Does EMDR Work for Complex PTSD?

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Eye Movement Desensitization and Reprocessing (EMDR) has become a popular psychotherapy treatment for post-traumatic stress disorder (PTSD).

However, there has been debate about whether it is also effective for complex PTSD (CPTSD).

This article analyzes the current research on using EMDR for CPTSD.

What is complex PTSD?

Complex PTSD is a disorder that develops after prolonged, repetitive trauma, unlike PTSD which can occur after a single event.

Examples include:

Childhood neglect, abuse, or abandonment
Domestic violence
Captivity or kidnapping

Symptoms are more severe and pervasive than PTSD, affecting self-regulation, relationships, identity, and cognition.

EMDR overview

EMDR is an eight-phase, evidence-based psychotherapy approach guided by adaptive information processing, where traumatic memories become “unstuck” and processed to adaptive resolution.

Type	Example
Visual	Tracking fingers moving back and forth
Auditory	Listening to alternating taps or tones
Tactile	Tapping hands alternately on thighs

EMDR utilizes bilateral stimulation like eye movements, taps, or tones to activate the brain’s information processing system.

Most sessions last 60-90 minutes and involve identifying a target memory and its related negative belief.

Analysis of current research

There have only been a few studies analyzing EMDR for CPTSD specifically. However, results generally show potential:

2023 case study

52-year old woman with CPTSD and Bipolar Personality Disorder diagnoses
Her CAPS (Clinician Administered PTSD Scale) score reduced from the clinical range to 0, indicating a full remission of her PTSD symptoms.
After 10 sessions of EMDR over 5 weeks, the client no longer met diagnostic criteria for complex PTSD or borderline personality disorder. Her symptoms of intrusive memories, avoidance, hyperarousal, emotion regulation difficulties, and interpersonal problems improved significantly.
By the end of treatment, the client reported much improved emotion regulation, behavior changes, increased self-confidence and fewer conflicts with others. She resumed pleasant activities and took up new hobbies.

Researchers concluded EMDR could be useful for CPTSD, but more research is needed.

2018 case control study

31 patients with histories of severe, early interpersonal trauma were assigned to receive 8 sessions of either trauma-focused psychoeducation alone (TAU) or psychoeducation plus limited EMDR protocols (TAU+EMDR).
EMDR techniques used included resource installation, self-care pattern enhancement, and processing of dissociative phobias and blockages while avoiding direct trauma memory work. Sets were very brief.
Results showed the addition of EMDR was safe, even for those with dissociative symptoms. The TAU+EMDR group showed significantly greater improvement in subjective well-being and perceived session usefulness compared to TAU.
Other areas like general health, satisfaction, and dissociation levels improved more with EMDR but differences were not statistically significant in this small sample.
Patients at times reported EMDR sessions as less useful, likely because bilateral stimulation increased emotional disturbance which this complex group struggles to tolerate.

In conclusion, incorporating controlled EMDR techniques into group therapy appears safe and may confer additional benefits versus psychoeducation alone for severely traumatized patients, but the emotional impact needs managing.