Eye Movement Desensitization and Reprocessing (EMDR) and Dialectical Behavior Therapy (DBT) are two evidence-based therapies used to treat various mental health conditions.
EMDR focuses on processing past trauma, while DBT teaches distress tolerance and emotion regulation skills.
Some wonder if these therapies can be combined safely and effectively in treatment. Here is what the research shows.
Overview of EMDR and DBT
What is EMDR?
EMDR utilizes bilateral stimulation, like eye movements or taps, to help the brain process traumatic memories.
This allows distressing memories to become less disturbing and triggers less reactive responses.
EMDR is an 8-phase treatment approach guided by a professionally trained therapist.
It is considered a frontline treatment for post-traumatic stress disorder (PTSD) and has applications in treating other conditions as well.
What is DBT?
DBT is a type of cognitive behavioral therapy (CBT) specifically developed to treat borderline personality disorder (BPD).
However, its skills are now applied to other mental health struggles, too.
DBT focuses on four skill modules:
- Mindfulness
- Distress tolerance
- Emotion regulation
- Interpersonal effectiveness
Teaching these skills helps reduce self-harm behaviors, emotional volatility, and instability associated with BPD and mood disorders.
Can EMDR and DBT Be Used Together?
EMDR and DBT take different approaches to improving mental health but have some overlap in their overall goals.
Using skills from both may provide greater benefits than either alone for some individuals.
However, there are also some important considerations.
Potential Benefits
Here are some potential benefits of combining EMDR and DBT:
- EMDR can reduce trauma-related triggers and reactions, making it easier to implement DBT skills
- DBT offers coping methods to manage emotions stirred up by EMDR sessions
- EMDR may free up mental resources so clients can absorb more of what is taught in DBT
- DBT group support can reinforce self-care and stability needed during intense EMDR work
Integrating the two therapies requires coordination between all providers involved to ensure the treatments complement each other.
| Common Goals of EMDR and DBT |
|---|
| Regulate emotions |
| Tolerate distress |
| Improve relationships |
| Enhance coping skills |
Cautions
However, there are also some reasons for caution:
- Processing trauma with EMDR can feel destabilizing initially
- Coping skills from DBT may not yet be solid enough to manage that instability
- Timing and sequence matter – skills may need to be established first
Additionally, EMDR requires training to administer properly. Mixing therapies without guidance could worsen symptoms.
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Creating an Integrated Treatment Plan
An expert therapist guides the integration of EMDR and DBT. With careful planning, the therapies can build on each other’s strengths. Here are some tips:
Get input from all providers
Collaboration ensures alignment on:
- Diagnosis and symptoms requiring treatment
- Sequence and timing of interventions
- Signs of client instability requiring a change in approach
Build coping skills first
Establish DBT skills so clients have support for EMDR processing.
Adjust EMDR pacing
Slow trauma processing if coping abilities feel thin or instability emerges.
Skillful integration allows clients to get the best out of EMDR and DBT together. But coordination is vital to do this safely and effectively.
