The Benefits of Integrating DBT with EMDR: For Clients and Clinicians

Brief Creation History

DBT, which is a modified form of Cognitive Behavioral Therapy, was developed by Dr. Marsha Linehan in the 1970s during a time in her life when she was experiencing problems with her own mental health.

EMDR was developed in the late 1980s by Dr. Francine Shapiro. The idea for EMDR originated a decade prior while she was working on her English literature degree. Her interest in behavior therapy and human psychology continued to develop and in 1987, after a fatal cancer diagnosis, and a chance discovery with eye movement, EMDR was developed.

How Does DBT work?

A trained DBT therapist assists you with learning and implementing skills incorporating 4 main modules: mindfulness, distress tolerance, interpersonal effectiveness, and emotional regulation. This can be adapted to work with individuals and groups of all ages. DBT has been used to effectively treat issues such as: borderline personality disorder, impulsive self-harming behaviors, substance abuse, eating disorders, and others.

How Does EMDR work?

A trained EMDR therapist guides you through a series of 8 Phases including: history-taking, preparation, assessment, desensitization, installation, body scan, closure, and re-evaluation. EMDR uses bilateral stimulation (eye movement, sound, tapping, etc.) to decrease emotional pain and distress associated with traumatic memories. It is used to treat illnesses such as: PTSD, addictions, anxiety, chronic pain, depression, OCD, eating disorders, panic attacks, panic disorder, phobias, and others.

So Why Combine them in Mental Health Treatment?

• Both approaches are modified from behavior therapy, are evidence-based, and have been found to be effective in working with people with mental health disorders. 

• Both help with addressing the past, present, and future.

• Wise Mind and other DBT skills can be used to support EMDR during the preparation phase.

• Clinicians can process and introduce DBT skills in sessions on treatment days that clients do not have time for EMDR reprocessing.

• DBT skills can be used by clients to help with in-between session emotional and affect regulation, stabilization, relaxation, and mindfulness in the present.

• Targeting different parts of the brain, top-down (talk-therapy) and bottom-up (EMDR reprocessing) helps with providing comprehensive mental health treatment.

Additional Factors to be Mindful of:

• Medication management and consistent monitoring by the client’s prescriber/ medical provider also enhances treatment effectiveness and improves holistic care.

• It’s important to apply the treatment correctly so they will be effective.

• It’s important for therapist to seek out consultation and additional trainings as needed.

• Informed consent, a thorough explanation of integrating the approaches, and agreed upon. Treatment Plans between the clinician and client is vital before the start of care.

I have included helpful books to learn more about these treatment modalities below.

Koerner, K. (2012). Doing Dialectical Behavior Therapy: A Practical Guide. The Guilford Press.

Shapiro, F. (2018). Eye Movement Desensitization and Reprocessing (EMDR) Therapy: Basic Principles, Protocols, and Procedures (3 rd ed.). The Guilford Press.

Van der Kolk, B., M.D. (2014) The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Penguin Books.