If you have heard of EMDR (Eye Movement Desensitization and Reprocessing) therapy, it's likely because it is known as a leading treatment for trauma. But did you know that it is also used to alleviate performance anxiety?
What is EMDR?
Developed in the late 1980s as a treatment for veterans with PTSD, EMDR has become a leading evidence-based treatment for trauma endorsed by institutions such as the World Health Organization (WHO), International Society for Traumatic Stress Studies (ISTSS), US Department of Veteran Affairs, and the American Psychological Association (APA).
But EMDR is now used for treating more than trauma. It is also an effective therapy for:
anxiety
performance anxiety
phobias,
panic
depression
mood and personality disorders
adjustment disorders, and more.
This is good news if you're someone who struggles with performance anxiety. People often seek out EMDR when other things they have tried have failed. EMDR uncovers and targets the source of the distress quickly. and it's been shown to be effective in decreasing performance anxiety in many domains including:
healthcare
performing arts, such as musicians, dancers, and theatre
business
military
athletes
public speaking
test taking
EMDR also has a modified protocol specifically for performance enhancement - PEP-EMDR- that helps folks interested elevating their performance levels. No need for a history of negative experiences or trauma.
Both EMDR and PEP - EMDR can help you:
Bring greater consistency to your performance area
Prepare for performance challenges (eg., auditions, interviews, competitions, presentations)
Perform with greater confidence
Manage anxiety and stress
Deal effectively with set-backs
Regulate difficult emotions
Adapt to transitions in life, work, or your performance area
The way EMDR has been adapted to respond to a breadth of issues is an exciting development because it can meet each performer's unique needs and goals. For example, someone might be struggling to overcome limiting self-beliefs instilled from traumatic or negative formative childhood experiences. Maybe something specific to preparing and performing currently is causing the distress. Someone might be trying to figure out how to return to performance or work after a major setback or injury. Or perhaps a performer believes they have hit a plateau and are looking to reach higher levels of performance. EMDR can respond flexibly to a variety of issues.
How does EMDR work?
EMDR is based on the Adaptive Information Processing model developed by Francine Shapiro. She found in her research and work with veterans that memories that are traumatic are stored differently from those that are not. This has since been shown by advances in neuroimaging, Traumatic memories are stored in isolated networks with the emotions, sensations, and images that accompany them. If they are not processed properly, they get stuck and continue to cause negative reactions long after the event occurred. The memories are cut off from the parts of the brain that apply logic and language. EMDR aims to integrate these neural networks so that distressing memories can be taken out of their disorganized, chaotic storage system, linked up with more adaptive information, and refiled into a coherent and empowering narrative.
Traditional cognitive behavioural therapies work with how thoughts and beliefs influence actions and emotions. EMDR goes a step further to includes the body and the senses while harnessing the brain’s natural capacity to heal and rewire.
As I noted in a previous post, traumatic memories do not have to be huge events. They can be small experiences that instill negative self-beliefs, such as not being good enough. Subsequent events reinforce these beliefs when the brain associates them with the previous negative experiences. This is why certain bodily sensations, places, interpersonal interactions, sounds, sights, etc., can trigger defeatist thinking and fear that can be overwhelming.
What does EMDR look like in a session?
After taking a history, the therapist prepares the client with tools designed to help with calming emotions. (These are great techniques for managing anxiety in general.) Emotionally-charged events that are associated with negative self-beliefs that underlie the anxiety are carefully chosen and targeted through bilateral stimulation (BLS). During BLS both sides of the body are alternately stimulated through tactile tapping, eye movement, or auditory means (with headphones). The therapist guides the client to process chosen memories from the past while maintaining attention in both past and present. This process desensitizes the client to the distress and anxiety and loosens the grip that limiting beliefs have on the mind and body. EMDR then moves to current distress before shifting focus to installing a desired future state with more empowering beliefs about self.
What does the research say about using EMDR for performance anxiety?
While there is still need for more research, controlled studies investigating the effectiveness of EMDR are growing with promising results. Here is a sample representing different domains:
Music
In this randomized control study from 2021, 46 pianists from 3 higher educational institutions were put in three groups: Cognitive Hypnotherapy (CH), EMDR, and a control group. After only 2 sessions and between 2 concerts, the CH and EMDR groups showed significant improvement in state anxiety (anxiety provoked in performance situation only) and a significant decrease in music performance anxiety. The EMDR group was the only one which also experienced significantly lower trait anxiety (the tendency to feel anxious in a variety of situations). Positive effects were maintained 4 months, 1 year, and 2 years after the intervention.
Public speaking
In a 2013 randomized control study, 30 female college students with public speaking anxiety were given 7 sessions of EMDR. Post-tests revealed that confidence increased significantly and physiological symptoms of anxiety decreased significantly.
Test taking and learning
A 2019 study of 40 university students who experienced an aversion to math and anxiety around a math exam were divided into two groups. One group was taught relaxation strategies for 2 hours and the other was given a single session of EMDR. The EMDR group experienced significantly reduced negative emotions related to math as well as significantly increased self-efficacy, or belief in their ability to perform. These results were maintained a month later.
Sport
A 2023 case study looked at four athletes who struggled with anxiety and subobtimal performance after a sports injury. After a single session of EMDR, the athletes returned to their previous performance levels with decreased anxiety levels and increased confidence.
What else do I need to consider before I try EMDR?
EMDR must be delivered by a trained clinician such as an LMHC, LSW, LMFT, or psychologist who is also specially trained in EMDR through an established EMDR institution such as EMDRIA (International Association). Most clinicians will be happy to show you their credentials.
Make sure you feel comfortable with the therapist. Scheduling a consultation call can give you a good idea of whether it is a good fit.
EMDR can be used as an adjunct with other therapies, such as talk therapy. In fact, this is often desirable, especially when there are a few different issues going on.
EMDR is becoming ever more accessible as it continues to grow. More people are seeing who they can become and what they can achieve when they are unburdened of the anxiety of performance and are free to experience the joy of their craft again.
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Aslani J, Miratashi M, Aslani L. Effectiveness of eye movement desensitization and reprocessing therapy on public speaking anxiety of university students. Zahedan J Res Med Sci. 2014; 16(Suppl 1): 46-49.
Brooker, E. (2021). A clinical study into the effects of cognitive hypnotherapy and EMDR on music performance anxiety. European Journal of Integrative Medicine, 48, 102008-. https://doi.org/10.1016/j.eujim.2021.102008
Reynoso-Sánchez, L. F., & Hoyos-Flores, J. R. (2023). A Single-Session Eye Movement Desensitization and Reprocessing (EMDR) Therapy Reduces Anxiety and Improves Self-confidence in Athletes with Post-traumatic Stress Associated with Injury. International Journal of Sport Studies for Health, 5(2). https://doi.org/10.5812/intjssh-134823
Scelles, C., & Bulnes, L. C. (2021). EMDR as Treatment Option for Conditions Other Than PTSD: A Systematic Review. Frontiers in Psychology, 12, 644369–644369. https://doi.org/10.3389/fpsyg.2021.644369
Vauthier, M., Paquet, Y., Krumm, C. M., and Tarquinio, C. (2019). Towards a new understanding of mathematics through Eyes Movement Desensitization and Reprocessing: news and perspectives. Psychol. Fr. 64, 295–304. doi: 10.1016/j.psfr.2017.11.001
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