Eye Movement Desensitization and Reprocessing (EMDR)
Eye Movement Desensitization and Reprocessing (EMDR) is a research-based therapy
for the treatment of trauma and past negative experiences.
EMDR involves recalling a stressful past event and “reprogramming” the memory in the light
of a positive, self-chosen belief, while using rapid eye movements to facilitate the process. Theories as to why EMDR works are still evolving, but many people have found EMDR to be extremely beneficial.
How does EMDR therapy work?
At the time of a traumatic event, strong emotions interfere with your ability to completely process the experience and one moment becomes “frozen in time.” Recalling the traumatic event may feel as though you are reliving the event all over again because the images, smells, sounds, and feelings are still there and can be triggered in the present. When activated, these memories cause a negative impact on your daily functioning and interfere with the ways you see yourself, the world, and how you relate to others.
EMDR therapy appears to directly affect the brain, “unfreezing” the traumatic memories, allowing you to resolve them. Over time the disturbing memory and associated beliefs, feelings, sensations become “digested” or worked through until you are able to think about the event without reliving it. The memory is still there, but it is less upsetting.
This enables you to access positive ways of reframing the original trauma (reprocessing), and to release the body’s stored negative emotional charges around it (desensitization).
EMDR may be thought of as a physiologically-based therapy that allows a person to see material
in a new and less distressing way, by allowing the negative, painful emotions to give way to more resolved, empowered feelings.
EMDR therapy combines different elements to maximize treatment effects.
EMDR involves attention to three time periods: the past, present, and future. Focus is given to past disturbing memories and related events. Also, it is given to current situations that cause distress, and to developing the skills and attitudes needed for positive future actions.
With EMDR therapy, these items are addressed using an eight-phase treatment approach.
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. Clients generally gain insight on their situations, the emotional distress resolves and they start to change their behaviors.
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 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 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.