EMDR

What is EMDR?

Eye Movement Desensitization and Reprocessing, or “EMDR”, is a highly research-supported type of therapy that draws on the wisdom of numerous other well-known psychotherapy theories and techniques.  It is compatible with all other types of psychotherapy, so if you are already in a different type of therapy, EMDR can be a useful tool to incorporate into the work.

EMDR is essentially an accelerated form of information processing.  When something traumatic happens to you, your brain may continue to hold onto the event in a manner that includes the original picture of the event, as well as the sounds, feelings, thoughts and/or sensations associated with it.  It may feel like the trauma is locked inside of you and can be triggered by many different experiences or people whom you encounter, both during the day and at nighttime.  These old experiences can therefore continue to cause you a great deal of trouble, making you feel anxious, vulnerable, scared, angry, etc.  You may also feel helpless sometimes because you are unable to control what is happening in your mind or in your body due to your being triggered by these past traumatic events. 

EMDR was discovered by Dr. Francine Shapiro, who noticed that when she moved her eyes back and forth repeatedly, this lessened her negative thoughts and feelings.  She then experimented with this some more on herself and on her friends, and continued to have similar results, so she started creating research protocols to test out the effectiveness of the approach more officially.  She discovered that when she used EMDR in her work with clients, people began to get better much faster and more completely.  Over time, she learned through her research that the essential healing component was not eye movements per se, but bilateral stimulation of the brain that seems to help our brains to reprocess the originally traumatic event and move past it.  As a result, therapists who use EMDR might incorporate eye movements, auditory tones to each ear, hand taps/stimulation and/or a combination of these techniques in order to create the bilateral brain stimulation needed for change to occur.

Research on EMDR

EMDR is one of the most thoroughly researched methods for treating trauma.  In recent studies, 84-90% of clients who survived rape, combat, loss of a loved one, accidents, or natural disasters no longer experienced post-traumatic stress disorder (PTSD) after only three treatment sessions.  A study done by Kaiser-Permanente (a California managed care company) discovered that EMDR was twice as effective in half of the time, compared to standard therapeutic treatments. 

People who suffer repeated or more complex traumas often take longer to get better than those with a single, simple trauma, but EMDR has proven effective with more complicated cases as well.  Every person’s needs are different.  It is important to do EMDR at a pace that feels comfortable for you, which sometimes means incorporating EMDR sessions into a more ongoing psychotherapy treatment so that you have time to absorb the impact of the EMDR regarding one traumatic event before proceeding to work on the next trauma through EMDR. 

Symptoms that EMDR Can Help To Treat:

In addition to trauma (see above), EMDR can be helpful with pain management, addictions, depression, anxiety, grief/loss, and issues related to early childhood abuse or neglect.  It may also assist in enhancing performance in school, sports, creative arts, etc.  (based on clinician observation but not yet documented by research).

How Does EMDR Work?

There are eight phases of treatment in EMDR, completed over a series of sessions:

1. History taking - We learn about all aspects of who you are in order to best determine how to focus your therapy and to create a treatment plan with you.

2. Preparation- We make sure you have the coping strategies you need in order to tackle your problems.  These may include ways to soothe yourself or to otherwise manage distressing feelings, thoughts or body sensations.  It also provides you with an introduction to EMDR so that you get a sense of how it works and can ask questions about it.  We will not proceed past this phase until you and I agree that you are ready to do so.

3. Assessment- We clarify which problem to work on by looking at what image represents each problem, how it makes you feel, negative ways that you think about yourself as a result of the issue, as well as how you would prefer to think about yourself now (more positively), and what body sensations the memory evokes in your body as we discuss it.   We also assess the degree of distress that you are feeling, as well as how much you believe the positive cognition about yourself  so that we can use those measures as a baseline to refer back to further in the treatment when we want to measure your progress.

4. Desensitization- We use bilateral stimulation (through eye movements, tapping, auditory noises) to work on the targeted problem and all associated material connected to it until it is cleared.  We use two scales to measure your progress—one (the SUDS) measures the degree of discomfort or disturbance with the problem while the other (the VOC) measures how much you are now able to believe your positive cognition about yourself.  This phase might be long or short, depending on what you need in order to resolve that particular target.

5. Installation - We connect your positive cognition to whatever remains of your previous targeted problem, diminishing the targeted problem and enhancing the now more positive view of yourself.

6. Body Scan- We check how you are feeling in terms of your body sensations to ensure that all discomfort has been addressed and released.  If not, we may resume some of the previous steps in order to more fully repair the damage that the targeted issue has caused.  We want to make sure that we have fully addressed all aspects of the targeted problem so that it will hopefully no longer be an issue for you going forward.

7. Closure - At the end of each session, we do a formal closing together, often by using one of your coping resources.  I want to make sure that you are feeling OK before you leave the office.  Once EMDR has begun, your mind and body might continue to process material not only during the sessions but also between them.  As a result, please write down any interesting changes that you observe in yourself (your mood, behavior, body sensations, thoughts, interactions, etc.), as well as dreams that you recall having.  Sometimes people can feel like they are re-experiencing old difficulties—this is a natural part of the process and will pass in time, so do not be alarmed if this occurs to you.  Please do contact me and let me know, though, if this or any other distressing experience occurs, so that I can help you to ground/soothe yourself till our next session together and help you to feel less alone while coping with this.

8. Re-evaluation- This occurs at the start of each EMDR session after the first one.  We review the information you have gathered between sessions in order to see if any new material needs to be incorporated into our work together.

These eight phases can be applied to situations from your past, to issues from your present life, or even be used regarding ways that you wish to approach life in your future.  EMDR can therefore free you up to be more fully the person you were meant to be and have always aspired to become.