Eye Movement Desensitization and Reprocessing (EMDR) Therapy

 WHAT IS EMDR?

Eye Movement Desensitization and Reprocessing (EMDR) therapy is an interactive psychotherapy method proven to help an individual recover from trauma and enable an individual to heal from the symptoms and emotional distress that are the result of disturbing life experiences, including anxiety, depression and PTSD.

EMDR uses rapid sets of eye movements to help update disturbing experiences, much like what occurs when we sleep. During sleep, we alternate between regular sleep and REM (rapid eye movement). This sleep patter helps you process things that are troublesome. EMDR replicate between sets of eye movements and brief reports about what you are noticing. This alternating process helps you update your memories to a healthier present perspective. EMDR includes assessment, resource development and treatment planning (float back to get targets) and is not suitable for all issues. 

How does EMDR Work?

EMDR involves eight phases of treatment that focus on the past, the present, and the future and is designed to break any associations you have between certain circumstances and symptoms. Each phase helps you work through emotional distress and trauma, then learn skills to cope with current and future stress.

No one knows how any form of psychotherapy works neurobiologically or in the brain. However, we do know that when a person is very upset. their brain cannot process information as it does ordinarily. One moment becomes “frozen in time," and remembering a trauma may feel as bad as going through it the first time because the images, sounds, smells, and feelings haven't changed. Such memories have a lasting negative effect that interferes with the way a person sees the world and the way they relate to other people.

EMDR seems to have a direct effect on the way that the brain processes information. Normal information processing is resumed, so following a successful EMDR session. a person no longer relives the images, sounds, and feelings when the event is brought to mind. You still remember what happened, but it is less upsetting. Many types of therapy have similar goals. However, EMDR appears to be similar to what occurs naturally during dreaming or REM (rapid eye movement) sleep. Therefore, EMDR con be thought of as a physiologically based Therapy that helps a person see disturbing material in a new and less distressing way.

The Phases of EMDR

1. History-taking and Treatment Planning

In addition to getting a full history and conducting appropriate assessment, the therapist and client work together to identify targets for treatment. Targets include past memories, current triggers and future goals.  

2. Preparation

The therapist offers an explanation for the treatment, and introduces the client to the procedures, practicing the eye movement and/or other Bi Lateral Stimulation (BLS) components.  The therapist ensures that the client has adequate resources for affect management, leading the client through the Safe/Calm Place exercise. 

3. Assessment

The third phase of EMDR, assessment, activates the memory that is being targeted in the session, by identifying and assessing each of the memory components: image, cognition, affect and body sensation.

4. Desensitization

During this phase, the client focuses on the memory, while engaging in eye movements or other Bi Lateral Stimulation (BLS). Then the client reports whatever new thoughts have emerged. The therapist determines the focus of each set of BLS using standardized procedures. Usually the associated material becomes the focus of the next set of brief BLS. This process continues until the client reports that the memory is no longer distressing.  

5. Installation

The fifth phase of EMDR is installation, which strengthens the preferred positive cognition.  

6. Body Scan

The sixth phase of EMDR is the body scan, in which clients are asked to observe their physical response while thinking of the incident and the positive cognition, and identify any residual somatic distress. If the client reports any disturbance, standardized procedures involving the BLS are used to process it. 

7. Closure

Closure is used to end the session. If the targeted memory was not fully processed in the session, specific instructions and techniques are used to provide containment and ensure safety until the next session. 

8. Re-evaluation

The next session starts with phase eight, re-evaluation, during which the therapist evaluates the client's current psychological state, whether treatment effects have maintained, what memories may have emerged since the last session, and works with the client to identify targets for the current session. 

WHAT IS AN ACTUAL EMDR SESSION LIKE?

During EMDR, the therapist works with the client to identify a specific problem as the focus of the treatment session. The client calls to mind the disturbing issue or event, what was seen, felt. heard, thought, etc., and what thoughts and beliefs are currently held about that event. The therapist facilitates the directional movement of the eyes or other dual attention stimulation of the brain, while the client focuses on the disturbing material, and the client just notices whatever comes to mind without making any effort to control direction or content. Each person will process information uniquely, based on personal experiences and values. Sets of eye movements are continued until the memory becomes less disturbing and is associated with positive thoughts and beliefs about one's self; for example, “I did the best I could." During EMDR, the client may experience intense emotions, but by the end of the session, most people report a great reduction in the level of disturbance.

HOW LONG DOES EMDR TAKE?

One or more sessions are required for the therapist to understand the nature of the problem and to decide whether EMDR is an appropriate treatment. The therapist will also discuss EMDR more fully and provide an opportunity to answer questions about the method. Once therapist and client have agreed that EMDR is appropriate for a specific problem, the actual EMDR therapy may begin.

A typical EMDR session lasts from 50 to 80 minutes. The type of problem, life circumstances, and the amount of previous trauma will determine how many treatment sessions are necessary. EMDR may be used within a standard “talking" therapy, as an adjunctive therapy with a separate therapist, or as a treatment all by itself.