Eye Movement Desensitization and Reprocessing Therapy (EMDR)

A meeting of therapist and person in therapyEye movement desensitization and reprocessing (EMDR), developed by Dr. Francine Shapiro, is a research-supported, integrative psychotherapy approach designed to treat symptoms of trauma and posttraumatic stress. EMDR sessions follow a specific sequence of phases, and practitioners use bilateral stimulation, such as eye movements, to help the client process unresolved memories from adverse experiences. EMDR can be used to address any number of concerns, and it is compatible with other types of therapy.

The Theory Behind EMDR Therapy

The adaptive information processing (AIP) model—the theoretical framework for EMDR therapy—explains that some memories associated with adverse life experiences may remain unprocessed due to the high level of disturbance experienced at the time of the event. The stored memory may be linked to emotions, negative cognitions, and physical sensations experienced during the event and the unprocessed memory can affect the way a person responds to subsequent similar adverse experiences. Through EMDR therapy, these fragmented memories can be reprocessed so that they become more coherent and less disruptive.

EMDR's Effectiveness

EMDR has been accepted as an effective form of treatment by several major health organizations including the World Health Organization, the American Psychiatric Association, and the Department of Defense. Studies show that it is possible to alleviate distressing symptoms more rapidly with EMDR than with talk therapy alone. PTSD was eliminated for 100% of people who had experienced a single traumatic event and for 77% who had experienced multiple traumas after six 50-minute sessions. Because discussing the details of a traumatic experience is not required in EMDR sessions, the anxiety associated with confronting and revealing those details may be alleviated.

What Are EMDR Therapy Sessions Like?

Although EMDR was originally designed to treat posttraumatic stress, it can be used to address other adverse life experiences or negative beliefs. In the regular course of therapy, the counselor and the person in therapy may identify a distressing event or negative belief that would benefit from EMDR. The practitioner will spend at least one therapy session describing EMDR and preparing the person for the process, and specific EMDR sessions will be scheduled.

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EMDR therapy is an eight-phase approach that identifies and processes memories of negative and traumatic events that contribute to present problems. After the person in therapy briefly accesses an unresolved memory, he or she will focus on external stimulus delivered by the therapist. These cues can include eye movement, taps, or tones. During each set of bilateral stimulus, or dual attention, new associations emerge in the form of insights, other memories, and new emotions. After each set, the client briefly reports what emerged in consciousness and the next focus of attention is identified for processing. The processing targets during EMDR therapy include past events, current triggers, and future needs.

The eight phases of EMDR therapy include:

  1. History taking: The therapist and client review past events, current concerns and future needs, and identify target events for processing.
  2. Preparation: To prepare for coping with any distress that may arise during the desensitization phase, the person in therapy selects a safe-place image that can provide stabilization and self-control as needed.
  3. Assessment: With the distressing event in mind, the client’s negative beliefs about himself or herself are recorded, evaluated, and measured. In contrast, a desirable positive belief is selected, and this belief is measured to determine how true it feels to the client. Physical symptoms are recorded as well.
  4. Desensitization: Bilateral stimulation, in the form of eye movements, tones, or taps are used to reprocess the distressing event. The therapist will break periodically to check in on the client’s level of disturbance.
  5. Installation: The selected positive cognition is the target of the bilateral stimulation in this phase. The therapist will check in periodically to see how true the desired belief feels to the client.
  6. Body scan: Any residual physical tension or distress indicates that the event is not fully processed, and the bilateral stimulation continues, if necessary.
  7. Closure: This phase will occur at the end of a session, regardless of whether or not the memory is fully processed. A complete sequence of EMDR therapy can take several sessions, and it is important to reach stabilization before the session ends. Closure can include guided imagery or discussion of the session.
  8. Reevaluation: The next session begins here, in order to evaluate and measure the level of disturbance and the accuracy of the targeted positive belief. If the target remains unresolved, the session will resume with desensitization, phase 4.

The two key elements of EMDR therapy are identified as the belief that eye movements enhance the efficacy of therapeutic treatment through the development of physiological and neurological transformations, and that these changes actually assist the client in healing and recovering from the negative memories. Research has also indicated that eye movement is a physiological method of internal desensitization to the emotional reaction to the memory.

Who Can Provide EMDR?

Therapists offering EMDR are licensed mental health professionals who have received specialized training through the EMDR Institute or the EMDR International Association. At a minimum, medical and mental health professionals must have participated in a basic EMDR training course to become EMDR practitioners. Some practitioners choose to seek further training in order to achieve EMDR Certification or to become an EMDR Approved Consultant.

References:

  1. Lee, Gale K, R.N., M.N., Beaton, Randal D, PhD, E.M.T., & Ensign, Josephine, R.N., PhD. (2003). Eye movement desensitization & reprocessing. Journal of Psychosocial Nursing & Mental Health Services, 41(6), 22-31. Retrieved from http://search.proquest.com/docview/225537073?accountid=1229
  2. Shapiro, F., & Laliotis, D. (2011). EMDR and the adaptive information processing model: Integrative treatment and case conceptualization. Clinical Social Work Journal, 39(2), 191-200. doi:http://dx.doi.org/10.1007/s10615-010-0300-7
  3. Seidler, G.H. and Wagner, F. E. (2006). Comparing the efficacy of EMDR and trauma-focused cognitive-behavioral therapy in the treatment of PTSD: A meta-analytic study. Psychological Medicine, 36(11), 1515-22. Retrieved from http://search.proquest.com/docview/204490302?accountid=1229

 

Last updated: 07-05-2016

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