In recent years, researchers have begun exploring the combination of psychedelic drugs and existing approaches to psychotherapy. Existing forms of psychotherapy, such as cognitive behavioral therapy (CBT) and exposure therapy, are helpful for some, but not for all—which underscores the need for alternative forms of treatment, particularly in light of the growing prevalence of mental illness.1

One promising combination is psychedelic medicine and Eye Movement Desensitization and Reprocessing (EMDR) therapy. There’s limited research on the efficacy of EMDR therapy and psychedelics, but the potential benefits are significant. Here’s what we know so far.

What Is EMDR Therapy?

EMDR therapy is a structured therapy that was developed in the late 1980s by psychologist Francine Shapiro.2In an EMDR session, the therapist uses bilateral stimulation to help a patient desensitize traumatic experiences and reprocess their emotions.

In a standard EMDR session, the patient concentrates on a traumatic memory. The therapist guides the patient through bilateral stimulation, such as tapping or following the therapist’s fingers to move their eyes from left to right. This left-right movement is thought to help the brain both desensitize and reprocess traumatic memories, allowing patients to heal. Clinical trials and case studies show that EMDR therapy is helpful for patients with trauma and PTSD symptoms, and for many clients, EMDR therapy can be completed in fewer sessions than other forms of therapy.3

The eight steps of EMDR

EMDR treatment is divided into eight steps, or phases:4

  • Phase 1: The therapist assesses the client’s history and begins developing a treatment plan.
  • Phase 2: During this phase, the therapist teaches the client a variety of coping strategies they can use between sessions. This phase also prepares the client for what they’ll experience during and after EMDR sessions.
  • Phase 3: The therapist and client identify a target memory to reprocess, an image associated with that memory, and any negative self-beliefs.
  • Phase 4: Under the therapist’s guidance, the client engages in bilateral stimulation while focusing on the target memory. In this phase, the client is instructed to remain open to whatever emotions, images, and sensations arise during the session. After each round of EMDR, the client is instructed to blank out the material they had previously focused on.
  • Phase 5: This is called the “installation” phase. The goal is to replace negative self-beliefs and thoughts with positive ones during EMDR sessions.
  • Phase 6: In the “body scan” phase, the therapist instructs the client to assess whether they feel any tension in their body. This tension is considered a residue of the traumatic event, and it can be targeted in future EMDR sessions.
  • Phase 7: This is the closure phase. The therapist may ask the client to practice their coping techniques, journal, and keep a log of any emotions and sensations that arise when they aren’t in session.
  • Phase 8: This phase involves a reevaluation of the client’s progress so far.

How Psychedelics Can Help With Trauma Resolution

Psychedelics have been studied for their potential to help patients explore and resolve traumatic experiences. For example, MDMA has been shown to produce a heightened state of consciousness and increase emotional openness, leading to a greater ability to process difficult emotions and experiences.5

In terms of trauma and psychedelics, one of the primary benefits of psychedelic-assisted therapy is that it allows individuals to access deeply buried emotions and memories that they may not be able to access through talk therapy alone. This can be especially helpful for those who have experienced severe trauma and may have difficulty verbalizing their experiences.

Research has shown that the use of MDMA-assisted therapy in treating PTSD can lead to significant improvements in symptoms such as anxiety, depression, and flashbacks. Similarly, psilocybin-assisted therapy has been found to reduce symptoms of depression and anxiety in a range of patient populations.6 8

In an interview with the Art and Science of EMDR, EMDR therapist Adam O’Brien, LMHC, shared that psychedelics alter the brain’s default mode network (DMN), a system of brain structures that relate to a person’s sense of self. “Some people are disconnected and really can’t reach that inner world,” O’Brien said. “Some psychedelics will bring it up for them to actually work with.”

The Integration of EMDR and Psychedelic Therapy

While EMDR therapy and psychedelic therapy are both effective treatments for trauma on their own, some experts believe that combining the two could have even greater benefits.

