Can EMDR Improve Low Self-Esteem?

Low self-esteem rarely appears as a diagnosis in its own right, yet it runs underneath a great deal of psychological distress. Persistent beliefs such as "I am worthless" or "I am not good enough" feature in depression, anxiety, eating difficulties, and social withdrawal, and can make other problems harder to shift. Given how central it is, surprisingly little research has looked at how best to treat it directly. EMDR is an interesting candidate here. Negative self-beliefs are not abstract ideas; they usually have a history. They tend to be traced back to specific experiences of humiliation, rejection, criticism, or failure. EMDR works precisely on such memories, aiming to reduce their emotional charge and allow more adaptive beliefs to take hold. In fact, shifting the negative self-belief attached to a memory is a built-in part of the standard EMDR protocol. A randomised controlled trial by Brecht Griffioen and colleagues, published in *Frontiers in Psychology* (2017), tested this in a general psychiatric outpatient population. Thirty participants were randomly assigned to receive ten weekly sessions of either EMDR or CBT, and were assessed before treatment, after each session, at the end, and three months later. The results were encouraging for both therapies. Both groups showed significant improvements in self-esteem, with scores on the main measure rising by around two standard deviations, a substantial change by any standard. Both also showed reductions in psychological symptoms more generally. The usual caveats apply, and here they matter: the sample was small, with only fifteen people per group, and fewer completed the full protocol. A trial of this size cannot reliably detect modest differences between two active treatments, so this is best read as promising early evidence rather than a settled conclusion. Still, the underlying idea is worth holding onto. If low self-esteem is built out of remembered experiences rather than simply a habit of thought, then a therapy that works directly on those memories has a plausible route to changing it. For people who have found that understanding their negative beliefs intellectually has not been enough to shift how they feel, that distinction may be the useful one. *Source: Griffioen, B. T., van der Vegt, A. A., de Groot, I. W., & de Jongh, A. (2017). The Effect of EMDR and CBT on Low Self-esteem in a General Psychiatric Population: A Randomized Controlled Trial. Frontiers in Psychology, 8, 1910.*