value that doesn't cause it to rise up to the level of mental health disorder, but still, you could gain a lot of benefit and a lot of freedom from addressing or from reducing those negative core values. I'm not good enough. I'm in danger.
I can't stand it. I'm a failure There's a ton of different negative core values that you could have that could be negatively affecting and creating this negative emotional, Overburden that you might be walking around with what we're going to do is we're going to post in our facebook group A link to some of those negative core values that you could be operating with And if you're reading through that list and you're like,
oh man I feel like i'm ticking off a lot of those and those really kind of poke at me and they hit to the core of who I am. We also have a program called Coaching with Truth, where we can work directly with our listeners. And if you'd like to set up a free consultation, or if you'd just like to set up a session and get working on EMDR, we have a link in our description down below where you can do that. All right, guys, thank you so much for listening. And remember, your mind is a powerful thing.
Thank you so much for tuning in to this episode of Mr. and Mrs. Therapy. We hope that you enjoyed today's episode and found it helpful. If so, would you take 30 seconds and share it with a friend? Also, we'd love for you to leave us a review on Apple Podcast. It lights us up to know that this podcast is helping you. If you have any questions or a topic you'd like discussed in future episodes, visit our Facebook group. Just click the link in the description below.
Although we are mental health providers, This podcast is for informational purposes only and is not intended to provide diagnosis or treatment. If you are struggling with persistent mental health issues, chronic marital issues, or feeling hopeless or suicidal, you are not alone. Help is available. Please seek professional help or call the National Suicide Hotline at 988- Thank you again for joining us on Mr. And Mrs. Therapy. Remember, there's always hope and there's always help. Music.