EMDR (Eye Movement Desensitization and Reprocessing) is a form of treatment for individuals who have suffered a traumatic event and are still suffering from its effects. EMDR enables clients to activate their own natural healing power through a guided process of remembering and feeling.
WHAT IS EMDR Therapy?
EMDR Therapy is an eight-phase treatment modality that uses side-to-side eye movements (sometimes in conjunction with other bilateral stimulation) during the session. The clinician triggers the side-to-side eye movements by having the patient focus on her fingers which she moves back-and-forth in front of the patient, asking patients to follow the movement without moving their head. This creates a similar experience in the brain to that which occurs during REM sleep.
We know that REM sleep plays a role in learning, memory, and mood. People who do not get REM sleep are much more likely to have anxiety and depression than people who do experience periods of REM sleep. One of the biggest problems with sleep medications, besides the very negative impact of regularly taking sleep medication, is that it does not allow for REM sleep.
Bottom line, the biological mechanisms involved in Rapid Eye Movement (REM) can be activated using EMDR as a way of helping patients begin to process painful memories and the disturbing feelings associated with them.
How Does EMDR Therapy Work?
EMDR is an eight-phased treatment method designed to help combat traumatic experiences and other mental health disorders. The phases are broken up into history taking, client preparation, assessment, desensitization, installation, body scan, closure, and examining the progress of the treatment.
Generally speaking, the theme is one of shifting from victimization to empowerment. For instance, in my practice, a rape victim shifted from feeling horror and self-disgust to holding the firm belief that, “I survived it and I am strong.”
Unlike talk therapy, the insights clients gain in EMDR therapy are patient-driven rather than a therapist- driven. In other words, the interpretation of the event evolves from the client’s own accelerated intellectual and emotional response to the process and not the therapists’ interpretation of the event. The therapist is in charge of the process the patient is in charge of interpreting it. It is probably this aspect, more than any other, that empowers the patient.
Another aspect of EMDR that patients seem to appreciate is the fact that they do not have to go into detail about the event during the session. They can recall it and with the help of the therapist, interpret it, without actually describing it, which in talk therapy, can be extremely painful and triggering for some.
How quickly does EMDR work?
EMDR therapy is a highly focused approach to treating traumatic events and the symptoms associated with those events. This takes place by reconnecting the client in a safe and measured way to the images, thoughts, and emotions associated with the event(s).
PROBLEMS THAT RESPOND WELL TO EMDR
EMDR has been found to effectively treat anxiety and mood disorders, including depression, and panic disorders as well as panic disorders, panic attacks, and agoraphobia.
What Can I Expect?
Typically, in EMDR, you will feel less overwhelmed when recalling aspects of your traumatic experience. You could also start to think and feel differently about related memories. This is an indicator that your mind is beginning to heal.
The EMDR Phases
Overall EMDR therapy involves attention to three time periods: the past, present, and future. Focus is given to past disturbing memories and related events, but it is also given to current situations that cause distress, and to developing the skills and attitudes needed for positive future actions. In contrast to standard PTSD treatments, EMDR not only closes mental wounds, but it also transforms them into personal empowerment. There are several phases that are essential for the success of EMDR.
Phase 1: History And Treatment Planning
The first phase is a history-taking session(s) in which the therapist assesses the client’s readiness and develops a treatment plan. The 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.
Phase 2: Preparation
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. This stage is also used to foster trust between the therapist and client. The therapist will explain the EMDR process in great detail so the client will be informed, relaxed, and confident during treatment. The goal of EMDR therapy is to produce rapid and effective change while the client maintains equilibrium during and between sessions.
Phase 3-6
These four phases include:
Assessment
Desensitization
Installation
Body Scan.
For phases three to six, a target is identified (Assessment) and processed (Desensitization)
Installation involves the client identifying 3 things:
• The vivid visual image related to the memory
• A negative belief about self
• Related emotions and body sensations
• 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 thoughts, 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 are 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 all goes well, the new beliefs and positive feelings are “installed.“
If the client becomes distressed or has difficulty in progressing, the therapist follows established procedures to help the client get back on track.
Phase 7: Closure
In phase seven, closure, the therapist asks the client to keep a log during the week following the EMDR session. 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: Reevaluation
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 hours. Multiple trauma victims may require a longer treatment time.
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. If the client has multiple traumas, this phase will identify those areas and the process will begin again with a new target trauma. After successful treatment with EMDR therapy, patients will achieve physiological reconciliation, relieved distress, and the ability to reformulate negative beliefs on their own.