 

In a case study published in EMDR Therapy Quarterly, researchers in the United Kingdom illustrated the use of EMDR in conjunction with a client’s visit to a psilocybin retreat in the Netherlands.8 Multiple EMDR sessions were used to prepare the client for their retreat and integrate the experience afterward. The authors note that EMDR supported the processing of the client’s psychedelic experience and shifts in perspective. “EMDR allowed me to go deeper and explore the associated memories that were connected to what came up in my (psychedelic) trip,” the client shared.

However, EMDR therapy and psychedelics remains a new field—which means best practices have yet to be established, particularly in relation to different psychedelics. Some providers use low doses of ketamine to complement the eight phases of EMDR therapy, while others use EMDR as an integration tool to support psychedelic-assisted psychotherapy.9

Psychotherapist Hannah Raine-Smith and psychedelic therapist Jocelyn Rose proposed a 12-session protocol for psychedelic-assisted eye movement desensitization and reprocessing therapy (PsyA-EMDR).10 In this approach, EMDR is used to prepare the patient for their psychedelic therapy session and integrate afterward. The authors propose six preparation sessions and six integration sessions.

However, it is important to note that there is limited research on the use of EMDR therapy and psychedelics together, and further research is needed to determine the safety and efficacy of this combination. Additionally, the use of psychedelics in therapy is highly regulated and currently only legal in certain contexts, making it difficult for researchers to study the potential benefits—and for clients to benefit from them.

Final Thoughts

To date, there is little research regarding the efficacy of EMDR therapy and psychedelics. However, case studies and our knowledge of the ways psychedelics can help patients access traumatic memories suggest that these therapies can complement each other in more ways than one. For now, further research is needed to evaluate how EMDR therapy and psychedelics can work together in a clinically studied protocol.

References

  1. Tupper KW, Wood E, Yensen R, Johnson MW. Psychedelic medicine: a re-emerging therapeutic paradigm. CMAJ. 2015;187(14):1054-1059. doi:10.1503/cmaj.141124
  2. Shapiro F. Efficacy of the eye movement desensitization procedure in the treatment of traumatic memories. J Trauma Stress. 1989;2(2):199-223. doi:10.1002/jts.2490020207
  3. Menon SB, Jayan C. Eye movement desensitization and reprocessing: a conceptual framework. Indian J Psychol Med. 2010;32(2):136-140. doi:10.4103/0253-7176.78512
  4. Smith KW, Sicignano DJ, Hernandez AV, White CM. MDMA-Assisted Psychotherapy for Treatment of Posttraumatic Stress Disorder: A Systematic Review With Meta-Analysis. J Clin Pharmacol. 2022;62(4):463-471. doi:10.1002/jcph.1995
  5. Davis AK, Barrett FS, May DG, et al. Effects of Psilocybin-Assisted Therapy on Major Depressive Disorder: A Randomized Clinical Trial. JAMA Psychiatry. 2021;78(5):481-489. doi:10.1001/jamapsychiatry.2020.3285
  6. Griffiths RR, Johnson MW, Carducci MA, et al. Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial. J Psychopharmacol (Oxford). 2016;30(12):1181-1197. doi:10.1177/0269881116675513
  7. EMDR and Psychedelics – Interview with Adam O’Brien – YouTube. Accessed April 27, 2023. https://www.youtube.com/watch?v=faHw51lHv-8
  8. Rose J, Raine-Smith H. EMDR as a preparation and integration tool in psychedelic-assisted therapy. EMDR Therapy Quarterly. January 2023.
  9. Roy A. Utilizing Eye Movement Desensitization and Reprocessing Therapy to Help Process Challenging Experiences with Psychedelics by Dr Alana Roy. Mind Medicine Australia. March 26, 2021. Accessed April 27, 2023. https://mindmedicineaustralia.org.au/utilizing-eye-movement-desensitization-and-reprocessing-therapy-to-help-process-challenging-experiences-with-psychedelics/
  10. 10. Raine-Smith H, Rose J. Psychedelic-assisted EMDR therapy (PsyA-EMDR): A memory consolidation approach to psychedelic healing. EMDR Therapy Quarterly. January 2023.