What is EMDR?
EYE MOVEMENT DESENSITIZATION AND REPROCESSING (EMDR) THERAPY
EMDR is a structured therapy for trauma that has been shown to effectively alleviate symptoms of PTSD. EMDR is different than many other exposure and processing-based trauma therapies in that it does not involve extended exposure or detailed recounting of the trauma, nor are there any homework assignments. Rather, EMDR aims to directly influence the neurological mechanisms involved with memory storage. While the client briefly focuses on the traumatic memory, the therapist guides the client through exercises that initiate bilateral stimulation of the brain, including eye movements and other forms of rhythmic left-right (bilateral) stimulation (e.g., tones or taps). Research suggests that this bilateral stimulation effectively reduces the vividness and emotional intensity of the distressing memory.
EMDR therapy uses a structured eight-phase approach that includes:
- Phase 1: History-taking
- Phase 2: Preparing the client
- Phase 3: Assessing the target memory
- Phases 4-7: Processing the memory to adaptive resolution
- Phase 8: Evaluating treatment results
It is typically carried out once or twice weekly over six to twelve sessions, though some people experience benefits in as few as three sessions.
If you are experiencing intrusive and vivid memories of trauma, contact us today to see if EMDR might be the right option for you.
Will it work?
More than 30 positive controlled outcome studies have been done on EMDR therapy. Some of the studies show that 84%-90% of single-trauma victims no longer have post-traumatic stress disorder after only three 90-minute sessions. Another study, funded by the HMO Kaiser Permanente, found that 100% of the single-trauma victims and 77% of multiple trauma victims no longer were diagnosed with PTSD after only six 50-minute sessions. In another study, 77% of combat veterans were free of PTSD in 12 sessions. There has been so much research on EMDR therapy that it is now recognized as an effective form of treatment for trauma and other disturbing experiences by organizations such as the American Psychiatric Association, the World Health Organization and the Department of Defense. Given the worldwide recognition as an effective treatment of trauma, you can easily see how EMDR therapy would be effective in treating the “everyday” memories that are the reason people have low self-esteem, feelings of powerlessness, and all the myriad problems that bring them in for therapy. Over 100,000 clinicians throughout the world use the EMDR therapy. Millions of people have been treated successfully over the past 25 years
Why is it done?
Francine Shapiro, an American psychologist, developed EMDR therapy in the late 1980's to treat Post Traumatic Stress Disorder (PTSD) . The US Dept. of Veterans Affairs highly recommends the Therapy. Since its introduction a wider variety of stress disorders were found to respond favorably to the EMDR treatment including:
- Phobias
- PTSD
- Anxiety
- Chronic Pain
- Depression
What to Expect
Phase 1: The first phase is a history-taking session(s). The therapist assesses the client’s readiness and develops a treatment plan. Client and therapist identify possible targets for EMDR processing. These include distressing memories and current situations that cause emotional distress. Other targets may include related incidents in the past. Emphasis is placed on the development of specific skills and behaviors that will be needed by the client in future situations.
Initial EMDR processing may be directed to childhood events rather than to adult onset stressors or the identified critical incident if the client had a problematic childhood. Clients generally gain insight on their situations, the emotional distress resolves and they start to change their behaviors. The length of treatment depends upon the number of traumas and the age of PTSD onset. Generally, those with single event adult onset trauma can be successfully treated in under 5 total hours. Multiple trauma victims may require a longer treatment time.
Phase 2: During the second phase of treatment, the therapist ensures that the client has several different ways of handling emotional distress. The therapist may teach the client a variety of imagery and stress reduction techniques the client can use during and between sessions. A goal of EMDR therapy is to produce rapid and effective change while the client maintains equilibrium during and between sessions.
Phases 3-6: In phases three to six, a target is identified and processed using EMDR therapy procedures. These involve the client identifying three things:
1. The vivid visual image related to the memory
2. A negative belief about self
3. Related emotions and body sensations.
In addition, the client identifies a positive belief. The therapist helps the client rate the positive belief as well as the intensity of the negative emotions. After this, the client is instructed to focus on the image, negative thought, and body sensations while simultaneously engaging in EMDR processing using sets of bilateral stimulation. These sets may include eye movements, taps, or tones. The type and length of these sets is different for each client. At this point, the EMDR client is instructed to just notice whatever spontaneously happens.
After each set of stimulation, the clinician instructs the client to let his/her mind go blank and to notice whatever thought, feeling, image, memory, or sensation comes to mind. Depending upon the client’s report, the clinician will choose the next focus of attention. These repeated sets with directed focused attention occur numerous times throughout the session. If the client becomes distressed or has difficulty in progressing, the therapist follows established procedures to help the client get back on track.
When the client reports no distress related to the targeted memory(s), he is asked to think of the preferred positive belief that was identified at the beginning of the session. At this time, the client may adjust the positive belief if necessary, and then focus on it during the next set of distressing events.
Phase 7: In phase seven, closure, the therapist asks the client to keep a log during the week. The log should document any related material that may arise. It serves to remind the client of the self-calming activities that were mastered in phase two.
Phase 8: The next session begins with phase eight. Phase eight consists of examining the progress made thus far. The EMDR treatment processes all related historical events, current incidents that elicit distress, and future events that will require different responses
For more information or to discuss if EMDR can help you or someone you know just call Richard Lill, LCSW
